【摘要】：目的比較同軸微小切口與標準切口超聲乳化吸出術在原發(fā)性閉角型青光眼(primary angle closure glaucoma,PACG)濾過術后白內障摘出術中的安全性與有效性。方法連續(xù)收集抗PACG濾過術后白內障患者72例(90眼),隨機分為兩組:試驗組37例(49眼)行2.0 mm同軸微小切口超聲乳化術,對照組35例(41眼)行3.0 mm標準透明角膜切口超聲乳化術,觀察兩組術中有效超聲乳化時間、超聲能量及術中前房穩(wěn)定性,于術后1 d、7 d觀察角膜水腫、視力情況,同時于術前、術后7 d觀察兩組患者角膜內皮細胞計數(shù)、角膜散光。結果試驗組和對照組患者術中超聲乳化時間分別為(6.43±1.03)s、(6.54±1.25)s,超聲能量分別為(16.52±2.35)%、(15.94±3.53)%,兩組間超聲乳化時間和超聲能量比較,差異均無統(tǒng)計學意義(均為P0.05)。兩組術后角膜水腫均以1級為主,術后1 d、7 d兩組角膜水腫程度比較,差異均有統(tǒng)計學意義(均為P0.05)。術后1d、7 d試驗組最佳矯正視力均好于對照組,差異均有統(tǒng)計學意義(均為P0.05)。試驗組術前角膜散光為(0.52±0.28)D,術后7 d為(0.56±0.32)D,差異無統(tǒng)計學意義(P0.05);對照組術前角膜散光為(0.49±0.31)D,術后7 d為(0.72±0.43)D,差異有統(tǒng)計學意義(P0.05);兩組術后7 d角膜散光比較,差異有統(tǒng)計學意義(P0.05)。兩組術后7 d角膜內皮細胞計數(shù)均低于術前(均為P0.01);術后7 d試驗組角膜內皮細胞計數(shù)高于對照組,差異有顯著統(tǒng)計學意義(P0.01)。結論同軸微小切口超聲乳化術具有術中前房穩(wěn)定性好,術后角膜內皮細胞丟失率低,促進視力迅速恢復,安全可靠等優(yōu)點。
[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 鹵1.03) s, (6.54 鹵1.25) s, (16.52 鹵2.35)% and (15.94 鹵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 鹵0.28) D before operation and (0.56 鹵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 鹵0.31) D before operation and (0.72 鹵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.
【作者單位】： 南陽醫(yī)學高等專科學校附屬第一醫(yī)院眼科;
【分類號】：R779.66

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