同轴微小切口白内障超声乳化联合折叠人工晶状体植入术的临床研究

发布时间：2018-03-01 14:09

  本文关键词： 微小切口 超声乳化 散光 白内障　出处：《吉林大学》2011年硕士论文　论文类型：学位论文

【摘要】：白内障是最常见的致盲眼病之一,其有效、确切的治疗方法是手术摘除混浊的晶状体。随着科学技术的进步,白内障手术治疗从传统的白内障针拨术、白内障囊内摘除(Intracapsular cataract extraction ICCE)和白内障囊外摘除术(Extracapsular cataract extraction ECCE)等术式发展至今天的白内障超声乳化技术已经取得了质的进步。自1967年Kelman医生发明白内障超声乳化技术以来,该项技术得到了不断的完善和迅速的发展,该手术方式以切口小,术后反应轻,视力恢复更快,并发症少等优点已成为公认的治疗白内障的主要方式,近几十年来,随着科学技术的发展,先进的仪器和手术技巧不断改进,给白内障患者带来了福音。如超声乳化机器的改进、手术切口的缩小、新型人工晶体的出现等使白内障手术日臻完善,如何使白内障手术切口进一步缩小以消除手术造成的散光及提高手术的安全性成了白内障手术的一大发展趋势。本研究拟通过观察2.2 mm微切口白内障同轴超声乳化联合人工晶状体植入术的临床效果,并与传统3.2mm切口同轴超声乳化手术进行比较,为指导临床提供客观资料。 研究对象选择在吉大二院眼科医院就诊的年龄相关性白内障患者80例,核硬度按LOCS II晶状体混浊分类体系分级,随机分2组,眼部检查排除角膜白斑、青光眼、糖尿病性视网膜病变、年龄相关性黄斑病变等。Ⅰ组行2.2mm微切口白内障超声乳化联合人工晶状体植入术,Ⅱ组行传统3.2mm角膜切口同轴超声乳化联合人工晶状体植入术。两组患者均使用美国Alcon公司的Infiniti超声乳化设备,手术由同一术者完成,植入晶体均为非球面人工晶体AcrySof SN60WF (AcrySofIQ),术中记录超声乳化累积释放能量,术后第1天、第1周和第1个月观察随访,记录术前术后的裸眼视力、散光改变和手术并发症,术后1个月时检查对比敏感度。 结果：术后1d裸眼视力两组有显著性差异(p=0.047,p＜0.05),且微小切口组高于正常超乳组；术后1d、1w、1m散光值,微小切口组散光值低于正常超乳组,有显著性差异(P0.05),其他方面无明显差异(P0.05). 结论：与3.2mm透明角膜切口超乳组比较,2.2mm透明角膜微小切口组白内障超声乳化术术源性散光少,术后视力提高更快；通过特殊的的Alcon MONARCHⅢ推进器配以D型夹头,在不扩大切口的情况下,通过微切口可将AcrySofIQ可折叠晶体顺利植入后房,实现微小切口白内障手术,安全可行。
[Abstract]:Cataract is one of the most common causes of blindness. It is effective and the exact treatment is to remove the opacity of the lens. With the development of science and technology, cataract surgery begins with the traditional cataract needle removal. The development of cataract phacoemulsification techniques, such as intra capsular cataract extraction ICCEE and extracapsular cataract extraction Ecce, has made qualitative progress. Since the invention of cataract phacoemulsification by Dr. Kelman in 1967, This technique has been continuously improved and developed rapidly. The advantages of this technique are small incision, light postoperative response, faster visual recovery and fewer complications. In recent decades, it has become the main way to treat cataract. With the development of science and technology, advanced instruments and surgical techniques have been improved, which bring good news to cataract patients. For example, the improvement of phacoemulsification machine, the reduction of surgical incision and the appearance of new intraocular lens make cataract surgery more and more perfect. How to further reduce the incision of cataract surgery to eliminate astigmatism caused by surgery and improve the safety of cataract surgery has become a major development trend of cataract surgery. This study intends to observe the 2.2 mm microincision cataract coaxial phacoemulsification. Clinical effect of intraocular lens implantation, And compared with the traditional 3. 2 mm incision coaxial phacoemulsification operation to provide objective data for clinical guidance. Participants of the study included 80 age-related cataract patients in the second Eye Hospital of Jida. The nuclear hardness was classified according to the LOCS II lens opacity classification system. The patients were randomly divided into two groups. The ocular examination excluded corneal leukoplakia and glaucoma. Diabetic retinopathy, age-related macular lesion, etc. Group 鈪，

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