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目的 评价软壳技术在成熟期白内障手术中降低角膜内皮损伤的有效性和安全性。方法 对5 9例75眼成熟期白内障患者行超声乳化白内障吸除联合人工晶状体植入术,其中37眼使用DuoVisc产品(软壳组) ,38眼使用透明质酸钠(对照组) ,观察比较两组术后视力、角膜内皮计数和并发症。结果 软壳组与对照组最佳矫正视力≥0 . 5在术后1周分别为91. 9%和71. 1% ,两组有显著性差异(P <0 . 0 5 ) ;在术后1月分别为97 .3%和92 . 1% ,两组无显著性差异(P >0 . 0 5 )。软壳组与对照组术后1月角膜内皮细胞丢失率分别为5 . 3%和14 . 9%。软壳组角膜内皮计数术后1月与术前无显著性差异(P >0 .0 5 ) ;对照组角膜内皮计数术后1月与术前有显著性差异(P <0 . 0 1)。软壳组和对照组术后第1天发生角膜水肿分别为13眼和2 8眼,术后1周无角膜水肿;两组术后第1天房水闪光均高于术前水平,1周内逐渐减轻,两组之间房水闪光无明显性差异(P >0 . 0 5 )。两组未发生其他严重并发症。结论 软壳技术在成熟期白内障手术中应用具有保护角膜内皮、提高手术安全性、使患者迅速恢复最佳视力等优点
Objective To evaluate the effectiveness and safety of soft shell technique in reducing corneal endothelium injury in mature cataract surgery. Methods 57 patients with mature cataract in 75 eyes underwent phacoemulsification combined with intraocular lens implantation. Of 37 patients, DuoVisc (soft shell) was used in 37 eyes and sodium hyaluronate (control) in 38 eyes. Two groups of postoperative visual acuity, corneal endothelium count and complications. Results The best corrected visual acuity of the soft shell group and the control group was ≥0.5 at 91.9% and 71.1% respectively at 1 week after operation, with significant difference between the two groups (P <0.05) January were 97.3% and 92.1%, no significant difference between the two groups (P> 0.05). Soft corneal group and control group 1 month corneal endothelial cell loss rates were 5.3% and 14.9%. The corneal endothelium of soft-shell group had no significant difference between January and January (P> 0.05), while the corneal endothelium of control group had a significant difference compared with that before operation (P <0.01) . Corneal edema on the first postoperative day in the soft shell group and the control group were 13 eyes and 28 eyes, respectively. There was no corneal edema one week after surgery. The flash of aqueous humor in the two groups was higher than preoperative level on the first day, Gradually reduced, there was no significant difference between the two groups of flash of aqueous humor (P> 0.05). No other serious complications occurred in both groups. Conclusion The application of soft shell technology in the mature cataract surgery has the advantages of protecting the corneal endothelium, improving the operation safety and enabling the patient to recover the best vision rapidly