超声乳化术与囊外摘出术治疗过熟期白内障

目的比较过熟期白内障超声乳化术和囊外摘出术的手术效果、术中和术后并发症，并探讨其手术技巧。方法将139例（184眼）过熟期白内障随机分成两组，A组70例（93眼）行晶状体超声乳化术，B组69例（91眼）行白内障囊外摘出术，均联合人工晶状体植入术。于术后1d对两组裸眼视力、术中及术后并发症进行比较。结果术后1d裸眼视力0．05—0．25者B组明显高于A组（P〈0．05）。术后1d裸眼视力〈0．05及≥0．3者B组明显低于A组（P〈0．05）。术中晶状体核掉入玻璃体腔、玻璃体脱出眼数A组明显高于B组（P〈0．05）。术后角膜水肿眼数A组明显高于B组（P〈0．05）。结论过熟期白内障行白内障囊外摘出术较超声乳化术更具有安全性。

The clinical evaluation of phacoemulsification and extracapsular cataract extraction in treatment of hypermature stage cataract

Objective Comparative study on curative effect and complication of hypermature stage cataract with phacoemulsification and extracapsular cataract extraction （ECCE） and implant intraocular lens. Methods 139 case 184 eyes were divided into two groups randomly, A group patients treated with phaco ＋ IOL; B grouppatients treated with ECCE ＋ IOL. Compared the uncorrected distant visual acuity（UCDVA） and complication of two groups after operation. Results The difference of values of UCDVA 〈 0.05 and O. 05-0.25 was significantly different between the two groups on the fist post - operative day （χ2 = 19. 830, P =0. 000 ）, （ χ2 = 35.17, P =0. 000）, The difference of values of UCDVA ≥0.3 was significantly different between the two groups on the fist postoperative day （ χ2 = 9. 785 , P = 0.002 ） , The difference of values of nuclear falling to vitreous and posterior capsule rupture wassignificantly different between the two groups during the operation （χ2 = 4. 070,P = 0. 044）, （χ2=7. 142,P = 0. 008）, The difference of values of corneal edema was significantly different between the two groups on the fist post - operative day （χ2 = 22. 132, P = 0.000） Conclusion Hypermature stage cataract with phacoemulsification is more likely to causing nuclear falling to vitreous, posterior capsule rupture and corneal edema than ECCE, ECCE is safer than phaco for the operation of hypermature stage cataract.