同轴微切口白内障超声乳化术控制术中虹膜松弛综合征的疗效分析

目的 评价同轴微切口白内障超声乳化术控制术中虹膜松弛综合征(intraoperative floppy iris syndrome,IFIS)的治疗效果.方法 前瞻性随机对照研究.2014年10月至2016年10月服用坦索罗辛≥2周的年龄相关性白内障患者80例(80眼),随机分为2组:微切口组和标准切口组,每组40例(40眼),分别通过1,8 mm微切口和2.6 mm标准透明角膜切口行同轴超声乳化白内障吸出联合人工晶状体植入术.记录并对比两组患者术中IFIS的发生率、严重程度及手术并发症,术后1d、1周、1个月的裸眼视力.结果 术后1d、1周、1个月的裸眼视力,微切口组分别为0.83±0.12、0.86±0.10、0.89±0.11,标准切口组分别为0.71 ±0.12、0.75 ±0.11、0.83 ±O.12,差异均有统计学意义(均为P＜0.05),微切口组裸眼视力均优于标准切口组.微切口组IFIS的发生率为60.0％,标准切口组IFIS的发生率为82.5％,差异有统计学意义(P＜0.05).两组术中IFIS发生的严重程度比较差异有统计学意义(P＜0.05),微切口组IFIS发生的严重程度低于标准切口组.结论 同轴微切口白内障超声乳化术对具有IFIS发生风险的白内障患者来说是一种安全有效的手术方式.

Clinical efficacy of coaxial microincision phacoemulsification for intraoperative floppy iris syndrome during cataract surgery

Objective To evaluate the clinical efficacy of coaxial micro-incision phacoemulsification for intraoperative floppy iris syndrome (IFIS) during cataract surgery.Methods A prospective randomized control study was conducted in 80 patients (80 eyes) taking tamsulosin more than two weeks with age-related cataract from October 2014 to October 2016.All cases were randomly divided into microincision group (MICS group) and standard incision group (SICS group),40 cases in each group.Coaxial 1.8 mm microincision cataract surgery was performed in the MICS group,and coaxial 2.6 mm standard incision cataract surgery was performed in the SICS group.The incidence and the degree of IFIS and complications were recorded during the operation.The uncorrected visual acuity (UCVA) was compared at 1 day,1 week,1 month after surgery.Results At postoperative 1 day,1 week and 1 month,UCVA was 0.83 ± 0.12,0.86 ±0.10,0.89 ±0.11 in the MICS group,and was 0.71-±0.12,0.75 ±0.11,0.83 ±0.12 in the SICS group,there were statistical differences (all P ＜ 0.05),the UCVA of MICS group was better than that of SICS group.The incidence of IFIS was 60.0％ in the MICS group,and 82.5％ in the SICS group,there was statistical difference (P ＜ 0.05).There was statistical difference on degree of IFIS between two groups (P ＜ 0.05),the degree of IFIS in the MICS group was lower than that in the SICS group.Conclusion The coaxial microincision phacoemuisification is a safe and effective surgery for the patients with cataract and high risk of IFIS.