白内障超声乳化手术中不同切口的应用及对角膜地形图与角膜散光的影响  

Application of different incisions in cataract phacoemulsification and their effects on corneal topography and astigmatism

作　　者：刘萍萍[1] 管怀进[2] 卞洪俊 张靖东[1] 姜瑾[1] Liu Pingping;Guan Huaijin;Bian Hongjun;Zhang Jingdong;Jiang Jin(Department of Ophthalmology,Affiliated Hospital of Nantong University,Nantong 226001 China;Department of Ophthalmology,Nantong Ruici Hospital,Nantong 226001,China)

机构地区：[1]江苏省南通市第三人民医院眼科,226001 [2]南通大学附属医院眼科 [3]南通市瑞慈医院眼科

出　　处：《临床眼科杂志》2021年第2期124-127,共4页Journal of Clinical Ophthalmology

摘　　要：目的探讨白内障超声乳化手术中不同切口的应用及对角膜地形图与角膜散光的影响。方法回顾性分析本院2018年9月至2019年12月共181例(200只眼)行白内障超声乳化手术患者临床资料,依照患者切口,将行强轴角膜切口的患者62例(70只眼)纳入A组,将行颞侧透明角膜切口57例纳入B组(62只眼),行右上方透明角膜切口62例纳入C组(68只眼),切口均为3.0 mm,比较3组患者视力恢复、角膜散光性质与散光度、角膜地形图。结果3组患者术后裸眼视力比较(P>0.05);A组、B组术后1周、1个月、3个月角膜内皮细胞丢失率低于B组(P<0.05);A组术后1周、1个月、3个月顺逆性散光与术前比较(P>0.05);B组术后1周、1个月、3个月顺规比例较术前升高,C组逆规比例较术前升高(P<0.05);A组术后1周、1个月、3个月角膜散光度低于B组,B组低于C组(P<0.05);A组术后1周、1个月表面不对称指数(SAI)、表面规则指数(SRI)水平低于B组,B组低于C组(P<0.05)。结论白内障超声乳化手术中强轴角膜切口、颞侧透明角膜切口、右上方透明角膜切口操作下患者术后视力恢复均较好,且强轴角膜切口对角膜散光度的影响较小,角膜表面形态恢复较快。Objective To explore the application of different surgical incisions in cataract phacoemulsification and their effects on corneal topography and astigmatism.Methods The clinical data of 181 patients(200 eyes)who underwent cataract phacoemulsification in our hospital from September 2018 to December 2019 were retrospectively analyzed.According to the surgical incision,62 patients(70 eyes)who underwent main axis incision were included in group A,57 patients(62 eyes)who underwent transparent temporal corneal incision were included in group B,and 62 patients(68 eyes)who underwent upper right transparent corneal incision were included in group C.The incisions length in the three groups was 3.0 mm.The visual acuity recovery,corneal astigmatism properties and degree,and corneal topography were compared among the three groups.Results There was no significant difference in the postoperative uncorrected visual acuity(UCVA)among the three groups(P>0.05).The loss rate of corneal endothelial cells in group A and B was lower than that in group C at 1week,1 month and 3 months after the surgery(P<0.05).At 1week,1 month and 3 months after surgery,the astigmatism was not statistically significant compared with that before the surgery in group A(P>0.05).At 1week,1 months and 3 months after the surgery,the ratio of with-the-rule astigmatism was increased in group B,and ratio of against-the-rule astigmatism was increased in group C compared with that before the surgery(P<0.05).At 1 week,1 monthd and 3 months after the surgery,corneal astigmatism in group A was lower than that in group B,which further lower than group C(P<0.05).At 1 week and 1 month after the surgery,the surface asymmetry index(SAI)and surface regularity index(SRI)in group A were lower than those in group B,which were further lower than group C(P<0.05).Conclusions The visual acuity recovery is good for all three surgical incisions after phacoemulsification.In addition,the main axis incision had less effect on the corneal astigmatism,and the corneal surface morphology r

关 键 词：白内障超声乳化手术 切口 角膜地形图 角膜散光 

分 类 号：R47[医药卫生—护理学]