年龄相关性白内障手术前后角膜非球面性的改变及意义  

Significance and change of corneal asphericity in patients with age-related cataract before and after operation

作　　者：王艳[1] 刘二华[1] 谭钢[1] 

机构地区：[1]南华大学附属第一医院眼科,湖南衡阳421001

出　　处：《中国现代医学杂志》2012年第9期81-84,共4页China Journal of Modern Medicine

基　　金：国家自然科学基金(No:81100648);湖南省科技计划项目(No:2010FJ4135)

摘　　要：目的探讨年龄相关性白内障患者手术前后角膜非球面系数Q值的改变及临床意义。方法采用前瞻性研究方法,将217例(332眼)年龄相关性白内障患者分为巩膜隧道切口联合非球面人工晶体组、巩膜隧道切口联合球面人工晶体组、透明角膜切口联合非球面人工晶体组及透明角膜切口联合球面人工晶体组。对比观察术前和术后3个月时角膜Q值以及视力的变化情况。结果所有患者术后角膜Q值较术前略小(P=0.013)。采用巩膜隧道切口与透明角膜切口对角膜Q值的影响无统计学差异(P=0.462);植入非球面人工晶体较植入球面人工晶体可显著降低角膜Q值,差异有显著性(P<0.001)。结论年龄相关性白内障超声乳化联合人工晶体植入手术后患者的角膜Q值减小;这和手术切口的位置无关,而和植入晶体的类型有一定关系;非球面IOL植入术后视觉质量优于球面IOL植入,在一定程度上可能和其角膜Q值改变更接近于正常眼有关。【Objective】 To evaluate the corneal asphericity change after cataract surgery of patients with age-related cataract.【Methods】 217 patients（332 eyes） with age-related cataract were enrolled in this study.We used scleral tunnel incision or corneal incision,and used the implantation of non-spherical or spherical IOL for the surgery.After systemic postoperative follow-up,we compared preoperative and postoperative corneal Q value.【Results】 The Q values of all the patients decreased obviously after phacoemulsification surgery（P =0.013）.After 3 months postoperative,there was no difference between the patients used scleral tunnel incision（171eyes） and used corneal incision（161 eyes） on corneal Q values（P =0.462）.Nevertheless,implantation of aspherical IOL could reduce corneal Q values significantly than spherical IOL（P〈0.001）.【Conclusion】 The corneal Q value will be smaller after phacoemulsification and intraocular lens implantation in patients with age-related cataract.It has no relationship with the position and the surgical incision,but related with implantation of crystals.Aspherical IOL implantation had better visual quality than spherical IOL implantation,which maybe result in the corneal spherical nature change closer to the normal eye.

关 键 词：白内障 超声乳化白内障吸除术 角膜 非球面性 Q值 

分 类 号：R[医药卫生]