不同切口超聲乳化聯合MI60型人工晶狀體植入術對白內障患者視覺質量的影響

趙　晨，章玉群，岑　潔，華佩炎

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·臨床論著·

不同切口超聲乳化聯合MI60型人工晶狀體植入術對白內障患者視覺質量的影響

趙晨，章玉群，岑潔，華佩炎

Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200092, China

?METHODS:A randomized prospective study was conducted on 100 patients with age-related cataract: coaxial 2.2 mm micro-incision cataract surgery was performed in 50 cases (50 eyes), and coaxial 3 mm small incision cataract surgery was performed in 50 cases (50 eyes). Statistical analysis was takenwith the data of the two groups. Visual acuity, VF and QOL were compared at intervals of 1wk and 3mo after surgery. In addition, surgically induced astigmatism (SIA) was analyzed. Statistic analysis was taken by Student’st-test and Chi-square test.

?RESULTS: There was no significant difference on BCVA (t=-1.366, -1.688;P=0.148, 0.107) between these two groups. One week and 3mo after the surgery, SIA was (0.46±0.29)D, (0.43±0.26)D in the 2.2 group; and (1.55±0.59)D, (0.89±0.28)D, in 3.0 group. The differences between these two groups were statistically significant (t=-7.348, -3.788;P=0.000, 0.000) There were no statistically significant differences on VF scores between two group, while it’s got a better score in 2.2 groups on vision adaptation. (t=-3.348,P<0.05).

?CONCLUSION:Coaxial 2.2mm micro-incision cataract surgery could significantly reduce SIA and obtain morestable status of VF and QOL. This suggests that the coaxial 2.2 phacoemulsification surgery implanted AkreosMI60 intraocular lens could get earliervisual rehabilitation postoperation.

目的：比較超聲乳化同軸3.0mm切口與2.2mm切口聯合MI60型人工晶狀體植入對白內障患者視覺質量的影響。

方法：前瞻性病例對照研究。采用隨機數字表法，將實施超聲乳化年齡相關性白內障手術的患者100例100眼隨機分為兩組，傳統3.0mm切口組50例50眼， 2.2mm切口組50例50眼。觀察患者術后1wk,3mo的最佳矯正視力(BCVA)、對比敏感度(CS)及手術源性散光(SIA)。并由2位工作人員在末次隨訪完成VF和QOL問卷調查。

結果：術后1wk,3mo,兩組矯正視力差異均無統計學意義(t=-1.366、-1. 688，P=0. 148、0.107)。2.2mm切口組在夜視(3、6c/d)及夜視加周邊眩光(1.5、3、6c/d)條件下，術后1wk對比敏感度值優于3.0mm切口組，差異有統計學意義(P<0.05)。術后3mo兩組對比敏感度差異無統計學意義(P>0.05)。術后1wk, 3mo,2.2mm切口組SIA分別為0. 46±0.29、0.43±0.26D；3.0mm切口組SIA分別為1.55±0.59、 0.89±0.28D,兩組差異具有統計學意義(t=-7.348、-3. 788，P=0.000、 0.000)。兩組病例平均VF得分差異無統計學意義,但視覺適應一項得分2.2mm切口組優于3.0mm切口組，差異具有統計學意義(t=-3.348,P<0.05)。

結論：同軸2.2mm切口超聲乳化聯合人工晶狀體植入較同軸3.0mm切口治療年齡相關性白內障手術相比,能有效減少SIA,且視覺適應性更優,具有更佳的視覺質量。

人工晶狀體；白內障；視覺質量

引用：趙晨，章玉群，岑潔，等.不同切口超聲乳化聯合MI60型人工晶狀體植入術對白內障患者視覺質量的影響.國際眼科雜志2016;16(11):2019-2021

0　引言

超聲乳化白內障聯合人工晶狀體植入手術，已經日臻完善。手術目的不僅在于幫助患者脫盲，如何提高患者術后視覺質量的問題已經具有越來越重要的地位。……