双陡峭轴透明角膜切口在白内障合并中低度数角膜散光中的应用  

Application of double steep axial transparent corneal incision in cataract patients with moderate to low corneal astigmatism

作　　者：林涛[1] 袁永刚 林翎 唐晓婷 马胜生 Tao Lin;Yong-Gang Yuan;Ling Lin;Xiao-Ting Tang;Sheng-Sheng Ma(Department of Ophthalmology,Guangzhou Red Cross Hospital,Jinan University,Guangzhou 510220,Guangdong Province,China;Zhongshan Ophthalmic Center,Sun Yat-sen University,Guangzhou 510030,Guangdong Province,China)

机构地区：[1]暨南大学附属广州红十字会医院眼科,中国广东省广州市510220 [2]中山大学中山眼科中心,中国广东省广州市510030

出　　处：《国际眼科杂志》2022年第11期1856-1860,共5页International Eye Science

摘　　要：目的:旨在证实双陡峭轴透明角膜切口能有效降低白内障合并中低度数角膜散光患者的角膜散光和高阶像差,提高术后视觉质量。方法:收集2020-10/2021-07在我院确诊为中低度数角膜散光的白内障患者共60例,随机分成A组(常规135°切口组,30例)和B组(双陡峭轴透明角膜切口组,30例),对比术前,术后1、3mo的裸眼视力、散光、散光矢量分解、极向散光值以及角膜中央3mm以内的二阶散光、球差、彗差、三叶草等指标。结果:A组和B组术后1、3mo的裸眼视力(UCVA)均较术前明显提高(P<0.05);B组术后1、3mo的UCVA均优于A组,但无差异(P>0.05)。A组术后1、3mo的角膜散光较术前无明显变化(P>0.05),B组术后1、3mo的平均角膜散光分别为0.66±0.13、0.61±0.12D,较术前1.38±0.24D明显降低(P<0.05)。B组术后1、3mo CJ0/CJ45与术前均无明显变化(P>0.05);A组术后1、3mo CJ0/CJ45与术前均有明显变化(P<0.05)。B组术后1、3mo的极向散光值均较术前低(P<0.05),A组术后1、3mo的极向散光值均较术前升高(P<0.05)。A组和B组术后3mo的HOA均较术前HOA降低(P<0.05),B组术后3mo平均HOA虽较A组的低,但无差异(P>0.05)。B组术后3mo的彗差较术前和A组低(均P<0.05)。结论:白内障合并中低度数角膜散光患者中,双陡峭轴透明角膜切口与常规切口的术后裸眼视力和HOA无明显差异,然而双陡峭轴透明角膜切口能通过有效降低角膜散光和彗差,提高患者的术后视觉质量。AIM:To explore that double steep axial transparent corneal incision can effectively minimize corneal astigmatism and high-order aberration(HOA)in cataract patients with moderate to low degree corneal astigmatism,as well as improve postoperative visual quality.METHODS:A total of 60 cataract patients diagnosed with moderate to low corneal astigmatism in our hospital from October 2020 to July 2021 were randomly divided into group A(normal 135°incision,30 cases)and group B(double steep axial transparent corneal incision,30 cases).The uncorrected visual acuity(UCVA),astigmatism,astigmatism vector decomposition,polar keratometry(Polar K),second-order astigmatism,spherical,coma and trefoil aberration within 3 mm of the central pupil were compared at 1 and 3 mo before and after surgery.RESULTS:UCVA of group A and group B at 1 and 3 mo after surgery was significantly higher than that before surgery(P<0.05).The mean UCVA of group B was higher than that of group A at 1 and 3 mo after surgery,but the difference was not statistically significant(P>0.05).The corneal astigmatism of group A at 1 and 3 mo postoperative were not significantly different from that before surgery(P>0.05).The mean corneal astigmatism of group B was 0.66±0.13 and 0.61±0.12 D at 1 and 3 mo after surgery,respectively,which was significantly lower than the preoperative value of 1.38±0.24 D(P<0.05).In group B,there was no significant change in CJ0/CJ45 at 1 and 3 mo after surgery(P>0.05).In group A,CJ0/CJ45 were both significantly different from those at 1 and 3 mo before surgery(P<0.05).The polar astigmatism values of group B at 1 and 3 mo after surgery were lower than those before surgery(P<0.05),while they were increased in the group A at 1 and 3 mo after surgery(P<0.05).HOA of both group A and B at 3 mo after surgery was lower than that before surgery(P<0.05).The mean HOA of group B was lower than that of group A at 3 mo after surgery,but the difference was not statistically significant(P>0.05).The coma aberration of group B at 3 mo after surgery w

关 键 词：白内障 双陡峭轴透明角膜切口 中低度数角膜散光 高阶像差 视觉质量 

分 类 号：R779.66[医药卫生—眼科]