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[摘要]
目的:对比分析小切口非超声乳化白内障摘除术与超声乳化白内障吸除术的临床应用效果。
方法:选取2010-03/2013-02收治的老年性白内障患者93例124眼随机分为两组,42例59眼行小切口非超声乳化白内障摘除术(SICS组),51例65眼行超声乳化白内障吸除术(Phaco组),比较两组患者术后视力、角膜散光、手术源性散光及术中、术后并发症。
结果:术后1d; 1wk两组患者视力≥0.5分别为SICS组38眼(64.4%),41眼(69.5%),Phaco组29眼(44.6%),32眼(49.2%),SICS组的视力优于Phaco组(χ2=4.877,5.243,P<0.05)。术后1,3mo两组视力≥0.5眼数比较差异无统计学意义(χ2=0.005,0.085,P>0.05)。平均角膜散光采用重复测量设计方差分析:组内比较不同时间有统计学意义(F=25.624,P<0.05),且有随时间降低的趋势; 组间比较无统计学意义(F=0.986,P>0.05),两组患眼术后1wk平均角膜散光较术前增大,差异有统计学意义(t=2.906,2.427,P<0.05)。术后1wk; 1mo Phaco组手术源性散光SIA均低于SICS组(t=-4.628,2.770,P<0.05),术后3mo两组SIA对比差异无统计学意义(t=0.754,P>0.05), 组内比较和组间比较不同时间的SIA均有统计学意义(F=26.37,P<0.05,F=14.29,P<0.05)。两组患者术中后囊膜破裂、术后角膜水肿、前房色素膜反应对比差异无统计学意义。
结论:小切口非超声乳化白内障摘除术与超声乳化白内障吸除术对比,两种手术术后效果相近,对于白内障的治疗方案选择,白内障超声乳化手术并非唯一最佳手术方案,在缺少超乳设备的边远地区,选择小切口非超声乳化手术同样可以达到与超乳手术接近的术后视觉效果。
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[Abstract]
AIM: To compare the clinical effect between small-incision cataract surgery and phacoemulsification.
METHODS: Totally 93 patients(124 eyes)with age-related cataract who received treatment in Mar 2010 and Feb 2013 were dicided into 2 groups randomly. Forty-two patients(59 eyes)in group small-incision cataract surgery(SICS)were treated by SICS, while other 51 patients(65 eyes)in group Phaco were treated by phacoemulsification. And then, postoperative visual acuity, corneal astigmatism, surgically induced astigmatism(SIA)and intraoperative and postoperative complications were contrasted between groups.
RESULTS: After 1d and 1wk of postoperation, there were 38 eyes(64.4%)and 41 eyes(69.5%)having a better visual acuity of 0.5 in the SICS group, while there were 29 eyes(44.6%)and 32 eyes(49.2%)in the Phaco group. The vision of SICS group was better than that of Phcao group(χ2=4.877, 5.242, P<0.05). On postoperative 1 and 3mo, with acuity of 0.5 or better, eye numbers showed no statistically significant differences between two groups(χ2=0.005, 0.085, P>0.05). The average corneal astigmatism used analysis of repeatedly measuring designing variance: Comparing the corneal astigmatism in intra-groups at different times, it was statistically significant(F=25.624, P<0.05), and had a tendency to decrease with time. However, there was no statistical significance for corneal astigmatism between groups(F=0.986, P>0.05). The coneal astigmatism of each group was higher at 1wk after the surgery than that of preoperation, and the contrast had statistical sigenficence(t=2.906, 2.427, P<0.05). The Phaco group with SIA was lower than the SICS group at 1wk and 1mo after the surgery(t=-4.628, 2.770, P<005). It had no statistical significance in SIA by comparing with the two groups at 3mo after the surgery(t=0.754, P>0.05). There were statistical differences in SIA at different time both by intra-group comparison and group comparison(F=26.37, P<0.05, F=14.29, P<0.05). The comparison of posterior capsule rupture, the postoperative corneal edema and anterior chamber pigment membrane reaction in two groups showed no statistical significance.
CONCLUSION: Our research shows that small-incision cataract surgery and phacoemulsification had similar effect in the treatment of cataract. Phacoemulsification is not the only surgery option for the best treatment effect. Small-incision cataract surgery can be popularized in basic-level hospitals, achieving the effect similar to phacoemulsification.
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