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目的观察对硬核白内障患者在行超声乳化术时采取高负压吸引下手法劈核技术治疗对减少术后并发症的意义。方法 86例(86眼)以硬核白内障为诊断且行手术治疗患者,随机分为劈核组与分核组,每组43例(43眼)。劈核组采用高负压吸引下手法劈核法,分核组采用乳化分核法,均行超声乳化术。比较两组患者并发症情况及术后矫正视力。结果两组患者均顺利完成手术。劈核组术中出现后囊膜破裂1例,分核组术中出现后囊膜破裂3例,比较差异无统计学意义(P>0.05);两组虽然术中出现并发症,但均顺利植入人工晶状体。劈核组术后出现轻、中、重度角膜水肿分别为3、1、0例,术后角膜水肿总发生率为9.30%;分核组术后出现轻、中、重度角膜水肿分别为1、6、9例,术后角膜水肿总发生率为37.21%;两组患者术后角膜水肿总发生率比较,差异具有统计学意义(P<0.01)。轻、中度角膜水肿5 d内均消失,重度角膜水肿对症治疗后10 d内消失。劈核组矫正视力<0.5者9例(9眼,占20.93%),≥0.5且<1.0者5例(5眼,占11.63%),≥1.0者29例(29眼,占67.44%);分核组矫正视力<0.5者11例(11眼,占25.58%),≥0.5且<1.0者5例(5眼,占11.63%),≥1.0者27例(27眼,占62.79%);两组患者术后1周矫正视力比较差异无统计学意义(P>0.05)。结论患有硬核白内障患者采用高负压吸引下手法劈核超声乳化术,可有效降低术后并发症发生率,手术安全有效,值得临床推广应用。
Objective To observe the significance of the treatment of hard nuclear cataract patients undergoing phacoemulsification under high negative pressure to reduce postoperative complications. Methods 86 cases (86 eyes) with hard nucleus cataract were diagnosed and operated surgically. There were 43 cases (43 eyes) in each group. The split-core group adopted the method of high negative pressure to attract the hack, and the split-core group was treated by phacoemulsification. The complication and corrected visual acuity were compared between the two groups. Results Both groups completed the operation smoothly. There were 1 case of posterior capsular rupture and 3 cases of posterior capsular rupture in the sub-nuclear group, the difference was not statistically significant (P> 0.05). Although complications occurred in both groups, Implantation of intraocular lens. There were 3, 1, and 0 cases of mild, moderate and severe corneal edema in the split-core group, respectively. The total incidence of postoperative corneal edema was 9.30%. In the sub-nuclear group, mild, moderate and severe corneal edema were 1, 6,9 cases, the total incidence of postoperative corneal edema was 37.21%; two groups of patients with postoperative corneal edema, the difference was statistically significant (P <0.01). Light and moderate corneal edema disappeared within 5 d, severe corneal edema disappear within 10 days after symptomatic treatment. There were 9 cases (9 eyes, accounting for 20.93%) with corrected visual acuity of less than 0.5 in 5 cases (5 eyes, 11.63%) with ≥0.5 and <1.0 eyes, 29 eyes (29 eyes, 67.44% There were 11 cases (11 eyes, 25.58%) with visual acuity less than 0.5 in nuclear group, 5 cases (≥5 eyes, 11.63%) in ≥0.5 and 27 eyes (27 eyes, 62.79% There was no significant difference in corrected visual acuity between the two groups one week after operation (P> 0.05). Conclusions Patients with hard nucleus cataract who underwent surgical treatment with high negative pressure to induce haphazard split phacoemulsification can effectively reduce the incidence of postoperative complications and the operation is safe and effective, which is worthy of clinical application.