小切口非超声乳化术中不同位置的切口对术后角膜散光度及角膜内皮细胞变化的影响  

The effect of different incisions on astigmatism and corneal endothelium in small incision non-phacoemulsification

作　　者：王青[1] 廖荣丰[2] 刘兴华[2] 汪永[2] 周艳峰[2] 

机构地区：[1]安徽医科大学第四附属医院眼科,230022 [2]安徽医科大学第一附属医院眼科,230022

出　　处：《实用防盲技术》2011年第2期62-65,83,共5页Journal of Practical Preventing Blind

摘　　要：目的研究距角膜缘不同距离切口对非超声乳化小切口白内障人工晶体植入术后角膜散光及角膜内皮细胞变化的影响。方法对150例(150只眼)白内障患者按切口距角膜缘距离分为A、B和C三组。在角膜上方部位行直线形切口的非超声乳化小切口白内障人工晶体植入术。分别于术前及术后1周、1个月、3个月用角膜地形图仪测量平均角膜散光度,用角膜内皮显微镜测量角膜内皮细胞计数。比较三组的平均角膜散光度和角膜内皮细胞平均密度及细胞平均丢失率。结果 A、B、C组的平均角膜散光度在术后一周时分别是(2.29±0.84)、(1.90±0.77)、(1.79±0.85)D,其中A组与B组差异有统计学意义(P=0.008),B组与C组差异无统计学意义(P=0.0573),术后1月、术后3月各组差异无统计学意义(P>0.05)。三组的角膜内皮细胞密度及角膜内皮细胞丢失率在术后差异无统计学意义(P>0.05)。结论切口所处的位置距角膜屈光中心的距离越远,术后早期平均角膜散光度越小。白内障手术切口与术后角膜内皮细胞丢失无直接关系。非超声乳化小切口白内障人工晶体植入术的最佳切口位置是角膜缘后2.0mm。Objetive To study the effect of incisions with different distance from limbus on the changes of postoperative astigmatism and corneal endothelium after small incision non-phacoemulsification cataract extraction.33To evaluate the effect of manual small-incision extracapsular cataract extraction combined with trabeculectomy.Methods 150 eyes of 150 patients were divided into three groups according to the incision location：Group A comprised of 48 eyes which had incision 1.5mm away from limbus,Group B comprised of 48 eyes which had incision 2.0mm away from limbus,Group C comprised of 54 eyes which had incision 2.5mm away from limbus.All patients were treated with small incision non-phacoemulsification cataract extraction and intraocular lens implantation through a straight-line incision were examined by corneal topography and specular microscopy preoperatively,one week,one month and three months postoperatively.We compared mean corneal astigmatism and the density of corneal endothelium among three groups up to 3 months postoperatively.Results Mean corneal astigmatism in Group A,Group B,Group C were（2.29卤0.84）銆？1.90卤0.77）銆？1.79卤0.85）D,at 1 week postoperatively.respectively Difference was are significant between group A and goup B（P=0.008）,but was are not significant between group B and group C（P=0.0573）.The difference of changes in the density of corneal endothelium was not significant among the three different incisions（P〉 0.05）,and the difference of percentages of endothelium loss was not significantly either（P 〉0.05）.Conclusion If incision location away from the corneal refractive center be farther,mean corneal astigmatism is smaller in the early time postoperatively.Cataract operation with different incisions does not produce significant influence on the loss of corneal endothelial cells.The best position of incision in small incision non-phacoemulsification is 2.0mm away from limbus.

关 键 词：白内障 角膜散光 切口 人工晶体 角膜内皮细胞 

分 类 号：R779.66[医药卫生—眼科]