白内障超声乳化吸除术和囊外摘除术初学者玻璃体脱出危险因素分析

目的 探讨白内障手术初学者超声乳化吸除术和囊外摘除术,学习曲线特点及学习过程中同玻璃体脱出相关的危险因素.方法 回顾分析作者最初的连续350例超声乳化手术和350例囊外摘除手术经过,并分析手术患者性别、年龄、眼别、白内障类型、人工晶状体度数、撕囊是否成功、患者是否配合等因素对玻璃体脱出的影响.结果 各因素对囊外摘除手术玻璃体脱出发生率均无影响,白内障类型、人工晶状体度数、撕囊是否成功对超声乳化手术玻璃体脱出率有影响,其中IV级核、撕囊不成功、IOL度数≥24.5、Ⅰ级核及IOL度数≤15.0等5个因素是玻璃体脱出的危险因素,Ⅱ级核是保护因素(P<0.05).结论 超声乳化手术较囊外摘除手术受患者条件影响更大,初学者宜选取正视眼、Ⅱ级核、相对年轻的患者并在撕囊成功的前提下进行超声乳化手术的学习.

Risk factors of vitreous loss analysis of phacoemulsification and extracapsular cataract extraction during the learning curve

Objective To investigate the risk factors related to vitreous loss of phacoemulsification and extracapsular cataract extraction. Methods The clinical data of the initial continuous 350 cases of pha-coemulsification and 350 cases of extracapsular cataract extraction were reviewed. Vitreous loss rate related to each risk factors (gender, age, laterality of the eye,type of cataract, IOL power,success of capsulorhexis,coordinafion of the patients, etc) were measured. Chi-square and Logistic analysis were used to identify the differ-ence of each rate. Results In the ECCE group, there is no significance among each risk factor. In the Phaco group,type of cataract,IOL power and capsulorhexis successful or not affected the vitreous loss rate. Grade IV nuclear,unsuccessful capsulorhexis, IOL power ≥ 24.5D, IOL power ≤ 15.0D and grade Ⅰ nuclear are the risk factors related to the vitreous loss rate,while grade Ⅱ nuclear is a significant protect factor (p <0.05). Conclu-sion The trainees are suggested to choose patients with emmetropia,cataract with grade n nuclear and relative young age and to perform phacoemulsification with successful capsulorhexis.