同轴微切口与传统小切口超声乳化术的临床疗效及术后并发症对比分析

目的比较1. 8 mm同轴微切口超声乳化术与传统同轴3. 0 mm小切口超声乳化术的临床疗效及术后并发症。方法收集2015年5月至10月北京同仁医院北京同仁眼科中心收治的老年性白内障患者48例(48眼),将患者分为微切口组和小切口组。微切口组主切口长1. 8 mm,前房内注入透明质酸钠,行直径约为5. 0 mm的中央连续环形撕囊,水分离后用劈核钩劈核,扭动模式超声乳化吸出术,自动灌注系统吸出残留皮质。小切口组角膜主切口大小为3. 0 mm,术中植入常规折叠式人工晶状体。术后行裂隙灯、眼底镜以及角膜地形图检查,电脑验光检查患者最佳矫正视力。结果术后1周、1个月、3个月两组患者最佳矫正视力比较,差异均无统计学意义(均为P> 0. 05)。术后1个月和3个月两组间手术源性散光比较,微切口组均明显低于小切口组,差异均有统计学意义(均为P <0. 01)。在微切口组组内术后1个月和3个月手术源性散光无明显差异(P>0. 05),微切口组手术源性散光在术后1个月保持稳定。在小切口组组内术后3个月手术源性散光明显低于术后1个月(P <0. 01)。微切口组术前角膜厚度为(567±27)μm,小切口组为(564±25)μm,两组差异无统计学意义(P> 0. 05);术后1个月与3个月两组间角膜厚度变化差异亦均无统计学意义(均为P> 0. 05)。在随访期间两组患者均未发生后发性白内障。结论1. 8 mm同轴微切口白内障超声乳化吸出术安全可靠,术后散光恢复快,可有效减少术后角膜手术源性散光。

Comparison analysis of clinical efficacy and postoperative complications between phacoemulsification with coaxial microincision and traditional small-incision corneal incision

Objective　To investigate the clinical efficacy and postoperative complications between phacoemulsification with Coaxial microincision (1.8 mm) and traditional Coaxial small-incision (3.0 mm) corneal incision.Methods　Totally 48 patients of senile cataract patients (48 eyes) admitted in Beijing Tongren Hospital between May and October 2015 was conducted and randomly divided into microincision and small-incision groups.The length of main incision in the microincision group was 1.8 mm,with injection of sodium hyaluronate into the anterior chamber.Then we performed a central continuous annular capsulorhexis with a diameter of 5.0 mm.After the water was separated,the nucleus were chopped with chopper,followed by torsional phacoemulsification and aspiration of the residual cortex by automatic perfusion system.The length of main incision in the small-incision group was 3.0 mm,with implantation of conventional foldable intraocular lens during the operations.After the operations,we performed slit lamp,funduscope and corneal topography examination to confirm patients’ best corrected visual acuity.Results　There’s no significant difference in best corrected visual acuity 1-week,1-month and 3-month post operation between two groups (all P>0.05).The surgically induced astigmatism 1-month and 3-month post operation in microincision group was significantly smaller than its in small-incision group (all P<0.01).There’s no significant difference in surgically induced astigmatism between 1-month and 3-month post operation in microincision group (P>0.05).The surgically induced astigmatism was stable in microincision group 1-month post operation.The surgically induced astigmatism 3-month post operation in small-incision group was significantly smaller than its of 1-month post operation (P<0.01).The pre-operative corneal thickness was (567±27)μm in microincision group and (564±25)μm in small-incision group,with no significant difference between the two groups (P>0.05).There were also no significant differences in corneal thickness changes between 1-month and 3-month post operation within both groups (both P>0.05).During the follow-ups,there was no posterior capsular opacification in both groups.Conclusion　Phacoemulsification with Coaxial microincision (1.8 mm) is safe and dependent with quick recovery of post-operative astigmatism.It can effectively reduce the post-operative corneal surgically induced astigmatism.