囊膜上與囊袋內超聲乳化治療高度近視硬核白內障

范　強，燕振國

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囊膜上與囊袋內超聲乳化治療高度近視硬核白內障

范強，燕振國

the Second Clinical Medical College of Lanzhou University, Lanzhou 730000, Gansu Province, China

?METHODS: A total of 297 patients(322 eyes) with hard nucleus cataract(Ⅳ-Ⅴ grade nucleus) and high myopia were selected from Mar.2014 to Mar.2016 in our hospital. They were randomly divided into the observation group with 149 cases(162 eyes) and the control group with 148 cases(160 eyes). The observation group received capsule membrane phacoemulsification and the control group received capsular bag in phacoemulsification. The therapeutic effect and safety of patients in two groups were compared. The comparison of phacoemulsification time, energy parameters and corneal endothelial cell density usedt-test, post-operative visual acuity and the occurrence of complications were tested by Chi-square test.

?RESULTS: The harder the nucleus was, the longer the phacoemulsification time and higher the average phacoemulsification energy was, and the differences were statistically significant(P<0.05). The phacoemulsification time and energy parameters of the observation group were significantly lower than that of the control group(P<0.05). One month after operation, the postoperative visual acuity in two groups was significantly higher than the visual acuity at 1d after operation(P<0.05). But there was no statistical significance on the visual acuity at 1mo after operation between two groups(P>0.05). After operation, the density of corneal endothelial cell in two groups was significantly lower than the density before operation(P<0.05). But there was no statistical significance on the density of corneal endothelial cell after operation between two groups(P>0.05). The intraoperative complication rate of observation group was significantly lower than that of the control group(P<0.05), but there was no statistical significance on postoperative complication rate between two groups(P>0.05).

?CONCLUSION: For the treatment of hard nuclear cataract with high myopia, capsule membrane phacoemulsification and capsular bag in phacoemulsification have similar effect, but capsule membrane phacoemulsification has better safety.

目的：比較囊膜上超聲乳化法與囊袋內超聲乳化法治療高度近視硬核白內障的療效。

方法：采集2014-03/2016-03我院收治的高度近視硬核(Ⅳ～Ⅴ級核)白內障患者297例322眼作為研究對象，隨機分為觀察組(給予囊膜上超聲乳化治療149例162眼)和對照組(給予囊袋內超聲乳化治療148例160眼)。對兩組患者治療效果及安全性進行比較。

結果：核硬度越高，超聲乳化時間及平均超聲能量越高，差異有統計學意義(P<0.05)，觀察組超聲乳化時間及能量參數明顯低于對照組，差異有統計學意義(P<0.05)；兩組患者術后1mo 視力均較術后1d明顯提高，差異有統計學意義(P<0.05)，兩組間比較差異無統計學意義(P>0.05)；兩組患者術后角膜內皮細胞密度較術前顯著降低，差異有統計學意義(P<0.05)，組間比較差異無統計學意義(P>0.05)；觀察組術中并發癥發生率明顯低于對照組，差異有統計學意義(P<0.05)，兩組術后并發癥發生率相比，差異無統計學意義(P>0.05)。

結論：囊膜上超聲乳化與囊袋內超聲乳化治療高度近視硬核白內障療效接近，但囊膜上超聲乳化具有更佳的安全性。

高度近視；硬核白內障；超聲乳化

引用：范強，燕振國.囊膜上與囊袋內超聲乳化治療高度近視硬核白內障.國際眼科雜志2016;16(11):2022-2025

0　引言

高度近視又稱病理性近視或惡性近視，是指近視度數大于600度、伴有眼軸延長、眼底視網膜和脈絡膜萎縮等退行性病變為特點的屈光不正[1]。隨著我國公民受教育程度提高，高度近視發生率也呈逐年上升狀態。高度近視可合并白內障，嚴重影響患者生活[2]。近年來，超聲乳化技術開始廣泛應用于白內障的治療當中，取得了良好的治療效果[3]。本研究以我院近年來收治的高度近視硬核白內障患者作為研究對象，分別采用不同超聲乳化術式進行治療，并對其臨床療效及安全性進行評價，以期為臨床治療方案的選擇提供理論依據，現對結果進行分析。……