小切口白内障摘除并人工晶体植入术治疗高度近视伴硬核白内障56例观察

Clinical effect of small incision cataract extraction and IOL implantation for cataract with high myopia in 56 cases

摘要:

探讨高度近视合并硬核白内障的小切口白内障摘除及人工晶状体植入术的临床治疗效果。方法收集该院2014 年1 月-2016 年1 月确诊并收治的高度近视合并硬核白内障患者112 例（125 眼），采用数字表法随机将患者分为对照组56 例（63 眼）和观察组56 例（62 眼），对照组患者行超声乳化白内障吸除术，观察组患者行小切口白内障摘除术。观察记录术后裸眼视力及术中、术后并发症，比较两组术前、术后的角膜内皮细胞密度及六角形细胞比例。结果术后1 d 观察组裸眼视力优于对照组，差异有统计学意义（p < 0.05），术后1 周、1 个月两组裸眼视力比较，差异无统计学意义（p >0.05）；术后1 周、1 个月角膜内皮细胞密度及六角形细胞比例均降低，与术前比较差异有统计学意义（p <0.05），术后1 周观察组角膜内皮细胞密度高于对照组，差异有统计学意义（p <0.05）；术后1 周、1 个月两组六角形细胞比例组间比较，差异无统计学意义（p >0.05）。观察组患者并发症的发生率低于对照组，差异有统计学意义（p <0.05）。结论小切口白内障摘除及人工晶状体植入术治疗高度近视合并硬核白内障临床效果好，能提高术后视力，术后并发症少，值得在临床推广。

Abstract:

To study the clinical effect of small incision cataract extraction and intraocular lens (IOL) implantation in hard nuclear cataract patients with high myopia. Methods Retrospective analysis was made in 112 patients (125 eyes) of hard nuclear cataract with high myopia who were hospitalized between January 2014 and January 2016. They were randomly divided into two groups. The treatment group (62 eyes) received small incision cataract extraction, and the control group (63 eyes) received phacoemulsification. The intraoperative and postoperative complications, and the postoperative visual acuity were observed. Non-contact corneal endothelial microscope was used to calculate the endothelial cell density and the proportion of hexagonal cells before operation and 1 w and 1 m after operation. Results The difference in the visual acuity was significant between the two groups 1 d after operation (p < 0.05). Both the endothelial cell density and the proportion of hexagonal cells of the two groups significantly decreased after operation (p < 0.05). The endothelial cell density of the control group was lower than that of the treatment group 1 w after operation (p < 0.05). There was no significant difference in the proportion of hexagonal cells between the two groups 1 w and 1 m after operation (p > 0.05). The intraoperative and postoperative complications inthe treatment group were significanthy lower than those in the control group (p < 0.05). Conclusions Small incision cataract extraction with IOL implantation is fit for high myopia with hard nuclear cataract. It can improve postoperative visual acuity and reduce postoperative complications, which is worth spreading in clinic.