超声乳化联合不同类型IOL植入对年龄相关性白内障的影响

目的:研究白内障超声乳化(Phaco)联合不同类型人工晶状体(IOL)植入术对年龄相关性白内障的影响。方法:回顾性研究。将我院行手术治疗的105例年龄相关性白内障患者按照植入不同类型人工晶状体,分为A组(35例51眼)、B组(35例49眼)、C组(35例52眼),均行IOL+Phaco术,三组的IOL分别为三片式、单片式Natural和Rayner,比较三组术前术后生物测量指标和术后并发症。结果:术后3mo,三组眼压(IOP)均明显下降(P<0.05),房角开放距离(AOD500)、小梁虹膜夹角(TIA500)、中央前房深度(ACD)、小梁睫状体距离(TCPD)、各象限房角、裸眼视力和BCVA均上升(P<0.05);A组ACD和TIA500高于B、C组(P<0.05),三组裸眼视力、BCVA及其他生物测量指标均无差异(P>0.05);三组术后1、3mo人工晶状体垂直偏移、水平偏移均有差异(P<0.05),A组术后1、3mo人工晶状体垂直偏移、水平偏移均低于B、C组(P<0.05),B、C组垂直偏移、水平偏移无差异(P>0.05);A组术后后囊褶皱发生率高于B、C组(P<0.05)。结论:Phaco+单片式IOL术后眼内稳定性和安全性优于Phaco+三片式IOL术,但Phaco+三片式IOL术后ACD更深,可预防IOL前移,两者各有优缺点。

Effect of phacoemulsification combined with different types of IOL implantation in age-related cataract

AIM: To study the effects of phacoemulsification(Phaco)combined with different types of intraocular lens implantation(IOL)on age-related cataract.

METHODS: A retrospective study was performed on 105 elderly patients with age-related cataract who were treated with surgery in our hospital, and they were divided into group A(35 cases, 51 affected eyes), group B(35 cases, 49 affected eyes)and group C(35 cases, 52 affected eyes). All subjects were treated by IOL+Phaco, and types of IOL in the three groups were three-piece and single-piece Natural and Rayner. The preoperative and postoperative biological measurement indexes and postoperative complications were compared among the three groups.

RESULTS: At 3mo after surgery, the intraocular pressure(IOP)in three groups was significantly decreased(P<0.05)while the angle opening distance(AOD500), trabecular iris angle(TIA500), central anterior chamber depth(ACD), trabecular-ciliary processes distance(TCPD), each quadrant angle, uncorrected visual acuity and best corrected visual acuity(BCVA)were significantly increased(P<0.05). The ACD and TIA500 in group A were significantly higher than those in groups B and C(P<0.05),and there were no significant differences in the uncorrected visual acuity, BCVA and other biological measurement indexes among the three groups(P>0.05). There were significant differences in vertical shift and horizontal shift of intraocular lens among the three groups at 1mo and 3mo after surgery(P<0.05), and the vertical shift and horizontal shift of intraocular lens at 1mo and 3mo after surgery in group A were lower than those in groups B and C(P<0.05), and there were no significant differences in vertical shift and horizontal shift between group B and group C(P>0.05).The incidence rate of posterior capsule wrinkle in group A after surgery was obviously higher than that in group B and group C(P<0.05).

CONCLUSION: The intraocular stability and safety of Phaco+single-piece IOL are better than those of Phaco+ three-piece IOL, but Phaco+ three-piece IOL has deeper ACD after surgery and can prevent the forward shift of IOL, and they have their own advantages and disadvantages.