小切口白内障摘除术中不同位置切口治疗白内障的临床效果
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摘要
目的探讨小切口白内障摘除术中不同位置切口治疗白内障的临床效果。方法选取2015年9月～2017年1月我院收治的103例(112只眼)白内障患者作为研究对象,对患者实施小切口白内障摘除联合人工晶体植入术,使用随机数字表法分为对照组(51例)和研究组(52例)。对照组于颞上方巩膜做切口;研究组手术切口于角巩膜缘上最大角膜屈光度子午线方位,并做一穿透性切口于对侧180°角膜缘内。术后观察两组角膜散光度(SIA)、裸眼视力。结果研究组术后不同时段的SIA值均低于对照组,且术后1、3个月裸眼视力均高于对照组,差异有统计学意义(P<0.05)。结论于角巩膜缘上选择手术切口入路比常规颞上方巩膜切口更具优势,对患者术后的视力及散光度作用效果较大,值得临床推广应用。
Objective To investigate the clinical effect of different incision in small incision cataract extraction for cataract. Methods A total of 103 cases(112 eyes) of cataract patients admitted to our hospital from September 2015 to January 2017 were enrolled in the study. Small incision cataract extraction combined with intraocular lens implantation was performed in patients, the subjects were divided into the control group(n=51) and the study group(n=52). The control group underwent incision of superior temporal sclera; the meridian orientation of maximum corneal diopter at the corneoscleral margin in the study group, and make a penetrating incision in the 180° limbus on the opposite side.Surgically induced astigmatism(SIA) and uncorrected visual acuity were observed in the two groups at different time points. Results The SIA values of the study group were lower than those of the control group at different time points,and the visual acuity of the naked eye was higher than that of the control group postoperative 1, 3 months, the differences were statistically significant(P<0.05). Conclusion Compared with the conventional supratemporal scleral incision, the choice of incision approach on the corneoscleral margin has more advantages, and has a greater effect on postoperative visual acuity and astigmatism, which is worthy of clinical application and promotion.
Objective To investigate the clinical effect of different incision in small incision cataract extraction for cataract. Methods A total of 103 cases(112 eyes) of cataract patients admitted to our hospital from September 2015 to January 2017 were enrolled in the study. Small incision cataract extraction combined with intraocular lens implantation was performed in patients, the subjects were divided into the control group(n=51) and the study group(n=52). The control group underwent incision of superior temporal sclera; the meridian orientation of maximum corneal diopter at the corneoscleral margin in the study group, and make a penetrating incision in the 180° limbus on the opposite side.Surgically induced astigmatism(SIA) and uncorrected visual acuity were observed in the two groups at different time points. Results The SIA values of the study group were lower than those of the control group at different time points,and the visual acuity of the naked eye was higher than that of the control group postoperative 1, 3 months, the differences were statistically significant(P<0.05). Conclusion Compared with the conventional supratemporal scleral incision, the choice of incision approach on the corneoscleral margin has more advantages, and has a greater effect on postoperative visual acuity and astigmatism, which is worthy of clinical application and promotion.
引文
[1]Gogate P,Ambardekar P,Kulkarni S,et al.Comparison of endothelial cell loss after cataract surgery:phacoemulsification versus manual small-incision cataract surgery:sixweek results of a randomized control trial[J].J Cataract Refracti Surg,2010,36(2):247-253.
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[3]钱莉,陈玲,陈春霞,等.玻璃体切除术后白内障的手术治疗探讨[J].临床眼科杂志,2016,24(1):52-54.
[4]王洪亮.改良小切口法治疗软核白内障的临床效果及安全性分析[J].国际眼科杂志,2017,17(7):1337-1339.
[5]黄昭昭,邱俊.小切口白内障摘除治疗急性闭角型青光眼合并白内障效果观察[J].实用医院临床杂志,2017,14(3):120-121.
[6]胡丰平,张燕,董立红,等.不同手术方式治疗青光眼合并白内障患者的疗效比较[J].安徽医学,2016,37(2):175-177.
[7]李润祥,薛洪华,顾操.两种不同位置小切口术治疗年龄相关性白内障的疗效比较[J].中国实用眼科杂志,2016,34(12):1314-1316.
[8]周婕.小切口白内障囊外摘除术与白内障超声乳化术临床效果对比[J].中外医学研究,2017,15(1):26-28.
[9]代商镇.100例白内障小切口摘除术临床效果观察[J].临床医学研究与实践,2016,1(20):28-29.
[10]邱艳飞,何建中,何琼,等.改良式小切口囊外摘除术治疗过熟期核下沉白内障临床观察[J].中国实用眼科杂志,2016, 4(3):263-265.
[11]崔德刚.90例不同切口手术治疗年龄相关性白内障患者的临床疗效观察[J].中国医药指南,2018,16(7):169-170.
[12]谢娇,周劲.小切口非超声乳化白内障摘除术对角膜内皮细胞的影响[J].国际眼科杂志,2017,17(9):1756-1758.
[13]唐强.小切口隧道内小梁切除术治疗白内障合并青光眼的疗效[J].国际眼科杂志,2016,16(10):1869-1871.
[14]冷非,白大勇,梁天蔚,等.开角型青光眼合并白内障患者不同手术方式治疗效果比较[J].解放军医学院学报,2017, 8(8):724-726.
[15]胡慧玲,方敏,陈静,等.角膜拱形刀及角膜平刀行白内障超声乳化摘除术主切口的对比研究[J].临床眼科杂志,2016,4(4):306-308.
[2]喻谦,付敏.小切口白内障摘除并人工晶体植入术治疗高度近视伴硬核白内障56例观察[J].中国现代医学杂志,2017,7(16):74-77.
[3]钱莉,陈玲,陈春霞,等.玻璃体切除术后白内障的手术治疗探讨[J].临床眼科杂志,2016,24(1):52-54.
[4]王洪亮.改良小切口法治疗软核白内障的临床效果及安全性分析[J].国际眼科杂志,2017,17(7):1337-1339.
[5]黄昭昭,邱俊.小切口白内障摘除治疗急性闭角型青光眼合并白内障效果观察[J].实用医院临床杂志,2017,14(3):120-121.
[6]胡丰平,张燕,董立红,等.不同手术方式治疗青光眼合并白内障患者的疗效比较[J].安徽医学,2016,37(2):175-177.
[7]李润祥,薛洪华,顾操.两种不同位置小切口术治疗年龄相关性白内障的疗效比较[J].中国实用眼科杂志,2016,34(12):1314-1316.
[8]周婕.小切口白内障囊外摘除术与白内障超声乳化术临床效果对比[J].中外医学研究,2017,15(1):26-28.
[9]代商镇.100例白内障小切口摘除术临床效果观察[J].临床医学研究与实践,2016,1(20):28-29.
[10]邱艳飞,何建中,何琼,等.改良式小切口囊外摘除术治疗过熟期核下沉白内障临床观察[J].中国实用眼科杂志,2016, 4(3):263-265.
[11]崔德刚.90例不同切口手术治疗年龄相关性白内障患者的临床疗效观察[J].中国医药指南,2018,16(7):169-170.
[12]谢娇,周劲.小切口非超声乳化白内障摘除术对角膜内皮细胞的影响[J].国际眼科杂志,2017,17(9):1756-1758.
[13]唐强.小切口隧道内小梁切除术治疗白内障合并青光眼的疗效[J].国际眼科杂志,2016,16(10):1869-1871.
[14]冷非,白大勇,梁天蔚,等.开角型青光眼合并白内障患者不同手术方式治疗效果比较[J].解放军医学院学报,2017, 8(8):724-726.
[15]胡慧玲,方敏,陈静,等.角膜拱形刀及角膜平刀行白内障超声乳化摘除术主切口的对比研究[J].临床眼科杂志,2016,4(4):306-308.