摘要
目的比较同轴微小切口与标准切口超声乳化吸出术(phacoemulsification,Phaco)在抗原发性闭角型青光眼(primary angle closure glaucoma,PACG)滤过术后白内障摘出的安全性与有效性。方法连续收集抗PACG滤过术后白内障患者46例(46眼),其中研究组行同轴微小切口(2.2mm透明角膜切口)Phaco26例(26眼),对照1组行标准切口(3.0mm透明角膜切口)Phaco20例(20眼),另设对照2组为单纯老年性白内障行2.2mm同轴微小切口Phaco50例(50眼)。所有病例均采用扭动模式行超声乳化术,记录术前白内障核分级,术前最佳矫正视力(best corrected visual acuity,BCVA)、眼压(intraocular pressure,IOP)、中央前房深度(central anterior chamber depth,ACD)、晶状体厚度(lens thickness,LT)、角膜内皮细胞计数(endothelial cell count,ECC)、眼轴长度(axial length,AL)及术中累积消散能量(cumulative dissipated energy,CDE)和灌注液消耗量(estimated fluids used,EFU),同时记录术后1d、7d、30d的BCVA、IOP、角膜水肿程度及术后30d的ECC值等。结果各组白内障均以3级核为主,术眼生物学参数分析显示,研究组的ACD值与AL值均小于对照2组,差异均有统计学意义(均为P=0.00)。研究组的LT值则略高于对照2组,差异无统计学意义(P=0.07)。研究组术中CED及EFU均低于对照1组,差异均有统计学意义(均为P<0.05)。术后BCVA分析,术后1d≥0.5的眼数,研究组占38.5%,高于对照1组的20.0%,但差异无统计学意义(P=0.11)。对术后角膜水肿程度分析发现,术后1d,研究组以1级水肿为主,对照1组则以2级水肿为主,两组间差异有统计学意义(P=0.03)。术后30d,各组ECC值均显著低于术前,研究组与对照1组分别较术前减少38.9%和52.5%,对照2组减少9.8%,其中研究组与对照1组的术前、术后差值比较差异有统计学意义(P=0.00)。结论同轴微小切口超声乳化术前房稳定性好,可以显著减少超声能量,缩短超声乳化时间,减少术中灌注液的用量,降�
Objective To compare the safety and efficacy of coaxial microinci- sion and standard incision phacoemuisification for cataract after primary angle closure glaucoma （PACG） filtering surgery. Methods Forty-six cases （46 eyes） with cata- racts after PACG filtering surgery were prospectively comprised in this study. All cases were divided into two groups randomly. Study group（2.2 mm coaxial mlcroincision ） in- cluded 26 cases. Control group 1 （ 3.0 mm incision） included 20 cases. Control group 2 （2.2 mm coaxial microincision, age related cataract） included 50 cases. All cases were received torsional mode phacoemulsification. Preoperative measurements included cata- ract nuclear grade, best correct visual acuity （ BCVA）, intraocuiar pressure （ IOP ）, cen- tral anterior chamber depth （ ACD ）, lens thickness （ LT）, endothelial cell count （ ECC ） and axial length（AL）. Intraoperalive measurements included cumuiative dissipated en- ergy （CDE） and estimated fluids used （EFU）. Postoperative measurements at l day, 7 days and 30 days included BCVA,IOP and corneal edema. Results The cataract nu- cleuses in all patients were mainly in grade Ⅲ. The ACD and AL in study group were lower than in control group 2, there were significant differences （ both P = 0.00 ）. The LT in study group were higher than that in control group 2, there was no statistical difference （P = 0.07）. The CDE and EFU in study group were lower than that in control group 1 ,there was statistical difference（P 〈0.05）. The percentages of BCVA more than 0.5 at 1 day after opera- tion in study group and control group 1 were 38.5% and 20.0% , but there was no statistical difference （P = 0.11 ）. The cor- neal edema at 1 day after operation in study group and control group 1 were mainly in grade 1 and grade 2, respectively, there was statistical difference（P =0.03 ）. ECC at 30 days after operation were all lower than that before operation,the re- duction of study group,control group 1 and 2 wer
出处
《眼科新进展》
CAS
北大核心
2012年第7期654-657,共4页
Recent Advances in Ophthalmology
