摘要
目的比较3种不同管径超声乳化针头在白内障超声乳化手术中对超声乳化有效时间、视轴区角膜散光、角膜内皮细胞计数、角膜水肿发生率及术后视力的影响，并进行对比分析。方法选择核硬度为Ⅲ级的年龄相关性白内障167例（180眼），随机分成3组，A组使用18G超声乳化针头，B组19G，C组20G，均采用相同切口，超声乳化吸出联合人工晶状体植入术。记录各组术中有效超声乳化时间，术后角膜内皮细胞计数、角膜水肿、散光及视力情况。随访3个月。结果3组术中有效超声乳化时间差异有统计学意义（P〈0．05）；手术前后的角膜内皮细胞计数差异在A组无统计学意义（P〉0．05），B组及c组差异有统计学意义（P〈0．05）；3组术后1d角膜水肿发生率对比差异具有统计学意义（P〈0．05）；术后1周视轴区角膜散光对比差异具有统计学意义（P〈0．05），术后1个月、3个月视轴区角膜散光对比差异无统计学意义（P〉0．05）；3组术后裸眼视力1d、1周、1个月对比差异具有统计学意义（P〈0．05），3个月后对比差异无统计学意义（P〉0．05）。结论在相同核硬度情况下，超声乳化针头管径越小，超声乳化有效时间越长，则效率越低，更容易导致角膜内皮细胞的损伤与丢失，不但角膜散光没有改善，反而会因角膜切口组织水肿导致术后早期角膜的散光增加。
Objective To study and analyze the effect of using three sizes of phacoemulsification needles with different calibers in phacoemulsification on effective phacoemulsification time （ EPT）, corneal a- stigmatism in optic axis, corneal endothelial cell count, incidence of corneal edema and vision after phacoe- mulsification surgery. Methods The study included 180 age-related cataract eyes of 167 cases, which matched Grade III nucleus （Emery criterion）. They were divided into 3 groups randomly, who underwent phacoemulcification with different needles. In Group A the 18G needles were used, Group B 19G, Group C 20G. Each group was used the same kind of phacoemulsification needle and incision. The EPT, the change of corneal endothelial cell count, the corneal edema incidence at 1 day after surgey, the corneal astigmatism in optic axis and the vision were recorded after surgery. The patients were followed up for 3 months. Results There were statistically significant differences among three groups in EPT （P 〈 0.05）. There was a statis- tically significant change in postoperative corneal endothelial cell count in group B and group C （P 〈 0.05 ）, but not in group A（ P 〉 0.05 ）. There were statistically significant differences between the three group in cor- neal edema incidence at 1 day after the surgery （P 〈 0.05 ） . The differences in corneal astigmatism in optic axis among the three groups at 1 week after the surgery were statistically significant （ P 〈 0.05 ）, but not at 1 m and 3ms postoperatively （P 〉 0, 05 ）. There were statistically significant differences in vision at 1 d, 1 w, lms after the surgery among three groups （P 〈0.05）, but there were no significant differences at 3 month postoperatively（ P 〉 0.05 ）. Conclusion While using three sizes of phacoemulsification needles with different calibers in phacoemulsification, we found that for the same nuclear hardness, the smaller caliber used in the surgery, the longer EPT we needed and the poorer efficiency of phacoemulsification. It may lead to lower corneal endothelial cell count and severer corneal endothelium hurt. Moreover, the edema of incision will increase the incidence of corneal astigmatism in early stage after surgery.
出处
《中华眼外伤职业眼病杂志》
2012年第11期856-860,共5页
Chinese Journal of Ocular Trauma and Occupational Eye Disease
关键词
白内障
超声乳化针头
管径
角膜散光
视轴区
术后视力
Cataract
Phacoemulsification needle
Caliber
Corneal astigmatism
Optic axis
Vi- sion, after surgery
