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无缝线大切口手法白内障摘除术(SLIMCE)后的内皮细胞丢失和手术诱导散光

Endothelial cell loss and surgically induced astigmatism after sutureless large-incision manual cataract extraction (SLIMCE).

作者信息

Lam Dennis S C, Rao Srinivas K, Fan Alex H, Congdon Nathan G, Wong Victoria, Liu Yingpeng, Lam Philip T H

机构信息

Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Third Floor, 147K Argyle St, Kowloon, Hong Kong.

出版信息

Arch Ophthalmol. 2009 Oct;127(10):1284-9. doi: 10.1001/archophthalmol.2009.142.

Abstract

OBJECTIVES

To describe a modified manual cataract extraction technique, sutureless large-incision manual cataract extraction (SLIMCE), and to report its clinical outcomes.

METHODS

Case notes of 50 consecutive patients with cataract surgery performed using the SLIMCE technique were retrospectively reviewed. Clinical outcomes 3 months after surgery were analyzed, including postoperative uncorrected visual acuity, best-corrected visual acuity, intraoperative and postoperative complications, endothelial cell loss, and surgically induced astigmatism using the vector analysis method.

RESULTS

At the 3-month follow-up, all 50 patients had postoperative best-corrected visual acuity of at least 20/60, and 37 patients (74%) had visual acuity of at least 20/30. Uncorrected visual acuity was at least 20/68 in 28 patients (56%) and was between 20/80 and 20/200 in 22 patients (44%). No significant intraoperative complications were encountered, and sutureless wounds were achieved in all but 2 patients. At the 3-month follow-up, endothelial cell loss was 3.9%, and the mean surgically induced astigmatism was 0.69 diopter.

CONCLUSIONS

SLIMCE is a safe and effective manual cataract extraction technique with low rates of surgically induced astigmatism and endothelial cell loss. In view of its low cost, SLIMCE may have a potential role in reducing cataract blindness in developing countries.

摘要

目的

描述一种改良的手动白内障摘除技术,即无缝线大切口手动白内障摘除术(SLIMCE),并报告其临床结果。

方法

回顾性分析连续50例采用SLIMCE技术行白内障手术患者的病历。分析术后3个月的临床结果,包括术后未矫正视力、最佳矫正视力、术中及术后并发症、内皮细胞丢失情况,以及采用矢量分析方法测量的手术源性散光。

结果

在3个月的随访中,所有50例患者术后最佳矫正视力均至少达到20/60,37例(74%)患者视力至少达到20/30。28例(56%)患者未矫正视力至少为20/68,22例(44%)患者未矫正视力在20/80至20/200之间。术中未出现明显并发症,除2例患者外均实现了无缝线伤口。在3个月的随访中,内皮细胞丢失率为3.9%,手术源性散光平均为0.69屈光度。

结论

SLIMCE是一种安全有效的手动白内障摘除技术,手术源性散光和内皮细胞丢失率低。鉴于其成本低廉,SLIMCE在发展中国家减少白内障致盲方面可能具有潜在作用。

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