黎瑞文　覃泳杰　歐陽(yáng)淑怡　曾運(yùn)考　張洪洋　黃少萍　張小妮　李浩君

【摘要】 目的 探討術(shù)前散光標(biāo)記宣教對(duì)超聲乳化聯(lián)合散光矯正型人工晶狀體（Toric IOL）植入術(shù)患者手術(shù)效果的影響。方法 50例（50眼）接受超聲乳化聯(lián)合Toric IOL植入術(shù)的老年白內(nèi)障患者， 隨機(jī)分為實(shí)驗(yàn)組和對(duì)照組， 各25例（25眼）。對(duì)照組給予術(shù)前常規(guī)護(hù)理， 實(shí)驗(yàn)組在對(duì)照組基礎(chǔ)上給予術(shù)前散光標(biāo)記宣教。觀察并比較兩組患者術(shù)前角膜標(biāo)記時(shí)間與術(shù)前角膜標(biāo)記配合情況， 比較兩組患眼術(shù)后角膜上皮完整情況及殘余散光度。結(jié)果 實(shí)驗(yàn)組術(shù)前角膜標(biāo)記所需時(shí)間為（87.5±8.4）s， 短于對(duì)照組的（94.9±8.3）s， 差異具有統(tǒng)計(jì)學(xué)意義（t=3.133， P<0.05）。術(shù)后， 實(shí)驗(yàn)組角膜上皮完整23眼（92%）， 對(duì)照組為17眼（68%）;實(shí)驗(yàn)組角膜上皮完整率高于對(duì)照組， 差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。實(shí)驗(yàn)組術(shù)前角膜標(biāo)記配合好20例（80%）， 配合較好5例（20%）， 配合差0例;對(duì)照組術(shù)中配合好12例（48%）， 配合較好9例（36%）， 配合差4例（16%）;實(shí)驗(yàn)組配合情況優(yōu)于對(duì)照組， 差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。實(shí)驗(yàn)組術(shù)后殘余散光度為（0.41±0.55）D， 對(duì)照組為（0.34±0.68）D， 兩組比較差異無(wú)統(tǒng)計(jì)學(xué)意義（t=0.400， P>0.05）。結(jié)論 術(shù)前散光標(biāo)記宣教可提高接受超聲乳化聯(lián)合Toric IOL植入術(shù)患者術(shù)前角膜標(biāo)記時(shí)的配合程度， 縮短術(shù)前角膜標(biāo)記時(shí)間， 降低角膜損傷的發(fā)生率， 從而減輕因角膜上皮損傷而引起的不適感。

【關(guān)鍵詞】 術(shù)前角膜標(biāo)記宣教;散光矯正型人工晶狀體植入術(shù);角膜上皮損傷;白內(nèi)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.