非同轴微小切口白内障超声乳化术的屈光变化分析

The analysis of refractive status after bimanual microphacomulsification

目的探讨非同轴微小切口超声乳化白内障吸除术前后的屈光变化与矫治疗效分析。方法对老年性白内障伴有屈光不正的68例(76只眼)行非同轴微小切口超声乳化白内障吸除术。在角膜缘10点处做1.2mm角巩膜隧道主切口,以快速晶状体核劈裂技术双手配合冷超声乳化吸除白内障,用蓝宝石刀将颞侧主切口扩大至1.6mm,植入一体式后房折叠型人工晶状体(德国产Acri.Smart36A疏水性硅丙稀酸酯折叠式IOL)。观察手术前后角膜曲率、角膜地形图、屈光状态和远近视力及并发症。并与常规超声乳化手术组78例(82只眼)进行比较分析。结果角膜地形图手术后呈向非散光图形方向改变,治疗组手术前后比较差异有统计学意义(x2=4.457,P<0.05)。手术后形成散光治疗组与对照组差异无统计学意义(x2=1.324,P>0.05)。术后屈光波动1周与2周间治疗组有90%在0.20D±0.14D的变化。而对照组有40%在0.20D±0.14D的变化,两组比较差异有统计学意义(x2=3.926,P<0.05)。结论非同轴微小切口超声乳化白内障吸除术可安全、有效地通过<1.4mm的切口吸除白内障并植入卷折式人工晶状体,较常规超声乳化术屈光稳定快,两组用角膜地形图选择切口可降低散光度,使白内障超声乳化术与屈光矫正结合具有更好的疗效。

Objective To analysis of refractive status after bimanual microphacomulsification and former curative efffct. Methods To senile cataract companion ametropia 68 case （76eyes） do bimanual microphacomulsification with 1.2mm incision and 1.6ram Acri.Smart36A IOLimplantion. And wrer refractd at week of 1 st ,2nd, 1 month post-operatively. The uncorrected and corrected visual acuity wrer examined, and keratometer, cornea topographic and the ocular axils wrer measured. And general phacomulsification operation 78 case（82eyes）compare analysis postoperative outcome. Results the refractive status, cornea topographic after operation was chang with nonastigmatism （X^2=4.457, P〈0.05）.bimanual microphacomulsification after operation 1, 2week at 90% has 0.20D ± 0.14D refractive variety. Companion group werr 40% have 0.20D ± 0.14D variety. （X^2=3.926, P〈0.05）. Conclusionl The get across1.2mm incision bimanual microphacoemulsification and 1.6mm Acri. Smart36A IOL implantion.and effective surgery for cataract extraction through a sub- clear. The stabilixation refractive have rapidness. Use cornea topographic is corrct after operation of retravtive, if bimanual microphacomulsification combine corrected astigmatism was finer curtive effect.