白内障小切口囊外摘出术与传统囊外摘出术效果的分析

目的分析白内障小切口非超声乳化囊外摘出术与传统囊外摘出术效果。方法回顾分析白内障复明行动中老年性白内障手术1437例（1675眼）。患者随机分成两组，分别采用小切口非超声乳化白内障囊外摘出与传统的囊外摘出术两种方法进行手术，术中都植入人工晶状体。其中，小切口组（A组），716例（846眼）；传统囊外摘出组（B组），721例（829眼）。对两组手术效果（术后视力及并发症）进行分析和比较。结果两组术后7d视力比较：A组，视力低于0．3者59眼（6．97％），0．3～0．5者183眼（21．63％），0．5以上者604眼（71．5％）；B组，视力低于0．3者128眼（15．44％），0．3～0．5者583眼（70．32％），0．5以上者118眼（14．23％）。并发症有角膜水肿、虹膜损伤、前房积血、后囊破裂、玻璃体脱出及瞳孔夹持。两组比较：A组发生并发症260眼（30．73％），B组发生并发症388眼（46．8％）。两组术后视力及并发症差异有统计学意义（视力：x^2=30．26，P〈0．01；并发症：x^2=45．59，P〈0．01）。结论在大规模白内障复明行动中，应用小切口无缝线非超声乳化白内障囊外摘出术较传统的白内障囊外摘出术术后视力较好，手术并发症较小，且无需昂贵的设备及特殊器械，手术步骤简单．适宜基层医院开展。

A comparative analysis of extracapsular cataract extraction through small incision and traditional method

Objective This paper is to analyze the effects of extracapsular cataract extraction (ECCE) through a small non-phaco-emulsification incision and that through the traditional way.Methods We retrospectively andlyzed 1437 cases ( 1675 eyes) of age-related cataract in the Vision Restoration Action.The patients were divided into two groups in random.One group was operated through a small non-phacoemulsificationincision,while the other was done through the traditional large limbal incision.All cases were implanted with intraocular lens ( IOL),among which the small incision group ( Group A) includes 716 cases (846 eyes),and the traditional way group ( Group B) 721 cases (829 eyes).And a comparative analysis was carried out on the effects of the visual acuity and the complications after operation.Results In 7 days after the operation the visual acuity of the two groups improved.In Group A,the visual acuity of 59 eyes (6.97％) were lower than 0.3,183 eyes (21.63％) between 0.3 and 0.5,and 604 eyes (71.5％) above 0.5.In Group B,there were 128 eyes (15.44％) whose visual acuity were lower than 0.3,583 eyes (70.32％) between 0.3 and 0.5,and 118 eyes (14.23％) above 0.5.The main complication were cornea edema,iris injury,hyphema,posterior capsule brocken,vitreous body prolapse and IOL dislocation.Complications occurred in 260 eyes (30.73％) in Group A,while 388 eyes (46.8％) in Group B.There were significant difference between the two group in vision and complication (vision:x2 =30.26,P ＜0.01 ; complication:x2 =45.59,P ＜ 0.01 ).Conclusion In a large-scale action for prevention against blindness caused by cataract,extracapsular cataract extraction through a small non-phaco-emulsification incision is more suitable for basic hospitals as it has less complication,good visual acuity outcome and simple technique in operation without expensive equipments.