目的:比较硬核白内障的两种不同手术方法及其术后视力恢复、术中术后并发症,对手术方法及疗效进行评价。方法:于2009-02/2010-03选取Ⅳ～Ⅴ级硬核白内障患者79例84眼,年龄60～80岁,患白内障时间为8～15a不等,按入院的先后顺序随机化分成超声乳化组42眼,小切口非超声乳化组42眼,分别比较两组术后1,3d;1wk;1mo时的视力、角膜散光程度和角膜内皮细胞密度、术中术后并发症。结果:患者84眼随访0.5～24(平均15)mo。小切口非超声乳化组术后1,3d视力较超声乳化组恢复快,差异有显著性意义(P<0.05);术后1wk;1mo时两组间视力无显著性差异;术后第1wk超声乳化组较小切口非超声乳化组角膜散光小,差异有显著性意义(P<0.01),术后1mo时差异无显著性意义;术后1wk和1mo角膜内皮细胞密度小切口非超声乳化组较高,差异有显著性意义(P<0.05);术中并发症两组无显著性差异;在术后并发症中的角膜水肿、房水闪辉方面超声乳化组较小切口非超声乳化组重,差异有显著性意义(P<0.05)。结论:小切口非超声乳化摘除术应用于硬核白内障术后的视力恢复较快。该手术安全、实用、经济、创伤小、技术难度小、并发症少。

AIM:To evaluate the operative ways and efficacy by comparing the safety and effectiveness of two kinds of surgery and postoperative visual acuity,postoperative complications in hard nucleus cataract.METHODS:Selected 79 cases 84 eyes of hard nucleus cataract grade Ⅳ-Ⅴ from the patients of 2009 to 2010,aged 60 to 80,who fell ill for 8 to 15 years,were randomly divided into phacoemulsification group for 42 eyes,small incision with non-phacoemulsification group for 42 eyes,visual acuity was compared the first day,the third day,1 week,1 month after the surgery respectively,corneal astigmatism and the density of corneal endothelial cells were observed 1 week,1 month after the surgery respectively,and postoperative complications during and after the surgery respectively.RESULTS:All the 84 eyes were followed-up for 0.5 to 24 months,an average of 15 months.Small incision phacoemulsification group recovered better in visual acuity than phacoemulsification group after the first day and the third day,there was significant difference(P<0.05).There was no significant difference after 1 week and 1 month;corneal astigmatism was smaller in phacoemulsification group than that in small incision phacoemulsification during 1 week after the operation,there was significant difference(P<0.01),and there was no significant difference during 1 month.The density of corneal endothelial cells was less in phacoemulsification group than that in non-phacoemulsification group during 1 week and 1 month after the operation,there was significance difference(P<0.05).It was severer in the postoperative complications such as corneal edema,aqueous flare of phacoemulsification group than that of small incision non-phacoemulsification group,there was significant difference(P<0.05).CONCLUSION:The small incision non-phacoemulsification is safer and more practical for treating hard nuclear cataract,and recovers better in visual acuity with minimal invasion.It is user-friendly and low cost.And the complications of small incision are less.

R779.66