白内障术后术源性散光及眼前节参数变化分析  

Analysis on the changes of surgically induced astigmatism and anterior segment parameters after phacoemulsification

作　　者：侯丽芳 孙晓萍 陈霞 朱冬梅 王媛 Hou Lifang;Sun Xiaoping;Chen Xia;Zhu Dongmei;Wang Yuan(Department of Ophthalmology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China)

机构地区：[1]郑州大学附属郑州中心医院眼科,郑州450007

出　　处：《中华眼外伤职业眼病杂志》2022年第2期94-101,共8页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：河南省医学科技攻关计划联合共建项目(2018020785);河南省医学科技攻关计划联合共建项目(2018020799);河南省高等学校重点科研项目(19A320076)。

摘　　要：目的分析白内障术后术源性散光(SIA)及眼前节参数的变化。方法前瞻性队列研究。纳入郑州大学附属郑州中心医院2020年9月至2021年2月行晶状体超声乳化术者36例(56只眼),分别于术前及术后1周、1个月及3个月行Scansys三维眼前节分析仪检查角膜前、后表面屈光力和轴位并计算得出SIA、中央角膜厚度(CCT)、前房容积(ACV)、前房角(ACA)及前房深度(ACD),比较其不同时间点的变化。结果角膜前表面屈光力、角膜后表面平坦轴屈光力、角膜后表面散光术前和术后各时间点的差异均无统计学意义(均P>0.05);角膜后表面陡峭轴屈光力术后1周及1个月为(-6.59±0.24)D、(-6.64±0.23)D,与术前(-6.49±0.27)D的差异有统计学意义(P<0.05);角膜前表面均数SIA术后1个月及3个月为(0.80±0.35)D、(0.74±0.34)D,与术后1周(1.07±0.47)D的差异有统计学意义(F=27.889,P<0.05);CCT术后各时间点与术前(539.81±27.64)μm相比差异有统计学意义(F=9.464,P<0.05);ACV、ACA、ACD术后各时间点与术前的差异均有统计学意义(F=148.64,367.50,625.93;均P<0.05)。结论晶状体超声乳化术术后1个月SIA趋于稳定,角膜后表面陡峭轴屈光力术后3个月、CCT术后1个月恢复至术前水平,ACV、ACA、ACD术后增大并保持稳定。Objective To analyse the changes of surgically induced astigmatism(SIA)and anterior segment parameters after phacoemulsification.Methods This was a prospective cohort study.A total of 56 eyes of 36 cases who underwent phacoemulsification from Sep.2020 to Feb.2021 in Zhengzhou Central Hospital Affiliated to Zhengzhou University was included.Scansys three-dimensional anterior segment analyzer was used to measure the refractive power and axial position of anterior and posterior corneal surfaces,central corneal thickness(CCT),anterior chamber volume(ACV),anterior chamber angle(ACA)and anterior chamber depth(ACD)before operation and at 1 week,1 month and 3 months after operation.The anterior and posterior surface SIA were calculated and the changes were compared at different time points.Results There was no significant difference in corneal anterior surface refractive power,corneal posterior surface flat axis refractive power,or corneal posterior surface astigmatism before and after operation(all P>0.05).But there was significant difference in the refractive power of steep axis of posterior corneal surface at 1 week[(-6.59±0.24)D]and 1 month[(-6.64±0.23)D]after operation compared with the[(-6.49±0.27)D]before operaton(P<0.05);there was significant difference in mean SIA of corneal anterior surface among 1 week[(1.07±0.47)D],1 month[(-0.80±0.35)D]and 3 months[(-0.74±0.34)D]after operation(F=27.889,P<0.05).The difference of CCT was statistically significant at each time point after operation compared with the[(539.8±27.64)μm]before operation(F=9.464,P<0.05).There were significant differences in ACV,ACA and ACD between before operation and 1 week,1 month and 3 months after operation(F=148.64,367.50,625.93;all P<0.05).Conclusion The SIA tends to be stable at 1 month after phacoemulsification.The steep axial refractive power of the posterior corneal surface returns to the preoperative level at 3 months after operation and CCT returns at 1 month after operation.ACV,ACA and ACD increase and remain stable after operat

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]