不同轴向透明角膜切口对低角膜散光度数白内障患者术后视力及角膜散光的影响  

Effects of different axial clear corneal incisions on postoperative visual acuity and corneal astigmatism in cataract patients with low corneal astigmatism

作　　者：唐雪珊 杨勇[1] 梁皓[1] TANG Xue-shan;YANG Yong;LIANG Hao(Department of Ophthalmology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院眼科,南宁市530021

出　　处：《广西医学》2018年第19期2257-2260,共4页Guangxi Medical Journal

基　　金：国家自然科学基金(81360146);广西医药卫生科研课题(Z2016309)

摘　　要：目的探讨不同轴向透明角膜切口对低角膜散光度数白内障患者超声乳化术后视力及角膜散光的影响。方法选取术前角膜散光≤0. 5 D的98例(100眼)白内障患者,均行白内障超声乳化术,根据术前角膜散光轴位将其分成3组,A组29例(30眼)行陡轴切口,B组33例(33眼)行平坦轴切口,C组36例(37眼)行中间轴切口。记录术前、术后1周、1个月、3个月的裸眼视力、矫正视力及角膜散光度大小和轴向变化,并采用Jaffe矢量分析法计算角膜术源性散光(SIA)。结果在术后1周、1个月、3个月,3组裸眼视力和矫正视力比较,差异均无统计学意义(均P> 0. 05)。术后1个月及3个月,A组角膜散光均低于B组及C组(均P <0. 05)。术后1周、1个月及3个月时,3组SIA比较差异均无统计学意义(均P> 0. 05)。A组术前与术后各时间点的角膜散光轴向比较,差异无统计学意义(均P> 0. 05),B、C两组术前与术后各时间点的角膜散光轴向比较,差异有统计学意义(均P <0. 05)。结论当白内障患者术前角膜散光≤0. 5 D时,选择陡轴向的切口可获得较佳的术后裸眼视力及矫正视力,且角膜散光度更小,术后轴位较稳定,能获得更好的视觉质量。Objective To investigate the effects of different axial clear corneal incisions on the postoperative visual acuity and corneal astigmatism in the cataract patients with low corneal astigmatism receiving phacoemulsification.Methods Ninety-eight patients(100 eyes)with cataract,whose preoperative corneal astigmatism were within 0.5 D,underwent phacoemulsification.And they were divided into three groups according to their preoperative corneal astigmatism axial positions,group A(29 cases,30 eyes),group B(33 cases,33 eyes)and group C(36 cases,37 eyes).The incisions of steep,flat and intermediate corneal meridian were adopted in group A,group B and group C respectively.The preoperative,postoperative 1-week,1-month and 3-month uncorrected visual acuity,corrected visual acuity as well as degree and axial changes of corneal astigmatism were recorded,and the corneal surgically induced astigmatism(SIA)was calculated using the Jaffe′s vector analysis.Results At 1 week,1 and 3 months after operation,no statistically significant difference was found among the three groups in the uncorrected visual acuity or corrected visual acuity(all P>0.05).At 1 and 3 months after surgery,the corneal astigmatism in group A was lower than that in group B or group C(all P<0.05).There was no statistically significant difference in the SIA among the three groups at 1 week,1 or 3 months after operation(all P>0.05).The preoperative astigmatism axis didn′t statistically differ from the postoperative one in any time point in group A(all P>0.05),but statistically differed from the postoperative one in each time point in group B and group C(all P<0.05).Conclusion The cataract patients using the corneal steep meridian incision,with the preoperative corneal astigmatism less than 0.5 D,can obtain better postoperative uncorrected visual acuity and corrected visual acuity after surgery,decreased corneal astigmatism and more stable postoperative axial position,achieving better visual quality.

关 键 词：白内障 透明角膜切口 散光轴位 角膜散光 视力 

分 类 号：R776.1[医药卫生—眼科]