超声乳化白内障吸出联合CTR植入对高度近视白内障术后囊袋稳定性的影响

doi:10.11958/20240043

天津医药 ›› 2024, Vol. 52 ›› Issue (10): 1056-1060.doi: 10.11958/20240043

超声乳化白内障吸出联合CTR植入对高度近视白内障术后囊袋稳定性的影响

孟克青(), 张武林, 董玮, 许衍辉, 李楠

河北省眼科医院白内障科，河北省眼科学重点实验室，河北省眼部疾病临床医学研究中心（邮编054001）

收稿日期:2024-01-08 修回日期:2024-05-08 出版日期:2024-10-15 发布日期:2024-10-14
作者简介:孟克青（1980），女，副主任医师，主要从事白内障及晶状体疾病的诊治方面研究。E-mail：dreamrabbit01@sina.com
基金资助:
邢台市重点研发计划项目(2021ZC066)

Effect of phacoemulsification combined with CTR implantation on capsule stability after cataract surgery for high myopia

MENG Keqing(), ZHANG Wulin, DONG Wei, XU Yanhui, LI Nan

Department of Cataract, Hebei Provincial Eye Hospital, Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Eye Disease Clinical Research Center, Xingtai 054001, China

Received:2024-01-08 Revised:2024-05-08 Published:2024-10-15 Online:2024-10-14

孟克青, 张武林, 董玮, 许衍辉, 李楠. 超声乳化白内障吸出联合CTR植入对高度近视白内障术后囊袋稳定性的影响[J]. 天津医药, 2024, 52(10): 1056-1060.

MENG Keqing, ZHANG Wulin, DONG Wei, XU Yanhui, LI Nan. Effect of phacoemulsification combined with CTR implantation on capsule stability after cataract surgery for high myopia[J]. Tianjin Medical Journal, 2024, 52(10): 1056-1060.

摘要/Abstract

摘要：

目的探究高度近视白内障患者行超声乳化白内障吸出联合囊袋张力环（CTR）植入术后囊袋的稳定性。方法纳入高度近视合并白内障的患者80例（80眼），随机均分为试验组和对照组。试验组行超声乳化白内障吸出联合CTR植入治疗，对照组未联合CTR植入，其余干预完全一致。比较2组术前和术后1、3、6个月时的裸眼视力（UCVA）、远距最佳矫正视力（BCVA）、角膜生物力学、对比敏感度、人工晶状体倾斜度、术后前囊口面积，并在术后6个月统计后发性白内障（PCO）发生率。结果 2组术后1、3、6个月UCVA、BCVA均较术前改善。2组患者术后角膜生物力学参数Ambrosio水平关系厚度（ARTh）、角膜硬度参数（SP-A1）和比较差异均无统计学意义。试验组Corvis生物力学指数（CBI）在术后3个月后较对照组显著升高（P<0.05），2组间其余时间点比较差异无统计学意义。术后各时间点，2组对比敏感度比较差异无统计学意义（P>0.05）；术后3个月和6个月，与对照组相比，试验组前囊口面积增大，人工晶状体植入术（IOL）倾斜角减小（P<0.05）。术后6个月时试验组未发生PCO 38眼，PCO Ⅰ级2眼；对照组未发生PCO 33眼，PCO Ⅰ级3眼，Ⅱ级2眼，Ⅲ级2眼。结论超声乳化白内障吸出联合CTR植入治疗对高度近视白内障患者术后囊袋具有较高的稳定性，远期临床效果及视觉质量更高，值得临床推广应用。

关键词: 白内障, 近视, 晶体，人工, 囊袋张力环, 囊袋稳定性

Abstract:

Objective To investigate the stability of pouch in patients with high myopia cataract after phacoemulsification cataract extraction combined with capsular tension ring (CTR) implantation. Methods A total of 80 patients with high myopia complicated with cataract (80 eyes) were included and randomly divided into the experimental group and the control group. The experimental group received phacoemulsification cataract extraction combined with CTR implantation, while the control group was not combined with CTR implantation, and the other interventions were completely consistent. The naked eye visual acuity (UCVA), best corrected distant visual acuity (BCVA), corneal biomechanics, contrast sensitivity, intraocular lens inclination and anterior capsular opening area were compared between the two groups at 1, 3 and 6 months after surgery. The incidence of late cataract (PCO) was measured 6 months after surgery. Results UCVA and BCVA were improved at 1, 3 and 6 months after operation. There were no significant differences in postoperative corneal biomechanical parameters ARTh and SP-A between the two groups of patients (P>0.05). The Corvis biomechanical index (CBI) of the experimental group was significantly higher 3 months after surgery than that of the control group (P<0.05), and there were no significant differences at other time points between the 2 groups. There was no significant difference in contrast sensitivity at each time point after surgery between the experimental group and the control group (P>0.05). At 3 and 6 months after operation, the anterior capsule opening area was increased in the experimental group, and IOL inclination angle was decreased compared with the control group (P<0.05). At 6 months after operation, no PCO occurred in 38 eyes and PCO grade Ⅰ in 2 eyes. No PCO occurred in 35 eyes in the control group, 3 eyes in grade Ⅰ, 2 eyes in grade Ⅱ and 2 eyes in grade Ⅲ. Conclusion Phacoemulsification cataract extraction combined with CTR implantation has higher stability, long-term clinical effect and visual quality in patients with high myopia cataract, and is worthy of clinical application.

Key words: cataract, myopia, lenses, intraocular, capsular tension ring, psule stability

中图分类号:

R776.1

图/表 6

参考文献 18

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组别	年龄/岁	性别（男/女）	角膜曲率/D	眼轴长度/mm	晶状体核硬度分级（Ⅱ/Ⅲ/Ⅳ）
对照组	64.8±5.5	20/20	47.34±0.75	28.57±0.62	23/11/6
试验组	65.5±5.2	20/20	47.48±0.83	28.72±0.81	20/14/6
t或χ²	0.544	0.000	0.792	0.930	0.569

组别	年龄/岁	性别（男/女）	角膜曲率/D	眼轴长度/mm	晶状体核硬度分级（Ⅱ/Ⅲ/Ⅳ）
对照组	64.8±5.5	20/20	47.34±0.75	28.57±0.62	23/11/6
试验组	65.5±5.2	20/20	47.48±0.83	28.72±0.81	20/14/6
t或χ²	0.544	0.000	0.792	0.930	0.569

组别	UCVA
组别	术前	术后1个月	术后3个月	术后6个月
对照组	1.73±0.34	0.83±0.21^a	0.76±0.19^a	0.73±0.17^a
试验组	1.72±0.42	0.82±0.22^a	0.74±0.23^a	0.62±0.14^a
t	0.175	0.175	0.350	1.926
组别	BCVA
组别	术前	术后1个月	术后3个月	术后6个月
对照组	1.88±0.32	0.92±0.42^a	0.84±0.26^a	0.78±0.32^a
试验组	1.86±0.31	0.81±0.36^a	0.76±0.32^a	0.62±0.41^a
t	0.284	2.151^＊	3.882^＊	2.764^＊

组别	UCVA
组别	术前	术后1个月	术后3个月	术后6个月
对照组	1.73±0.34	0.83±0.21^a	0.76±0.19^a	0.73±0.17^a
试验组	1.72±0.42	0.82±0.22^a	0.74±0.23^a	0.62±0.14^a
t	0.175	0.175	0.350	1.926
组别	BCVA
组别	术前	术后1个月	术后3个月	术后6个月
对照组	1.88±0.32	0.92±0.42^a	0.84±0.26^a	0.78±0.32^a
试验组	1.86±0.31	0.81±0.36^a	0.76±0.32^a	0.62±0.41^a
t	0.284	2.151^＊	3.882^＊	2.764^＊

组别	ARTh
组别	术前			术后1个月		术后3个月			术后6个月
对照组	520.5±7.4			520.5±4.9		532.1±5.3^a			530.1±6.3^a
试验组	523.3±6.2			521.4±2.5		531.3±3.2^a			528.5±7.6^a
t	1.829			1.033		0.812			1.025
组别	SP-A1
组别	术前			术后1个月			术后3个月		术后6个月
对照组	100.5±4.2			102.3±5.9			101.1±3.1		103.1±3.7^a
试验组	100.1±2.2			103.4±2.3^a			102.3±3.1^a		102.5±1.6^a
t	0.530			1.103			1.717		0.940
组别		CBI
组别		术前	术后1个月		术后3个月			术后6个月
对照组		0.11±0.03	0.13±0.03^a		0.12±0.01			0.13±0.03
试验组		0.12±0.03	0.14±0.04^a		0.13±0.02			0.12±0.02
t		1.491	1.265		2.828^＊＊			1.754

超声乳化白内障吸出联合CTR植入对高度近视白内障术后囊袋稳定性的影响

Effect of phacoemulsification combined with CTR implantation on capsule stability after cataract surgery for high myopia

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组别	对比敏感度/cpd			前囊口面积/mm²			IOL倾斜角/°
组别	术后1个月	术后3个月	术后6个月	术后1个月	术后3个月	术后6个月	术后1个月	术后3个月	术后6个月
对照组	1.58±0.17	1.75±0.21^a	1.63±0.14^ab	26.67±3.84	24.13±2.62	21.53±2.71	3.77±0.94	3.94±0.62	4.32±0.75^a
试验组	1.62±0.12	1.73±0.10^a	1.65±0.18	28.12±3.57	26.63±2.87	25.15±2.96	3.42±0.93	3.53±0.87	3.75±0.96
t	1.216	0.544	0.555	1.749	4.069^＊＊	5.705^＊＊	1.674	2.427^＊	2.959^＊＊

组别	对比敏感度/cpd			前囊口面积/mm²			IOL倾斜角/°
组别	术后1个月	术后3个月	术后6个月	术后1个月	术后3个月	术后6个月	术后1个月	术后3个月	术后6个月
对照组	1.58±0.17	1.75±0.21^a	1.63±0.14^ab	26.67±3.84	24.13±2.62	21.53±2.71	3.77±0.94	3.94±0.62	4.32±0.75^a
试验组	1.62±0.12	1.73±0.10^a	1.65±0.18	28.12±3.57	26.63±2.87	25.15±2.96	3.42±0.93	3.53±0.87	3.75±0.96
t	1.216	0.544	0.555	1.749	4.069^＊＊	5.705^＊＊	1.674	2.427^＊	2.959^＊＊