改良梯形切口非超声乳化摘除术治疗超大核白内障的疗效观察(1)
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[摘要] 目的 评价改良梯形切口及常规直切口非超声乳化摘除术治疗超大核白内障的疗效。 方法 将64例患者83眼随机分为两组，行小切口非超声乳化白内障摘除并人工晶体植入手术，其中，直切口组31例38眼；改良梯形切口组33例45眼，术后随访3~6个月，观察两组视力及并发症情况。 结果 两组术后视力恢复差异无统计学意义(χ2 = 0.024，P > 0.05)；两组并发症发生率差异有统计学意义(χ2 = 4.08，P < 0.05)。 结论 对超大核白内障行小切口非超声乳化摘除术疗效良好，梯形手术切口优于直切口。
[关键词] 白内障；小切口非超声乳化；改良梯形切口
[中图分类号] R776.1 [文献标识码] B [文章编号] 1673-7210(2012)01(b)-161-03
Clinical effect observation of modified trapezoidal incision non-phacoemulsification in the treatment of super macronucleus cataract
GUO Jianli YAO Fangfang CAO Jin ZHENG Xiangyu
Department of Ophthalmology, the First People's Hospital of Nanyang City, He'nan Province, Nanyang 473010, China
[Abstract] Objective To evaluate the different effects of straight incision and modified trapezoidal incision non-phacoemulsification operation in the treatment of super macronucleus cataract. Methods 64 cases (83 eyes) of patients with super macronucleus cataracts were all treated with small incision non-phacoemulsification and lens implantation surgery, which were randomly divided into straight incision group (31 cases, 38 eyes) and modified trapezoidal incision group (33 cases, 45 eyes). All cases were followed up 3 to 6 months after operation, the vision and complications were observed between the two groups. Results There was no significant difference of visual recovery after surgery between the two goups (χ2 = 0.024 7, P > 0.05). There was a great significant difference of postoperative complications between the two groups (χ2 = 4.08, P < 0.05). Conclusion The clinical effect of small incision non-phacoemulsification in the treatment of super macronucleus cataract is good, and trapezoidal incision is obviously superior to straight incision.
[Key words] Super macronucleus cataract; Small incision non-phacoemulsification; Modified trapezoidal incision
对于普通白内障患者采用小切口非超声乳化手术，术中充分分离晶体外核，可达到近乎超声乳化的效果，但对于一些超大核白内障患者，采用常规的小切口非超声乳化手术，往往造成角膜损伤，甚至后囊破裂而至手术失败。近年来，我院眼科针对超大核白内障患者分别采用改良梯形切口及常规直切口两种方法实施手术，现将手术中的一些体会及疗效总结报道如下：
1 资料与方法
1.1 一般资料
2009年1月~2011年2月我院因白内障复明“曙光行动”及“百万贫困白内障患者复明工程”等项目，共行白内障小切口非超声乳化白内障摘除并人工晶体植入手术736眼，其中，Ⅴ级核、核又大又硬者64例83眼。随机将64例患者(83眼)分为改良梯形切口组和常规直切口组 ......
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