机构地区:[1]首都医科大学附属北京同仁医院同仁眼科中心北京市眼科学与视觉科学实验室,100730
出 处:《中华眼视光学与视觉科学杂志》2012年第7期388-392,共5页Chinese Journal Of Optometry Ophthalmology And Visual Science
基 金:北京市自然科学基金(7092021,7112031);国家自然科学基金(81041018);北京市卫生系统高层次卫生技术人才培养计划(2009-3-32)
摘 要:目的比较23-G微创与常规20-G玻璃体手术后角膜屈光状态改变的差异。方法前瞻性病例对照研究。选择同仁医院眼科中心2011年1月至2012年3月间行23.G微创玻璃体手术的患者44例(44眼)为23.G组,同期行20.G玻璃体手术的48例(48眼)患者为20.G组,分别于术前,术后2周、1个月、3个月行角膜地形图检查观察角膜屈光状态的改变。记录角膜地形图参数并进行比较分析。采用单因素方差分析,两样本t检验和x2检验。结果①术后3个月两组角膜地形图形态与术前比较差异无统计学意义(x2=5.26,P〉0.05)。②20.G组内比较:术后1个月及3个月角膜曲率参数SimK2、MeanK低于术前(t=1.08、-3.67,P〈0.05),术后3d、2周及1个月角膜散光参数8SimK高于术前(t=0.53、0.9、0.56,P〈0.05),角膜表面规则参数术后3d高于术前(t=0.74、0.63、1.08,P〈0.05)。23-G组内比较:术后3d及术后2周角膜曲率参数SimKl高于术前(t=0.37、0.46,P〈0.05),角膜散光及角膜表面规则参数术后3d高于术前(P〈0.01)。③与23,G组比较,20.G组术后1个月及3个月角膜曲率参数较低(P〈0.05),而散光参数较高(仁0.81、1.08,P〈0.05),角膜表面规则参数较高(P(0.05)。结论20-G组患眼术后散光于术后1—3个月恢复至术前状态,但是术后3个月曲率依然低于术前:23-G组患眼术后角膜屈光状态于术后2周至1个月恢复至术前状态。与23.G组比较.20-G组术后曲率低而散光高。由此可见,23-G玻璃体手术后切口愈合时间短,角膜屈光状态的改变小。Objective To observe corneal refractive change after 20-G and 23-G incision vitreoretinal surgery. Methods It was a prospective case-control study. Forty-four patients (44 eyes) who underwent 23-G vitreoretinal surgery were selected for a 23-G grouPsand 48 patients (48 eyes) who underwent 20-G vitreoretinal surgery during the same period were selected for the 20-G group. Corneal topography was performed before surgery and 3 days, 2 weeks, 1 month and 3 months postoperatively. The corneal topography parameters were recorded and the data were analyzed by ANOVA, independent samples t test and x2 test. Results (1)Corneal topography showed no significant differences in shape preoperatively compared to 3 months postoperatively 0(2=-5.26, P〉0.05). (2)In the 20-G group: corneal curvature was reduced at 1 and 3 months postoperatively compared to preoperative parameters (t=1.08, -3.67, P〈0.05). Corneal astigmatism 3 days, 2 weeks and 1 month postoperatively was higher than preoperative parameters (t=0.53, 0.9, 0.56, P〈0.05). The regular parameters of the corneal surface were higher 3 days postoperatively compared to preoperative parameters (t=0.74, 0.63, 1.08, P〈0.05). In the 23-G group: corneal curvature was higher 3 days and 2 weeks postoperatively compared to preoperative parameters (t=0.37, 0.46, P〈0.05). Corneal astigmatism and the regular parameters of the corneal surface were higher 3 days postoperatively compared to preoperative parameters (P〈0.01). (3)The 20-G group had lower corneal curvature parameters (P〈0.05), higher astigmatism parameters (t=0.81, 1.08, P〈0.05), and higher corneal surface regularity (P〈0.05) compared to the 23-G group. Conclusion Astigmatism recovered to preoperative levels in 1-3 months postoperatively, and corneal curvature was lower 3 months postoperatively compared to preoperative curvature. In the 23-G group, the corneal refractive status recovered to preoperative levels in from 2 weeks to 3 months postoperativ
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