白内障手术透明角膜切口不同位置对角膜散光轴位的影响  

Effect of transparent corneal incision design at different locations on the axis of corneal astigmatism in cataract surgery

作　　者：李慧 张素华[1] 王晓刚[1] 张哲[1] 周晶 Li Hui;Zhang Suhua;Wang Xiaogang;Zhang Zhe;Zhou Jing(Shanxi Eye Hospital,Taiyuan 030001,China)

机构地区：[1]山西省眼科医院,太原030001

出　　处：《中华眼外伤职业眼病杂志》2022年第1期12-17,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的比较白内障手术透明角膜切口位于120°与位于角膜散光平坦径线位, 对术后角膜散光轴位的影响。方法回顾性分析山西省眼科医院2018年6月至2020年9月收治白内障110例(110只眼)的临床资料。所有患者均行超声乳化白内障吸除联合人工晶状体植入术。依据散光轴向将患者分为顺规散光组40例(40只眼)和逆规散光组70例(70只眼), 根据角膜切口位置每组又均分为切口位于120°(11点位)及切口位于角膜散光平坦径线位两亚组。术后1周、1及3个月进行随访, 分析两组散光轴位变化。结果顺规散光组中术后角膜散光轴位变化值两亚组之间差异无统计学意义(F=2.246, P=0.374);不同时间点角膜散光轴位变化差异有统计学意义(F=4.595, P=0.023)。逆规散光组中术后角膜散光轴位变化值两亚组之间差异无统计学意义(F=2.564, P=0.114);不同时间点角膜散光轴位变化差异有统计学意义(F=7.153, P<0.001)。结论对于角膜有顺规或逆规散光的患者, 切口位于角膜散光平坦径线与切口固定于120°对术后角膜散光轴位无影响。白内障手术后随着时间推移角膜散光轴位变化逐渐减小。Objective To compare the effect of the post operative corneal astigmatism axis between the corneal incision located at 120°and the flat axis of the corneal astigmatism.Methods This was a retrospective study.The clinical data of 110 eyes of 110 patients with cataract from Jun.2018 to Sep.2020 in Shanxi Eye Hospital were analyzed.All cases received phacoemulsification combined with intraocular lens implantation.These patients were divided into two groups based on astigmatism axis.There were 40 eyes of 40 cases in the with-the-rule astigmatism group and 70 eyes of 70 cases in the against-the-rule astigmatism group.Each group was divided into two subgroups based on the position of corneal incision:the incision located at 120°(11 o’clock position)and the incision located at the flat axis of corneal astigmatism.All patients were followed up at 1 week,1 and 3 months after operation.The changes of astigmatism axis of the two groups were analyzed.Results In the with-the-rule astigmatism group,there was no statistical difference in the change of corneal astigmatism axis between the two subgroups(F=2.246,P=0.374);but there was statistical difference in the change of corneal astigmatism axis at different time points after operation(F=4.595,P=0.023).In the against-the-rule astigmatism group,there was no statistical difference in the change of corneal astigmatism axis between the two subgroups(F=2.564,P=0.114),but there was statistical difference in the change of comeal astigmatism axis at different time points after operation(F=1.153,P<0.001).Conclusion For patients with corneal with-the-rule or against-the-rule astigmatism,the corneal incision at the flat axis of corneal astigmatism and the incision at 120°have no effect on the corneal astigmatism axis after operation.The change of corneal astigmatism axis decreases gradually with the passage of time after cataract surgery.

关 键 词：超声乳化白内障吸除术 手术后并发症 散光 屈光 眼 

分 类 号：R779.66[医药卫生—眼科]