两种切口超声乳化白内障术后的角膜地形图分析

Topographic chang after cataract phacoemulsification through different incisions

目的研究两种切口白内障超声乳化术后的角膜地形图的变化特点及手术性散光的差异。方法分别行5.5 mm(A组)和3.5 mm(B组)的巩膜隧道切口白内障超声乳化术28只眼和22只眼,术前、术后用角膜地形图仪进行角膜形态的分析。结果术后1周B组裸眼视力高于A组,两组裸眼视力分布情况比较,差异有显著意义(X^2=4.37,P<0.05);两组术后1个月和3个月裸眼视力分布比较,差异无显著意义(X^2=2.18,0.15,P>0.05)。术后3个月A组圆形6只眼(21.43%),蝴蝶结形20只眼(71.43%),不规则形2只眼(7.14%);B组圆形8只眼(36.36%),蝴蝶结形14只眼(63.64%),纵向10只眼。两组患者术后1周的角膜散光较术前有显著差异,B组术后1个月无显著差异,A组术后3个月无显著差异。术后1周A组的SRI明显高于B组,SAI则无显著差异。两组术后1周SRI、SAI均高于术前,至术后3个月则与术前无显著差异。结论3.5 mm反眉状巩膜隧道切口超声乳化白内障吸除术术眼早期的视力和角膜地形图明显优于5.5 mm切口手术术眼,提示3.5mm切口手术具有术后视力恢复快且稳定的优点。

Objective To compare the changes of corneal shape and astigmatism between twe groups of cataract patients operated with different incisions. Methods A to.tal of 28 eyes of cataract were operated through 5.5mm scleral tunnel incision and 20 eyes through 3.5mm scleral tunnel incision. Corneal shapes pre-and postoperation were toptgraphically analyzed. Results One week after surgery, Visual acuity of B group was better than A group （χ^2= 4.37, P 〈 0.05 ）. Signification diffirence was lost in both groups after 1 and 3 mouths （ χ^2 = 2.18 ,0.15, P 〉 0.05 ）. One week after surgery , The value of corneal astigmatism were significantly greater than that before surgery in both groups. Significant difference was lost in B group 1 mouth later and in A group 3mouths later respectively. One week after surgery,SRI in A group was significandy greater than that in B group,But SAI appeared no significant difference. Condusion Coneal shape shift is relatively slight and resoration is comparatively rapid in B group.