摘要
目的探讨3种白内障超声乳化联合人工晶状体植入术的切口对角膜散光及高阶像差的影响。方法将54例(54眼)老年性白内障患者随机分为3组,进行超声乳化联合人工晶状体植入术。A组为2.6mm颞侧透明角膜切口组18眼,B组为2.6mm颞上角巩膜隧道切口组17眼,C组为3.2mm颞上角巩膜隧道切口组19眼。术前及术后3个月应用NidekOPD角膜地形图/像差仪测定患者瞳孔直径为5mm时角膜总像差和角膜总高阶像差、角膜散光、彗差、三叶草、球差的均方根值。比较手术前后各像差的变化。结果术后最佳矫正视力≥20/25者例数的组间差异无统计学意义(P=0.690)。手术源性散光的组间差异无统计学意义(P=0.376);3.2mm角巩膜隧道切口组的球差从术前的(0.23±0.12)μm增加为术后的(0.40±0.20)μm,差异有统计学意义(P<0.01);三叶草术前(0.41±0.19)μm,术后(0.74±0.20)μm,差异也有统计学意义(P<0.01)。结论不同的白内障超声乳化联合人工晶状体植入术切口对角膜高阶像差的影响不同。其中2.6mm透明角膜切口与2.6mm角巩膜隧道切口均不影响患者角膜的高阶像差,3.2mm角巩膜隧道切口可增加角膜球差和三叶草像差。
Objective To investigate the changes of corneal astigmatism and high-order aberrations after phacoemulsification with three sorts of incisions. Methods Fifty-four eyes of 54 patients were randomly divided into 3 groups. All patients underwent phacoemulsification. Patients in group A( 18 eyes) underwent phacoemulsification through a 2.6- mm temporal clear corneal tunnel incision, group B ( 17 eyes) through a 2.6-mm temporal sclera tunnel incision and group C (19 eyes) through a 3.2-mm temporal sclera tunnel incision. Root-mean-square (RMS) of corneal coma, trefoil, spherical aberration, higher corneal aberration and total corneal aberration at 5-mm pupil diameter were measured using the OPD aberrometer/topographer before and 3 months after surgery. The changes of the aberrations were compared among 3 groups. Results There was no significant difference among 3 groups in the number of eyes which achieved best corrected visual acuity (BCVA) 20/25 or better 3 months after surgery ( P = 0.690). The difference of surgery-induced astigmatisms among 3 groups was not significant(P =0.376). The spherical aberration in group C increased significantly after surgery [ (0.23 ± 0.12) p.m pre-operation, ( 0.40 ± 0.20 ) p.m post-operation, P 〈 0.01 ]. The trefoil aberration in group C increased significantly [ (0.41 ± 0. 19) p.m pre-operation, ( 0.74 ± 0. 20) p.m post-operation, P 〈 0.01 ]. Conclusions Different incisions of phacoemulsification have different effects on corneal aberrations. 3.2-mm sclera tunnel incision might increase the spherical and trefoil aberration of cornea,while 2.6-mm clear corneal tunnel incision and sclera tunnel incision surgery do not increase the high-order aberrations of the cornea. ( Chin J Ophthalmol and Otorhinolaryngo1,2008,8 : 154-156)
出处
《中国眼耳鼻喉科杂志》
2008年第3期154-156,共3页
Chinese Journal of Ophthalmology and Otorhinolaryngology
关键词
角膜
切口
波前像差
超声乳化术
Comea
Incision
Wavefront aberration
Phacoemulsification