摘要
目的 对比观察超声乳化白内障摘除术与小切口白内障囊外摘除术治疗老年Ⅱ~Ⅲ级核年龄相关性白内障的效果,为治疗该病症提供方法。方法 回顾性分析2018年7月—2021年7月于南充市中心医院接受手术治疗的老年Ⅱ~Ⅲ级核年龄相关性白内障患者的临床资料,根据手术方式的不同分为观察组和对照组。观察组行超声乳化白内障摘除术,对照组行小切口白内障囊外摘除术。经倾向性匹配评分法排除性别和年龄等混杂因素,最终获得观察组114例,对照组114例。观察2组术前、术后7 d、术后1个月和术后3个月时视力[最佳矫正视力(BCVA)]、散光情况、角膜内皮细胞[中央角膜厚度(CCT)、内皮细胞密度(ECD)]差异,比较2组患者术后并发症发生情况。结果 术后7 d、术后1个月和术后3个月时,2组的BCVA值均较同组术前上升(P<0.05),观察组BCVA高于同期对照组(P<0.05)。术后7 d和术后1个月时,2组角膜散光值均同组较术前上升(P<0.05),观察组角膜散光值低于同期对照组(P<0.05);术后3个月时,观察组角膜散光值较同组术前下降(P<0.05),且观察组角膜散光值低于同期对照组(P<0.05)。术后7 d时,2组CCT值均较同组术前上升(P<0.05);术后1个月时,对照组CCT较同组术前上升(P<0.05),而观察组低于同期对照组(P<0.05)。术后7 d、术后1个月和术后3个月时,2组ECD值均低于同组术前(P<0.05),但2组ECD值差异无统计学意义(P>0.05)。观察组角膜水肿发生率低于对照组(P<0.05)。结论 超声乳化白内障摘除术治疗老年Ⅱ~Ⅲ级核年龄相关性白内障患者,视力矫正效果更好,术后散光影响效果更低,其与小切口白内障囊外摘除术对角膜内皮细胞的影响相近,且能减低部分术后并发症发生率。
Objective To compare the curative effect between phacoemulsification and small incision extracapsular cataract extraction in the treatment of elderly patients with grade Ⅱ-Ⅲ nuclear age-related cataract,and provide a method for the treatment of this disease.Methods The clinical data of patients with grade Ⅱ-Ⅲ nuclear age-related cataract who received surgical treatment inCentral Hospital of Nanchong City from July 2018 to July 2021 were retrospectively analyzed.According to the different surgical methods,they were divided into observation group and control group.The observation group underwent phacoemulsification while the control group received extracapsular cataract extraction with small incision.After excluding the confounding factors such as gender and age by propensity matching score,114 cases in the observation group and 114 cases in the control group were obtained.The differences in visual acuity [best corrected visual acuity(BCVA)],astigmatism and corneal endothelial cells [central corneal thickness(CCT),endothelial cell density(ECD)] were compared between the two groups before operation and at 7 d,1 month and 3 months after operation.The differences in occurrence of postoperative complications of the two groups were compared.Results At 7 days,1 month and 3 months after operation,the BCVA of the two groups was higher than that of the same group before operation(P<0.05),and the BCVA of the observation group was higher than that of the control group(P<0.05).At 7 days and 1 month after operation,the corneal astigmatism of the two groups was higher than that of the same group before operation(P<0.05),and the corneal astigmatism of the observation group was lower than that of the control group(P<0.05);at 3 month after operation,the corneal astigmatism of the observation group was lower than that of the same group before operation(P<0.05),and the corneal astigmatism of the observation group was lower than that of the control group(P<0.05).At 7 days after operation,the CCT of the two groups was higher than that of the same group before operation(P<0.05);at 1 month after operation,the CCT of the control group was higher than that of the same group before operation(P<0.05),while the CCT of the observation group was lower than that of the control group(P<0.05).At 7 days,1 month and 3 months after operation,the ECD of the two groups was lower than that of the same group before operation(P<0.05),but there was no significant difference between the two groups(P>0.05).The incidence of corneal edema in the observation group was lower than that in the control group(P<0.05).Conclusion Phacoemulsification in the treatment of elderly patients with grade Ⅱ-Ⅲ nuclear age-related cataract has better visual correction effect and less effect of postoperative astigmatism.It is similar to the effect of small incision extracapsular cataract extraction on corneal endothelial cells,and it can reduce the incidence of some postoperative complications.
作者
李娜
杨宇
黄海
Li Na;Yang Yu;Huang Hai(Department of Ophthalmology,Central Hospital of Nanchong City(Second Clinical Medical College of North Sichuan Medical College),Nanchong,Sichuan,637000,P.R.China)
出处
《老年医学与保健》
CAS
2022年第4期907-911,共5页
Geriatrics & Health Care
基金
2020年四川省卫生健康委员会科研课题(普及应用项目)立项课题(20PJ300)。
