白内障手术联合角膜缘松解对散光的矫正  

Cataract Surgery with Limbal Relaxing Incisions (LRI) on Correction of Astigmatism

作　　者：吴昌睿[1] 林浩添[1] 晏丕松[1] 汪琪璘[1] 陈伟蓉[1] 

机构地区：[1]眼科学国家重点实验室//中山大学中山眼科中心,广东广州510060

出　　处：《中山大学学报（医学科学版）》2010年第6期736-739,共4页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家重点实验室专项经费资助项目;广东省科技计划(社会发展)项目(2009B080701017)

摘　　要：【目的】动态观察白内障超声乳化手术联合角膜缘松解对角膜散光的矫正效果。【方法】本研究纳入2009年11～12月在中山眼科中心住院的35例(37只眼)白内障患者。依据术前光学相干生物测量仪(IOL-Master)检测角膜散光的结果,分为对照组15例(15只眼,角膜散光<1.5m-1)和干预组20例(22只眼,角膜散光≥1.5m-1)。干预组于最陡角膜散光轴向上做一对角膜缘松解切口,同时按常规行颞侧透明角膜切口白内障超声乳化术,而对照组仅行颞侧透明角膜切口白内障超声乳化术。分别于术后1d、1周、1月、3月观察两组角膜散光情况,并进行统计分析。【结果】对照组和干预组术后裸眼视力均有明显改善,同时根据IOL-Master的检测结果,术前对照组及干预组角膜平均散光(m-1)分别为0.56±0.23、2.44±0.79;术后1天、1周、1月、3月对照组角膜平均散光分别为0.52±0.18、0.46±0.14、0.50±0.19、0.49±0.12,干预组角膜平均散光分别为0.96±0.49、0.90±0.45、1.12±0.46、1.13±0.43。统计学分析显示对照组手术前后角膜散光无明显变化,干预组术后各随访时间点散光与术前相比均有显著降低,但术后1月、3月与术后1周相比,角膜散光矫正效果有所回退。【结论】白内障超声乳化手术联合角膜缘松解是矫正白内障术前散光的一种简便、经济、安全、有效的方法。【Objective】 To observe the effect of phacoemulsification combined with limbal relaxing incisions （LRI） on the correction of preoperative corneal astigmatism. 【Methods】 Thirty-five cataract patients （37 eyes） hospitalized in Zhongshan Ophthalmic Center from November 2009 to December 2009 were involved in the study. According to the preoperative corneal astigmatism measured by IOL-master, they were divided into two groups. Twenty patients （22 eyes） whose preoperative corneal astigmatism larger than 1.5D were included in LRI group, while the other 15 patients （15 eyes） less than 1.5D were included in control group. LRI group received limbal relaxing incisions （LRI） at the steepest meridian axis during phacoemulsification with temporal corneal incision, and the control group only received phacoemulsification with temporal corneal incision. The residual astigmatism was measured using IOL-Master at 1 day, 1 week, 1 month and 3 months postoperatively and the results were statistically analyzed. 【Results】 In both groups, post-operative uncorrected visual acuity was significantly improved. Meanwhile, the mean pre- existing astigmatism （m-1） of control and LRI groups were 0.56 ± 0.23 and 2.44 ± 0.79, respectively. For LRI group, the post- operative astigmatism at 1 day, 1 week, 1 month and 3 months were 0.52 ± 0.18, 0.46 ± 0.14, 0.50 ± 0.19, and 0.49 ± 0.12; comparatively, the residual astigmatism of control group were 0.96 ± 0.49, 0.90 ± 0.45, 1.12 ± 0.46, and 1.13 ± 0.43. Statistical analysis indicated that no different astigmatism change was seen between pre- and post-operative in control group, but there were significantly difference between pre- and post-operative astigmatism of LRI group. We also found that the residual astigmatism at 1 month and 3 months after operation was larger than that at 1 week. 【Conclusions】 Limbal relaxing incisions （LRI） during phacoemulsification appear to be an easy-to-follow, economic, safe and effective procedure to reduce pre-existi

关 键 词：白内障超声乳化术 角膜缘松解 散光 

分 类 号：R77[医药卫生—眼科]