透明角膜切口选择对白内障超声乳化术后角膜散光的影响研究  

Effect of transparent corneal incision on corneal astigmatism after phacoemulsification of cataract

作　　者：李金奇[1] 黄妙 程巧敏 杜伟雄 Li Jinqi;Huang Miao;Cheng Qiaomin;Du Weixiong(The Second People's Hospital of Zhaoqing City,Guangdong Province,Guangdong Zhaoqing 526060)

机构地区：[1]广东省肇庆市第二人民医院,广东肇庆526060

出　　处：《中国社区医师》2020年第34期38-39,共2页Chinese Community Doctors

摘　　要：目的:研究白内障超声乳化人工晶状体植入手术不同位置角膜切口对术后角膜散光的影响。方法:选取2018年5月-2019年4月年龄相关性白内障患者120例(120眼),随机分为三组,各40例。上方切口组行3.2 mm上方切口白内障摘除联合人工晶状体植入术;颞侧切口组行颞侧切口白内障摘除联合人工晶状体植入术;曲光轴位组根据角膜曲率最大屈光轴方向选择切口。比较三组手术源性角膜散光度情况。结果:各组患者术后1 d、1周、1个月及3个月平均角膜散光度情况比较,曲光轴位组均低于上方切口组和颞侧切口组,差异有统计学意义(P<0.05)。术后1周~3个月,各组手术源性散光度均呈缓慢降低趋势,且曲光轴位组术后1个月、3个月平均角膜散光度均低于上方切口组和颞侧切口组,差异有统计学意义(P<0.05)。结论:根据角膜曲率最大屈光轴方向调整切口,可以最大限度减少手术源性散光的产生,精细化选择是实现术后恢复视觉质量有效而关键的途径。Objective:To study the effect of different corneal incisions on postoperative corneal astigmatism after phacoemulsification and intraocular lens implantation.Methods:From May 2018 to April 2019,120 patients(120 eyes)with age-related cataract were selected,they were randomly divided into the three groups with 40 cases in each group.The upper incision group received cataract extraction combined with intraocular lens implantation with 3.2 mm upper incision.The temporal incision group received cataract extraction with temporal incision combined with intraocular lens implantation.The curvature axis group selected the incision according to the direction of the maximum refractive axis of corneal curvature.The corneal astigmatism,surgical corneal astigmatism and best corrected visual acuity were compared among the three groups.Results:The postoperative visual acuity was significantly improved in all groups.The average postoperative corneal astigmatism in the curvature axial position group was significantly lower than that in the upper incision group and temporal incision group,the differences were statistically significant(P<0.05).The average corneal astigmatism in the curvature axial position group was significantly lower than that in the upper incision group and the temporal incision group at 1 and 3 months after operation,the differences were statistically significant(P<0.05).Conclusion:Adjusting the incision according to the direction of the maximum refractive axis of corneal curvature can minimize the occurrence of surgical astigmatism.Refined selection is an effective and key way to restore visual quality after operation.

关 键 词：超声乳化 透明角膜切口 白内障 角膜散光 

分 类 号：R779.6[医药卫生—眼科]