巩膜电凝对白内障术后角膜散光及切口愈合的影响

目的 探讨巩膜电凝（SEC）对小切口白内障囊外摘除术（SIECCE）后角膜散光及切口愈合影响.方法 选取行SIECCE并人工晶体植入术（IOLI）的白内障患者70例,按随机数字表法分为观察组和对照组各35例,观察组采用SEC,对照组不采用.采用角膜地形图仪比较两组术后角膜散光的变化,通过裂隙灯观察术后眼前房反应.结果 手术后1周,观察组与对照组角膜散光分别为（0.88±0.47）°与（1.24±0.79）°,观察组角膜散光明显小于对照组（t=2.20,P＜0.05）;术后1个月两组角膜散光分别为（0.86±0.54）°与（1.01±0.69）°,差异无统计学意义（t=l.14,P＞0.05）;术后3个月两组角膜散光分别为（0.79±0.28）°与（0.87±0.49）°,差异无统计学意义（t=1.86,P＞0.05）;对照组术后发生浅前房、前房渗漏者分别有2例、3例,并发症发生率为14.28％,观察组无l例发生此类术后并发症（并发症发生率为0.00％）,观察组并发症发生率明显低于对照组（x2 =13.83,P＜0.01）.结论 SIECCE采用SEC,不仅可以增强切口稳定性,减少术后早期角膜散光,并且可以促进切口愈合,避免术后并发症的发生.

Effects of scleral electric coagulation on cataract postoperative astigmatism and incisional cicatrization

Objective To explore the effects of scleral electric coagulation（SEC） on postoperative astigma- tism and incisional cicatrization after small-incision extracapsular cataract extraction （SIECCE）. Methods 70 cata- ract patients who received SIECCE and intraocular lens implantation（IOLI） in our hospital were selected and random- ly divided into the observation group and control group, 35 cases in each group. The observation group received SEC, while the control group did not receive SEC. The postoperative corneal astigmatism of two groups was compared by u- sing corneal topographic map meter, the postoperative anterior chamber reaction was observed through the slit lamp. Results 1 week after the surgery, the corneal astigmatism of the observation group and the control group were （0.88 ± 0.47）°, （ 1.24 ± 0.79 ）° respectively, the corneal astigmatism of observation group was smaller than the control group（ P 〈 0.05 ）. Postoperative 1 and 3 months, the corneal astigmatism of observation group and control group were （0.86 ±0.54） ° vs （ 1.01 ±0.69）°, （0.79 ±0.28） ° vs （0.87 ±0.49）° ,there were no statistically sig- nificant differences between the two groups （ t = 1.14, 1.86, all P 〉 0.05 ）. Postoperative shallow anterior chamber, leakage of anterior chamber of control group occurred 2 cases, 3 cases, respectively, the incidence rate of complica- tions was 14.28%. No postoperative complications occurred in observation group,the incidence rate of complications in the observation group （0.00%） was obviously lower than control group（ X2 = 13.83, P 〈 0.01 ）. Conclusion Ap- plication of SEC in SIECCE not only can strengthen stability of incision, reduce early postoperative corneal astigma- tism, but also can promote healing of incision, prevent postoperative complications such as shallow anterior chamber and anterior chamber leaks.