黎源

[摘要] 目的 探討小切口囊外白内障摘除应用于老龄成熟期白内障贫困患者的疗效与安全性。 方法 回顾我院2014年6月～2016年6月实施小切口囊外白内障摘除加人工晶体植入手术的206例（206眼）白内障贫困患者资料，并与同期实施白内障超声乳化+人工晶体植入手术的206例（206眼）患者资料进行比较。采用小切口囊外白内障摘除加人工晶体植入手术为研究组（均为扶贫手术病例），实施白内障超声乳化+人工晶状植入手术为对照组。比较两组患者手术后的视力恢复情况和手术并发症发生率。 结果 研究组中术后1 d、1个月和6个月视力<0.3的患者所占的比例分别是19.42%，5.83%和1.94%，≥0.3的患者所占的比例分别是80.58%，94.17%和98.06%。对照组患者的视力术后1 d、1个月和6个月的视力<0.3的患者所占的比例分别是27.18%，8.74%和0，≥0.3的患者所占的比例分别是72.82%，91.26%和100.00%，差异有统计学意义（P<0.05）。研究组并发症发生率（9.71%）低于对照组（19.90%），差异有统计学意义（P<0.05）。 结论 小切口囊外白内障摘除手术治疗老龄成熟期白内障具有并发症少、疗效好、安全性高的特点，加上手术操作和设备相对简便，特别适合于在基层医院开展的白内障扶贫工程中推广应用。

[关键词] 老龄；成熟期白内障；复明手术；安全性分析

[中图分类号] R776.1 [文献标识码] B [文章编号] 1673-9701（2017）16-0062-04

[Abstract] Objective To investigate the efficacy and safety of small incision extracapsular cataract extraction in aged poor patients with cataract in mature stage. Methods The data of 206 poor patients （206 eyes） with cataract who underwent small incision extracapsular cataract extraction and intraocular lens implantation from June 2014 to June 2016 were reviewed and were compared with those of 206 patients（206 eyes） in the same period who underwent cataract phacoemulsification and intraocular lens implantation surgery. The patients treated with underwent small incision extracapsular cataract extraction and intraocular lens implantation were included in the study group （cases of poverty alleviation surgery）. The patients treated with cataract phacoemulsification and intraocular lens implantation were chosen as the control group. The recovery of visual acuity and the complication incidence of surgery were compared between the two groups. Results The proportion of patients with visual acuity <0.3 in the study group was 19.42%， 5.83% and 1.94% respectively and the proportion of patients with ≥0.3 in the study group was 80.58 %， 94.17% and 98.06% respectively at 1 day， 1 month and 6 months after surgery. The proportion of patients with visual acuity <0.3 in the control group at 1 day， 1 month and 6 months after surgery was 27.18%， 8.74% and 0， respectively， and the proportion of patients with ≥0.3 was 72.82%， 91.26% and 100.00%. The difference between the two groups was statistically significant（P<0.05）. The complication incidence of the study group（9.71%）was lower than that of the control group（19.90%），and the difference was statistically significant（P<0.05）. Conclusion Small incision extracapsular cataract surgery for the treatment of aged mature cataract has few complications， good efficacy and high safety， of which the surgical operation and equipment is relatively simple， especially suitable for promotion in the cataract poverty alleviation project of primary hospitals.

[Key words] Aging； Mature cataract； Sight rehabilitating surgery； Safety analysis

白内障是眼科临床的常见病和多发病，多发于老年人。随着老龄化问题的加剧，白内障人数呈升高趋势[1]。由于白内障的致盲和降低视力的结果，不仅会影响患者的生活自理能力，还降低患者生命质量，给家庭和社会造成负担。尤其是给生活在边远贫困地区患者以及患者的家庭带来较为严重的经济负担，造成患者家庭陷入贫困[2]。我院是一所国家二级甲等综合医院，是北海市白内障扶贫手术的定点医院，为当地贫困患者免费开展白内障复明手术一直是我院防盲治盲工作的任务。近年来我院采用小切口囊外白内障摘除加人工晶体植入手术作为白内障扶贫手术主要方式，让许多贫困老龄白内障患者重见光明，取得了良好的效果。……