原有散光白内障行不同位置切口手术后散光程度变化的临床观察

目的 比较两种不同位置的白内障手术切口对角膜原有散光程度的影响。方法 选取我院术前散光≤2.0 D的单纯年龄相关性白内障患者186例(186只眼)作为研究对象,均行3.0 mm透明角膜切口白内障超声乳化摘除联合人工晶体植入术,按手术切口位置将患者分为 A 组(88只眼)和 B组(98只眼),A 组在10～12点透明角膜做切口,B组则根据术前角膜曲率检查,选择角膜陡峭轴做切口;又根据术前散光程度是否≤0.75 D比较两组术后角膜散光程度变化及视力恢复情况。结果 散光程度≤0.75 D患者中,与术前比较,术后1周散光程度明显降低,P<0.05,但术后1、3月散光程度变化不明显。散光程度≤0.75 D患者中,与A组比较,B组术后不同时间点散光程度明显降低,P<0.05。B组中,随着术后时间延长,散光程度逐渐降低,P<0.05。结论 对术前散光度≤0.75 D者,不同切口术后早期散光程度降低,晚期差别不大;但对于术前散光度为>0.75 D者,术后散光程度降低,在角膜陡峭轴行手术切口可获得更好的裸眼视力。

Clinical observation on the changes of astigmatism degree of the originalastigmatism cataract after different incision operations

Objective To compare the effect of two different incision positions on the original astigmatism of cornea.Methods One hundred and eighty-six cases (186 eyes) of age-related cataract with preoperative astigmatism≤2.0 D in our hospital were selected as the study objects. All the patients underwent phacoemulsification combined with IOL implantation with 3.0 mm transparent corneal incision. According to the incision position, the patients were divided into group A (88 eyes) and group B (98 eyes). The incision of clear cornea was made at 10-12 points in group A, while the incision of steep corneal axis was selected in group B according to the preoperative corneal curvature examination. According to whether the preoperative astigmatism degree≤0.75 D, the changes of postoperative corneal astigmatism degree and visual acuity recovery were compared between the two groups.Results In patients with astigmatism ≤0.75 D, compared with that before surgery, the astigmatism degree decreased significantly 1 week after surgery, with P<0.05, without significant changes in astigmatism 1 month and 3 months after the operation. In patients with astigmatism≤0.75 D, compared with group A, the astigmatism degree of group B decreased significantly at different time points after the operation, P<0.05. In group B, the astigmatism degree gradually decreased with the extension of postoperative time, P<0.05.Conclusion For the patients with preoperative astigmatism≤0.75 D, the early astigmatism of different incisions decreased, but for the patients with preoperative astigmatism>0.75 D, the postoperative astigmatism decreased, and the better uncorrected visual acuity could be obtained by incision on the steep axis of cornea.