“T”切口对白内障伴高度角膜散光患者视功能和生存质量的影响  

Effects of “T”incision on visual function and quality of life of cataract patients with high corneal astigmatism

作　　者：李晓红[1] 张铁民[1] 

机构地区：[1]承德医学院附属医院眼科,河北省承德市067000

出　　处：《眼科新进展》2013年第12期1152-1155,共4页Recent Advances in Ophthalmology

摘　　要：目的评价"T"切口对白内障伴角膜高度散光患者视功能及生存质量的影响。方法年龄相关性白内障患者100例(100眼),角膜散光度均>2.00 D。将患者分为两组:A组50例(50眼),行透明角膜切口超声乳化白内障摘出联合后房型人工晶状体植入术;B组50例(50眼),先完成同A组的手术操作,然后以最陡峭子午线为中心,做成对横切口。观察患者术后1周、1个月、3个月的裸眼视力、角膜散光,术前及术后3个月视功能和生存质量量表得分情况。结果两组术后裸眼视力均较术前改善,A组术后1周、1个月、3个月裸眼视力分别为0.51±0.07、0.55±0.05、0.55±0.05,B组术后1周、1个月、3个月裸眼视力分别为0.56±0.05、0.70±0.10、0.82±0.06,两组术后各时间点比较差异均有统计学意义(P<0.05或P<0.01)。A组角膜散光矢量J0绝对值和P值术后1周、1个月、3个月分别为(1.27±0.14)D和(1.30±0.13)D、(1.23±0.15)D和(1.26±0.13)D、(1.20±0.14)D和(1.24±0.13)D,B组角膜散光矢量J0绝对值和P值术后1周、1个月、3个月分别为(0.89±0.19)D和(0.93±0.16)D、(0.71±0.19)D和(0.76±0.15)D、(0.65±0.19)D和(0.70±0.15)D,两组术后各时间点比较差异均有显著统计学意义(均为P<0.01),B组小于A组;术后两组在视觉适应、立体视觉、周边视野得分差异均有统计学意义(t=-2.994、-2.932、-2.478,P<0.01或P<0.05),在活动能力、社交能力、心理方面得分差异均有统计学意义(t=-2.536,-2.234,-2.727,均为P<0.05),B组高于A组。结论 "T"切口可以提高白内障伴高度角膜散光患者的视功能及生存质量。Objective To evaluate the effects of 'T' incision on visual function and quality of life(VF/QOL)cataract patients with high corneal astigmatism.Methods A total of 100 age-related cataract patients(100 eyes),preoperative corneal astigmatism >2.00 D,were randomly divided into two groups:Group A(50 cases,50 eyes)and group B(50 cases 50 eyes).The patients in group A received phacoemulsification and posterior chamber lens implantation with superior clear corneal incision, and based in the surgery of group A,an additional couple of 'T' incisions on the steepest meridian were made to release the preexisting corneal astigmatism in group B.The uncorrected visual acuity(UCVA)and corneal astigmatism at postoperative 1 week,1 month and 3 months were examined and the VF/QOL questionnaire were observed at pre-operation and postoperative 3 months.Results In both groups,the postoperative UCVA were significantly improved,UCVA at postoperative 1 week,1 month and 3 months in group A were 0.51±0.07,0.55±0.05 and 0.55±0.05,respectively,which in group B were 0.56±0.05, 0.70±0.10 and 0.82±0.06,respectively,there were statistical differences at different time points between two groups(P <0.05 or P<0.01).The corneal astigmatism vector J_0 and Pat postoperative 1 week,1 month and 3 months in group A were(1.27±0.14)D and(1.30±0.13)D,(1.23±0.15)D and(1.26±0.13)D,(1.20±0.14)D and(1.24± 0.13)D respectively which in group B were(0.89±0.19)D and(0.93±0.16)D,(0.71±0.19)D and(0.76±0. 15)D,(0.65±0.19)D and(0.70±0.15)D,respectively,there were statistical differences at different time points between two groups(all P<0.05)group B were smaller than group A.There were statistical differences in postoperative vision adaption scores stereo vision scores,peripheral visual field scores between two groups(t=-2.994,-2.932,-2. 478;P<0.01 or P<0.05),also statistical differences in ability of action scores,ability of social scores,condition of psychology scores(t=-2.536,-2.234,-2.727;all P<0.05)groupB were higher than group A.Conclusion The 'T

关 键 词：“T”切口 角膜散光 白内障 视功能 生存质量 

分 类 号：R779.66[医药卫生—眼科]