不同长度角膜缘切口对白内障超声乳化术后角膜前后表面高阶像差影响对比  

Influence of different length corneal limbal incisions on the anterior and posterior corneal high order aberrations after phacoemulsification

作　　者：常平骏[1] 喻芳[1] 王丹丹[1] 赵云娥[1] 

机构地区：[1]温州医学院附属眼视光医院,325027

出　　处：《中国实用眼科杂志》2013年第10期1263-1267,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的采用Pentacam系统对2．2mm、3．0mm两种角膜缘切口白内障超声乳化吸除联合人丁晶状体植入术后角膜前后表面高阶像差的变化以及两组间手术源性高阶像差值进行对比研究。方法前瞻性对照临床研究。对2010年7～12月在温州医学院附属眼视光医院就诊的33例（55只眼）年龄相关性白内障患者分成2．2mm切口组和3．0mm切口组，行白内障超声乳化吸除联合折叠型人工晶状体植入术，分别于术前1d，术后3个月利用Pentacam系统测量并计算角膜前后表面的高阶像差（包括总的高阶像差、球差、彗差、三叶草、四叶草以及二次散光）。使用独立样本t检验比较两组术前与术后角膜前后表面各高阶像差以及两组间角膜前后表面手术源性高阶像差。结果两组白内障超声乳化吸除并人丁品状体植入术前、术后角膜前表面各指标高阶像差值差异均无统计学意义。3．0mm切口组角膜后表面总的高阶像差值术前1d为（0．186±0．036）μm，至术后3个月时明显增加为（0．217±0．04）μm，手术前后变化差异有统计学意义（P=O．046）。2．2mm切口组角膜后表面球差术前1d为（-0．128±0．036）μm，至术后3个月时增加为（-0．157±0．025）μm，手术前后变化差异有统计学意义（P=0．043）。其余各项高阶像差指标手术前后的差异均无统计学意义。两组角膜前后表面手术源性高阶像差的差异均无统计学意义。结论2．2mm组及3．0mm组白内障超声乳化吸除联合人工晶状体植入术后角膜前表面高阶像差及两组问手术源性高阶像差均无明显变化。3．0mm切口组较2．2mm切口组术后角膜后表面高阶像差改变差异有统计学意义，是否导致两组间术后视觉质量的差异还有待进一步研究。Objective To study the effect of limbal incision with 2.2mm and 3.0mm of phaco-emulsification surgery on the optical high order aberrations （HOA） of the cornea measured with pen-tacam. Methods It was a prospective case series study. Fifty-five eyes of 33 patients were divided into 2.2mm group and 3.0mm group based on the size of limbal incision. HOAs of the anterior and posterior surface of cornea were measured by pentacam before and after 3 months of phacoemulsifi-cation surgery. HOAs included the total high order aberration （tHOA）, spherical aberration （SA）, co-ma, trefoil, four-leaf clover and secondary astigmatism. Independent samples group t test were con-ducted to compare the difference of HOA between the two groups. Results The HOAs of the ante-rior surface was not statistically significant between 3.0mm group and 2.2mm group. The HOA of posterior surface increased from a mean of （0.186±0.036）μm preoperatively to （-0.128±0.036）μm post-operatively in 3.0 group. The increase was statistically difference （P =0.046）. The HOA of posterior surface increased from a mean of （-0.128±0.036）μm preoperatively to （-0.157±0.025）μm postoperatively in 2.2 group. The increase was statistically difference （P =0.043）. The changes of other HOAs and HOAs caused by surgery were no significant differences. Conclusions HOA of anterior surface, as well as caused by surgery are not significant different between 2.2mm group and 3.0mm group. There are sig- nificant differences in HOA of posterior surface between 2.2mm group and 3.0mm group. However, whether it is a factor to induce disparity of visual acuity needs to be further investigated.

关 键 词：超声乳化 角膜 高阶像差 后表面 

分 类 号：R779.66[医药卫生—眼科]