许道成，罗燕珊，庄曼贤，郭伟如

　　作者单位：（515041）中国广东省汕头市，汕头大学医学院第一附属医院眼科

　　作者简介：许道成，副主任医师。

　　Analysis of the modality and effect of the cataract surgeries in basic level hospital in the poverty alleviation action

　　Dao-Cheng Xu, Yan-Shan Luo, Man-Xian Zhuang, Wei-Ru Guo
Department of Ophthalmology, the First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China

　　Correspondence to: Dao-Cheng Xu. Department of Ophthalmo-logy, the First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China.
　
　　Abstract

　　AIM: To analyze and compare the modality and effect of cataract surgeries in basic level hospital in the poverty alleviation action.

　　METHODS:  Two hundred cases undergone extracapsular cataract extraction and intraocular lens (ECCE+IOL) , 200 cases taken Sutureless Large Incision Manual Cataract Extraction and intraocular lens (SLIMCE +IOL) were chosen randomly from 2006 to 2007 in basic level hospital. The post-operation vision, complications, matter and price of operation were compared between the ECCE+IOL and SLIMCE +IOL group.  

　　RESULTS:  After the operation, the visions of 115 cases (57.5%) in ECCE+IOL group and 139 cases (69.5%) in SLIMCE +IOL group were improved above 0.5; 7 cases (3.5%) in ECCE+IOL group and 6 cases (3.0%) in SLIMCE +IOL group were complicated with posterior-capsule rupture; 13 cases (6.5%) in ECCE+IOL group and 10 cases in SLIMCE +IOL group were complicated with corneal edema. The SLIMCE +IOL use more matter and cost higher than the ECCE+IOL group.  

　　CONCLUSION: The cataract surgeries should be safe, good-effect and low price when enforced in basic level hospital. The ECCE+IOL is still the main modus operandi now. The SLIMCE +IOL has less steps, cost less time and reduce astigmatism after the operation. The SLIMCE +IOL has better effect, is worth to advocate. However, the SLIMCE +IOL cost more and require expert operator. There will be more complications without a seasoned doctor. No matter which modus operandi used, vision rehabilitation is the unaltered objective. A large number of kind and skilled ophthalmology professional staffs are needed to be cultured to make millions of cataract patients to recover their visions.

　　KEYWORDS: cataract; modus operandi; effect
Xu DC, Luo YS, Zhuang MX, et al. Analysis of the modality and effect of the cataract surgeries in basic level hospital in the poverty alleviation action. Int J Ophthalmol(Guoji Yanke Zazhi) 2008;8(6):1173-1175

　　摘要

　　目的：比较、分析基层医院扶贫白内障复明手术方式及效果。

　　方法：比较随机选取的2006/2007在基层医院采取现代囊外白内障摘除（extracapsular cataract extraction,ECCE）、大切口（隧道）无缝线白内障（囊外）摘除（sutureless large incision manual cataract extraction,SLIMCE），并人工晶状体（intraocular lens,IOL）植入手术各200例。统计术后视力，术中、术后并发症，手术耗品及费用。

　　结果：术后视力在0.5以上的：ECCE+IOL手术组115例（57.5％），SLIMCE＋IOL手术组139例（69.5％）；术中后囊膜破裂：ECCE+IOL手术组7例（3.5％），SLIMCE＋IOL手术组6例（3.0％）；角膜水肿：ECCE+IOL手术组13例（6.5％），SLIMCE＋IOL手术组10例（5.0％）。平均每例手术耗品及费用SLIMCE＋IOL手术组稍高。

　　结论：在基层医院施行扶贫白内障复明手术，手术要安全、效果要好，手术费用要低，ECCE+IOL植入手术目前还是主要的手术方式。SLIMCE＋IOL植入手术采用隧道无缝线切口，操作步骤减少、时间缩短、能够减少术后散光，获得更好的效果，值得提倡。但手术耗费稍增加，对手术操作者的手术技巧要求较高。无论是哪一种手术方式，复明是永恒的主题，需要培养大批有爱心的技术优秀的眼科专业人员，才能使数以百万计的白内障盲患者重见光明。

　　关键词：白内障；手术方式；效果

　　许道成，罗燕珊，庄曼贤，等.基层医院扶贫白内障复明手术方式与效果分析.国际眼科杂志2008;8(6):1173-1175