mm同轴微切口白内障超声乳化手术的初步临床研究谭念叶剑第.DOC

1.8mm同轴微切口白内障超声乳化手术的初步临床研究 谭念, 叶剑 第三军医大学大坪医院野战外科研究所，眼科，重庆，400042 【摘要】 目的 观察1.8mm同轴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3.2mm同轴超声乳化手术进行比较。 方法 年龄相关性白内障患者46例（60眼），年龄55～78岁，晶状体混浊3级，随机分为2组，I组22例（28眼），Ⅱ组24例（32眼）。I组行1.8mm同轴微切口白内障超声乳化联合人工晶状体植入术，Ⅱ组行3.2mm传统同轴超声乳化联合人工晶状体植入术。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。应用卡方检验和t检验对所得数据进行分析。 结果 术中，两组平均超声乳化时间（APT）、有效超声乳化时间（EPT）、平均超声乳化能量（AVE）均无统计学差异（P0.05）。视力变化：术后第1周I组裸眼好于Ⅱ组裸眼视力，两组差异有统计学意义（P0.05），术后第1天和第1个月两组视力差别无统计学意义；术后1个月两组最佳矫正视力差别无统计学意义。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、第1周和第1个月，I组角膜散光均小于Ⅱ组，差异有统计学意义（P0.05）。结论 1.8mm同轴微切口白内障超声乳化手术术源性散光更小，早期视力恢复快，前房密闭稳定，手术安全可靠。 【关键词】微切口；白内障超声乳化术；视力；角膜散光 【中图分类号】R779.66 The clinical observation of coaxial 1.8 mm microincision phacoemulsification with IOL implantation Tan Nian , Ye Jian Department of Ophthalmology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China, 400042 [Abstract] Objective To investigate the clinical outcomes of coaxial 1.8 mm microincision phacoemulsification and compare it to traditional 3.2 mm incision phacoemulsification. Methods 52 eyes of 43 patients with age-related cataract (grade Ⅲ nucleus) were randomly divided into two groups. The age range was 55~78 years. There were 28eyes in Group I and 32 eyes in GroupⅡ. Group I underwent 1.8 mm microincision phacoemulsification while GroupⅡ underwent traditional 3.2 mm incision phacoemulsification. 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, corneal endothelial cell count and complications were assessed for the two groups．Statistical analysis was done with a X2 test and t-test. Results No statistically significant difference was found in the average phaco time (APT) ,the effective phaco time (EPT) and the average phaco power(AVE) of the two groups（P0.05）; On the first day, first month after surgery,