切口位置选择对散光型人工晶状体植入术影响预测分析  

Predictive analysis the effects of clear corneal temporal and on-axis incisions on surgical planning for the Acrysoftoric intraocular lens

作　　者：徐力[1] 张晓云[1] 林英[2] 陈楚音[2] 

机构地区：[1]内蒙古医学院附届医院,呼和浩特010050 [2]中山大学中山眼科中心 眼科学国家重点实验室,广州510060

出　　处：《中国实用眼科杂志》2010年第11期1255-1258,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的 以两种不同位置的角膜切口设计手术,预测其对植入散光型人工晶状体（Acrysof toricIOL）手术计划的影响.方法 收集白内障专科拟行手术治疗的年龄相关性白内障患者1389例（1389只跟）的术前角膜曲率资料,双跟患者纳入第一发病眼,以0.50D作为手术源性散光值（Surgically induced astigmatism,SIA）,分别以两种不同位置手术切口,即颞侧角膜切口（Temporal clear corneal incision,TCCI）或陡峭轴角膜切口（On-axis clear corneal incision,OCCI）进行手术设计,通过在线Acrysof toric IOL计算器运算,比较在本观察人群中两种手术设计的差异.结果 （1）Acrysof toric IOL预计植入率比较：OCCI组小于TCCI组,差异有统计学意义（x2=10.529,P=0.004）.（2）Acrysof toric IOL植入手术预计散光矫正量比较：OCCI组高于TCCI组,差异有统计学意义（三种型号的Acrysof toric IOL：SN60T3、T4、T5的P值分别为0.000,0.000,0.001）,而预计术后残留散光量两组差异无统计学意义（SN60T3、T4、T5的P值分别为0.760,0.560,0.594）.结论 手术切口位置的不同选择可以影响Acrysof toric手术设计：OCCI设计有提高手术的散光矫正量,和减少散光型晶状体植入的可能.Objective To evaluate the expected effects of 2 types of clear corneal incisions used in phacoemulsification on surgical planning for the Acrysof toric intraocular lens （Acrysof toric IOL）： the temporal and the on-axis （i.e on steeper corneal meridian） clear corneal incision （TCCI and OCCI, respectively）. Methods Preoperative keratometric data were obtained from 1389 patients （1389 eyes） with cataract. Anticipated residual astigmatism and IOL type were calculated using 0.50 D a presumed surgery induced astigmatism （SIA）value in the Acrysof toric IOL Calculator for TCCI or OCCI, respectively. Difference of anticipated implantation rate and capacity of correct corneal astigmatism were analyzed. Results Compared the anticipated values between the two groups： 1） The OCCI could decrease the anticipated implantation rate of Acrysof toric IOL （x2 = 10.529, P =0.004）; 2） The OCCI could raise the anticipated ability of Acrysof toric IOL implantation surgery to correct corneal astigmatism. The average amount of anticipated correct astigmatism was increased significantly （P value of 3 toric models： SN60T3, T4, T5 was 0.000, 0.000, 0.001, respectively）, and the difference of average amount of anticipated residual astigmatism was not significant （P value of SN60T3, T4, T5 was 0.760, 0.560, 0.594, respectively）. Conclusions In the designment period, the different choice of the incision location can affect the Acrysof toric IOL application. Compared with the TCCI, the OCCI can take advantage of the SIA to release preexisting corneal astigmatism without being affected by astigmatism type. As a result, the corneal astigmatism reduced by the OCCI can raise the anticipated capability to correct corneal astigmatism.The potential clinical significance is to reduce the implantation rate of Acrysof toric IOL.

关 键 词：白内障 散光 人工晶状体 

分 类 号：R776.1[医药卫生—眼科]