不同位置切口对非超声乳化白内障手术角膜散光控制的研究  

Corneal astigmatism correction by different posision of incision during manual small-incision cataract surgery

作　　者：戴红梅[1] 李兰[1] 吴柄成 杨文艳[1] 曹倩[1] 侯静[1] 李云川[1] 康艳伟[1] 

机构地区：[1]云南省昆明市第一人民医院眼科,昆明650011

出　　处：《中国实用眼科杂志》2015年第11期1235-1239,共5页Chinese Journal of Practical Ophthalmology

基　　金：云南省科技厅项目（2010ZC224）

摘　　要：目的研究手术切口位置对非超声乳化白内障手术角膜散光控制及手术效果的评价。方法采用临床病例对照研究。对2011年7月至2014年3月在昆明市第一医院眼科有≥0．5D角膜散光的白内障患者，按临床人院先后顺序随机分成三组：A组：颞上方角巩膜缘切口组23只眼，B组：颞上方巩膜切口组21只眼，C组：28只眼，选择最大角膜屈光度子午线方位做角巩膜缘切口，并在切口对侧180。角膜缘内制作一个穿透性切口。行非超声乳化白内障摘除联合人工晶状体植入术。分别于术前及术后1周、1个月、3月用TomeyIV角膜地形图测量角膜散光度和轴向，采用Vector矢量分析法计算手术源性散光，比较三组术后不同时间的裸眼视力、平均角膜散光度和手术源散光度。结果三组术后早期裸眼视力无显著性差异，C组术后1、3个月角膜散光度与A、B组比较有差异有统计学意义（P〈0．05），C组术后视力恢复好、角膜散光和手术源性散光最小。结论根据角膜地形图测量的散光轴位选择最大角膜屈光度子午线方位的角巩膜缘做手术主切口，联合对侧角膜缘穿透性切口，可以有效降低术前角膜散光及手术源性散光，提高患者术后视力和视觉质量。Objective To evaluate the effectiveness of corneal astigmatism correction with differ- ent position of incision. Methods Cataract patients with ≥0.5D astigmatism were divided into 3 groups randomly, A： upper temporal limbus incision （23 eyes）; B： temporal scleral incision （21 eyes）, C： 28 eyes, corneal astigmatism axial incisions combined with contralateral penetrating inci- sion. Corneal astigmatism and axial was measured by corneal topography measurement respectively pre-operation and post-operation at week 1, month 1 and 3. Surgically induced astigmatism was cal- culated by vector analysis. Postoperative uncorrected visual acuity, corneal astigmatism and surgically induced astigmatism were compared. Results Group C showed a better visual acuity, lower corneal astigmatism and surgically induced astigmatism. Conclusions Corneal astigmatism axial incisions combined with contralateral penetrating incision is a good choice to improve postoperative visual acu- ity and visual quality.

关 键 词：小切口 白内障囊外摘出术 最大角膜屈光度 手术源散光 

分 类 号：R779.66[医药卫生—眼科]