小切口白内障摘除术的不同切口方位对散光的影响

目的探讨小切口白内障摘除术的不同切口方位对散光的影响,从机制上分析小切口白内障术后角膜散光的影响因素。方法白内障60例患者根据入院顺序平分为治疗组与对照组,每组各30例,两组均采用手法小切口白内障囊外摘除联合人工晶状体植入术,治疗组选择角膜曲率最大子午线轴向切口方位,对照组选择于水平子午线轴向切口方位。结果术前两组之间散光较均衡,两组间散光差别无统计学意义（P〉0.05）。治疗后,两组平均角膜散光度较术前明显增加,差别有统计学意义（P〈0.05）;治疗组术后散光明显小于对照组,差别有统计学意义（P〈0.05）,两组术后散光均随时间推移而减小。术后1个月,治疗组散光明显下降,与术前相比差别无统计学意义（P〉0.05）：对照组散光仍高于术前,差别有统计学意义（P〈0.05）。术前散光轴位两组差别无统计学意义（P〉0.05）。治疗组术后第3天顺规为83.3%,术后1个月顺规为66.7%;对照组术后第3天顺规为86.7%,术后1个月顺规为73.3%。术后3 d与1个月,两组差别都无统计学意义（P〉0.05）。结论小切口白内障术后角膜散光的影响因素众多,选择切口方位角膜曲率最大子午线轴向能有效地减少术后角膜散光度,值得推广应用。

Impact of different positions of small-incision cataract extraction on astigmatism

Objective To explore the impact of different positions of small-incision cataract extraction on astigmatism so as to systemically analyze impact factors of corneal astigmatism after small-incision cataract extraction.Methods Sixty cataract patients were divided into treatment group and control group（n=30） by admission sequence.Both groups were treated with the therapy of small-incision cataract extraction combined with artificial lens implantation.The incision position for treatment group was in the max meridian axis of cornea curvature,that for control group was in the horizontal meridian axis.Results Both groups showed equivalent astigmatism prior to operation（P0.05）,however,higher average cornea astigmatism was observed in both groups after treatment.Besides,lower astigmatism was found in treatment group than that in control group after treatment,with statistical significance（P0.05）.Astigmatism of both groups decreased with passage of time.Lower astigmatism was observed in treatment group one month later,without statistical significance as compared preoperatively（P0.05）.Higher astigmatism was still observed in control group,with statistical significance as compared preoperatively（P0.05）.Astigmatism with the rule of three days and one month after operation were 83.3% and 66.7%,while those in treatment group were 86.7% and 73.3% without statistical difference（P0.05）.Conclusion There are many factors affecting cornea astigmatism after small-incision cataract extraction.Incision position of cataract extraction in the max meridian axis of cornea curvature can effectively reduce cornea astigmatism and it is worth promoting.