爆破模式在农村硬核白内障防盲手术中的应用

目的:探讨爆破模式超声乳化吸除术在农村硬核白内障防盲手术中的应用价值。方法:将162例162眼硬核(Ⅳ～V级核)白内障患者随机分为爆破超声乳化吸除术组和小切口白内障囊外摘除术(small incision cataract extraction,SICE)组。记录两组患者术后视力及视力恢复时间、角膜散光以及手术并发症的发生情况,同时记录爆破模式超声乳化术中的实际超声能量和超声时间。结果:两组患者术后视力均有提高,但相比差异有统计学意义(P<0.05),且SICE组视力恢复显著慢于爆破模式组(P<0.01)。术后角膜散光SICE组明显高于爆破模式组(P<0.05)。爆破模式组术中实际超声能量为(16.2±5.4)%、超声时间为(42.8±6.1)s。手术并发症主要是角膜水肿和后囊膜破裂,SICE组角膜水肿69眼、后囊破裂6眼,而爆破模式组角膜水肿12眼、无后囊膜破裂。结论:爆破模式超声乳化吸除术治疗农村防盲中的硬核白内障,可显著改善术后视力,缩短恢复时间,可以用较低的超声能量和时间,减少术后早期角膜水肿,降低手术并发症发生率,值得推广使用。

Burst mode of phacoemulsification for rural hard nucleus cataract

AIM: To investigate the advantage of burst mode of phacoemulsification for rural hard nucleus cataract.

METHODS: Totally 162 eyes(162 cases)were randomly divided into small incision cataract extraction(SICE)group and burst group. Actual phaco-emulsification(Phaco)power, Phaco time, visual acuity, corneal edema and other complications were recorded.

RESULTS: Visual acuity was significant improved in both two groups postoperatively. But the difference between the two groups was statistically significant(P <0.05)and visual acuity recovery was faster in burst group than in SICE group. In comparison of the astigmatism between the burst group and SICE group, the difference was significant(P <0.05)in early stage. The actual Phaco power in burst group was(16.2±5.4)% and Phaco time was(42.8±6.1)s econds. Serious corneal edema occurred more frequently in SICE group(69 eyes)than that in the burst mode group(12 eyes), 6 eyes suffered posterior capsular rupture in SICE group.

CONCLUSION: Burst Phaco mode reduced Phaco time and actual Phaco power consumed during phacoemulsification and reduced corneal edema and surgery complications in hard nucleus cataract surgery. It is an effective measure for hard nucleus cataract for better postoperative visual acuity and shorten recovery time.