不同切角巩膜隧道切口对白内障术后角膜散光影响研究

目的 比较与评价不同切角巩膜隧道切口对白内障术后角膜散光的影响.方法 设定从巩膜反眉状隧道切口的顶点作一条切线,该切线与术前角膜散光轴形成的夹角,称之为切角将131例(135只眼)白内障分为3组,每组45只眼,A组采用0°切角;B组采用45°切角;C组采用90°切角.手术方式均采用小切口无缝线白内障摘除术,巩膜反眉状6mm隧道切口,植入光学部直径为5.5mm的聚甲基丙烯酸甲酯(PMMA)硬性人工晶状体.随访术后1周、1月、3月裸眼视力及角膜散光数值.结果 术后3月裸眼视力A、B组与C组间差别有统计学意义(P＜0.01).术后各时间段A组角膜散光度均小于B、C二组,术后1周角膜散光度与术前比较,A组无统计学意义,B、C二组有统计学意义,术后3月角膜散光度与术前比较,A、B组无统计学意义,C组有统计学意义;A、B、C三组在术后3个月平均角膜散光度的变化差异有统计学意义(P＜0.01).结论 对于采用小切口无缝线白内障摘除术,根据术前散光轴位选择0°切角,有利于减小术后角膜散光,获得更好的裸眼视力.

Reserch of the effect of scleral tunnel incision for cataract extraction with different cutting angles in corneal astigmatism

Objective To compare and evaluate the effect of inversed frown shaped scleral tunnel incision cataract extraction with different Cutting Angles on corneal astigmatism. Methods A tangent was made from the vertex of inversed frown shaped scleral incision, the angle formed by the tangent and preoperative corneal astigmatism axis was called Cutting Angle. A total of 131 patients (135 eyes) were divided into three groups, each group contained 45 eyes. Group A performed with 0° Cutting Angle; Group B performed with 45° Cutting Angle; Group C performed with 90° Cutting Angle. All the patients were performed by small sutureless incision cataract extraction through 6mm inversed frown shaped scleral incision and implanted one piece of 5.5mm PMMA intraocular lense (IOL). The visual acuity and corneal astigmatism were measured at postoperative 1 week, 1 month and 3 months. Results At 3 months after surgry, there were statistical significant difference in visual acuity between group A, B and C (P <0.01). Compared postoperative corneal astigmatism at 1 week with that before surgery, there were no significant difference in statistics in group A, but there were statistical significant difference in group B and C. At 3 months after surgery, there were statistical significant difference in the average changes of corneal astigmatism among three groups (P <0.01). Conclusions Better visual acuity and less postoperative astigmatism can be obtained with small sutureless incision cataract extraction when choose 0 ° Cutting Angle.