角膜地形图引导下白内障手术角膜切口对术后散光影响  

The influence of phacoemulsification incision decided by corneal topography on postoperative astigmatism

作　　者：王丽[1] 周永祚[1] 肖耀廷[1] 

机构地区：[1]上海市长宁区中心医院眼科,上海200336

出　　处：《眼外伤职业眼病杂志》2008年第2期96-98,共3页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的观察角膜地形图引导下白内障手术角膜切口对术后散光影响。方法透明角膜切口晶状体超声乳化术70眼,随机分成切口位于角膜最大屈光轴方向(A组)和切口位于常规90°方向(B组)两组,每组35眼。检测术前、术后1周、1月、3月角膜散光度和视力变化。结果由于失访,实际入组56例(61眼),A组28例(31眼),B组28例(30眼)。A组术前、术后1周、1月、3月角膜散光度分别为(1.13±0.12)D、(1.52±0.13)D、(1.38±0.10)D及(1.22±0.13)D;术后1月、3月与术前相比散光度差异无统计学意义(P>0.05)。B组为(1.00±0.14)D、(1.99±0.15)D、(1.62±0.14)D及(1.36±0.15)D,术后1月散光值仍大于术前(P<0.05)。A组术后1周、1月、3月与术前相比散光度的变化值分别为(0.45±0.18)D、(0.27±0.14)D和(0.11±0.13)D。B组为(0.98±0.16)D、(0.61±0.12)D、(0.44±0.08)D,均大于A组(P<0.05)。A组术后1月和3月视力>0.7者分别为11眼和14眼,要多于B组的4眼和6眼(P<0.05)。结论角膜地形图引导下位于角膜最大屈光轴方向的切口有助于控制术后散光和视力恢复。Objective To observe the influence of phacoe- mulsification incision decided by corneal topography system on post- operative astigmatism prospectively. Methods 70 eyes underwent phacoemulsification with corneal incision were randomly divided into two groups： group A （incision at the steepest corneal meridian decided by corneal topography and group B （incision at the superior）. The changes of corneal astigmatism before and after operation were compared as well as visual acuity. Results The actual members were 56 patients （61 eyes） because of failure of follow-up. Group A had 28 patients（31 eyes） and group B had 28 patients（30eyes）. The astigmatism were（1. 13±0. 12） D, （1.52 ± 0. 13） D, （1.38 ±0. 10）D,（1.22 ±0. 13）D before and 1 week, 1 month,3 months after operation respectively in group A. Both the latter two showed no difference compared with the first one （ P 〉 0.05 ）. In group B, the astigmatism （1.00 ±0. 14）D,（1.99 ±0. 15）D, （ 1.62 ±0. 14） D, （ 1.36 ± 0. 15 ） D respectively. Only the last one showed no difference compared with the first one （ P 〉 0. 05）. The changes of astigmatism were （ 0. 45 ±0. 18 ） D, （ 0. 27 ± 0. 14 ） D and （0. 11 ±0. 13）D 1 week, 1 month, 3 rmonths after operation respectively in group A, while （0. 98 ±0. 16）D,（0. 16 ±0. 12）D, （0.44 ±0. 08） D in group B. The difference were statistically significant （P 〈0.05）. There were 11 and 14 eyes obtained visual acuity to better than 0. 7 for 1 month and 3 months after operation, while 4 and 6 in group B（P 〈 0. 05）. Conclusions The incision at the steepest corneal meridian decided by corneal topography can reduce postoperative, astigmatism and help visual acuity to recover.

关 键 词：角膜地形图 白内障 角膜切口 散光 

分 类 号：R779.66[医药卫生—眼科]