摘要
目的 对比白内障超声乳化术后3.0 mm和2.2 mm透明角膜切口构型及水肿程度的变化.方法 前瞻性随机对照研究.选择Ⅱ至Ⅲ级核年龄相关性白内障患者35例（58眼）,采用随机数字表法分为2组,其中3.0 mm组,共30眼,2.2 mm组,共28眼.术后2h,1周,1个月及3个月分别进行前节OCT检查,观测角膜切口厚度以及外切口哆开、内切口哆开、局部后弹力层脱离、切口失对合等4种切口形态特征.采用独立样本t检验、非参数秩和检验以及卡方检验进行数据分析.结果 2组术后不同时期切口水肿程度差异均无统计学意义,切口水肿在术后3个月才基本消退.术后2h2组外切口哆开、内切口哆开、局部后弹力层脱离以及切口失对合发生率的差异均无统计学意义;术后1周3.0 mm组较2.2 mm组在内切口哆开发生率上较高,两者差异有统计学意义（3.0 mm组23％,2.2 mm组4％,x2=5.192,P＜0.05）;术后3个月2组的各种角膜切口形态均愈合.结论 对于Ⅱ至Ⅲ级核的白内障而言,微切口较传统小切口在角膜切口形态恢复时间上可能更短.
Objective To compare the architecture and wound edema degree changes of clear-corneal 3.0 mm incisions and 2.2 mm incisions after cataract removal.Methods It was a prospective randomized controlled study.Fifty-eight eyes of 35 age related cataract patients were included and the density of all the cataracts varied from grade Ⅱ to Ⅲ （Emery-Little＇s classification）.Patients were randomized to have phacoemulsification through a small-incision （3.0 mm,n=30） or clear corneal microincision （2.2 mm,n=28） by random digital table.Anterior segment optical coherence tomography evaluation was performed at 2 hours,1 week,1 month and 3 months after surgery.Incisional corneal thickness and wound architecture,including epithelial gaping,endothelial gaping,local detachment of Descemet＇s membrane and loss of coaptation,were assessed.Independent sample t test,nonparametric Wilcoxon rank-sum test and Chi-square test were used for data analysis.Results There was no statistically significant difference in incisional corneal edema degree between 2 groups at all time points.At 2 hours after the surgery,the difference between 2 groups in the occurrence of epithelial gaping,endothelial gaping,local detachment of Descemet＇s membrane and loss of coaptation was not statistically significant.At 1 week postoperatively,the incidence of epithelial gaping was higher in the 3.0 mm group than 2.2 mm group and the statistical difference was significant （23％ vs 4％,x2=5.192,P＜0.05）.All different morphological incisions in both group recovered at 3 months postoperatively.Conclusion Compared to the traditional small-incisions,the wound morphological characteristics of microincisions might recover faster in the cataracts varying from grade Ⅱ to Ⅲ.
出处
《中华眼视光学与视觉科学杂志》
CAS
2014年第8期456-460,共5页
Chinese Journal Of Optometry Ophthalmology And Visual Science
基金
国家自然科学基金（81370995）
浙江省自然科学基金（LY12H12004）
