超声乳化自内障吸除联合人工晶状体植入术治疗硬核白内障的临床效果评价

目的比较超声乳化白内障吸除联合人工晶状体植入术与现代白内障囊外摘除联合人工晶状体植入术治疗硬核白内障的临床效果。方法将124例（124眼）硬核白内障患者随机分为两组，分别行现代白内障囊外摘除联合人工晶状体植入术（ECCE组，62眼）和超声乳化白内障吸除联合人工晶状体植入术（PHACO组，62眼）。分别记录两组患者术后3个月的视力和角膜中央区内皮细胞丢失率，并观察手术并发症。采用非参数检验、t检验和X^2检验进行统计学分析。结果术后3个月PHACO组视力明显高于ECCE组，两组比较差异有统计学意义（P〈0．05）。术后3个月PHACO组角膜中央区内皮细胞丢失率高于ECCE组，两组比较差异有统计学意义（P〈0．05）。PHACO组术后3个月后发性白内障的发生率较ECCE组低，两组比较差异有统计学意义（P〈0．05）。结论超声乳化白内障吸除联合人工晶状体植入术是治疗硬核白内障有效和比较安全的手术方法，但与现代白内障囊外摘除联合人工晶状体植入术相比，对角膜内皮细胞的损伤较大。

Clinical effect evaluation of phacoemulsification combined with intraocu- lar lens implantation in treatment of hard nuclear cataract

Objective To compare the clinical effects of phacoemulsification combined with intraocular lens implanta- tion and modern extracapsular cataract extraction combined with intraocular lens implantation in the treatment of hard nuclear cataract.Methods One hundred and twenty-four patients （124 eyes） with hard nuclear cataract were randomly divided into two groups,which received modern extracapsular cataract extraction combined with intraocular lens im- plantation （ECCE group with 62 eyes） and phacoemulsification combined with intraocular lens implantation （PHACO group with 62 eyes） respectively.The eyesight and the endothelial cell loss rates in the corneal central region of the two groups 3 months after the surgery were recorded respectively and the surgical complications were observed.The non- parametric test,t test and ~2 test were used for statistical analysis.Results Three months after the surgery,the eyesight of the PHACO group was significantly higher than that of the ECCE group,with statistically significant difference between the two groups （P〈0.05）.Three months after the surgery,the endothelial cell loss rate in the corneal central region of the PHACO group was higher than that of the ECCE group,with statistically significant difference between the two groups （P〈0.05）.Three months after the surgery,the proportion of the occurrence of secondary cataract of the PHACO group was lower than that of the ECCE group,with statistically significant difference between the two groups （P〈0.05）.Con- clusion Phacoemulsification combined with intraocular lens implantation is an effective and safe surgical method for the treatment of hard nuclear cataract,but it causes larger injury to the corneal endothelial cells compared to modern extracapsular cataract extraction combined with intraocular lens implantation.