Clinical Study On Age-related Cataract Treated With Gold-needle Nuclear Fragmentation Combined With Phacoemulsification

Objective:Cataract is the first blinding disease in the world.About half of the blind in China are caused by cataract.Therefore,cataract blindness is the most priority of blindness prevention and treatment.It is currently believed that there is no clear evidence that drugs can treat cataracts and can only be treated by surgery.In this study,we observed the application and curative effect of special gold needle nuclear crushing combined with phacoemulsification in cataract surgery of hard nucleus(grade IV-V),determined the effect of this method in the surgical treatment of cataract and the improvement of postoperative complications,and explored the application of phacoemulsification combined with manual nuclear fragmentation technique in the ultrasonic emulsion of hard nucleus cataract in order to reduce the volume of cataract less ultrasound energy damage to the cornea,reduce corneal endothelial cell loss,reduce surgical complications,and restore useful vision.Methods:In this study,90 patients with grade IV-V sclerotic cataract were randomly sampled and divided into observation group(combined with gold needle nucleus and phacoemulsification),control group 1(phacoemulsification group),control group 2(small incision non-phacoemulsification manual cleavage group),30 eyes each,and their vision,incision healing,astigmatism,corneal endothelial cell loss rate and complications were observed.and statistical analysis and treatment of curative effect.The key technique is to use 0.4%fenoxi anesthesia as conjunctival flap of the base of the dome,3.2 mm arch scleral tunnel incision or 3.2 mm corneal edge tunnel incision at 2:30 Azimuth transparent cornea was cut into the anterior chamber through the original tunnel incision.After the anterior capsule annular capsulotomy and water separation and water separation and water layer were performed,an antique gold needle(steel)was combined with a self-made crystal washer(diameter 1.5 mm).After mechanical segmentation of the hard nucleus of the cataract into several fragments,the fragments were emulsified and sucked out one by one,and the crystal cortex was removed with the injection head and implanted into the bagResults:Observe the energy and operation time displayed in the interface of the superlactor in S the AP(energy)and AECP(energy composite parameters of the gold needle broken nucleus combined with phacoemulsification observation group were significantly lower than those of the phacoemulsification control group 1,and the difference was significant(P<0.05).A significant difference was found in the safety of three groups(P<0.05).The best corrected visual acuity(UCVA)d 1 mo and 7 eyes after operation were compared between the three groups.The best corrected visual acuity mo 1 after operation was significantly different(P<0.05).The corneal transparency of d 1,7 was significantly different in the three groups(P<0.05).On the aspect of corneal endothelial cell density,the preoperative values of all subjects were measured>1700 mm2,,and the data of 3 groups were significantly different(P>0.05).1 mo after operation,the cornea was in a transparent state,the corneal endothelial cell count was re-checked,and the loss rate of corneal cells in 3 groups was compared,and the data difference was very obvious(PP>0.05).Preoperative powder There was no significant difference between the light observation group 0.42±0.23 D,control group 1 0.44±0.23 D,control group 20.43(t=0.62,0.05).the operative astigmatism was all astigmatism(the third day after operation)the observation group was 0.95±0.26 D,control group 1 was 1.17±0.34 D,control group 2 was 2.22 and 0.65(t=6.68,Pt=0.05).The postoperative astigmatism group was 0.53±0.22 D,control group was 0.78±0.25 D,control group was 1.The difference D,23±0.48 was statistically significant(t=6.22,Pt=0.05)Conclusion:the application of phacoemulsification combined with manual nuclear fragmentation technique in sclerotic cataract ultrasound milk can not only reduce the damage of ultrasound energy to cornea,but also reduce the loss rate of corneal endothelial cells,reduce surgical complications and restore useful vision,which is worthy of clinical application.