CAJ | 학술논문

目的探讨2.5 mm辅助切口在小切口非超乳白内障手术(MSICS)中的实用性及手术效果.方法回顾性分析近年来批量小切口非超乳白内障手术中Ⅳ-Ⅴ级核白内障患者的临床资料,A组:传统MSICS且经上方巩膜隧道切口劈核病例36例,B组:改良MSICS构建2.5 mm辅助切口行劈核病例42例.所有手术均由熟练掌握小切口手术的医师完成.结果 (1)B组术中前房稳定性优于A组,术中后弹力层撕脱、虹膜损伤、悬韧带离断、后囊破裂,以及术后角膜水肿等并发症发生率均较A组为少;(2)术后1周、2周裸眼视力及手术源性散光比较,B组均优于A组,差异具有统计学意义(P＜0.05).1个月、2个月时比较差异无统计学意义(P＞0.05).结论硬核白内障患者MSICS术中构建2.5mm辅助切口分担术中操作,前房稳定,简单器械完成手法碎核,减少术中、后并发症及术后手术源性散光,缩短手术进程,在批量MSICS手术中具有实用性及有效性.
목적 탐토2.5 mm보조절구재소절구비초유백내장수술(MSICS)중적실용성급수술효과.방법 회고성분석근년래비량소절구비초유백내장수술중Ⅳ-Ⅴ급핵백내장환자적림상자료,A조:전통MSICS차경상방공막수도절구벽핵병례36례,B조:개량MSICS구건2.5 mm보조절구행벽핵병례42례.소유수술균유숙련장악소절구수술적의사완성.결과 (1)B조술중전방은정성우우A조,술중후탄력층시탈、홍막손상、현인대리단、후낭파렬,이급술후각막수종등병발증발생솔균교A조위소;(2)술후1주、2주라안시력급수술원성산광비교,B조균우우A조,차이구유통계학의의(P＜0.05).1개월、2개월시비교차이무통계학의의(P＞0.05).결론 경핵백내장환자MSICS술중구건2.5mm보조절구분담술중조작,전방은정,간단기계완성수법쇄핵,감소술중、후병발증급술후수술원성산광,축단수술진정,재비량MSICS수술중구유실용성급유효성.
Objective To evaluate the clinical efficiency and safety of modified 2.5mm auxiliary incision in batch sutureless small-incision non-phacoemulsification cataract surgery.Methods In a retrospective study,traditional MSICS was performed through superior scleral tunnel in 36 eyes of Group A,and Modified MSICS with 2.5mm extra constructed auxiliary incision was performed in 42 eyes of Group B.The complications were compared between two groups.The uncorrected visual acuity (UCVA) and surgically induced astigmatism (SIA) were recorded at 1 week,2 weeks,1 month and 2 months post-operatively.Results The intraoperative anterior chamber was more stable in group B than in group A,The intraoperative and postoperative complications such as posterior capsule rupture,corneal edema,detachment of Descemet's membrane,zonules as well as iris injury occurred less in group B.Patients in the group A had significantly higher SIA and lower UCVA compared to those in the group B at the postoperative 1 week and 2 weeks (P＜0.05).Construction of 2.5mm auxiliary incision help to shunt most operations and maintain the stability of anterior chamber in batch MSICS performed in the hard nucleus cataract patients,it is also benefit to chop nucleus manually with simple instruments,decrease complications and SIA and shorten the operation process.All the effects show that it's practical and effective in batch MSICS.