本文選題：白內(nèi)障 + 小瞳孔　； 參考：《安徽醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:與非瞳孔擴(kuò)張法相比,OASIS內(nèi)置式虹膜擴(kuò)張器在小瞳孔白內(nèi)障超聲乳化術(shù)中的總體手術(shù)時(shí)間、有效超乳時(shí)間和術(shù)后早期房水閃光情況、角膜內(nèi)皮細(xì)胞計(jì)數(shù)情況、角膜水腫程度、最佳矯正視力,以及手術(shù)難度評(píng)價(jià)和患者術(shù)后滿意度等方面對(duì)比分析,從而評(píng)價(jià)新型內(nèi)置式虹膜擴(kuò)張器的應(yīng)用效果。方法:選擇2014年12月-2015年12月于我院住院行手術(shù)治療的小瞳孔白內(nèi)障患者(藥物不能散大瞳孔)32例(32眼)設(shè)為OASIS組,選擇回顧性小瞳孔白內(nèi)障臨床病例(未借助擴(kuò)瞳器械)32例(32眼)設(shè)為傳統(tǒng)手術(shù)組。OASIS組植入OASIS內(nèi)置式虹膜擴(kuò)張器擴(kuò)大瞳孔行常規(guī)晶狀體超聲乳化摘除聯(lián)合人工晶體植入術(shù);傳統(tǒng)手術(shù)組未做任何形式的瞳孔擴(kuò)張,直接行小直徑環(huán)形撕囊及后續(xù)操作。記錄兩組總體手術(shù)時(shí)間,有效超乳時(shí)間,并于術(shù)后30天內(nèi)隨訪比較兩組術(shù)后房水閃光情況、角膜水腫程度和角膜內(nèi)皮細(xì)胞計(jì)數(shù)情況、術(shù)后早期最佳矯正視力、分析手術(shù)難度和患者術(shù)后滿意度情況。結(jié)果:II級(jí)核白內(nèi)障兩組總體手術(shù)時(shí)間比較差異無(wú)統(tǒng)計(jì)意義(P=0.463),在III、IV級(jí)核白內(nèi)障總體手術(shù)時(shí)間中OASIS組均少于傳統(tǒng)手術(shù)組,差異有統(tǒng)計(jì)學(xué)意(P=0.004,0.001)。II、III、IV級(jí)核白內(nèi)障有效超聲乳化時(shí)間OASIS組均少于傳統(tǒng)手術(shù)組,差異有統(tǒng)計(jì)學(xué)意義(P=0.003,P0.001,P0.001)。兩組患者術(shù)后1d房水閃光差異有統(tǒng)計(jì)學(xué)意義(P=0.018),術(shù)后1周兩組房水閃光均消失。兩組患者術(shù)后1d及7d角膜水腫情況差異有統(tǒng)計(jì)學(xué)意義(P=0.001,0.012)。術(shù)后7d及30d角膜內(nèi)皮細(xì)胞計(jì)數(shù)差異有統(tǒng)計(jì)學(xué)意義(P=0.001,0.04)。兩組患者術(shù)后1d最佳矯正視力差異有統(tǒng)計(jì)學(xué)意義(P=0.001),術(shù)后7d,30d差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.053,1.000)。兩組手術(shù)難度比較差異有統(tǒng)計(jì)學(xué)意義(P0.001)。術(shù)后滿意度比較兩組差異有統(tǒng)計(jì)學(xué)意義(P=0.047)。結(jié)論:OASIS新型內(nèi)置式虹膜擴(kuò)張器較非瞳孔擴(kuò)張法在小瞳孔白內(nèi)障超聲乳化術(shù)中降低手術(shù)難度,縮短超乳時(shí)間,組織損傷小,患者滿意度高,是一種安全有效的擴(kuò)瞳裝置,值得臨床推廣應(yīng)用。
[Abstract]:Objective: compared with non-pupil dilatation, the total operative time, effective superemulsion time, early aqueous humor flash and corneal endothelial cell count in phacoemulsification of small pupillary cataract with Oasis built-in iris dilator were studied. The degree of corneal edema, the best corrected visual acuity, the evaluation of surgical difficulty and the patients' satisfaction after operation were compared and analyzed, so as to evaluate the application effect of the new built in iris dilator. Methods: from December 2014 to December 2015, 32 patients (32 eyes) with small pupillary cataract who underwent surgical treatment in our hospital from December 2014 to December 2015 were selected as Oasis group. 32 cases (32 eyes) of small pupillary cataract (without pupil dilatation) were selected as traditional operation group. Oasis group was implanted with Oasis inbuilt iris dilator to dilate pupil, and routine phacoemulsification combined with intraocular lens implantation was performed. The traditional operation group did not do any form of pupil dilatation, directly small diameter circular capsulorhexis and follow-up operation. The total operative time and effective suckling time were recorded in both groups. The flash of aqueous humor, the degree of corneal edema and the count of corneal endothelial cells were compared between the two groups within 30 days after operation, and the best corrected visual acuity was obtained in the early postoperative period. The difficulty of operation and patients' satisfaction after operation were analyzed. Results there was no significant difference in the total operative time between the two groups (P0. 463). Oasis group was less than the traditional operation group in the total operation time of grade IV nuclear cataract. The effective phacoemulsification time in the Oasis group was significantly shorter than that in the traditional operation group (P0. 003 + P0.001 / P0.001). There was a significant difference in the flash of aqueous humor between the two groups on the 1st day after operation (P0. 018), and the flash of aqueous humor disappeared 1 week after operation in both groups. There was a significant difference in corneal edema between the two groups on day 1 and day 7 after operation (P < 0.001 or 0.012). There was significant difference in corneal endothelial cell count between 7 days and 30 days after operation (P < 0.001 / 0. 04). There was significant difference in the best corrected visual acuity between the two groups on the 1st day after operation (P0. 001), but there was no significant difference between the two groups on the 7th day after operation (P0. 053 / 1. 000). There was significant difference in the difficulty of operation between the two groups (P 0.001). There was a significant difference in postoperative satisfaction between the two groups (P0. 047). Conclusion compared with the non-pupillary dilatation, the new type of iridodilator is a safe and effective pupil dilatation device, which can reduce the difficulty of operation, shorten the time of superemulsion, reduce the tissue damage and increase the satisfaction of patients with the phacoemulsification of small pupillary cataract. It is worth popularizing and applying in clinic.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R779.66

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