“和谐使命—2017”非洲七国开展白内障超声乳化手术临床疗效分析

目的 分析“和谐使命―2017”任务中对非洲七国白内障患者行白内障超声乳化联合人工晶状体植入术的临床疗效。方法 回顾性分析2017年8月至11月在海军“和平方舟”医院船上行白内障超声乳化联合人工晶状体植入术治疗的51例（52眼）白内障患者的临床资料。观察并记录术前、术后1 d术眼的最佳矫正视力和散光度，术后眼部恢复情况，以及术中和术后并发症。结果 52只术眼中，4眼（7.7%）术后1 d的最佳矫正视力为0.06～0.3，26眼（50.0%）为0.4～0.6，22眼（42.3%）为0.8～1.2。裂隙灯检查：术后1～3 d，48眼（92.3%）角膜透明；4眼（7.7%）角膜水肿；50眼（96.2%）瞳孔圆，瞳孔直径为2.0～3.0 mm；所有术眼角膜后沉积物（－），丁达尔效应（－）。52眼的术前平均散光度为（1.13±1.02）D，较术后1 d[（2.67±0.87）D]增加，差异有统计学意义（t=2.365，P<0.05）。术中后囊破裂及玻璃体脱出2眼（3.8%），虹膜脱出1眼（1.9%），瞳孔进行性缩小2眼（3.8%）；术后1 d角膜水肿4眼（7.7%）。结论 在“和平方舟”医院船上施行白内障超声乳化联合人工晶状体植入术，手术安全、效果良好。
Objective To analyze the clinical efficacy of cataract phacoemulsification combined with implantation of artificial lens for patients with cataract in seven African countries during"Mission Harmony-2017"task. Methods We retrospectively analyzed the data from 51 cataract patients (52 eyes) receiving cataract phacoemulsification combined with implantation of artificial lens between Aug. 2017 and Nov. 2017 on Ark-peace Hospital Ship. The preoperative and 1 d postoperative best-corrected visual acuity and astigmatism were compared, the postoperative ocular recovery was observed, and the intraoperative and postoperative complications were analyzed. Results One day postoperation, 4 (7.7%) of 52 eyes had a best-corrected visual acuity ranging from 0.06 to 0.3, 26 (50.0%) 0.4 to 0.6, and 22 (42.3%) 0.8 to 1.2. Slit-lamp examination showed that 48 eyes (92.3%) had corneal hyaline on 1-3 d after operation, 4 eyes (7.7%) had corneal edema, and 50 eyes (96.2%) had round pupil with diameter being 2.0-3.0 mm, and posterior corneal deposits and Tyndall effect were negative in all eyes. The mean astigmatism of 52 eyes before operation was significantly higher than that on 1 d after operation ([1.13±1.02] D vs[2.67±0.87] D, t=2.365, P<0.05). Posterior capsular rupture and vitreous prolapse occurred in 2 eyes (3.8%), prolapse of iris in 1 eye (1.9%), and progressive pupil reduction in 2 eyes (3.8%) during operation. Corneal edema occurred in 4 eyes (7.7%) on 1 d after operation. Conclusion Cataract phacoemulsification combined with implantation of artificial lens can be safely and effectively performed on Ark-peace Hospital Ship