小切口非超声乳化白内障取核方法的改进

目的:寻找一个方法简单,不要特殊器械,并发症少,且能快速取核的方法。方法:我院2010年手术治疗白内障746例,从中选出老年性单纯性Ⅱ～Ⅳ级核的白内障患者352例352眼,随机分成两组。2010-03-29/05-15用常规圈套器取核法176例;2010-06-01/10-22改进采用玻璃酸钠及针头取核176例。结果:经过统计学处理结果显示:改进组比常规组每例平均节省手术时间约2.55min,P<0.01,两者差别有非常显著意义。两组手术后1wk视力恢复情况,常规组脱残率为81.25%,改进组脱残率为92.61%,P<0.05,差别有显著意义。1～3mo视力恢复情况,常规组≥0.5者139例(78.98%),改进组≥0.5者165例(93.75%),P<0.05,差别有显著意义。术中术后并发症改进组也明显少于常规组。结论:改进组的取核方法简单、不要特殊器械,省时、并发症少、视力恢复好,适合基层医院应用,更利于开展农村大规模防盲治盲工作。

Improvement of cataract nuclear extraction methods in small incision non-phacoemulsification

AIM:To look for a approach which is simple,has no need for special equipment and fewer complications,and can quickly take out the lens nucleus.METHODS:Totally 746 cases of cataract surgery were performed in our hospital in 2010,from which 352 cases(352 eyes)of grade Ⅱ～Ⅳ nucleus senile simple cataract patients were chosen and randomly divided into two groups.During 2010- 03-29/05-15 conventional snare method fornuclear extraction was performed in 176 cases;During 2010- 06- 01/10-22 improved sodium hyaluronate and needle method for nuclear extraction was used in 176 cases.RESULTS:Statistical analysis showed:an average operative time of about 2.55min per patient was saved in improvement group than in conventional group,the difference was very significant (P<0.01).As for visual recovery of two groups 1week after surgery,the conventional group was 81.25% in off-disability rate,the improvement group was 92.61%,the difference was significant (P<0.05).As for visual recovery 1～3 month after surgery,the conventional group was≥0.5 in 139 cases (78.98%),the improvement group was≥0.5 in 165 cases (93.75%),the difference was significant(P<0.05).Intraoperative and postoperative complications in improvemeht group was also significantly less than those in the conventional group.CONCLUSION:The method of nuclear extractionin improvement group is simple,has no need for special equipment,saves time,has fewer complications and good visual recovery.It is suitable for the primary hospital,but also conducive to large-scale prevention of blindness in rural areas.