小切口非超声乳化白内障术后角膜散光的变化

①目的　探讨不同切口非超声乳化白内障摘除联合后房型人工晶状体植入术对后角膜散光情况及手术性散光的变化影响。②方法　将 40 3例 (40 3只眼 )白内障分为A、B两组。A组为硬核白内障 (2 85例 ) ,取上方巩膜反眉状 8mm隧道切口 ;B组为非硬核白内障 (1 1 8例 ) ,取上方巩膜反眉状 6mm隧道切口 ,均行非超声乳化白内障摘除术 ,植入光学部直径为 6mm的聚甲基丙烯酸甲酯(PMMA)硬性人工晶状体 ,并使用角膜地形图、角膜曲率计随访术前、术后 1～ 3天、6个月、1年角膜散光的变化。③结果　发生手术性散光A组为 (1 .50± 0 .87)D ,B组为 (0 .98± 0 .50 )D ;散光轴向变化A组为 86 .5°± 54 .7° ,B组为 75 .0°± 53 .4°,术后两组角膜散光差异有显著意义 (P <0 .0 5)。④结论　检查术前及术后不同时间角膜散光 ,可综合评价小切口非超声乳化手术致角膜屈光状态变化。

Analysis of postoperative astigmastim after No-phacoemulsification with intraocular lens implantation

Objective To study the corneal astigmastim and the changes of surgically induced astigmastim after no-phacoemulsification with intraocular lens through a 8mm superior inversed frown shaped scleral tunnel incision and 6mm scleral tunnel incision. Methods 403 eyes of 403 patients who had no-phacoemulsification were studied through a two-step scleral tunnel incision and implantation of one piece intraocular lenses(IOLS). Patients were divided into two groups: Group A was made up of 285 eyes, performed through a 8mm superior inversed frown shaped scleral self-sealing incision; Group B was made up of 118 eyes, performed through a 6mm self-sealing incision and examined by corneal topography preoperatively and 1-3 day, 6 month, 1 year postoperatively.Results The postoperative corneal astigmatism at 1-3 day, 6 month, 1 year were: Group A 1.75D, 1.25D, 1.03D; Group B 1.25D, 0.87D 0.82D respectively 1-3 day, 6 months and 1 year postoperatively. (P<0.05).Conclusion Comparison of the induced astigmatism after superior inversed frown shaped scleral tunnel incision of different sizes. Vector analysis can systemically evaluate surgically induced astigmatism. Corneal topography has more important clinical value in evaluating surgically induced astigmatism.