白内障手术同时矫正散光的远期疗效观察  

Long-term clinical efficacy of simultaneous treatment of astigmatism during cataract surgery

作　　者：江文捷 曲超[2] JIANG Wen - jie;QU Chao(Clinical Medical College of Southwest Medical University, Luzhou 646000, Sichuan, Chin)

机构地区：[1]西南医科大学临床医学院,四川泸州646000 [2]四川省医学科学院.四川省人民医院眼科,四川成都610072

出　　处：《广东医学》2018年第9期1353-1358,共6页Guangdong Medical Journal

基　　金：国家自然科学基金资助项目(编号:81570848)

摘　　要：目的观察不同术式矫正年龄相关性白内障术前散光的远期临床疗效。方法选取角膜散光≥0.5D的白内障患者共126例(141眼)。角膜散光在0.5~1.0D的患者43例(48眼),按就诊顺序分为观察组A1组22例(25眼)和对照组A2组21例(23眼);角膜散光在1.0~1.5D的患者44例(48眼),分为观察组B1组23例(26眼),对照组B2组21例(22眼);角膜散光>1.5D的患者39例(45眼),分为观察组C1组19例(23眼),对照组C2组20例(22眼)。对照组在角膜135°方向行2.8 mm主切口,按常规行白内障摘除联合人工晶体植入术;A1组于角膜最陡峭子午线行2.8 mm主切口,余操作同对照组;B1组先利用飞秒激光作角膜松解切口、主切口、辅助切口,余操作同对照组;C1组除了植入Toric IOL外,其余操作同对照组。比较观察组和对照组患者术后的主观视觉质量、视力、散光度数以及对比敏感度,比较观察组各术式的散光矫正效果。结果末次随访时间均值为11.5个月。观察组术后总和散光的矢量合成值及矢量分解值均小于对照组(P<0.01);观察组患者的主观视觉质量、裸眼视力、昼夜不同空间频率下的对比敏感度均优于对照组(P<0.05)。末次随访时,A1、B1、C1组的矫正率分别为(46.5±42.5)%、(66.0±27.2)%、(87.8±26.4)%,C1组优于A1组和B1组(P<0.05),A1组与B1组之间差异无统计学意义(P>0.05)。结论选择在陡峭子午线上作切口、飞秒激光的辅助以及植入Toric IOL三种方式在术后远期仍具有较好的散光矫正效果,患者拥有良好的视觉质量。Objective To observe the long-term clinical efficacy of different surgical techniques combined with preoperative astigmatism for senile cataract. Methods A total of 126 senile cataract patients（ 141 eyes） with preoperative astigmatism（ ≥0. 5D）,who underwent selective cataract ultrasonic emulsification resorption combined with intraocular lens implantation,were selected. Among them,43 patients（ 48 eyes） with preoperative astigmatism in 0. 5 - 1. 0D were divided into observation group A1（ 22 patients,25 eyes） and control group A2（ 21 patients,23 eyes）; 44 patients（ 48 eyes） with preoperative astigmatism in 1. 0 - 1. 5D were divided into observation group B1（ 23 patients,26 eyes）and control group B2（ 21 patients,22 eyes）; and 39 patients（ 45 eyes） with preoperative astigmatism ≥1. 5D were divided into observation group C1（ 19 patients,23 eyes） and control group C2（ 20 patients,22 eyes）. Control groups received superior（ 135°） 2. 8 mm clear corneal incision（ CCI） during phacoemulsification; Group A1 received 2. 8 mm CCI at the steepest meridian axis during phacoemulsification; Group B1 received corneal releasing incision,the main and auxiliary incision by femtosecond laser,and the remaining operation was as the control group; Group C1 received the Toric IOL implantation after phacoemulsification. The postoperative subjective visual quality,uncorrected visual acuity,and astigmatism and contrast sensitivity（ CS） were compared among observation groups and control groups. The astigmatism correction index was compared among the observation groups. Results With an average follow-up of 11. 5 months,the postoperative total astigmatism（ include vector composite value and vector decomposition value） of the observation group was significantly lower than that of the control group（ P 〈 0. 01）. The improvement of subjective visual quality,uncorrected visual acuity,day and night contrast sensitivity in different spatial frequency of the observation group were si

关 键 词：超声乳化白内障手术 散光矫正 远期疗效 

分 类 号：R779.66[医药卫生—眼科]