角膜切口对白内障手术后散光的影响

目的:观察沿角膜散光陡峭轴方向做透明角膜切口行白内障超声乳化联合人工晶状体植入术后散光和视力的变化。方法:根据IOL-Master检测结果选择角膜最大屈光力轴行3.0mm透明角膜切口做白内障超声乳化术42眼作为观察组(A组),常规颞上(右眼)、鼻上(左眼)3.0mm透明角膜切口白内障超声乳化术68眼作为对照组(B组)。检测术前、术后1d;1wk;1,3mo角膜散光和视力变化。结果:A组术前、术后1d;1wk;1,3mo视力分别为0.2±0.24,0.73±0.37,0.78±0.38,0.94±0.36,0.76±0.13;B组为0.17±0.2,0.82±0.3,0.84±0.2,0.77±0.26,0.8±0.36;差异无统计学意义(P>0.05)。A组术前、术后1d;1wk;1,3mo角膜散光度分别为1.01±0.10D,1.33±0.13D,1.15±0.14D,0.90±0.13D,0.89±0.12D;B组为0.95±0.13D,1.25±0.15D,1.07±0.13D,0.87±0.12D,0.82±0.11D。术后1d;1wk;1mo与术前相比散光度均无统计学意义(P>0.05)。两组术后3mo散光度与术前相比差异有统计学意义(P<0.05)。两组术后3mo裸眼视力≥0.8者分别为21眼(50%)和32眼(47%),两者相比有统计学意义(P<0.05)。结论:沿陡轴透明角膜切口白内障超声乳化联合人工晶状体植入术有助于患者视力提高及减少术后角膜散光。

Influence of clear corneal incisions on the corneal astigmatism after phacoemulsification

AIM ： To observe the influence of clear corneal incisions on the corneal astigmatism after phacoemulsification. METHODS ： 3.0mm clear corneal incision was done on the steep axis before phacoemulsification according to the test results of the IOL-Master in 42 eyes as the observation group （group A）. Conventional upper- temporal （ right eye） or upper-nasal （ left eye） 3.0ram clear corneal incisions were done in 68 eyes as control group （group B）. Changes of corneal astigmatism of preoperative and postoperative 1 day, 1 week, 1 month and months were observed. RESULTS： Preoperative and postoperative 1 day, 1 week, 1 month, 3 months visual acuity of group A was 0.2±0.24, 0.73±0.37, 0.78±0.38, 0.94±0.36; Group B, 0.17±0.2, 0.82±0.3, 0.84±0.2, 0.77±0.26, 0.8±0.36; The difference was not statistically significant （P〉 0. 05 ）. Corneal astigmatism of preoperative and postoperative 1 day, 1 week, 1 month, 3 months in group A were 1.01±0.10D, 1.33±0.13D, 1.15±0.14D, 0. 90±0.13D and 0.89± 0.12D; B group were 0.95±0.13D, 1.25±0.15D, 1.07±0.13D, 0.87±0.12D and 0.82±0.11D. Compared with the preoperative astigmatism, the changes of astigmatism on postoperative 1 day, 1 week, 1 month of two group had no statistical difference （P〉0.05）. The differences of astigmatism change before and 3 months postoperatively between two groups was statistically significant （P〈 0.05）. There were 21 eyes （50%） in group A and 32 eyes（47%） in group B respectively whose uncorrected visual acuity 〉10.8, the difference was statistically significant （ P 〈0.05）. CONCLUSION. Steep axis clear corneal incision cataract phacoemulsification could help reduce postoperative astigmatism and improve visual acuity accordingly.