角膜缘松解切开术治疗白内障患者术后角膜散光

目的 研究角膜缘松解切开术治疗白内障患者术后角膜散光的临床疗效.方法 前瞻性队列研究.纳入2018年1月至2020年11月期间,既往行6.0 mm切口白内障手术3个月以上且术后伴有明显角膜散光拟行视力增效手术者61例(71眼)进行研究,按患眼角膜散光大小分为A组(≤1.50 D)和B组(＞1.50 D),所有患眼数据在...

Limbal relaxing incisions for astigmatism after cataract surgery

Objective To observe the clinical effect of limbal relaxing incisions(LRIs)for different astigmatism after cataract surgery.Methods Prospective cohort study.From January 2018 to November 2020,61 patients(71 eyes)who underwent 6.0 mm-incision cataract surgery for more than 3 months and who had obvious corneal astigmatism planned to undergo visual enhancement surgery were included in the study.According to the size of corneal astigmatism,the patients were divided into group A(≤1.50 D)and group B(>1.50 D).All patients completed LRIs manually after incisions data calculated by Nichamin Age Pachymetry Adjusted Nomogram.Changes in corneal astigmatism was detected by Alpins astigmatism vector and visual acuity were observed before surgery and 3 months after months between the two groups.A subjective questionnaire was conducted 3 months after surgery to evaluate satisfaction with all patients’operations.Results A total of 49 eyes were followed up effectively for more than 3 months,including 20 eyes in group A and 29 eyes in group B.Preoperative differences in steep keratometry(Ks)of the verion and corneal astigmatism between the two groups were statistically significant(both P<0.01).The reduction of astigmatism and the improvement of uncorrected distance visual acuity 3 months after surgery in the two groups were statistically significant(both P<0.01).Improved corrected distance visual acuity was statistically significant in group B(P<0.01)but not in group A(P=0.50).Alpins astigmatism vector analysis showed there were statistically significant differences between the two groups in target induced astigmatism and surgically induced astigmatism(both P<0.05),while no statistically significant differences in other astigmatism vector analysis(all P>0.05).In 49 eyes,target-induced astigmatism vector was 0.9-2.5(1.61±0.37)D,surgically induced astigmatism vector was 0.5-3.0(1.46±0.55)D,and the difference vector was(-0.15±0.45)D,the correction index was 0.91±0.29,angle of error was 3.57°±12.46°,the index of flattening was 0.89±0.29,index of success was 0.28±0.09,and the success rate was 72%.There were no significant corneal astigmatism changes in 3 to 6 months after surgery(P>0.05).None of severe surgical complications occurred in the patients during the follow-up period.A subjective questionnaire survey at 3 months after surgery showed that 20 eyes(40.82%)were satisfied,and 19 eyes(38.77%)were moderately satisfied.Conclusion LRIs can safely and effectively reduce corneal astigmatism after cataract surgery.