超声乳化白内障摘出术中不同切口矫正术前角膜散光的比较研究

Effects of different incision on preexisting cornea astigmatism during phacoemulcification

目的比较超声乳化白内障摘出术中不同切口矫正术前角膜散光的作用。方法患者58名(75眼)按术前角膜散光程度分为3组,每组患者选择不同手术切口及角膜散光松解切口。A组(25眼)的术前角膜散光≤1.0D,手术切口为角膜屈光力最大径线上的角膜缘内透明角膜隧道切口;B组(25眼)的术前角膜散光>1.0D～2.0D,手术切口同A组,同时在对侧角膜缘内2mm处做一弧长1/4象限,深度60%或80%角膜厚度的弧形板层角膜切口;C组(25眼)的术前角膜散光>2.0D,手术切口同A组,同时在对侧角膜缘内做一长3.2或5.5mm的穿透性角膜隧道切口。术后观察角膜散光的变化情况。结果术后3个月时,各组手术引起的角膜散光变化分别为:(0.34±0.15)D、(0.86±0.22)D和(1.79±0.43)D。结论在屈光力最大径线上的角膜切口可以矫正术前存在的角膜散光,联合对侧透明角膜切口可以增加矫正效果。

Objective To compare the effects of different incision on preexisting cornea astigmatism during phacoemulcification. Methods 58 patients （75 eyes） were divided into 3 groups according to the preexisting cornea astigmatism, different incisions for cataract surgery and reeasing cornea astigmatism were made for each group. In group A, the preexisting cornea astigmatism less than 1.0D, the clear cornea incision （CCI） was made on the steepest meridian; In group B, the preexisting cornea astigmatism was between 1.0D to 2.0D, besides the CCI for surgery on the steepest meridian, an additional arcutate keratotomy （ak） was made on the opposite side to release the preexisting cornea astigmatism; in group C, besides the CCI for surgery on the steepest meridian, an additional opposite clear cornea incision （OCCI） was made to release the preexisting cornea astigmatism. The postoperative cornea astigmatism change was recorede. Result At 3 postoperative months, the surgically induced refractive change （SIRC） were （0.34±0.15）D. （0.86 ±0.22）D and （1.79 ±0.43）D respectively in group A, B and C. Coclusions The incisions on the steepest meridian can correct the preexisting cornea astigmatism, combined with opposite incision can enhance the correcting effects.