摘要
目的观察爆破模式与挤压劈核法的超声乳化手术治疗硬核白内障的效果。设计回顾性病例系列。研究对象珠海市第二人民医院就诊的198例(198眼)硬核白内障患者。方法使用Laureate超声乳化仪进行白内障超声乳化吸除联合人工晶状体植入术。患者随机分为两组,A组采用爆破超声模式和挤压式劈核方法,B组采用传统连续超声模式与刻槽的分核方法。术前记录患者角膜内皮细胞计数,术中记录两组平均超声能量和平均超声时间,术后1天、1周、1个月分别观察两组视力、角膜内皮细胞计数、角膜水肿情况。主要指标术中超声能量和超声时间、术后视力、角膜水肿程度、角膜内皮细胞丢失情况及手术并发症。结果 A组平均超声能量为(8.1±1.3)%,B组为(27.0±3.4)%;平均超声时间A组为(59.2±5.8)s,B组为(256.1±14.5)s,两组比较差异有统计学意义(P均=0.000)。A组术后第1天矫正视力大于0.5者70眼(68.0%),B组为12眼(12.6%),两组比较差异有统计学意义(P=0.000)。A组术后第1天角膜水肿Ⅰ级者72眼(69.9%),B组13眼(13.6%),A、B两组Ⅳ级水肿分别为6眼(5.8%)和35眼(36.8%)。A组平均角膜内皮细胞丢失率为(4.5±2.4)%,B组为(9.5±5.4)%,两组比较差异有统计学意义(P=0.000);A组无后囊膜破裂病例,B组术中后囊膜破裂1眼。结论与采用传统超声模式和劈核方式的超声乳化手术相比,应用爆破模式与挤压劈核法的超声乳化手术治疗硬核白内障,可使超声时间缩短,超声能量减少,手术疗效好且并发症少。
Objective To analyze the effect of a new phacoemulsification technique in the treatment of hard nuclear cataract. Design Retrospective case series. Participants One hundred ninety eight patients with hard nuclear cataract were enrolled in this study. Methods Phacoemulsification and intraocular lens implantation were performed. Patients were divided into two groups： A, burst mode using a crushing and chopping technique, and B, a continue mode with a divide and conquer technique. Main Outcome Measure Phaco power, phaco time, visual acuity, corneal edema and corneal endothelial cell loss were evaluated at day 1, and 1 week and 1 month postoperatively. Results Average phacoemulsification power in group A and group B were 8.1%±1.3% and 27.0%±3.4%, respectively. Average phaco time was 59.2±5.8 seconds and 256.1±14.5 seconds in group A and B, respectively. The differences were statistically significant （all P〈0.001）. Endothelial cells loss was 4.5±2.4% and 9.5±5.4% in group A and B, respectively. One day after surgery, 70 cases （68.0%） in group A and 12 cases （12.6%） in group B achieved corrected visual acuity of 0.5 or better. The difference was statistically significant （P〈0.001）. One day after surgery, 72（69.9%） and 13（13.6%） patients were found to have grade I corneal edema, and 6 （5.8%） and 35 （36.8%） cases had grade IV corneal edema, in group A and B respectively. Posterior capsular rupture only occurred in one case in group B. Conclusion Compared with the continue mode, phacoemulsification with the burst mode and an effective chop technique may reduce phaco power and time for the treatment of patients with hard nucleus. Burst mode seemed to be more effective with less complications.
出处
《眼科》
CAS
2013年第2期94-97,共4页
Ophthalmology in China
