眼科 ›› 2014, Vol. 23 ›› Issue (2): 86-90.doi: 10.13281/j.cnki.issn.1004-4469.2014.02.004

• 论著 • 上一篇    下一篇

双钩法预劈核在白内障超声乳化手术中的应用

姚涛, 何伟   

  1. 110034 沈阳何氏眼科医院
  • 收稿日期:2014-01-15 出版日期:2014-03-25 发布日期:2014-03-31
  • 通讯作者: 何伟,Email:hewei0111@163.com

Clinical application of double choppers pre-chop technique in phacoemulsification

 YAO  Tao, HE  Wei   

  1. Shenyang He Eye Hospital, Shenyang 110034, China
  • Received:2014-01-15 Online:2014-03-25 Published:2014-03-31
  • Contact: HE Wei, Email:hewei0111@163.com

摘要: 目的 探讨双钩法预劈核技术在白内障超声乳化手术中的应用效果。设计 前瞻性比较性病例系列。研究对象 2013年3-5月在沈阳何氏眼科医院治疗的老年性白内障患者80例(80眼)。方法 按随机数字表法将患儿分为两组,分别采用双钩法预劈核及常规拦截劈核法(对照组)进行手术。比较两组术中所用的有效超声时间,术后1、3、7、30天的最佳矫正视力,角膜水肿程度(评分)及手术并发症情况。主要指标 有效超声时间,术后最佳矫正视力、角膜水肿程度及并发症。结果 与对照组(19.32 s ±6.12 s)相比,双钩法预劈核组(13.56 s ±5.21 s)的有效超声时间更短(P=0.000)。术后3天,预劈核组视力(<0.5者1眼、0.5~0.8者19眼、>0.8者18眼)也较对照组(<0.5者9眼、0.5~0.8者21眼、>0.8者12眼)好(P=0.023);术后1个月,预劈核组视力(<0.5者0眼、0.5~0.8者9眼、>0.8者29眼)与对照组(<0.5者1眼、0.5~0.8者10眼、>0.8者31眼)无差异(P=0.879)。术后3天预劈核组角膜水肿程度评分(0分18眼、1分11眼、2分8眼、3分1眼)较对照组(0分12眼、1分10眼、2分11眼、3分9眼)低(P=0.047);术后1个月预劈核组角膜水肿程度评分(0分37眼、1分1眼、2分0眼、3分0眼)较对照组(0分38眼、1分4眼、2分0眼、3分0眼)无差异(P=0.653)。双钩法预劈核组术中未见明显并发症发生,对照组发生1例后囊膜破裂。结论 在白内障超声乳化手术中与常规拦截劈核法相比,双钩法预劈核技术有效超声时间短,术后早期即获得较好的视力,无严重并发症发生。(眼科,2014, 23: 86-90)

关键词: 白内障/外科学, 超声乳化白内障吸除术, 双钩法预劈核

Abstract:  Objective To evaluate the effect of pre-chopping technique with double choppers on phacoemulsification. Design Prospective comparative case seires. Participants 80 patients (80 eyes) with senile cataract from 2013 March to 2013 May in Shenyang He Eye Hospital. Methods 80 cataract patients (80 eyes) with nucleus density at grade II~IV were randomly divided into the pre-chopping group and the control group (stopping and chopping method ) according to random number table. The effective phaco time (EPT), best corrected visual acuity (BCVA) and cornea edema at 1, 3, 7, 30 days after operation, and operative complications were compared between two groups. Main Outcome Measures EPT, BCVA, cornea edema, and operative complications. Results Compare with the control group (19.32±6.12 s), the EPT of the pre-chopping group (13.56±5.21 s) was lower (P=0.000). BCVA was better in the early stages (3 days) after operation (postoperative 3 days, 1 eye < 0.5, 19 eyes 0.5~0.8, 18 eyes > 0.8 in pre-chopping group, and 9 eyes < 0.5, 21 eyes 0.5~0.8, 12 eyes >0.8 in the control group, P=0.023). Corneal edema was minorer in the early stages (3 days) after operation (postoperative 3 days, score 0, 18 eyes; score 1, 11 eyes; score 2, 8 eyes; score 3, 1 eye in pre-chopping group, and score 0, 12 eyes; score 1, 10 eyes; score 2, 11 eyes; score 3, 9 eyes in the control group, P=0.047). There was no significant difference of BCVA and corneal edema between two groups in 1 month after surgery. Postoperative 1 month, BCVA< 0.5, 0 eyes; 0.5~0.8, 9 eyes; > 0.8, 29 eyes in pre-chopping group, and BCVA< 0.5, 1 eye; 0.5~0.8, 10 eyes; >0.8, 31 eyes in the control group, P=0.879. Postoperative 1 month, score 0, 37 eyes; score 1, 1 eye; score 2, 0 eye; score 3, 0 eye in pre-chopping group, and score 0, 38 eyes; score 1, 4 eyes; score 2, 0 eye; score 3, 0 eye in the control group(P=0.653). There were no obvious complications occurred in pre-chopping group and there was 1 case of posterior capsular rupture in the control group. Conclusion The pre-chopping technique with double choppers technique can effectively reduce the EPT in phacoemulsification, diminish injury to corneal endothelium, and improve the quality of operation. (Ophthalmol CHN, 2014, 23: 86-90)

Key words: cataract/surgery, phacoemulsification, double choppers pre-chopping