角膜切口矫正白内障合并低度角膜散光的光学质量评价

目的 评价角膜地形图引导下2.6 mm最大曲率子午线轴向透明角膜切口矫正年龄相关性白内障合并低度角膜散光(0.50～1.50 D)的光学质量和效果.方法 试验组为角膜地形图引导下2.6 mm最大曲率子午线轴向透明角膜切口白内障超声乳化人工晶状体植入术患者15例(21眼),对照组为常规颞侧2.6 mm透明角膜切口白内障超声乳化人工晶状体植入术患者18例(21眼).比较术前、术后3个月角膜散光和5 mm瞳孔直径下手术诱导的角膜各高阶像差以及角膜点扩散函数.结果 随访3个月,试验组术眼裸眼视力≥0.8者15眼,对照组8眼(X2=4.709,P＜0.05);试验组矫正视力≥1.0者17眼,对照组14眼(X2=1.109,P＞0.05).试验组平均角膜散光度较术前减少(0.29±0.27)D,对照组较术前增加(0.03±0.53)D(t=0.018,P＜0.05).手术诱导的角膜各高阶像差在试验组和对照组之间.差异无统计学意义(t=1.540,P＞0.05);试验组和对照组手术诱导的总高级散光像差分别为(-0.33±0.59)μm和(0.10±0.21)μm,差异有统计学意义(z=2.568,P＜0.05);试验组和对照组术后角膜点扩散函数Strehl ratio值分别为0.023±0.043和0.008±0.012(z=-2.069,P＜0.05).结论 角膜地形图引导下2.6 mm最大曲率子午线轴向透明角膜切口白内障超声乳化人工晶状体植入术后的角膜光学质量优于常规颞侧角膜切口,是治疗年龄相关性白内障合并低度角膜散光的理想术式(中国眼耳鼻喉科杂志,2008,8:354-356)

Changes in corneal optical quality with clear corneal incision to correct pre-existing mild astigmatism in cataract Patients

Objective To study the changes in corneal optical quality with 2.6 mm clear corneal incision on the steepest meridian guided by corneal topography to correct pre-existing mild astigmatism （0.50 - 1.50 D） in cataract patients. Methods Two point six milimeters clear corneal tunnel incision phacoemulsificatiou on the steepest meridian guided by corneal topography followed by iutraocular lens （IOL） implantation was performed on 21 eyes of 15 patients in the test group ,and conventional temporal corneal tunnel phacoemulsification and IOL implantation were performed on 21 eyes of 18 patients in the control group. The corneal astigmatism, high order aberrations and point spread function were measured using the aberrometer and topographer preoperatively and up to 3 months after surgery. The corneal astigmatism and the root-mean-square of surgically induced corneal high order aberrations, total spherical aberrations, total coma, total trefoil, total high astigmatism aberrations at 5-mm pupil diameter and corneal point spread function were measured. Results Fifteen eyes in the test group and 8 eyes in the control group achieved ≥0.8 uncorrected visual acuity 3 months after surgery, which had statistical significance （ X^2 = 4.709, P 〈 0.05 ）. The best spectacle-corrected visual acuity was ≥1.0 in 17 eyes in the test group and 14 eyes in the control group （X^2 = 1. 109, P 〉 0. 05）. The change in corneal astigmatism from preoperative to 3 months after surgery was （0.29 ± 0. 27 ） D for the test group and （0.03 ± 0.53 ） D for the control group, which had statistical significance （t =0.018 ,P 〈0.05）. There were no significant differences in the surgery induced high order aberrations between the two groups （ t = 1. 540, P 〉 0. 05 ）. The surgery induced total high order astigmatism aberration were （ -0.33 ± 0.59 ） μm and （0.10 ±0.21 ） μm in the test group and the control group respectively （ z = 2. 568, P 〈 0.05 ）. The values of Strehl ratio in corneal point spread f