角膜切口白内障手术对患者术后角膜屈光度及视觉质量的影响研究

目的：研究角膜切口白内障手术对患者术后角膜屈光度及视觉质量的影响。方法选择2014年8月至2015年8月收入我院行白内障手术的患者72例（72只眼）为研究对象，患者术前角膜散光度超过1．00 D。根据患者术前散光度分为Ⅰ组和Ⅱ组，两组均行透明角膜2．2 mm切口超声乳化白内障吸出＋后房型人工晶状体植入术联合角膜缘穿透性弧形切口松解术，Ⅱ组根据患者根据散光度确定切口长度。观察并比较术前及术后7、30 d及90 d患者术眼裸眼视力、角膜散光度数、散光矫正量及不良反应发生情况。结果术后，两组患者视力均大幅提高。与Ⅱ组相比，Ⅰ组患者术后30 d及90 d视力平均值均显著优于Ⅱ组，两组相比差异具有统计学意义（ P ＜0.05）。两组不同时间角膜散光度分析结果表明，与术前相比，Ⅰ组术后7、30、90 d患者平均角膜散光度未见显著性差异（ P ＞0．05）。Ⅱ组术后7、30、90 d患者平均角膜散光度均显著降低，差异具有统计学差异（ P ＜0．05）。术后3个月，Ⅰ组患者角膜散光平均矫正量为（2．10±0．09）D，显著高于Ⅱ组的（1．40±0．01）D，两组相比差异有统计学意义（ P ＜0．05）。所有患者均顺利完成手术，术后Ⅰ组1例有轻度的角膜水肿，Ⅱ组1例轻度角膜水肿，3例中度角膜水肿，经相应治疗后恢复正常。术后少数患者出现干眼、异物感、畏光等症状，均在7d内自行缓解。结论透明角膜2．2 mm切口超声乳化白内障吸出＋后房型人工晶状体植入术联合角膜缘穿透性弧形切口松解术，可有效增加眼球通光，减少手术性散光，大幅度矫正术前散光，提高了患者视觉质量，值得临床推广应用。

Effect of corneal incision cataract surgery on corneal refractive and visual quality in patients with cataract

Objective To investigate the effect of corneal incision cataract surgery on corneal refractive and visual quality in patients with cataract .Methods Seventy-two cataract patients were enrolled in this study .Patients were diag-nosed with cataract and had astigmatism larger than 1.00D.According to the preoperative level of astigmatism , patients were divided into group I (>2.00D) and group II (<2.00D).Both groups received transparent corneal incision , phaco-emulsification , and posterior chamber intraocular lens implantation .Visual acuity , astigmatism degree and correction a-mount, and adverse effects were observed before and 7d, 30d and 90d after surgery.Results Visual acuity significantly improved after treatment in both groups .At 30d and 90d, visual acuity was significantly better in group I than in group II ( P <0.05).Postoperative astigmatism did not change significantly in group I but reduced significantly in group II .At 90d, average astigmatic correction amount was 2.10 +0.09D in group I, higher than that in group II (1.40 ±0.01D). All surgeries were successful.Complications were only mild, including mild to moderate corneal edema (n=4), dry eye, foreign body sensation , photophobia .These symptoms were relieved within 7d.Conclusions Transparent corneal incision phacoemulsification combined with posterior chamber intraocular lens implantation and corneal limbal penetrating arc inci -sion can effectively improve the optics , reduce surgically induced astigmatism , and improve the visual quality of the pa-tients.It is worthy of clinical promotion .