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目的分析西藏林芝地区白内障的发病特点并观察开展超声乳化手术的效果。方法通过门诊和下乡普查,随机抽取718例当地居民作为研究对象,按年龄段和性别分别计算白内障的发病率,同时计算各类白内障的构成百分比,随访3d～7个月比较白内障超声乳化手术前后的视力变化,观察术中和术后的并发症情况。结果 718例中有712例接受检查(受检率为99.2%),诊断为白内障203例(256眼),总患病率为28.5%。在256眼白内障患者中,老年性白内障228眼(89.1%),IV度及Ⅴ度硬核比例合计为36.3%。完成手术170眼,其中165眼一期植入了人工晶状体。术后视力提高5行(包括5行)以上者108眼(65.1%),提高2～5行者(包括2行)39眼(23.5%)。术中后囊膜破裂9眼(5.3%),术后角膜水肿26眼(15.3%)。结论西藏林芝地区白内障发病率明显高于同纬度的平原地区,白内障超声乳化技术适合在西藏地区推广。
Objective To analyze the incidence of cataract in Linzhi area of Tibet and to observe the effect of phacoemulsification. Methods A total of 718 local residents were selected from outpatients and rural censuses. The incidence of cataract was calculated by age group and sex respectively. The percentages of cataract were calculated. Phacoemulsification was performed at 3-7 months of follow-up. Changes in visual acuity before and after the observation of intraoperative and postoperative complications. Results Of the 718 cases, 712 were examined (the detection rate was 99.2%), and 203 cases (256 eyes) were diagnosed as cataract, with a total prevalence of 28.5%. Among 256 eyes with cataract, 228 eyes (89.1%) had senile cataract and 36.3% had IV and Ⅴ degree hard nuclei. 170 eyes were completed, of which 165 eyes were implanted with intraocular lens. Postoperative visual acuity increased by 5 lines (including 5 lines) more than 108 eyes (65.1%), improved 2-5 lines (including 2 lines) 39 eyes (23.5%). There were 9 eyes (5.3%) with posterior capsular rupture and 26 eyes (15.3%) with postoperative corneal edema. Conclusion The incidence of cataracts in Linzhi area in Tibet is significantly higher than that in plain areas at the same latitude. Cataract phacoemulsification is suitable for promotion in Tibet.