術前散光標記宣教對超聲乳化聯合Toric IOL植入術患者手術效果的影響

黎瑞文　覃泳杰　歐陽淑怡　曾運考　張洪洋　黃少萍　張小妮　李浩君

【摘要】 目的 探討術前散光標記宣教對超聲乳化聯合散光矯正型人工晶狀體（Toric IOL）植入術患者手術效果的影響。方法 50例（50眼）接受超聲乳化聯合Toric IOL植入術的老年白內障患者， 隨機分為實驗組和對照組， 各25例（25眼）。對照組給予術前常規護理， 實驗組在對照組基礎上給予術前散光標記宣教。觀察并比較兩組患者術前角膜標記時間與術前角膜標記配合情況， 比較兩組患眼術后角膜上皮完整情況及殘余散光度。結果 實驗組術前角膜標記所需時間為（87.5±8.4）s， 短于對照組的（94.9±8.3）s， 差異具有統計學意義（t=3.133， P<0.05）。術后， 實驗組角膜上皮完整23眼（92%）， 對照組為17眼（68%）;實驗組角膜上皮完整率高于對照組， 差異具有統計學意義（P<0.05）。實驗組術前角膜標記配合好20例（80%）， 配合較好5例（20%）， 配合差0例;對照組術中配合好12例（48%）， 配合較好9例（36%）， 配合差4例（16%）;實驗組配合情況優于對照組， 差異具有統計學意義（P<0.05）。實驗組術后殘余散光度為（0.41±0.55）D， 對照組為（0.34±0.68）D， 兩組比較差異無統計學意義（t=0.400， P>0.05）。結論 術前散光標記宣教可提高接受超聲乳化聯合Toric IOL植入術患者術前角膜標記時的配合程度， 縮短術前角膜標記時間， 降低角膜損傷的發生率， 從而減輕因角膜上皮損傷而引起的不適感。

【關鍵詞】 術前角膜標記宣教;散光矯正型人工晶狀體植入術;角膜上皮損傷;白內障

DOI：10.14163/j.cnki.11-5547/r.2019.24.074

Effect of preoperative astigmatism marker education on the surgical outcome of patients undergoing phacoemulsification combined with Toric IOL implantation? ?LI Rui-wen， QIN Yong-jie， OUYANG Shu-yi， et al. Department of Ophthalmology， Guangdong People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Institute of Ophthalmology Prevention and Control， Guangzhou 510080， China

【Abstract】 Objective? ?To discuss the effect of preoperative astigmatism marker education on the surgical outcome of patients undergoing phacoemulsification combined with Toric intraocular lens （Toric IOL） implantation. Methods? ?A total of 50 elderly patients （50 involved eyes） with cataract undergoing phacoemulsification combined with Toric IOL implantation were randomly divided into experimental group and control group， with 25 cases （25 eyes） in each group. The control group received preoperative conventional nursing and eye marking， and the experimental group received preoperative astigmatism marker education on the basis of the control group. The preoperative corneal marking time and cooperation of preoperative corneal marking in the two groups were observed and compared， and the corneal epithelial integrity and residual astigmatism in the two groups was compared. Results? ?The experimental group had obviously shorter time required for preoperative corneal marking as （87.5±8.4） s than （94.9±8.3） s in the control group， and the difference was statistically significant （t=3.133， P<0.05）. After operation， the experimental group had corneal epithelial integrity in 23 eyes （92%）， and that of

17 eyes （68%） in the control group. The experimental group had higher corneal epithelial integrity rate than that of the control group， and the difference was statistically significant （P<0.05）. In the experimental group， there were 20 well cooperated cases （80%）， 5 cooperated cases （20%） and 0 poor cooperated case （0） during preoperative corneal marking. In the control group， there were 12 well cooperated cases （48%）， 9 cooperated cases （36%） and 4 poor cooperated cases （16%）. The experimental group had better cooperation of preoperative corneal marking than that of the control group， and the difference was statistically significant （P<0.05）. The experimental group had postoperative residual astigmatism as （0.41±0.55） D， and that of （0.34±0.68） D in the control group， and the difference was not significantly difference （t=0.400， P>0.05）. Conclusion? ?Preoperative astigmatism marker education can improve the cooperation of patients undergoing phacoemulsification combined with Toric IOL implantation during preoperative astigmatism marker， shorten time of preoperative astigmatism marker， lower incidence of corneal epithelial injury， thus alleviating the discomfort caused by corneal epithelial injury.