白内障手术中陡峭轴透明角膜切口所致手术源性散光的长期临床研究  

Long-Term Clinical Study of Astigmatism Induced by Steep Axis Clean Corneal Incisions during Cataract Surgery

作　　者：陈海威 刘冬梅[1] 毕宏生[1] 李洋[1] Haiwei Chen;Dongmei Liu;Hongsheng Bi;Yang Li(The Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine,Institute of Ophthalmology Disease Prevention and Control of Shandong,Key Laboratory of IntegratedTraditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong,Jinan 250002,China)

机构地区：[1]山东中医药大学附属眼科医院、山东省眼病防治研究院、山东省高校中西医结合眼病防治技术重点实验室,济南250002

出　　处：《中华眼视光学与视觉科学杂志》2023年第1期33-37,共5页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的:观察超声乳化白内障吸除术陡峭轴透明角膜切口对手术源性散光(SIA)的长期变化特点。方法:回顾性病例研究。收集2018年1月1日至2021年3月1日所有在山东中医药大学附属眼科医院进行白内障手术符合纳排标准的患者56例(63眼,右眼32只,左眼31只)。所有患者均行白内障超声乳化联合人工晶状体植入手术,手术由同一医师完成,采用IOL-Master 700测量并记录术前及术后于2021年10月1日至12月31日随访患者的角膜曲率、角膜散光陡峭轴及平坦轴的屈光力和轴向,运用矢量分析法计算SIA。比较不同眼别、不同陡峭轴方向角膜切口(顺规散光组对应上方切口组、逆规散光组对应颞侧切口组、斜轴散光组对应斜轴切口组)、不同时间段(白内障术后36~48个月组、24~36个月组、12~24个月组)及使用不同计算方法的SIA(矢量分析法与质心法)。采用单因素方差齐性检验与独立样本t检验进行数据分析。结果:63眼中,不同眼别比较SIA,右眼为(0.45±0.19)D,左眼为(0.48±0.34)D,二者差异有统计学意义(t=0.43,P=0.045);不同陡峭轴方向切口比较SIA,顺规散光组对应上方切口组、逆规散光组对应颞侧切口组、斜轴散光组对应斜轴切口组分别为(0.44±0.36)D、(0.47±0.23)D、(0.50±0.20)D,三者差异无统计学意义(F=0.22,P=0.800);术后3个时间段比较差异无统计学意义(F=0.28,P=0.756);使用矢量分析法计算与质心法计算SIA比较差异无统计学意义(t=0.08,P=0.800)。结论:通过矢量分析法计算SIA,右眼手术切口的SIA明显小于左眼切口,但在所有患者中不同陡峭轴方向切口、不同时间段、不同计算方法后的SIA均无明显变化。Objective:To observe the long-term changes of surgically induced astigmatism(SIA)in phacoemulsifcation surgery with steep axis clear corneal incision.Methods:Retrospective case analysis was used.The data was gathered from 56 patients(63 eyes,32 right eyes,and 31 left eyes)who underwent cataract surgery at the Eye Hospital of Shandong University of Traditional Chinese Medicine from January 1 st,2018,to March 1 st,2021.In addition to intraocular lens implantation,all patients had their cataracts phacoemulsified.The same doctor conducted the procedure.During the most recent follow-up(follow-up period from October 1 st,2021,to December 31 st,2021)and prior,the IOL-Master 700's corneal curvature was assessed.Through the use of vector analysis,axial,SIAis determined.Corneal incisions in different eye types,in different directions(the incision group corresponding to the upper incision group in the compliant astigmatism group,the temporal incision group in the anti-regular astigmatism group,and the oblique axis incision group in the oblique axis astigmatism group)and different periods(from 36 months to 48 months after cataract surgery,24 months to 36 months after cataract surgery,and 12 months to 24 months after cataract surgery)and SIAusing different calculation methods(vector analysis method and centroid method)were compared.The obtained data was analyzed by one-way homogeneity of variance test and independent-sample t test method.Results:Among 63 eyes,the SIAof different eyes was compared,the right eye was(0.45±0.19)D,the left eye was(0.48±0.34)D,and the difference was statistically signifcant(t=0.43,P=0.045);the incision comparison of SIAwas(0.44±0.36)D,(0.47±0.23)D,(0.50±0.20)D respectively and the difference was not statistically significant(F=0.22,P=0.800);the difference of different periods was not statistically signifcant(F=0.28,P=0.756);there was no signifcant difference between the SIAcalculated by the vector analysis method and the centroid method(t=0.08,P=0.800).Conclusion:The SIAof the incision of the

关 键 词：白内障 术源性散光 陡峭轴 超声乳化白内障吸除术 

分 类 号：R779.6[医药卫生—眼科]