角膜地形图引导下白内障手术切口对角膜散光的矫正  

Correction of corneal astigmatism by topography-guided incision in cataract surgery

作　　者：孙小银[1] 李一壮[1] 钱涛[1] 

机构地区：[1]南京大学医学院附属鼓楼医院眼科南京宁益眼科中心,中国江苏省南京市210008

出　　处：《国际眼科杂志》2010年第3期462-465,共4页International Eye Science

摘　　要：目的:比较不同位置和形态的手术切口对白内障摘除术后角膜散光及裸眼视力的影响。方法:选取术前角膜散光值>1.00D的白内障患者43例52眼,将患者随机分成两组,A组患者采用超声乳化白内障吸除联合人工晶状体植入术,手术切口为位于上方10∶30～11∶30的透明角膜隧道切口。B组患者采用手法碎核白内障摘除联合人工晶状体植入术,其中角膜散光值为1.00～2.00D的患者,切口为位于角膜最大屈光度径线的直线形巩膜隧道切口,长度为6.0～7.0mm,角膜散光值>2.00D的患者,在上述直线形切口对侧角膜缘处,另作一弧形板层松解切口。分别于术后2wk,3mo随访患者,检查裸眼视力及行角膜地形图检查。结果:B组患者术后2wk,3mo裸眼视力好于A组。B组患者术后角膜散光度在术后2wk,3mo时均小于A组。结论:位于角膜最大屈光度径线的6.0～7.0mm直线形巩膜隧道切口,及此切口联合作对侧弧形板层松解切口均能有效矫正白内障术前存在的角膜散光,能够使患者获得更好的术后裸眼视力。AIM： To compare the effect of different incisions on corneal astigmatism and uncorrected visual acuity in cataract surgery. METHODS： Fifty-two eyes of 43 patients with corneal astigmatism above 1. 00D were selected to undergo cataract surgery. Patients were randomly divided into two groups. Group A underwent phacoemulsification and intraocular lens （IOL） implantation with clear corneal incision on superior position（10： 30-11：30 o＇clock）. Group B received extracapsular cataract extraction by manual nucleus division and IOL implantation. The eyes with astigmatism of 1. 00-2. 00D in group B received extracapsular cataract extraction with 6.0-7.0mm straight scleral tunnel incision at the maximum curvature meridian. The eyes with corneal astigmatism above 2.00D in group B received extracapsular cataract extraction with 6.0-7.0mm straight scleral tunnel incision at the maximum curvature meridian and an arcuate limbal incision 90° in length on the opposite side of the straight incision. The uncorrected visual acuity and corneal astigmatism were observed 2 weeks, 3 months after operation, RESULTS： Two weeks,3 months after operation, the uncorrected visual acuity in the group B was better than that in the group A. The corneal astigmatism in the group B was lower than that in the group A 2 weeks, 3 months postoperatively. CONCLUSION. The 6.0-7.0ram straight scleral tunnel incision at the maximum curvature meridian or together with an arcuate limbal incision straight incision in cataract on the opposite side of the surgery can reduce the preexisting corneal astigmatism. This is an effective way to achieve better visual quality after operation.

关 键 词：白内障 角膜散光 切口 

分 类 号：R779.66[医药卫生—眼科]