不同位置陡轴切口对角膜散光的影响  

Corneal astigmatism changes after cataract surgery with different incision locations on steep meridian

作　　者：谢灵仙[1] 石维练[2] 王勤美[1] 

机构地区：[1]温州医学院附属眼视光医院,浙江温州325027 [2]福鼎市医院眼科,福建福鼎355200

出　　处：《中国实用眼科杂志》2013年第3期286-288,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的评价在白内障超声乳化术中不同位置角膜陡轴上的角膜透明切口引起手术源性散光的情况。方法根据透明角膜切口位置，将100例（121只眼）进行3．00mm透明角膜切口白内障超声乳化吸除联合人T晶状体植入术的患者分为3组：A组上方切口，38只眼；B组颞侧切口，42只眼；C组颞上方切口，41只眼。术后1周、1月、3月进行随访，根据Pentacam结果采用矢量分析法对角膜散光及手术源性散光进行分析。结果A、B、C3组术后角膜散光均较术前下降，差异有统计学意义（P〈0．01）；术后1周与术后1月角膜散光比较差异有统计学意义（P=0．024）；术后1月与术后3月角膜散光比较差异无统计学意义（P〉0．05）；术后3月3组平均手术源性散光分别为（0．48±0．06）D，（0．26±0．04）D，（0．33±0．04）D，3组间手术源性散光差异有统计学意义（P〈0．01）。结论将白内障手术切口位置做在角膜曲率的陡轴上可以有效控制白内障患者术后残余散光，提高患者术后视觉质量；合理利用手术源性散光可以为白内障患者进行手术切口个性化设计。ObJective To evaluate surgically induced astigmatism （SIA） when locate the clear corneal incision on the preoperative steep meridian of the cornea in the cataract surgery. Methods According to where the corneal incision was chosen by rounding the steep corneal meridian to the closest 10 degrees, 100 patients （121 eyes） who had received phacoemulsification and IOL implantation with 3.0mm clear corneal incision, were divided into 3 groups： Group A, superior corneal inci- sion, 38 eyes; Group B, temporal incision, 42 eyes; Group C, superotemporal incision, 41 eyes. Pen- tacam results were obtained preoperatively, at postoperative 1 week, 1 month and 3 months. Corneal astigmatism changes and SIA were analyzed with vector method. Results Compared with the preoperative corneal astigmatism, the postoperative astigmatism decreased significantly in 3 groups （P 〈 0.01）. The corneal astigmatism had significant difference between 1 week and 1 month （P =0.024）, but not between 1 month and 3 months （P 〉0.05）. The SIA was （0.48±0.06）D, （0.26±0.04）D, （0.33± 0.04）D respectively, the difference was significant among 3 groups （P 〈0.01）. Conclusions Choosing the corneal incision based on the preoperative steep meridian significantly decrease residual astigmatism. It is feasible to utilize the SIA reasonably for individually incision design in cataract surgery.

关 键 词：手术源性散光 白内障手术 角膜散光 

分 类 号：R778.11[医药卫生—眼科]