白内障手术切口对角膜原有散光的影响  

Effect of cataract surgery incision on original corneal astigmatism

作　　者：邵敬芝[1] 张凤妍[1] 王显丽 冯帆[1] 高航[1] 

机构地区：[1]郑州大学第一附属医院眼科,河南省郑州市450052 [2]中平能化医疗集团总医院眼科,河南省平顶山市467000

出　　处：《眼科新进展》2011年第6期558-560,共3页Recent Advances in Ophthalmology

摘　　要：目的评价小切口常规白内障手术联合角膜缘松解切口矫正散光的效果。方法对角膜散光>1.00D的30例(37眼)老年性白内障患者进行研究,以散光度数≥2.00D为A组,共11例(13眼);散光度数小于2.00D为B组,共19例(24眼)。两组患者均在角膜最大屈光径线上行角膜缘切口白内障囊外摘出联合人工晶状体植入术,A组患者再在白内障手术切口对侧角膜缘处行4mm穿透性切口。检测术前、术后1周、1个月、3个月角膜散光度数和视力变化。采用SPSS17.0统计学软件进行分析。结果术后1周、1个月、3个月,A组平均视力分别为0.57±0.07、0.67±0.07、0.67±0.06,B组分别为0.52±0.07、0.56±0.06、0.59±0.06,A组术后各时间段均优于B组。A组患者术前平均散光度数为(3.06±0.89)D,术后1周、1个月、3个月平均散光度分别为(1.58±0.18)D、(1.18±0.17)D、(1.03±0.22)D,手术前后散光度数差异均有统计学意义(均为P<0.05)。B组患者术前平均散光度数为(1.69±0.17)D,术后1周、1个月、3个月平均散光度数分别为(0.67±0.04)D、(0.47±0.05)D、(0.26±0.13)D,手术前后散光度数差异有统计学意义(均为P<0.05)。术后3个月,A组患者角膜散光平均矫正量为(2.08±0.08)D,B组患者角膜散光平均矫正量为(1.42±0.02)D,A、B两组患者手术散光矫正量差异有统计学意义(P<0.05)。结论小切口常规白内障手术联合对侧角膜缘穿透性松解切口可以更大范围地矫正术前已存在的角膜散光,提高患者裸眼视力和减少患者的不适。Objective To evaluate the curative effect of the combination surgery including routine cataract surgery and limbal relaxing incisions to correct the pre-existing astigmatism.MethodsThirty patients with pre-existing astigmatism,whose pre-existing astigmatism was greater than 1.00D,were divided into group A（≥2.00 D,13 eyes）and group B（2.00 D,24 eyes）.All eyes were treated with the small-incision routine cataract surgery combined with intraocular lens implantation at the most dioptric strength meridians.Then a penetratical 4.0mm incision was made at the opposite side of former incision in each eye of group A.Preoperative and postoperative visual acuities,corneal refractions at 1 week,1 month and 3 months were recorded,and the changes of corneal astigmatism and visual acuities between the two groups were compared.ResultsAt postoperative 1 week,1 month and 3 months,average visual acuities were 0.57±0.07,0.67±0.07 and 0.67±0.06 in group A,0.52±0.07,0.56±0.06 and 0.59±0.06 in group B.Group A had better visual acuity than group B in each time point.In group A,the preoperative average astigmatism degree was（3.06±0.89）D;The postoperative average astigmatism degree were（1.58±0.18）D,（1.18±0.17）D,（1.03±0.22）D at 1 week,1 month and 3 months,respectively.There were statistical differences with astigmatism degree between pre-operation and post-operation（all P0.05）.In group B,the preoperative average astigmatism degree was（1.69±0.17）D;The postoperative average astigmatism degree were（0.67±0.04）D,（0.47±0.05）D,（0.26±0.13）D at 1 week,1 month and 3 months,respectively.There were statistical differences（all P0.05）.At the postoperative 3 months,the surgical correction amount of astigmatisin of group A and B were（2.08±0.08）D and（1.42±0.02）D.The amount of surgical correction of astigmatism between the two groups was statistically significant（P0.05）.ConclusionSmall incision routine cataract surgery combined with limbal corneal relaxing incision can correct pre-e

关 键 词：角膜地形图 白内障 角膜缘松解切口 角膜散光 

分 类 号：R772.2[医药卫生—眼科]