2．2mm透明角膜切15飞秒激光辅助白内障超声乳化手术术源性散光的临床研究  

Investigation of surgically induced astigmatism resulting from femtosecond laser-assisted cataractsurgery using a 2.2 mm clear corneal incision

作　　者：李博[1] 张素华[1] 张哲[1] 刘建亭[1] 曹伟芳[1] 李晓艳[1] 董慧[1] 郭彩虹[1] 张海宁[1] 

机构地区：[1]山西省眼科医院,太原030000

出　　处：《中华眼视光学与视觉科学杂志》2016年第11期654-659,共6页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的观察飞秒激光辅助白内障超声乳化手术中2．2mm透明角膜切口引起的术源性散光（SIA）的影响因素。方法前瞻性研究。纳入2014年3月至2016年4月期间，在山西省眼科医院白内障一科行飞秒激光辅助白内障超声乳化手术的患者84例（105眼），测量并记录患者术前，术后1、3、6个月的裸眼视力（UCVA），球镜度和角膜地形图数据。视力记录为logMAR视力，使用Alpins矢量分析法计算SIA。并从术后随访时间（术后1、3、6个月3个时间点）、晶状体核硬度（分Ⅱ、Ⅲ、Ⅳ级核3组）、角膜散光类型（分顺规组、逆规组、斜轴组）、眼别（左眼组、右眼组）4个方面分析SIA。符合正态性分布的数据的比较使用重复测量的方差分析。结果84例（105眼）患者UCVA术前为0．65±0．24，术后1、3、6个月为0．07±0．02、0．06±0．01、0．06±0．01；手术前后比较差异有统计学意义（F=321．14，P〈0．01）；术后各时间点比较差异无统计学意义。术后1、3、6个月SIA分别为（0．28±o．11）D、（0．25±0．13）D、（0．24±0．10）D；3个时间点比较差异无统计学意义。按晶状体核硬度分组从时间上及组别间比较差异均无统计学意义；顺规组、逆规组、斜轴组3组从时间上及组别间比较差异均无统计学意义；右眼组与左眼组从时间上及组别间比较差异均无统计学意义。结论2．2mm透明角膜切口飞秒激光辅助白内障超声乳化术后SIA稳定，术后UCVA显著提高，且SIA与UCVA于术后1个月趋于稳定。Objective To evaluate surgically induced astigmatism （SIA） resulting from femtosecond laser-assisted phacoemulsification cataract surgery with a 2.2 mm clear corneal incision. Methods A prospective, comparative analysis was performed in a case series. A total of 105 eyes of 84 patients （from No. 1 cataract department of Shanxi Eye Hospital） who underwent femtosecond laser-assisted phacoemulsification cataract surgery between March 2014 and April 2016 were enrolled in this study. The main outcomes were a comparison of SIA, far visual acuity, and spherical refractive power preoperatively and l, 3, and 6 months postoperatively. Distance visual acuity was recorded as logMAR. Based on follow-up times （1, 3, and 6 months postoperatively）, lens nucleus hardness （grades lI, m, IV）, corneal astigmatism types （with-the-rule, against-the-rule, oblique） and laterality （left, right）, SIA was analyzed using Alphins vector analysis. Data were analyzed using repeated measured ANOVA. Results The mean preoperative logMAR visual acuity was 0.65±0.24, which was significantly different from postoperative logMAR visual acuity at 1 month （0.07±0.02）, 3 months （0.06±0.01）, and 6 months （0.06±0.01）. No significant logMAR visual acuity differences were found at the three postoperative follow-up times. SIAs at 1, 3, and 6 months after surgery were 0.28±0.11 D, 0.25＋0.13 D, 0.24±0.10 D, respectively. No statistically significant differences in SIA were foundwhen postoperative follow-up times （1, 3, and 6 months） and factor groups for lens nucleus hardness （grades Ⅱ、Ⅲ、Ⅳ）, corneal astigmatism types （with-the-rnle, against-the-role, oblique） and laterality （left, right） were compared. Conclusion Femtosecond laser-assisted phacoemulsification cataract surgery using a 2.2 mm clear corneal incision can provide stable SIA and better postoperative visual acuity.

关 键 词：白内障 超声乳化白内障吸除术 飞秒激光 术源性散光 

分 类 号：R779.6[医药卫生—眼科]