两种散光矫正方式治疗白内障合并中低度数角膜散光的临床对比研究  

Clinical comparative study of two kinds of astigmatism correction methods in treating cataract combined with moderate and low corneal astigmatism

作　　者：王海燕[1] 孙朝晖[1] 冯艳霞[1] 李亚楠[1] 李小磊 左建霞[1] 霍伊明 WANG Hai-yan;SUN Chao-hui;FENG Yan-xia(Department of Ophthalmology,The No.1 Hospital of Shijiazhuang,Shijiazhuang 050000,China)

机构地区：[1]石家庄市第一医院眼科,河北石家庄050000

出　　处：《中国医学装备》2020年第8期113-117,共5页China Medical Equipment

基　　金：河北省卫生厅重点科技研究计划(20191477)“白内障合并中低度数角膜散光患者矫正角膜散光后的长期视觉质量研究”。

摘　　要：目的:对比研究角膜缘松解切开(LRI)术与散光晶体植入术在治疗伴有中低度数角膜散光白内障患者中的临床效果。方法:选取在医院就诊的502例(502眼)白内障合并中低度数角膜散光患者,根据治疗方法的不同将其分为LRI组(238例)和散光晶体组(264例);LRI组采用LRI术,散光晶体组采用散光晶体植入术对患者行白内障超声乳化联合散光矫正术。统计分析两组术前,以及术后1周、1个月、3个月和6个月时的裸眼远视力(UCVA)、最佳矫正远视力(BCVA)、角膜散光及显然验光等屈光指标。结果:散光晶体组和LRI组患者术后1周、1个月、3个月和6个月时的UCVA及BCVA均较术前提高,差异有统计学意义(F散光晶体组=8.312,F=5.354;FLRI组=6.214,F=4.132;P<0.05);散光晶体组术后6个月时的UCVA和BCVA略好于LRI组,差异有统计学意义(t=3.82,t=3.76;P<0.05);散光晶体组和LRI组患者术后1周、1个月、3个月和6个月时的显然验光散光结果较术前明显减小(F=5.835,F=4.334;P<0.05);LRI组术后6个月的显然验光散光结果高于散光晶体组,差异有统计学意义(t=2.75,P<0.05)。LRI组术后不同时间点角膜散光较术前降低,差异有统计学意义(F=6.214,P<0.05),散光晶体组术后1周、1个月、3个月和6个月时的角膜散光明显高于LRI组,差异有统计学意义(t=1.73,t=2.85,t=2.73,t=1.65;P<0.05)。结论:两种散光矫正方式对角膜散光矫正作用大致相同,但应用角膜松解刀进行角膜缘松解切开术相对经济、安全且有效,是一种较好的角膜散光矫正方法。Objective: To compare and study the clinical effect of limbal relaxing incisions(LRI) and implantation of astigmatism intraocular lens in treating patients with cataract combined with moderate and low corneal astigmatism. Methods: 502 patients(502 eyes) with cataract combined with moderate and low corneal astigmatism who admitted to hospital were selected, and were divided into LRI group(238 cases) and astigmatism lens group(264 cases) according to different therapeutic method. The LRI group adopted LRI technique, and the astigmatism lens group adopted astigmatism lens implantation to implement the combination of cataract ultrasonic emulsification and astigmatism diorthosis. And then, the uncorrected distance visual acuity(UCVA), best corrected distance visual acuity(BCVA), corneal astigmatism and manifest refraction of two groups before surgery, and at the 1 th week, the 1 th month, the 3 th month and the 6 th month after surgery were further analyzed as statistic method. Results: The UCVA and BCVA of two group at the 1 th week, the 1 th month, the 3 th month and the 6 th month after surgery were sisgnificantly better than those before surgery(Fastigmatism lens group=8.312, F=5.354, FLRI=6.214, F=4.132, P<0.05), respectively. And the UCVA and BCVA of astigmatism lens group were better than those of LRI group at the 6 th month after surgery(t=3.82, t=3.76, P<0.05). Compared with the preoperative results, the astigmatism of manifest refraction of the two groups at the 1 th week, the 1 th month, the 3 th month and the 6 th month after surgery were significantly reduced(F= 5.835, F=4.334, P<0.05), respectively. Astigmatism of manifest refraction in LRI group was significantly higher than that of astigmatism lens group at the 6 th months after surgery(t=2.75, P<0.05). The results of corneal astigmatism in LRI group at different time points after surgery were significantly lower than those before surgery(F=6.214, P<0.05). And the corneal astigmatism of astigmatism lens group at the 1 th week, the 1 th month, the 3 th

关 键 词：角膜松解保护刀 白内障 角膜散光 散光型人工晶状体 角膜缘松解切开(LRI)术 

分 类 号：R776.1[医药卫生—眼科]