颞侧与鼻侧透明角膜切口白内障术后角膜形态变化的对比  

Comparison of corneal morphological changes between temporal and nasal transparent corneal incision in cataract surgery

作　　者：李斌 李俊逸 Li Bin;Li Junyi(Department of Ophthalmology,Shandong Provincial Corps Hospital of Chinese People’s Armed Police Forces,Jinan 250014,China)

机构地区：[1]武警山东省总队医院眼科,济南250014

出　　处：《中华眼外伤职业眼病杂志》2020年第10期721-726,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的比较两种透明角膜切口白内障手术后全角膜和角膜后表面形态及散光度的变化。方法前瞻性随机病例对照研究。武警山东省总队医院2016年8月至2018年3月100例年龄相关性白内障的左眼随机等分为两组:鼻侧切口组和颞侧切口组,各50例(50只眼)。所有患者行超声乳化术。分别利用屈光力矢量分析法和角膜地形图比较两组术后角膜散光和形态变化。随访观察8周。结果术后2周和4周,鼻侧切口组全角膜散光平均J0和J45值明显高于颞侧切口组(P<0.05),但术后2天和8周组间差异无统计学意义(均P>0.05)。角膜地形图显示术后2天两组角膜整体呈楔形变平,切口周围角膜后表面变陡,鼻侧切口组更为显著。术后8周,全角膜和角膜后表面的切口相关改变减少,两组间差异无统计学意义。结论超声乳化手术颞侧与鼻侧透明角膜切口术后8周角膜形态和散光度变化相似。Objective To compare the changes of the morphological and astigmatism of the total and posterior cornea between two corneal incisions after cataract surgery.Methods This was a prospective random case control study.The 100 left eyes of 100 patients with age-related cataract underwent phacoemulsification from Aug.2016 to Mar.2018 in Shandong Provincial Corps Hospital of Chinese People’s Armed Police Forces were randomly divided into two groups equally,as the nasal incision group and the temporal incision group.Corneal astigmatic changes were compared between the two groups with power vector analysis,and corneal morphological changes between the two groups were compared with corneal topography postoperatively.The follow-up time was 8 weeks.Results The mean J0 and J45 values of the total corneal astigmatism were significantly higher in the nasal incision group than those in the temporal incision group at 2 and 4 weeks postoperatively(all P<0.05).But the difference was not statistically significant between the two groups at 2 days and 8 weeks postoperatively(P>0.05).The corneal morphology revealed a wedge-shaped flattening in the total cornea and a steepening in the posterior cornea around the incision in the two groups at 2 days postoperatively,which were more prominent in the nasal incision group than those in the temporal incision group.The incision-related changes diminished at 8 weeks postoperatively in the total and posterior cornea.And the difference was not statistically significant between the two groups.Conclusion Corneal morphological and astigmatic changes are similar between temporal and nasal incision in phacoemulsification at 8 weeks postoperatively.

关 键 词：散光 角膜 像差 高阶 白内障 年龄相关性 

分 类 号：R779.66[医药卫生—眼科]