CAJ | 학술논문

目的以传统3.0mm小切口白内障超声乳化手术为对照,评价同轴1.8mm微切口白内障超声乳化手术的临床效果.方法选取年龄相关性白内障患者53例(61眼),分为微切口组28例(32眼)和对照组25例(29眼),分别行同轴1.8mm和3.0mm超声乳化白内障手术,并随访至术后12个月.记录两组患者术中有效超声时间(EPT)和平均超声能量(AVE),观察患者眼部一般情况并记录术前及术后1d、1周及1、3、6、12个月的裸眼视力、最佳矫正视力、Sim-K值、角膜内皮细胞计数及OCT黄斑中心凹厚度,并计算手术源性角膜散光(SIA)及角膜内皮细胞丢失率.结果微切口组EPT明显长于对照组(P<0.05),两组AVE的差异无统计学意义(P>0.05).随访12个月,除1例患者发生后发性白内障,余无明显并发症.微切口组术后1d、1周的裸眼视力及最佳矫正视力明显优于对照组(均P<0.05).微切口组术后1d、1周及1、3、6、12个月SIA明显小于对照组(均P<0.01).两组患者术后3、12个月角膜内皮细胞丢失率及术后1周及1、3、12个月黄斑中心凹厚度无明显差异(均P>0.05).结论同轴1.8mm微切口白内障超声乳化手术技术易于开展.该术式创伤更小,有助于术后早期的视力恢复,术后短期效果与传统3mm小切口白内障超声乳化手术相当.
목적이전통3.0mm소절구백내장초성유화수술위대조,평개동축1.8mm미절구백내장초성유화수술적림상효과.방법선취년령상관성백내장환자53례(61안),분위미절구조28례(32안)화대조조25례(29안),분별행동축1.8mm화3.0mm초성유화백내장수술,병수방지술후12개월.기록량조환자술중유효초성시간(EPT)화평균초성능량(AVE),관찰환자안부일반정황병기록술전급술후1d、1주급1、3、6、12개월적라안시력、최가교정시력、Sim-K치、각막내피세포계수급OCT황반중심요후도,병계산수술원성각막산광(SIA)급각막내피세포주실솔.결과미절구조EPT명현장우대조조(P<0.05),량조AVE적차이무통계학의의(P>0.05).수방12개월,제1례환자발생후발성백내장,여무명현병발증.미절구조술후1d、1주적라안시력급최가교정시력명현우우대조조(균P<0.05).미절구조술후1d、1주급1、3、6、12개월SIA명현소우대조조(균P<0.01).량조환자술후3、12개월각막내피세포주실솔급술후1주급1、3、12개월황반중심요후도무명현차이(균P>0.05).결론동축1.8mm미절구백내장초성유화수술기술역우개전.해술식창상경소,유조우술후조기적시력회복,술후단기효과여전통3mm소절구백내장초성유화수술상당.
Objective To evaluate the clinical efficacy of coaxial cataract phaoemulsification through micro incision, com-paring with normal phacoemusification through 3mm incision. Methods Sixty one eyes(53 patients)with aged cataract were di-vided into two groups: 32 eyes (28 patients) received coaxial cataract phaoemulsification through 1.8mm micro-incision (mi-cro-incision group) and 29 eyes (25 patients) received coaxial cataract phaoemulsification with incision of 3mm (control group). Both groups were followed up for 12 months, and the effective phacoemusification time (EPT), average ultrasonic energy (AVE), visual acurity, best corrected visual acurity, surgery induced astigmatism (SIA), cornea endothelial cel loss and macula fovea thickness were examined and compared between two groups. Results The EPT of micro-incision group was longer than that of control group, and there was no significant difference in AVE between two groups (P>0.05). No other complications were ob-served except a case of posterior capsular opacification in control group. Visual acurity and best corrected visual acurity on the first day and the first week after surgery was better in micro-incision group than those in control group (P<0.01). The SIA of mi-cro-incision group was significantly decreased than that of control group (P<0.01) after surgery. And there was no difference in cornea endothelial cel loss and macula fovea thickness between two groups(P>0.05). Conclusion Coaxial cataract phaoemul-sification through 1.8mm micro incision is feasible for skil ed cataract surgeons, which has the same outcome as conventional phacoemusification through 3mm incision, but it improves the postoperational visual acurity earlier with less operative injury.