双手微小切口白内障超声乳化术治疗硅油填充眼并发性白内障

目的:探讨双手微小切口白内障超声乳化吸除术在治疗硅油填充眼并发性白内障的临床疗效及安全性。方法:选取2007-10/2008-11收治的病例完整的硅油填充眼并发性白内障患者的31例(31眼),随机分成两组,分别采用两种不同的手术方式。A组16例(16眼)行双手微小切口白内障超声乳化吸除术,B组15例(15眼)行常规的超声乳化吸除术,分别于术前、术后1wk;1,3mo行视力、角膜地形图检查。结果:所有术眼在手术过程中前房稳定,未见切口热灼伤,术后2眼角膜轻度水肿,均在术后1wk内缓解。两组术后均随访3mo以上,未发现有视网膜脱离复发。术后1wkA组最佳矫正视力高于B组,两组间比较,有显著性差异(P<0.05);术后角膜地形图曲率和散光simk值手术前后比较,B组术后1wk角膜地形图散光与术前相比有显著性差异(P<0.05)。结论:双手微小切口白内障超声乳化吸除术在治疗硅油填充眼并发性白内障时安全有效,临床上值得推广。

Bimanual microphacoemulsification at the treatment of cataract associated with the use of silicon oil

AIM: To evaluate the safety and clinical effect of bimanual microphacoemulsification at the treatment of cataract associated with the use of silicon oil. ·METHODS: Thirty-one patients (31 eyes) with cataract associated with the use of silicon oil between October 2007 and November 2008 were randomly divided into two groups. In group A, 16 eyes were treated with bimanual microphacoemulsification, and in group B, 15 eyes were treated with regular phacoemulsification. Their visual acuity, complications, curvature and astigmatism of cornea topography were examined preoperatively, 1 week, 1 month and 3 months after the surgery. ·RESULTS: The formation of the anterior chamber was successfully maintained in every case. None of the cases showed heat injury from the incision, After surgery, corneal mild edema were found in 2 eyes and relieved within 1 week. There was no recurrence of retinal detachment during the 3-month following-up. The best corrected visual acuity in group A was better than that in group B 1 week after surgery, with a statistical signi-ficance (P<0.05). No significant changes were found in curvature and astigmatism of cornea topography at 1, 3 months after operation (P>0.05). But there was a significant difference of astigmatism of cornea topography in group B 1 week after surgery compared with preo-perative (P<0.05). ·CONCLUSION: Bimanual microphacoemulsification is a feasible, safe and effective surgery method for the cataract patients associated with the use of silicon oil, it is worth promoting.