项岳晖 徐硕 陈颖 李国星

[摘要] 目的 调查本地区白内障手术现状，评价两种不同的超声乳化术，从而找到一种最佳的白内障手术方案，以保障本地区白内障防治工作更加有效实施。 方法 收集我院2012年1月1日～2015年9月31日期间来我院接受白内障手术的所有病例，分析手术现状，同时选择2014年1月1日～2015年9月31日进行白内障手术的患者，按手术切口大小与植入晶体类型分为两组，观察两组患者在术前、术后第3天、1周、1个月、3个月裸眼视力、角膜容积、角膜中央厚度、角膜散光、角膜内皮细胞数、晶体伪调节力的变化等。 结果 我院手术量逐年增加，大部分患者选择2.75 mm组植入博士伦Akreos AO折叠晶体。两组在术后第3天、1周、1个月在角膜散光、角膜容积、视力、晶体伪调节力等方面，差异有统计学意义（P<0.05），但术后3个月差异无统计学意义（P>0.05）；且在角膜中央厚度方面两组差异无统计学意义（P>0.05）。 结论 1.8 mm组较2.75 mm组在术后第3天、1周、1个月，具有更高的角膜伪调节力，更早的获得比较好的视力，更少的角膜损伤与更稳定的散光等。1.8 mm组植入博士伦MI60折叠人工晶体更适合推广应用。

[关键词] 白内障；手术；超声乳化；人工晶体

[中图分类号] R779.66 [文献标识码] B [文章编号] 1673-9701（2016）09-0061-04

[Abstract] Objective To investigate the current situation of cataract surgery in Ruian region and to assess two kinds of phacoemulsification， in order to seek out the best cataract surgery plan and to guarantee the application of cataract prevention and treatment. Methods All cases receiving cataract surgery in our hospital from January 1st， 2012 to September 31st， 2015 were selected and the status of surgery was analyzed. Meanwhile patients receiving cataract surgery from January 1st， 2014 to September 31st， 2015 were divided into two groups according to the size of incision and type of implanted lens. The changes of naked vision， corneal volume， central corneal thickness， corneal astigmatism， corneal endothelial cell number， and the fake regulation force of lens were observed in both groups before surgery and at three days， one week， one month， and three months after surgery. Results Among the increasing amounts of cataract surgery， Baushe and Lomb Akreos AO folded lens of 2.75 mm group were mostly selected. The differences in corneal astigmatism， corneal volume， naked vision， and fake regulation force of lens were significant between two group at three days， one week， and one month after surgery（P<0.05）. However， the differences were no longer observed at three months after surgery （P>0.05）. There was no significant difference in central corneal thickness between two groups （P>0.05）. Conclusion Higher fake regulation force of lens， better and earlier-obtained naked vision， less corneal injury， and more stable astigmatism are observed in the 1.8 mm group rather than in the 2.75 mm group at three days， one week， and one month after surgery， indicating that Baushe and Lomb MI60 folded lens of 1.8 mm group is more appropriate in clinical practice.

[Key words] Cataract； Surgery； Phacoemulsification； Intraocular lens

据统计，我国有将近400多万白内障患者，约占世界白内障患者总数的1/5[1]。农村是治盲防盲的难点与重点地区。我院近年来收治白内障患者数量、白内障手术例数、享受医疗保险手术患者例数、手术成功率高低及手术后疗效及生活质量如何，是我们研究的重点。目前白内障超声乳化术是治疗白内障的主要方法，主要包括白内障摘除术联合人工晶体植入术。在我……