Dholakia Sheena A, Vasavada Abhay R
Iladevi Cataract & IOL Research Centre, Ahmedabad, India.
Indian J Ophthalmol. 2004 Dec;52(4):311-7.
To evaluate intraoperative performance and longterm surgical outcome after phacoemulsification of age-related cataracts.
Prospective, observational, non-comparative study of 165 consecutive eyes undergoing phacoemulsification with nuclear sclerosis Grade I to III (Scale I to V). Preoperative evaluation included specular microscopy. Phacoemulsification was performed by a single surgeon using a standardised surgical technique under topical anaesthesia. Intraoperatively, effective phaco time (EPT), wound site thermal injury (WSTI), serious complications (eg. vitreous loss, posterior capsule rupture, zonulolysis) and intraoperative posterior capsule opacification (plaque) were evaluated. Postoperatively, posterior capsule opacification (PCO), Neodymium:YAG (Nd:YAG) laser posterior capsulotomy rate, corneal endothelial count, best corrected visual acuity and cystoid macular oedema were evaluated. Eyes were examined at 6 months and then yearly for 3 years.
Mean ages of 78 males and 87 females were 59.12 +/- 8.56 and 58.34 +/- 7.45 years respectively. EPT was 36 +/- 19 seconds and WSTI occurred in 7 eyes (4.7%). No serious intraocular complications occurred. Intraoperative posterior capsule opacification (plaque) was present in 21 eyes (13.93%). Postoperatively, PCO occurred in 8 eyes (4.84%) and Nd:YAG laser posterior capsulotomy was performed in 3 eyes (1.8%). Endothelial cell loss was 7.1% at 3 years follow-up. At the end of 3 years follow-up, 146 eyes (88.89%) maintained a best corrected visual acuity of > or = 6/12. Cystoid macular oedema did not occur in any eye at 1 and 6 months' follow-up.
PCO rates and endothelial cell loss were acceptable. Consistent and reproducible outcome can be obtained after phacoemulsification of age related cataracts (grade I to III).
评估年龄相关性白内障超声乳化术后的术中表现及长期手术效果。
对165例连续行I至III级核硬化(I至V级)白内障超声乳化术的患眼进行前瞻性、观察性、非对照研究。术前评估包括镜面显微镜检查。由一名外科医生在表面麻醉下采用标准化手术技术进行超声乳化术。术中评估有效超声乳化时间(EPT)、伤口部位热损伤(WSTI)、严重并发症(如玻璃体脱出、后囊破裂、悬韧带离断)及术中后囊混浊(斑块)情况。术后评估后囊混浊(PCO)、钕:钇铝石榴石(Nd:YAG)激光后囊切开率、角膜内皮细胞计数、最佳矫正视力及黄斑囊样水肿情况。术后6个月进行检查,之后每年检查1次,共检查3年。
78例男性和87例女性的平均年龄分别为59.12±8.56岁和58.34±7.45岁。EPT为36±19秒,7只眼(4.7%)发生WSTI。未发生严重眼内并发症。21只眼(13.93%)出现术中后囊混浊(斑块)。术后,8只眼(4.84%)发生PCO,3只眼(1.8%)接受了Nd:YAG激光后囊切开术。随访3年时内皮细胞损失率为7.1%。随访3年结束时,146只眼(88.89%)的最佳矫正视力维持在≥6/12。随访1个月和6个月时,所有患眼均未发生黄斑囊样水肿。
PCO发生率和内皮细胞损失率可接受。年龄相关性白内障(I至III级)超声乳化术后可获得一致且可重复的手术效果。