两种透明角膜切口白内障超声乳化术后角膜散光比较

目的 评价2.6mm与3.0mm两种透明角膜小切口超声乳化白内障吸除联合折叠式人工晶状体植入术对角膜散光的影响.方法 将69例(69只眼)白内障患者,按照2.6mm与3.0mm两种不同大小透明角膜切口随机分为A、B两组,行透明角膜小切口超声乳化白内障吸除联合折叠式人工晶状体植入术,比较两组手术性角膜散光的情况.结果 A组(3.0mm组)术后1周、术后1个月、术后3个月平均手术性角膜散光度分别为(0.6347±0.57773)D、(0.6029±0.52986)D和(0.6471±0.51902)D;B组(2.6mm组)术后1周、术后1个月、术后3个月平均手术性角膜散光度分别为(0.7286±0.62241)D、(0.6286±0.45927)D和(0.5714±0.49472)D;差异无统计学意义(P>0.05).结论 在同轴白内障超声乳化吸除联合折叠式人工晶状体植入术中,2.6mm透明角膜切口是一种安全有效的手术切口.     

同轴1.8mm微切口超声乳化术治疗短眼轴白内障的疗效

目的:观察1.8mm透明角膜切口白内障超声乳化联合超薄人工晶状体植入术治疗短眼轴白内障的临床疗效,并与传统的3.0mm透明角膜切口超声乳化手术进行比较.方法:前瞻性随机对照研究.将84例84眼平均眼轴长20.26±1.59mm(眼轴范围17.68 ～ 21.32mm)的年龄相关性白内障患者随机分为两组,分别行1.8mm同轴微切口白内障超声乳化吸除联合人工晶状体植入术和3.0mm同轴小切口白内障超声乳化吸除联合人工晶状体植入术.术中记录两组患者超声乳化所用的有效超声时间(EPT)和平均超声能量(AVE),术后随访1d,1wk,1、3mo,观察两组术后最佳矫正视力、眼压、中央前房深度、角膜内皮细胞密度、手术源性散光和手术并发症情况.结果:A、B两组患者术中EPT分别为6.88±3.05、7.04±3.57s,术中AVE分别为(14.54±7.26)％和(15.08±3.67)％.术后1d,1wk,1、3mo微切口组手术源性散光低于小切口组,差异具有统计学意义(P＜0.05).两组间最佳矫正视力及角膜内皮细胞密度无显著性差异.两组患者术后眼压均较术前明显下降,术后前房深度均较术前明显加深.所有患者术中前房稳定,术中及术后无并发症发生,均无切口热烧伤.结论:同轴1.8mm微切口与传统的同轴3..mm小切口超声乳化手术治疗短眼轴白内障相比,能有效地减少手术源性散光,可显著改善早期视功能.     

双手法微切口白内障手术临床效果评价

目的比较双手法微切口白内障手术术与常规同轴小切口白内障手术的临床效果。方法将80例（82眼）白内障随机分为两组行双手法微切口白内障超声乳化吸出人工晶状体植入术（微切口组）和常规小切口组超声乳化吸出人工晶状体植入术（小切口组）。分别记录两组超声乳化所用的时间、平均功率，     

透明角膜小切口白内障手术后角膜散光变化

目的　评价透明角膜小切口超声乳化白内障吸除折叠式人工晶状体植入术后角膜散光的变化。方法　将62例(78只眼)白内障患者,按照切口位置位于颞上方及鼻上方或角膜曲率最大子午线轴位分为A、B两组,行透明角膜小切口超声乳化白内障吸除折叠式人工晶状体植入术,比较术后角膜散光的变化情况。结果　A、B两组术后3个月平均手术性角膜散光度分别为（0.83±0.65）D和（0.72±0.55）D,差异无显著性(P>0.05);平均角膜散光度分别较术前减少0.11D和0.39D,两者比较差异有显著性（P<0.05）。结论　以透明角膜小切口行超声乳化白内障吸除折叠式人工晶状体植入术,术后角膜散光度小;结合散光轴位选择切口位置,术后可明显减小角膜散光度。     

小切口非超声乳化白内障手术中选择性切口矫正术前散光的临床观察

目的:评价小切口白内障非超声乳化手术中根据角膜散光轴位选择不同切口位置矫正术前散光的疗效。方法:对角膜散光>1.00D的39例39眼老年性白内障患者进行研究,随机分为A,B两组。A组20例患者,术前根据患者散光轴位行12∶00(顺规)及9∶00(逆规)位的角膜切口小切口白内障非超声乳化吸除人工晶状体植入术;B组19例患者行常规上方角膜切口小切口白内障非超声乳化摘除人工晶状体植入术。术前及术后记录最佳矫正视力、角膜屈光度及散光轴位,比较两组术后角膜散光的变化。结果:术后A组视力平均提高0.66,B组平均提高0.57,两组比较差异无统计学意义。A组平均矫正散光1.10D,B组矫正0.40D,两组差异显著。在随访过程中未出现并发症。结论:根据术前散光轴位,在小切口白内障非超声乳化摘除人工晶状体植入术中选择不同位置的切口,可安全有效地矫正术前散光。     

白内障双手微切口超声乳化及Acri.smart人工晶状体植入术的临床研究

目的评价双手微切口晶状体超声乳化及Acri.smart人工晶状体植入术的临床效果。方法75例(89眼)老年性白内障随机分为两组,一组34例(40眼)行双手超声乳化术,另一组41例(49眼)行传统超声乳化术。观察术后视力、超声乳化时间、角膜内皮细胞丢失率、前房蛋白浓度、散光变化及手术并发症。结果双手组的平均超声能量(12.34±7.52)%低于传统组的(17.16±9.35)%,术后1 d、1周的裸眼视力优于传统组。双手组术后1 d的前房蛋白浓度(19.47±5.28)pc/ms低于传统组的(22.86±4.30)pc/ms。术后1月双手组散光度(0.78±0.40)D低于传统组(1.12±0.48)D。两组的有效超声乳化时间、超声乳化时间、角膜内皮细胞丢失率和六角形细胞比率的差异均无统计学意义。结论白内障双手超声乳化及Acri.smart人工晶状体植入术是安全有效的,手术切口小,散光小,炎症反应轻,视力恢复快。     

1.8mm微切口白内障超声乳化吸除联合青光眼小梁切除术临床观察

目的：观察同轴1.8mm微切口白内障超声乳化吸除超薄人工晶状体植入联合小梁切除术治疗青光眼合并白内障的临床疗效和安全性,并与传统的同轴3.0mm 小切口超声乳化吸除折叠人工晶状体植入联合小梁切除术进行比较。
　　方法：前瞻性对照研究。收集在我院眼科行超声乳化白内障手术的青光眼合并白内障患者36例36眼随机分为2组。微切口组：同轴1.8mm微切口白内障超声乳化吸除超薄人工晶状体植入联合小梁切除手术18例18眼：小切口组：传统同轴3.0mm小切口超声乳化吸除折叠人工晶状体植入联合小梁切除术18例18眼。分别记录两组1wk;1,3mo的视力、角膜内皮细胞密度、手术源性散光、眼压、滤过泡的形成和并发症的情况。采用均数t检验和χ2检验对数据进行统计学分析。
　　结果：术后1 wk微切口组裸眼视力优于小切口组,差异有统计学意义(P<0.05)。术后1,3mo两组矫正视力差异无统计学意义(P>0.05)。术后1wk;1,3mo两组手术源性散光差异有统计学意义(P<0.05)。术后1wk两组角膜内皮细胞密度差异有统计学意义(P<0.05)。术后1,3 mo 两组角膜内皮细胞密度差异无统计学意义( P>0.05)。术后微切口组平均眼压15.26±3.12mmHg,小切口组平均眼压14.57±2.86mmHg,两组术后眼压差异无统计学意义(P>0.05),两组术后功能型滤过泡和非功能型滤过泡比较,差异无统计学意义(P>0.05)。两组术中均未出现虹膜损伤、后囊膜破裂、前房出血等并发症。
　　结论：同轴1.8mm微切口白内障超声乳化吸除超薄人工晶状体植入联合小梁切除术与传统同轴3.0mm小切口超声乳化吸除植入折叠人工晶状体联合小梁切除术相比,能有效减少手术源性散光,是一种安全、有效、便捷的治疗白内障合并青光眼的手术方法。     

双手法微切口白内障超声乳化手术的初步临床观察

目的 探讨双手法微切口白内障超声乳化手术的疗效.方法 将40例(40眼)年龄相关性白内障患者随机分为两组,每组20例(20眼),分别行双手法微切口白内障超声乳化摘除并人工晶体植入术及常规的白内障超声乳化摘除并人工晶体植入术.观察两组术中有效超声乳化时间、术后视力和角膜屈光状态变化等至3个月到6个月.结果 双手法组术中有效超声乳化时间(EPT)为0.9～22.1s,平均5.91±4.70s.术后1周平均散光度数为0.65±0.24D,术后1个月为0.67±0.22D,术后1个月角膜内皮细胞计数为2590.6±243个/mm2.常规组术中有效超声乳化时间为1.2～23s,平均7.1±2.30s.术后1周平均散光度为2.05±0.54D,术后1个月为1.45±0.75D.术后1个月角膜内皮细胞计数为2623±287个/mm2.两组患者术后手术性散光1天时差异有统计学意义(P＜0.01);术后1周对比仍有统计学意义(P＜0.05);1个月时无统计学意义(P＞0.05);术后矫正视力1周,1个月,3个月两组均有明显提高,比较视力变化无统计学意义(P＞0.05).结论 双手微切口超声乳化白内障吸除术可安全、有效地通过＜1.9mm的切口摘除白内障并植入人工晶体,术后早期视功能恢复优于常规白内障超声乳化手术.     

小切口非超声乳化白内障术后的角膜散光变化

目的总结小切口非超声乳化人工晶状体植入术后的角膜散光变化.方法 39例44眼老年性白内障患者行小切口非超声乳化人工晶状体植入术,检查术前及术后3天,2周,1、2、3、6个月等不同时期的角膜散光情况;计算手术产生的角膜散光在各时期的变化.同期常规现代囊外手术的老年性白内障42例42眼作为对照.结果小切口非超声乳化组术后1、2、3、6个月的散光度接近于术前的散光值.对照组手术各时期的散光度明显高于术前的散光值.两组术后产生的角膜散光有显著性差异(P<0.05).结论小切口非超声乳化人工晶状体植入术能在术后早期减少角膜散光,获得较快的视力恢复,有利于基层医院推广.     

不同方向透明角膜小切口白内障术后角膜散光比较

目的 :比较与评价不同方向透明角膜小切口超声乳化白内障吸除联合折叠人工晶状体植入术后角膜散光的变化。方法 :将 6 8例 (72只眼 )白内障患者 ,按切口方向位于角膜曲率最大子午线方向或位于颞上方及鼻上方分为A、B两组 ,行透明角膜切口超声乳化白内障吸除联合折叠人工晶状体植入术 ,比较术后角膜散光的变化情况。结果 :A、B两组术后 3个月平均手术性角膜散光度分别为 (0 92± 0 38)D和 (1 2 6± 1 0 8)D ,差异无显著性 (P >0 0 5 ) ;A组平均角膜散光度较术前减少0 14D ,B组增加 0 4 8D ,两组差异有显著性 (P <0 0 5 )。结论 :根据术前散光轴位选择切口方向 ,行透明角膜切口超声乳化白内障吸除联合折叠人工晶状体植入术 ,术后可减少角膜散光度。     

同轴1.8mm微切口超声乳化白内障手术临床效果评价

目的 观察同轴1.8mm微切口超声乳化白内障手术的临床效果,并与传统同轴3.0mm小切口超声乳化手术进行比较.方法 前瞻性随机对照研究.采用随机数字表法,将实施超声乳化白内障手术的年龄相关性白内障患者89例(89只眼)随机分为2组.微切口组:同轴1.8mm微切口超声乳化白内障吸除联合人工晶状体植入手术45例(45只眼);小切口组:传统同轴3.0mm小切口超声乳化白内障吸除联合人工晶状体植入术44例(44只眼).取随访资料完整者,微切口组40例(40只眼),小切口组40例(40只眼)进行分析.分别记录两组超声乳化所用的平均超声能量(AVE)和有效超声时间(EPT),术后1d、1周、1个月和3个月随访,检查并记录视力、角膜内皮密度、中央角膜厚度,手术源性散光.采用两均数t检验和x2检验对数据进行统计学分析.结果 两组所用EPT和AVE差异无统计学意义(t=-0.149,P=0.882;t=-0.769,P=0.444).术后1d,微切口组裸眼LogMAR视力0.16±0.14优于小切口组0.23±0.12,且差异具有统计学意义(t=-2.371,P=0.020).术后1周、1个月和3个月,两组矫正视力差异均无统计学意义(t=-1.469,-1.437,-1.585;P=0.146,0.155,0.117).术后1d、1周、1个月和3个月,两组角膜内皮细胞密度及中央角膜增厚程度改变差异无统计学意义(P＞0.05).术后1d、1周、1个月及3个月,同轴微切口组手术源性散光分别为(0.62±0.28)D,(0.48±0.28)D,(0.47±0.25)D,(0.40±0.24)D;同轴小切口组手术源性散光分别为(1.27±0.65)D,(1.18±0.59)D,(1.02±0.56)D,(0.79±0.48)D,两组间差异具有统计学意义(t=-5.940,-7.247,-5.779,-4.788;P =0.000,0.000,0.000,0.000).微切口组手术源性散光于1周后明显下降(t=2.517,P=0.014)并趋于稳定,小切口组手术源性散光则于术后1个月出现明显下降(t =2.105,P=0.038).结论 同轴1.8mm微切口与传统的同轴3.0mm小切口超声乳化白内障手术相比,能有效减少手术源性散光,且散光状态更早稳定,对术后视力早期恢复具有优势.     

Intraindividual comparison of surgical trauma after bimanual microincision and conventional small-incision coaxial phacoemulsification

PURPOSE: To compare the surgical trauma after microincision phacoemulsification and small-incision coaxial phacoemulsification after implantation of conventional, foldable, hydrophobic acrylic intraocular lenses (IOLs). SETTING: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS: A prospective investigator-masked case series comprised patients with bilateral cataract who had cataract surgery on the same day. Thirty-three patients (66 eyes) were randomized. Microincision cataract surgery (MICS) was performed through 2, 1.4 mm clear corneal incisions (CCIs) using bimanual sleeveless phacoemulsification (cool phaco) in 1 eye. Small-incision cataract surgery (SICS) was performed on the other eye through a 3.2 mm CCI. In all cases, an AcrySof SA60AT IOL was inserted, in the MICS group after the CCI was enlarged. Laser flare photometry, specular microscopy, corneal endothelial cell density, and pachymetry were evaluated preoperatively and postoperatively. Intraindividual comparison and statistical analyses were performed. RESULTS: There were no relevant clinical differences or perioperative complications in either group. There were no statistically significant differences between preoperative and postoperative anterior chamber flare or endothelial cell loss. On the first postoperative day, the MICS group had statistically significantly increased corneal swelling (P = .008). Postoperatively, the mean endothelial cell density loss was higher in the MICS group (6.2%) than in the SICS group (3.10%); however, the difference between groups was not significant (P = .08) CONCLUSIONS: Microincision cataract surgery was a safe and reproducible technique. The postoperative results in the MICS group were comparable to those in the SICS group.     

同轴微切口白内障超声乳化术控制术中虹膜松弛综合征的疗效分析

目的 评价同轴微切口白内障超声乳化术控制术中虹膜松弛综合征(intraoperative floppy iris syndrome,IFIS)的治疗效果.方法 前瞻性随机对照研究.2014年10月至2016年10月服用坦索罗辛≥2周的年龄相关性白内障患者80例(80眼),随机分为2组:微切口组和标准切口组,每组40例(40眼),分别通过1,8 mm微切口和2.6 mm标准透明角膜切口行同轴超声乳化白内障吸出联合人工晶状体植入术.记录并对比两组患者术中IFIS的发生率、严重程度及手术并发症,术后1d、1周、1个月的裸眼视力.结果 术后1d、1周、1个月的裸眼视力,微切口组分别为0.83±0.12、0.86±0.10、0.89±0.11,标准切口组分别为0.71 ±0.12、0.75 ±0.11、0.83 ±O.12,差异均有统计学意义(均为P＜0.05),微切口组裸眼视力均优于标准切口组.微切口组IFIS的发生率为60.0％,标准切口组IFIS的发生率为82.5％,差异有统计学意义(P＜0.05).两组术中IFIS发生的严重程度比较差异有统计学意义(P＜0.05),微切口组IFIS发生的严重程度低于标准切口组.结论 同轴微切口白内障超声乳化术对具有IFIS发生风险的白内障患者来说是一种安全有效的手术方式.     

西藏地区影响老年性白内障术后视力改善因素分析

目的 分析影响西藏地区老年性白内障术后视力改善的因素.方法 对西藏地区接受白内障手术的老年性白内障278例,分析年龄、核分级、术式(超声乳化术和小切口白内障囊外摘除术)、人工晶状体度数、角膜水肿部位等对术后视力改善的影响.视力采用LogMAR视力.统计方法分别采用单因素和多因素线性回归方法.结果 (1)单因素分析:术式:超声乳化术组术后较术前视力改善(平均视力差) 0.92±0.48,小切口白内障囊外摘除术组平均视力差0.83±0.46,两种手术方式对视力改善的影响,差异没有统计学意义(P＞0.05).年龄:70-、80-年龄组分别与40-、50-、60-年龄组差异有统计学意义(P＜0.05).角膜水肿部位:弥漫性水肿(平均视力差0.52±0.42)较中央部位水肿(平均视力差0.70±0.44))对视力改善影响更大,差异有统计学意义(P＜0.05).(2)多因素线性回归分析:年龄、角膜水肿部位均对视力改善有影响,差异有统计学意义(P＜0.05).结论 (1)超声乳化术和小切口白内障囊外摘除术两种手术方式对视力提高程度无明显差异,因此在西藏地区可以根据当地条件,包括经济状况和医师具备的手术水平,来选择术式,以使患者获得最佳有用视力.(2)年龄为白内障术后视力改善的影响因素之一,随年龄增加视力改善减少,而西藏地区就医条件有限,故在西藏地区更应重视白内障的普查,强调早期发现和早期手术.(3)在角膜水肿分级无明显差异的基础上,弥漫性水肿较中央部水肿对视力改善影响更大,因此在术中应谨慎操作,尽量避免角膜内皮广泛的损伤.     

Controlled clinical trial comparing biaxial microincision with coaxial small incision for cataract surgery

Purpose. Clinical outcomes of biaxial microincision versus coaxial small incision cataract surgery were compared in a prospective, controlled, paired-eye clinical study. Methods. A total of 84 eyes of 42 patients underwent cataract surgery using the biaxial microincision (B-MICS) technique in either the right or left eye. The fellow eye was to undergo cataract surgery using the standard coaxial small incision (SICS) technique. All surgeries were performed using the Stellaris Vision Enhancement System and all eyes were implanted with an aspheric microincision intraocular lens (IOL). The 1.2-mm B-MICS incision was widened to 1.8 mm for IOL insertion. The main outcome measure was the change from baseline best-corrected visual acuity (BCVA). Secondary outcome measures were uncorrected visual acuity (UCVA), surgically induced astigmatism (SIA), manifest subjective refraction in spherical equivalent (MRSE), absolute phacoemulsification time (APT), effective phacoemulsification time (EPT), mean phacoemulsification power, and endothelial cell count (ECC). Follow-up was at 1 day, 3 days, 1 week, and 2 months. Results. The treatment groups did not differ in baseline characteristics. Improvement in BCVA over baseline logarithm of the minimum angle of resolution (logMAR) was statistically significantly greater with B-MICS than SICS at 1 day (B-MICS -0.1, SICS -0.05; 95% CI -0.26 to -0.05, p=0.005). Mean improvement in UCVA from baseline was greater with B-MICS at 1 day (B-MICS -0.33, SICS -0.12; 95% CI -0.35 to -0.10, p=0.001), 3 days (B-MICS -0.39, SICS -0.26; 95% CI -0.22 to -0.02, p=0.022), 1 week (B-MICS -0.44, SICS -0.33; 95% CI -0.20 to -0.009, p=0.033), and 2 months (B-MICS -0.47, SICS 0.38; 95% CI -0.19 to +0.002, p =0.054). At 2 months, SIA was significantly lower with B-MICS than SICS (B-MICS 0.70 D, SICS 0.89 D; 95% CI -0.39 to -0.1, p=0.045), as was endothelial cell loss (B-MICS -1.4%, SICS -7.8%; p=0.05). The EPT was lower with B-MICS (B-MICS 1.60 s, SICS 2.80 s; 95% CI -1.68 to -0.77, p<0.001) with no difference in mean phaco power. Conclusions. Compared to the standard small incision technique, B-MICS showed earlier improvement in BCVA, better overall UCVA, less SIA, and less endothelial cell loss.     

Biaxial microincision cataract surgery versus conventional coaxial cataract surgery: metaanalysis of randomized controlled trials

A comprehensive literature search of Cochrane Library, PubMed, and Embase was performed to identify relevant prospective randomized controlled trials (RCTs) comparing biaxial microincision cataract surgery (MICS) and conventional coaxial phacoemulsification. A metaanalysis was performed on the following outcome measures: effective phacoemulsification time (EPT), phacoemulsification power (%), corrected distance visual acuity (CDVA), surgically induced astigmatism (SIA), laser flare photometry value, percentage of endothelial cell loss, change in central corneal thickness (CCT), and complications. Eleven RCTs describing a total of 1064 eyes were identified. There were no significant differences between the techniques in CDVA, mean percentage of endothelial cell loss, laser flare photometry value, CCT change, and intraoperative and postoperative complications. However, EPT was statistically significantly shorter and the mean phaco power was statistically significantly lower in the biaxial group than in the coaxial group, and biaxial MICS induced less SIA. Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.     

Corneal endothelial damage after cataract surgery: Microincision versus standard technique

PURPOSE: To compare corneal endothelial changes after phacoemulsification performed with a standard technique versus a bimanual microincision cataract surgery (MICS) technique. SETTING: University ophthalmology department. METHODS: Eighty patients scheduled for routine cataract surgery were randomized into 2 groups; 40 eyes had standard stop-and-chop phacoemulsification (standard group) and 40 eyes had stop-and-chop phacoemulsification with microincision surgery (MICS group). Central corneal endothelial cell counts, coefficient of variation in cell size, hexagonality, and pachymetry were assessed preoperatively and 1 and 3 months postoperatively. RESULTS: The mean preoperative cell count in the entire sample was 2245 cells/mm2 +/- 37 (SE). The mean decreased by 102 cells at 1 month (95% confidence interval [CI], -133 to -71; P < .001) and by 144 cells at 3 months (95% CI, -187 to -102; P < .001). The difference between the standard group and the MICS group was 25 cells at baseline (95% CI, -169 to 120 cells; P = .739), 19 cells at 1 month (95% CI, -163 to 126; P = .799), and 19 cells at 3 months (95% CI, -164 to 125; P = .793). There were no changes in the coefficient of variation or morphology in the overall sample, and the pattern of change did not differ between the 2 groups. Corneal thickness increased by 10.2 microm in the overall sample (95% CI, +4.5 to +16.0; P < .001) and approached baseline values by 3 months with an increase of 3.4 microm (95% CI, -4.1 to 10.8; P = .372). There was no difference in corneal thickness between the groups. CONCLUSION: No significant differences in corneal endothelial cell loss or endothelial morphology were found between MICS and standard incision techniques.     

Microincision cataract surgery with implantation of an Acri. Smart 48S lens

PURPOSE: To evaluate visual and refractive outcome and complications after microincision cataract surgery (MICS) with implantation of an Acri.Smart 48S intraocular lens (IOL). MATERIAL AND METHODS: This study comprised 22 eyes of 11 patients having bilateral microincision cataract surgery. MICS was performed through a 1.4 mm clear corneal incision using the MacKool System and low ultrasound power. The IOL was implanted through a 1.7 or smaller clear corneal incision with a Acri.Smart Glide System. The final size of the clear corneal incision, postoperative uncorrected and best corrected distance visual acuity, best corrected near visual acuity (Snellen, Jaeger Table), astigmatism, pseudoaccommodation possibility of Acri.Smart 48S IOL, complications and patient satisfaction were analyzed. The follow up was 1 month. RESULTS: The Acri.Smart 48S lens was implanted through mean incision of 1.56 +/- 0.07 mm. One month after surgery the mean uncorrected distance visual acuity (UCVA) and the best corrected visual acuity (BCVA) significantly improved (UCVA: preoperatively--0.49 +/- 0.33; postoperatively--0.97 +/- 0.11; p < 0.001; BCVA: preoperatively 0.68 +/- 0.3; postoperatively--1.0; p < 0.001) as well as BCVA for near (BCVA: preoperatively--5.27 +/- 3.30; postoperatively--2.91 +/- 1.48; p = 0.002). One month after surgery, there was not significant increase of astigmatism and the pseudoaccommodative ability of Acri.Smart 48S was not observed. There were no serious intraoperative and postoperative complications. All the patients were highly satisfied with the quality of the vision. CONCLUSIONS: Our preliminary results show that MICS with Acri.Smart 48S lens implantation is safe and effective procedure. This conclusion has to be confirmed by studies with longer follow up period and larger series of patients.     

双手法微切口白内障手术评价及术后早期视觉质量观察

目的 评价双手法微切口自内障摘除联合1.4mm微切口人工晶体植入手术技术的安全性、有效性及其术后早期视功能恢复情况.方法 选择2004年8月至2006年12月行老年性白内障摘除手术的患者320只眼,随机分成两组,A组进行常规3.0mm切口同轴超声乳化白内障摘除手术,B组进行微切口自内障摘除手术(MICS).术后一个月对两组术眼进行以下检查:裸眼远、近视力;最佳矫正远、近视力;自动验光仪验光观察角膜散光;全眼像差变化,并比较两组的差异.结果 术后1个月两组裸眼远视力有统计学差异,术后1个月两组手术前后散光变化有统计学意义(P<0.05),全眼总像差及高阶相差A组均高于B组,MICS组的观察结果优于常规同轴超声乳化组.结论 微切口白内障手术作为一种新的超声乳化手术技巧会逐渐发展完善,在临床中得到进一步应用.     

Outcomes of coaxial microincision cataract surgery versus conventional coaxial cataract surgery

PURPOSE: To compare the outcomes of coaxial microincision cataract surgery (MICS) with those of conventional coaxial cataract surgery. SETTING: University Eye Clinic, Geneva, Switzerland. METHODS: In a prospective study, 50 eyes of 50 patients with nuclear or corticonuclear cataract (grades 2 to 4 on the Lens Opacities Classification System III) were randomly selected to have cataract extraction through a temporal clear corneal incision using 1 of 2 techniques: coaxial MICS (25 eyes) or conventional coaxial cataract surgery (25 eyes). Coaxial MICS was performed through a 1.6 mm incision and conventional coaxial cataract surgery, through a 2.8 mm incision. In all cases, a flexible hydrophobic acrylic intraocular lens (Lentis L-303, WaveLight GmbH) was implanted. Intraoperative parameters were ultrasound time, surgical time, and total volume of balanced salt solution used. The best corrected visual acuity, corneal thickness, and endothelial cell count were evaluated preoperatively and postoperatively. RESULTS: There were no relevant clinical differences between groups or perioperative complications in either group. The only statistically significant differences between the 2 groups were ultrasound time (P = .0002) and surgical time (P = .005). CONCLUSIONS: Coaxial microincision cataract surgery was a safe and effective technique. Although ultrasound and surgical time were significantly higher with coaxial MICS than with conventional coaxial cataract surgery, the postoperative results in the 2 techniques were comparable.