同轴微小切口超声乳化吸出术在闭角型青光眼滤过术后白内障中的应用

发布时间：2018-11-09 16:12

【摘要】：目的比较同轴微小切口与标准切口超声乳化吸出术在原发性闭角型青光眼(primary angle closure glaucoma,PACG)滤过术后白内障摘出术中的安全性与有效性。方法连续收集抗PACG滤过术后白内障患者72例(90眼),随机分为两组:试验组37例(49眼)行2.0 mm同轴微小切口超声乳化术,对照组35例(41眼)行3.0 mm标准透明角膜切口超声乳化术,观察两组术中有效超声乳化时间、超声能量及术中前房稳定性,于术后1 d、7 d观察角膜水肿、视力情况,同时于术前、术后7 d观察两组患者角膜内皮细胞计数、角膜散光。结果试验组和对照组患者术中超声乳化时间分别为(6.43±1.03)s、(6.54±1.25)s,超声能量分别为(16.52±2.35)%、(15.94±3.53)%,两组间超声乳化时间和超声能量比较,差异均无统计学意义(均为P0.05)。两组术后角膜水肿均以1级为主,术后1 d、7 d两组角膜水肿程度比较,差异均有统计学意义(均为P0.05)。术后1d、7 d试验组最佳矫正视力均好于对照组,差异均有统计学意义(均为P0.05)。试验组术前角膜散光为(0.52±0.28)D,术后7 d为(0.56±0.32)D,差异无统计学意义(P0.05);对照组术前角膜散光为(0.49±0.31)D,术后7 d为(0.72±0.43)D,差异有统计学意义(P0.05);两组术后7 d角膜散光比较,差异有统计学意义(P0.05)。两组术后7 d角膜内皮细胞计数均低于术前(均为P0.01);术后7 d试验组角膜内皮细胞计数高于对照组,差异有显著统计学意义(P0.01)。结论同轴微小切口超声乳化术具有术中前房稳定性好,术后角膜内皮细胞丢失率低,促进视力迅速恢复,安全可靠等优点。
[Abstract]:Objective to compare the safety and efficacy of phacoemulsification between coaxial mini-incision and standard incision in cataract extraction after primary angle-closure glaucoma (primary angle closure glaucoma,PACG) filtration. Methods Seventy-two patients (90 eyes) with cataract after anti PACG filtering were randomly divided into two groups: the experimental group (37 cases, 49 eyes) received 2. 0 mm microincision phacoemulsification. 35 cases (41 eyes) of the control group were treated with 3. 0 mm standard transparent corneal incision phacoemulsification. The effective phacoemulsification time, ultrasonic energy and intraoperative anterior chamber stability were observed in both groups. Corneal edema and visual acuity were observed at 1 day and 7 days after operation. At the same time, the corneal endothelial cell count and corneal astigmatism were observed before and 7 days after operation. Results the intraoperative phacoemulsification time and ultrasonic energy were (6.43 卤1.03) s, (6.54 卤1.25) s, (16.52 卤2.35)% and (15.94 卤3.53)%, respectively. There was no significant difference in phacoemulsification time and ultrasonic energy between the two groups (P0.05). Corneal edema in the two groups was mainly grade 1, and the degree of corneal edema was significantly different between the two groups on the 7th day after operation (P0.05). The best corrected visual acuity in the trial group was better than that in the control group on the 7th day after operation, and the difference was statistically significant (P0.05). In the experimental group, the corneal astigmatism was (0.52 卤0.28) D before operation and (0.56 卤0.32) D on the 7th day after operation, with no significant difference (P0.05). The corneal astigmatism in the control group was (0.49 卤0.31) D before operation and (0.72 卤0.43) D on the 7th day after operation (P0.05), and there was a significant difference between the two groups in corneal astigmatism 7 days after operation (P0.05). The number of corneal endothelial cells in the experimental group was significantly higher than that in the control group on the 7th day after operation (P0.01), and the number of corneal endothelial cells in the experimental group was significantly higher than that in the control group on the 7th day after operation (P0.01). Conclusion Coaxial micro-incision phacoemulsification has the advantages of good anterior chamber stability, low loss rate of corneal endothelial cells, rapid recovery of visual acuity and safety and reliability.
【作者单位】：南阳医学高等专科学校附属第一医院眼科;
【分类号】：R779.66

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