共同切口超声乳化联合小梁切除术后近期角膜地形演变观察  

The use of fourier analysis in the observation of corneal topographic changes after one-site phacotrabeculectomy

作　　者：骆训达[1] 叶纹[1] 钟一声[1] 

机构地区：[1]上海瑞金医院眼科,上海200025

出　　处：《眼视光学杂志》2003年第1期8-12,共5页Chinese Journal of Optometry & Ophthalmology

摘　　要：目的 :用Fourier分析观察共同切口青光眼白内障联合手术后近期角膜地形演变的情况。方法 :18例因同时罹患原发性开角型青光眼 (POAG)和白内障而需进行联合手术的患者被纳入研究范围。经 3.2mm上方巩膜隧道切口行超声乳化、折叠式人工晶状体植入联合小梁切除术。用Fourier分析观察患者术前 ,术后第 1周、第 1个月和第 3个月时的角膜地形演变情况。结果 :联合手术后各时期平均眼压较术前下降 6mmHg ,术后第 1个月起眼压水平显著低于术前。术后没有发生严重并发症。Fourier分析显示手术前后角膜规则散光大小未发生显著变化 ,但角膜散光由术前以逆规性为主变为术后短期内 (1w～ 1个月 )以循规性散光为主。术后角膜不规则散光较术前显著增大 ,历经 3个月基本恢复到术前水平。结论 :共同切口联合手术是有效和安全的。手术引起的角膜地形变化在术后 3月内恢复至术前水平。Objective:To clarify postoperative corneal topographic changes after one site phacotrabeculectomy with the aid of fourier analysis.Methods:Six male patients(6 eyes) and 12 female patients(12 eyes) suffering from cataract and primary open angle glaucoma were included in this study. They underwent one site phacotrabeculectomy during the period from Sept. 2001 to Feb. 2002 in our department. The mean age of patients enrolled was(73.7±6.9)years. Preoperative IOP level was(20.7±8.1)mmHg. Preoperative antiglaucoma medications included 2% pilocarpin,0.5% timolol,and 0.5% betagan. Uncorrected Snellen visual acuity before surgery was below 6/20 in all patients. Five cases had with the rule astigmatism and the other 13 cases had against the rule astigmatism(the astigmatism axis was calculated with fourier analysis. With the rule astigmatism was defined as an astigmatism with its axis in the range 0 ° to 45 °,or 135 ° to 180 °,while against the rule astigmatism was defined as an astigmatism with its axis in the range 45 ° to 135 °). Preoperative,1 week,1 month,and 3 months postoperative corneal topographic data were obtained for further analysis. All the surgeries were performed by a surgeon with a standardized one site technique and peribulbar anesthesia. After IOL insertion,the integrity of the watertight wound was deliberately breached by removing a block of tissue from the posterior lip of the tunnel with a punch,followed by peripheral iridectomy,and careful scleral and conjunctival closure with 2 stitches and cauterization. Topographic data were analyzed with fourier analysis. Two indices concerning the irregularities of corneal surface,root mean square of total astigmatism(r.m.s total ) and root mean square of irregularities(r.m.s irreg ),were introduced in this study. r.m.s total describes the extent the actual cornea deviates from an ideal sphere,and r.m.s irreg describes the extent the actual cornea deviates from an imaginary surface with certain spherical equivalent and regul

关 键 词：角膜地形 傅立叶分析 开角型青光眼 外科学 白内障摘除术 

分 类 号：R779.6[医药卫生—眼科]