慢性肾衰竭的老年性白内障手术的安全性及疗效分析
Safety and Efficacy of Senile Cataract Surgery in Patients with Chronic Renal Failure

目的：观察慢性肾衰竭的老年患者进行超声乳化联合人工晶体植入手术的安全性及疗效。方法：选择2014年1月至2021年4月患有慢性肾衰竭并患有白内障的老年患者28例(31眼)为观察组进行超声乳化联合人工晶体植入手术；选择同期行超声乳化联合人工晶体植入手术的无糖尿病、肾病、自身免疫性疾病等全身性疾病的老年性白内障40例(42眼)为对照组。观察并比较两组视力、角膜水肿、前房反应及并发症等发生情况。结果：两组均顺利完成手术，成功植入折叠式人工晶体。术后1周，观察组矫正视力≥4.8者构成比均显著低于对照组(P < 0.05)；4.5~4.7者和<4.5者构成比比较，均差异不显著(P > 0.05)。术后连续复查随访2个月，视力均无明显变化，两组并发症发生情况比较，差异不显著(P > 0.05)。结论：慢性肾衰竭患者行超声乳化联合折叠人工晶体植入术治疗白内障同样安全有效，但眼底情况决定术后视力，并且在白内障成熟时手术术后更容易出现角膜水肿及前房炎症反应。
Objective: To observe the safety and efficacy of phacoemulsification combined with intraocular lens implantation in elderly patients with chronic renal failure. Methods: 28 elderly patients (31 eyes) with chronic renal failure and cataract from January 2014 to April 2021 were selected as the observation group; 40 cases (42 eyes) of senile cataract without diabetes, nephropathy and autoimmune diseases were selected as control group. Visual acuity, corneal edema, anterior chamber reaction and complications were observed and compared between the two groups. Results: Both groups successfully completed the operation and successfully implanted foldable intraocular lens. One week after operation, the constituent ratios of corrected visual acuity ≥4.8 in the observation group were significantly lower than those in the control group (P < 0.05). There was no significant difference between 4.5~4.7 and <4.5 (P > 0.05). After continuous follow-up for 2 months, there was no significant change in visual acuity. There was no significant difference in the incidence of complications between the two groups (P > 0.05). Conclusion: Phacoemulsification combined with foldable intraocular lens implantation is equally safe and effective in the treatment of cataract in patients with chronic renal failure, but the fundus condition determines the postoperative visual acuity, and corneal edema and anterior chamber inflammatory reaction are more likely to occur when the cataract is mature.