摘要目的 回顾性分析、研究小切口非超声乳化白内障摘除人工晶状体植入术在白内障复明工程中的应用的可行性.方法 对2007年9月至2010年5月在福建省浦城县残联共组织642例(642只眼)贫困人群白内障患者行小切口非超声乳化白内障摘除人工晶状体植入术,观察术后1天、1周、1个月的视力恢复情况和术中、术后出现的并发症.结果 (1)术后视力:第1天,≥0.3者528只眼(82.3％),≥0.05～＜0.3者87只眼(13.5％),＜0.05者27只眼(4.2％)；术后1周复诊504例,视力情况:≧0.3者466只眼(92.4％),≥0.05～＜0.3者22只眼(4.5％),＜0.05者16只眼(3.1％)；术后1个月复诊488例,视力情况:≧0.3者473只眼(96.5％),≥0.05-＜0.3者9只眼(1.9％),＜0.05者6只眼(1.6％),6眼中4只眼为高度近视,2只眼为老年黄斑变性.(2)术前及术后1d、1周、1月测得角膜平均散光度分别为:(0.53±0.21)D、(0.56±0.36)D、(0.46±0.33)D、(0.43±0.31)D.术后散光随时间的推移逐渐减小,术后各时间段角膜散光之间差异无统计学意义(P＞0.05),与术前散光比较也无统计学意义(P＞0.05).(3)术中并发症:后囊破裂16只眼(2.49％),虹膜脱出8只眼(1.24％),穿透巩膜2只眼(0.311％),眼睑皮下淤血20只眼(3.11％).(4)术后并发症:短暂性眼压升高23只眼(3.58％)；不同程度角膜水肿48只眼(7.47％),一周内恢复透明；人工晶状体偏位4只眼(0.62％)；瞳孔变形12只眼(1.86％)；晶状体皮质残留并附着于人工晶状体表丽影响视力2只眼(0.311％),第二天进行前房抽吸后清除.1个月时脱盲率98.0％ (480/488).结论 小切口非超声乳化白内障摘除人工晶体状植入术是一种安全、有效的手术方式,尤其适用于白内障复明工程.

abstractsObjective To analyze and explore the clinical practicality and efficacy of small non-phacoemulsification surgery and intraocular lens implantation in the preventing blinding project.Methods A total of 642 patients with cataract recruited by the association for the handicapped in Pucheng city,Fujian province received small non-phacoemulsification cataract surgery and intraocular lens implantation between September 2007 and May 2010.The vision and complications were observed during the operation,1 day,1 week,and 1 month after operation respectively. Results Visual acuity on the postoperative day 1,equal to or better than 0.3 accounted for 528 eyes (82.3％),less than 0.3 accounted for 87 eyes (13.5％),less than 0.05 accounted for 27 eyes (4.2％); by the end of the 1st week,504 patients were followed up,visual acuity of 466 eyes were equal to or above 0.3 (92.4％),less than 0.3 accounted for 22 eyes (4.5％),less than 0.05 accounted for 16 eyes (3.1％); 488 patients were followed up 1 month after operation,visual acuity of 473 eyes were equal to or above 0.3 (96.5％),less than 0.3 accounted for 9 eyes (1.9％),less than 0.05 accounted for 6 eyes (1.6％); 4 of the 6 eyes were high myopia,2 were age-related macular degeneration.Average corneal- astigmatism before and after operation on the 1st day,1st week and the 1st month were (0.53±0.21)D,(0.56±0.36)D,(0.43±0.31)D respectively,and there were no significant differences (P ＞0.05) between each group.Intraoperative complications were rupture of posterior capsule in 16eyes (2.49％),prolapse of iris in 8 eyes,penetrated through sclera in 2 eyes (0.31％),eyelid pore in 20 eyes (3.11％).Postoperative complications were ocular hypertension in 23 eyes (3.58％),corneal endothelial edema in 48 eyes (7.47％),IOL dislocation in 4 eyes (0.62％),pupil deformation in 12eyes (1.86％),with lens cortex remain in 2 eyes (0.31％).98.0％ of 488 eyes were off-disability one month after operation. Conclusions It is safe and practical of using the small incision non-phacoemulsification cataract surgery,which is worth promoting in the preventing blinding project.