术前散光标记宣教对超声乳化联合Toric IOL植入术患者手术效果的影响

黎瑞文　覃泳杰　欧阳淑怡　曾运考　张洪洋　黄少萍　张小妮　李浩君

【摘要】 目的 探討术前散光标记宣教对超声乳化联合散光矫正型人工晶状体（Toric IOL）植入术患者手术效果的影响。方法 50例（50眼）接受超声乳化联合Toric IOL植入术的老年白内障患者， 随机分为实验组和对照组， 各25例（25眼）。对照组给予术前常规护理， 实验组在对照组基础上给予术前散光标记宣教。观察并比较两组患者术前角膜标记时间与术前角膜标记配合情况， 比较两组患眼术后角膜上皮完整情况及残余散光度。结果 实验组术前角膜标记所需时间为（87.5±8.4）s， 短于对照组的（94.9±8.3）s， 差异具有统计学意义（t=3.133， P<0.05）。术后， 实验组角膜上皮完整23眼（92%）， 对照组为17眼（68%）;实验组角膜上皮完整率高于对照组， 差异具有统计学意义（P<0.05）。实验组术前角膜标记配合好20例（80%）， 配合较好5例（20%）， 配合差0例;对照组术中配合好12例（48%）， 配合较好9例（36%）， 配合差4例（16%）;实验组配合情况优于对照组， 差异具有统计学意义（P<0.05）。实验组术后残余散光度为（0.41±0.55）D， 对照组为（0.34±0.68）D， 两组比较差异无统计学意义（t=0.400， P>0.05）。结论 术前散光标记宣教可提高接受超声乳化联合Toric IOL植入术患者术前角膜标记时的配合程度， 缩短术前角膜标记时间， 降低角膜损伤的发生率， 从而减轻因角膜上皮损伤而引起的不适感。

【关键词】 术前角膜标记宣教;散光矫正型人工晶状体植入术;角膜上皮损伤;白内障

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.