手法小切口白内障手术在复明工程中的应用

目的探讨复明工程中应用手法小切口白内障摘除术的效果和安全性。方法194例白内障患者分为两组,白内障超声乳化吸除术（Phaco）组80例,手法小切口白内障摘除术（MSICS）组114例,比较两种术式的术后视力和并发症的种类及发生率。结果核硬度≤Ⅲ白内障患者77眼两种手术方法的并发症发生情况类似,Phaco组25眼中后囊膜破裂玻璃体脱出1例（4.00%）,角膜水肿4例（16.00%）,MSICS组52眼中后囊膜破裂玻璃体脱出发生2眼（3.85%,和Phaco组比较P=0.766）,角膜水肿发生7例（13.46%,和Phaco组比较P=0.453）;而对于核硬度≥Ⅳ者117眼,Phaco组55眼角膜水肿为36眼（65.45%）,MSICS组7眼（11.29%）,P=0.000,后囊膜破裂玻璃体脱出前者为5眼（9.09%）,后者1例（1.61%）,P=0.02。结论对于核硬度≥Ⅳ的白内障,MSICS手术安全性高于Phaco手术。

The application of manual small incision cataract surgery in sight rehabilitating project

Objective To explore the efficacy and safety of manual small incision cataract surgery in a number of patients.Methods 194 cases of cataract extraction were divided into two groups,80 patients in Phaco group,and 114 in MSICS group.Their postoperative visual acuity and complications were compared.Results In Phaco group,the visual acuity in 80%of patients was≥0.3 at the first day after operation,and the nuclear hardness of cataract in a part of them was ≤ Ⅲ,and ≥Ⅳ in remaining patients,and incidence rates of complications including capsule rupture associated with vitreous prolapse and corneal edema in patients with nuclear hardness ≤III were 4.30% and 22.20% respectively;while those with nuclear hardness ≥IV were 12.50% and 67.50% respectively.These 5 corresponding figures were 75.44%,3.80%,19.01%,5.26% and 11.40% in patients of MSICS group.Conclusion In patients with nuclear cataract hardness ≥ Ⅳ,MSICS is more safe than Phaco.