不同透明角膜切口对白内障超声乳化术后角膜散光影响

目的 研究不同部位、不同方式的透明角膜切口白内障超声乳化联合后房型折叠式人工晶状体植入术对角膜散光的影响.方法 回顾性临床自身对照研究.将2009年3月至12月在广州医学院第二附属医院眼科就诊的96例(112只眼)白内障患者随机分为3组:A组颞侧透明角膜切口34例(39只眼);B组11:00钟方位透明角膜切口26例(31只眼);C组角膜曲率引导下透明角膜切口(切口位于角膜最大屈光轴方向)36例(42只眼).比较3组病人术前、术后1周、1个月、3个月的视力及角膜散光度变化.结果 术前、术后1周、3组间裸眼视力的差异无统计学意义(P值均>0.05);而术后1个月和3个月C组裸眼视力显著优于A、B组(P值均<0.05),而A组与B组间的差异无统计学意义(P值均>0.05).C组在术后1个月和3个月的角膜散光度显著小于A、B组(P值<0.05).结论 角膜曲率引导下位于角膜最大屈光轴方向的切口对白内障手术术后角膜散光影响最小,并有利于术后视力较快恢复.

Effect of phacoemulsification with different transparent corneal incisions on corneal astigmatism

Objective To investigate the effect of phacoemulsification with different transparent corneal incisions and foldable posterior chamber intraocular lens implantation on corneal astigmatism. Methods All 112 eyes of 96 patients with cataract were divided into three groups randomly, group A, received superior temporal clear corneal incision(39 eyes of 34 cases); group B, received superior clear corneal incision at 11 O'clock(31 eyes of 26 cases); group C, received steepest corneal meridian as guided by corneal(42 eyes of 36 cases). The changes of corneal astigmatism and visual acuity were determined before and 1 week, 1 month and 3 months after operation. Results There was no statistically significant(P >0.05)in visual acuity in three groups before and after operation 1 week; 1 and 3 months after operation the visual acuities in group C were much better than those of the group A and B(P <0.05), though there was no statistically significant(P >0.05)between group A and B; 1 and 3 months after operation the corneal astigmatism of group C was much lower than in group B and group C(P <0.05). Conclusions The incision at the steepest corneal meridian guided by corneal has the least effect on corneal astigmatism and can improve visual acuity rapidly.