两种不同超声乳化方法在援外假性剥脱综合征性白内障手术中的比较研究

摘要

Objective To compare the clinical efficacy and safety of two phacoemulsification methods:tilt-flip technique and phaco-chop technique,in patients of pseudoexfoliation syndrome combined with cataract (PEXC) in Morocco.Methods Using the random number table,30 PEXC patients (30 eyes) were randomly divided into two groups including the tilt-flip group and the phaco-chop group.All of the patients had undergone phacoemulsification and intraocular lens (IOL) implantation.Preoperative and postoperative corrected visual acuity,operative complications,corneal endothelial cell counting,endothelial cell loss rate and intraocular pressure between the two groups were evaluated.Results The follow-up time was one month.There was no statistically significant difference between the two groups in postoperative corneal edema in the first day,postoperative corrected visual acuity,posterior capsular rupture and intraocular pressure.Intraoperative zonular dialysis was not found in the tilt-flip group,where as 5 eyes had zonular dialysis in the phaco-chop group.The difference between the two groups was statistically significant.The postoperative corneal endothelium cell counting was (1 804 ± 267)/mm2 in the tilt-flip group and (2 007 ± 259)/mm2 in the phacochop group.The endothelial cell loss rate was (18.15 ± 7.40) ％ in the tilt-flip group and (12.92 ± 3.48) ％ in the phaco-chop group.Both of them had significant differences between the two groups.Conclusions Comparing the two methods in the phacoemulsification for patients with PEXC,the complication of zonular dialysis is more common in the phaco-chop group,while the injury of corneal endothelial cell is relatively serious in the tilt-flip group.%目的 比较援摩洛哥复明手术中,运用倾斜翻转法与超声乳化劈核技术行假性剥脱综合征性白内障(PEXC)超声乳化手术的临床疗效及安全性.方法 摩洛哥塔扎伊本努·巴加医院PEXC患者30例(30眼),采用随机数字表法将患者分成2组:倾斜翻转组和超声乳化劈核组,分别采用倾斜翻转法与超声乳化劈核技术完成白内障超声乳化联合人工晶状体(IOL)植入术.比较2组手术前后矫正视力、手术并发症、角膜内皮计数、内皮细胞丢失率和眼压情况.结果 随访1个月.倾斜翻转组和超声乳化劈核组术后第1天角膜水肿、术后矫正视力、后囊膜破裂、眼压比较,差异无统计学意义.术中悬韧带离断倾斜翻转组0眼,超声乳化劈核组5眼,二者比较差异有统计学意义.术后角膜内皮细胞数量、内皮细胞丢失率倾斜翻转组为(1 804±267)个/mm2和(18.15±7.40)％,超声乳化劈核组为(2 007 ±259)个/mm2和(12.92±3.48)％,2组比较差异有统计学意义.结论 2种方法行PEXC超声乳化吸除比较,超声乳化劈核组的晶状体悬韧带离断较多,倾斜翻转组的角膜内皮损伤相对较大.