Kaimbo wa Kaimbo D
Service d'Ophthalmologic, Cliniques Universitaires, Zaïre.
Bull Soc Belge Ophtalmol. 1993;249:81-7.
In the developed countries, the great majority of operations for cataract are performed using the extracapsular cataract extraction (ECCE) and phacoemulsification generally combined with the implantation of an intraocular lens in the posterior chamber of the eye. However, in most developing countries, like Zaïre, the more widespread method is still intracapsular cataract extraction (ICCE). In a retrospective study, the results of the 33 first consecutive ECCE with or without IOL performed during six months (from January 1990 through June 1990) were reviewed. These results of ECCE were compared to those of patients who underwent ICCE (52 eyes) during the same period. The follow-up ranged from one month to 32 months with a mean of 7 months for the ECCE group and from one month to 24 months with a mean of 5 months for the ICCE group. The number of eyes that had peroperative complications was one (3%) for the ECCE and 14 (27%) for the ICCE. The number of eyes that had immediate postoperative complications was 12 (36%) for the ECCE and 20 (38%) for the ICCE. And the number of eyes that had later postoperative complications was 4 (9%) and 11 (22%) for respectively the ECCE and ICCE. The most important peroperative complication for the ECCE group was vitreous loss in 6% of the cases compared to 16% for the ICCE group. The most important immediate postoperative complication was striate keratitis (24%) in the ECCE group and striate keratitis (15%), iritis (12%), pupillary block (6%) in the ECCE group. The most important late complications were posterior capsule opacification (6%) for the ECCE and glaucoma (6%) for the ICCE. Of 33 eyes which underwent ECCE, 73% achieved a visual acuity of 0.5 or better. Of 52 eyes which underwent ICCE, 56% achieved a visual acuity of 0.5 or better. In this study, rates of complications were higher in ICCE and visual outcome was better in ECCE. This study shows that the ECCE with IOL implantation would be preferable than the ICCE in our country.
在发达国家，大多数白内障手术采用囊外白内障摘除术（ECCE）和超声乳化术，通常还会在眼后房植入人工晶状体。然而，在大多数发展中国家，如扎伊尔，更普遍的方法仍然是囊内白内障摘除术（ICCE）。在一项回顾性研究中，对连续33例在6个月内（从1990年1月至1990年6月）进行的有或无人工晶状体植入的ECCE手术结果进行了回顾。将这些ECCE手术结果与同期接受ICCE手术的患者（52只眼）的结果进行了比较。ECCE组的随访时间为1个月至32个月，平均7个月；ICCE组的随访时间为1个月至24个月，平均5个月。ECCE组术中出现并发症的眼数为1只（3%），ICCE组为14只（27%）。ECCE组术后立即出现并发症的眼数为12只（36%），ICCE组为20只（38%）。ECCE组和ICCE组术后晚期出现并发症的眼数分别为4只（9%）和11只（22%）。ECCE组最重要的术中并发症是6%的病例出现玻璃体脱出，而ICCE组为16%。ECCE组术后立即出现的最重要并发症是角膜条纹状角膜炎（24%），ICCE组为角膜条纹状角膜炎（15%）、虹膜炎（12%）、瞳孔阻滞（6%）。ECCE组最重要的晚期并发症是后囊膜混浊（6%），ICCE组是青光眼（6%）。在接受ECCE手术的33只眼中，73%的患者视力达到0.5或更好。在接受ICCE手术的52只眼中，56%的患者视力达到0.5或更好。在本研究中，ICCE的并发症发生率更高，ECCE的视力结果更好。本研究表明，在我国，植入人工晶状体的ECCE比ICCE更可取。
