目的:探讨白内障小切口非超声乳化术向超声乳化术转型中的技术转变。
方法:对 2009 年 4 月 - 2009 年 12 月“光明工程”中白内障超声乳化手术转型期 193 例 193 眼的情况进行回顾性分析,同期行小切口非超声乳化吸除术患者 43 例 48 眼作对照。
结果:对照组术后第 1 日裸眼视力大于或等于 0.5 的比例高于治疗组(P < 0.05),术后第 1 周、 第 1 个月裸眼视力大于或等于 0.5 及术后第 1 个月最佳矫正视力大于或等于 0.5 的比例,两组比较差异无统计学意义(均 P > 0.05)。对照组术后主要并发症比率均低于治疗组(均 P < 0.05)。
结论:小切口非超声乳化术向超声乳化术转型中,由于技术差异较大,发生后囊破裂和角膜内皮水肿的几率较高,转型此手术要有熟练的显微手术基础、处理并发症的能力和一定的设备条件。
Purpose: To investigate the clinical outcome during the conversion from small incision sutureless cataract surgery (SICS) to phacoemulsification cataract surgery (phaco).
Methods: During the conversion period from SICS to phaco, 241 cataract cases were assigned to SICS and phaco surgery procedures. The intraoperative complications and early postoperative outcomes were assessed.
Results: The 1st day visual acuity outcome (VA 0.5 or better) was lower in the phaco group (P < 0.05); however, the visual acuity outcomes were no longer statistically different at 1 week and 1 month visits (P > 0.05 for each visit). Among 193 cases operated in the phaco group, 51 cases (26.4%) developed corneal edema at the 1 day visit, 13 cases (6.7%) had posterior capsular rupture, 5 cases (2.6%) had zonular rupture, and 5 cases (2.6%) failed to implant IOL. These rates were higher than those found in the SICS group.
Conclusion: The outcome of phaco cataract surgery is comparable with SICS during this conversion period. Techniques that the surgeons may pay attention to are also discussed.