合并浅前房的年龄相关性白内障患者超声乳化术后疗效分析

目的:探讨合并浅前房的年龄相关性白内障患者超声乳化术后的疗效.方法:选取我院2015-06/2016-10收治的年龄相关性白内障合并浅前房患者38例38眼,根据中央前房深度:轻度浅前房 (2~2.5mm)23眼,高危浅前房(<2.0mm)15眼.收集同时期正常前房的年龄相关性白内障患者38例38眼作为对照组.两组均由同一位眼科医师行白内障超声乳化术,术后随访3mo,观察手术前后视力、眼压、前房深度、角膜内皮细胞密度及术后并发症情况.结果:术前两组患者视力、眼压、角膜内皮细胞密度比较均无统计学意义(P>0.05).术后两组患者视力均比术前提高,差异有统计学意义(P<0.05),术后不同时间两组患者眼压比术前降低,差异有统计学意义(P<0.05),两组患者前房深度较术前增加,差异有统计学意义(P<0.05),角膜内皮细胞密度较术前减少,差异有统计学意义(P<0.05).术后不同时间两组间眼压、角膜内皮细胞密度、前房深度比较均无统计学意义(P>0.05).术中浅前房组发生后囊膜破裂1眼、悬韧带断裂1眼.正常前房组无后囊膜破裂,悬韧带断裂发生.术后浅前房组发生角膜水肿10眼,角膜水肿的发生率为26%.正常前房组角膜水肿3眼,角膜水肿的发生率为8%.两组患者的并发症发生率比较有统计学意义(P<0.05).结论:对于合并浅前房的年龄相关性白内障患者应及时进行超声乳化手术.术前准确评估,术中仔细操作,可使患者术后视力提高,前房深度加深,超声乳化术治疗合并浅前房的年龄相关性白内障患者安全、有效.

Curative effect analysis for patients with age related cataract and shallow anterior chamber after phacoemulsification

AIM: To study the curative effect for patients with age related cataract and shallow anterior chamber after phacoemulsification.

METHODS: Totally 38 patients(38 eyes)with age related cataract and shallow anterior chamber were selected and divided into two groups according to the depth of the anterior chamber, as mild shallow anterior chamber group(2-2.5mm)23 eyes, high risk shallow anterior chamber group(<2.0mm)15 eyes. Thirty-eight patients(38 eyes)with age related cataract with normal anterior chamber were as control group at the same period. All the patients received the operations by the same doctor and were followed up for 3mo. The observed items included visual acuity before and after operations, intraocular pressure, anterior chamber depth, corneal endothelial cell density and complications.

RESULTS: There were no significant difference on visual acuity, intraocular pressure and corneal endothelial cell density between the two groups before operations(P>0.05). The visual acuity improved significantly after operation in both groups(P<0.05). Intraocular pressure after operation decreased significantly in both groups(P<0.05). Anterior chamber depth increased significantly after operation in both groups(P<0.05). Corneal endothelial cell density decreased significantly in both groups(P<0.05). There were no significant difference on anterior chamber depth, intraocular pressure and corneal endothelial cell density between the two groups at different time point after operations(P>0.05). Posterior capsular rupture occurred in shallow anterior chamber group in 1 eye, suspensory ligament rupture in 1 eye. Posterior capsular rupture and suspensory ligament rupture occurred none in normal anterior chamber group. Postoperative corneal edema occurred in 10 eyes(26%)in shallow anterior chamber group, which occurred in 3 eyes(8%)in normal anterior chamber group. The difference on the incidence was significant(P <0.05).

CONCLUSION: Phacoemulsification should be taken timely for patients with age related cataract and shallow anterior chamber. The postoperative visual acuity can be improved and the anterior chamber depth can increase. The operation is safe and effective for those patients.