1.4 mm双手微切口白内障超声乳化联合人工晶状体植入术的临床应用.doc

1.4 mm双手微切口白内障超声乳化联合人工晶状体植入术的临床应用 作者：周斌兵,林敏,朱宇东,林文雄,鲍炯琳 单位：广东药学院附属第一医院 眼科，广东 广州 510080 【摘要】 目的 观察1.4 mm双手微切口白内障超声乳化联合人工晶状体植入术的临床效果，并与传统同轴超声乳化手术进行比较。方法 年龄相关性白内障患者48例(56眼)，年龄55～75岁，晶状体混浊分级为Ⅱ~Ⅲ级，随机分为2组，每组28眼。Ⅰ组行1.4 mm双手微切口冷超声乳化联合Acri.Smart人工晶状体植入术，Ⅱ组行传统同轴超声乳化人工晶状体植入术。术中记录超声乳化时间和能量。术后第1天、第1周和第1个月观察随访，记录术后的散光改变、裸眼视力和手术并发症，术后1个月同时检查最佳矫正视力。采用卡方检验和t检验对所得数据进行分析。结果 术中，Ⅰ组平均超声乳化时间为(0.75plusmn;0.63)min，超声乳化能量为9.6%(Ⅲ级核)和11.6%(Ⅳ级核)；Ⅱ组平均超声乳化时间为(1.15plusmn;0.56)min，超声乳化能量为12.5%(Ⅲ级核)和20.4%(Ⅳ级核)；两组比较，Ⅰ组超声时间更短，超声能量更少，差异均有统计学意义(Plt;0.05）。视力变化：术后第1天、第1周和第1个月，Ⅰ组裸眼视力ge;0.5的分别占82.14%、92.86%和100%，Ⅱ组裸眼视力ge;0.5的分别占53.57%、71.43%和96.43%；术后第1天、第1周，Ⅰ组视力ge;0.5者均多于Ⅱ组，两组差异有统计学意义（Plt;0.05），术后第1个月两组最佳矫正视力ge;0.8者均占92.86%，无差异。角膜散光变化：术前与术后比较，两组角膜散光均有不同程度改变；术后第1天，Ⅱ组角膜散光大于Ⅰ组（Plt;0.05），术后第1周和第1个月，两组角膜散光差异无统计学意义（Pgt;0.05）。结论 双手冷超乳联合Acri.Smart人工晶状体植入可以使白内障手术切口缩小至1.4 mm，手术源性散光更小，前房密闭稳定，手术安全可靠。 【关键词】 双手法；微切口白内障超声乳化；人工晶状体植入；视力；角膜散光 Clinical application of 1.4 mm bimanual microphacoemulsification with IOL implantation 　　ZHOU Binbing， LIN Min， ZHU Yudong， et al. 　　Department of Ophthalmology， the First Affiliated Hospital of Guangdong Pharmacy University， Guangzhou China， 510080 　　［Abstract］ Objective To investigate the clinical outcomes of bimanual microphacoemulsification with implantation and compare it to traditional phacoemulsification in cataract surgery. Methods Forty-eight eyes of 56 patients with age-related cataract were randomly divided into two groups. The age range was 55~75 years. There were 28 eyes in each group. Group Ⅰ underwent 1.4 mm bimanual cold phacoemulsification while group Ⅱ underwent traditional phaco. Phaco power and time were recorded for each procedure. Follow-up exams were performed on 1 day， 1 week and 1 month after surgery. Preoperative and postoperative astigmatism changes， postoperative visual acuity and complications were assessed for the two groups. Statistical analysis was done with a ?字2 test and t-test. Results The average phaco time(EPT) for group Ⅰ was (0.75plusmn;0.63)min