白内障超声乳化术后早期角膜地形图形态分析

Analysis of Early Corneal Topographical Changes after Phacoemulsification Surgery

目的研究白内障超声乳化术后早期角膜形态的变化特点。方法采用ＡＬＣＯＮＥＹＥＭＡＰＥＨ－２９０型角膜地形图仪分析２４例白内障超声乳化人工晶体植入术后早期角膜地形图所表现的变化。分别于术后１天、１周、１月和３月时行角膜地形图检查，记录距角膜中心１．５、２．５、３．５ｍｍ处０、１８０、９０、２７０度方向角膜曲率值并分析角膜地形图变化特点。结果所有病例于术后１天均呈轻度循规性散光，１６例（６６．７％）于术后１月转为逆规性散光。１８例（７５％）于术后１月内角膜形态基本恢复至术前状态。术后各时间段角膜曲率与术前相比无明显改变。结论白内障超声乳化术后早期角膜散光小，角膜地形图变化较小，并可很快恢复至术前状态。角膜地形图可以作为全面分析白内障术后角膜形态变化的有效手段。

ObjectiveDifferent surgery methods will cause different corneal topographical changes.Our objective is to analyze corneal topographical changes in the early period after 6mm incision phacoemulsification surgery and posterior chamber lens implantation.MethodsALCON UNIVERSAL PHACO machine was used to perform phacoemulsification surgery through 6mm incision.We used ALCON EYEMAP EH 290 system to study the corneal topographical in 24 eyes of 23 patients.The corneal topography examination was performed pre operatively and at 1 d,1 wk,one month and three months post operatively.Three graphs were taken each time,and the best one was chosen to be analyzed.Corneal curvature were assessed at radial distances of 1.5,2.5,3.5mm along the 0 ,90 ,180 and 270 degree semimeridians.No serious complications were found before and during surgery.ResultsThe corneal curvature slightly steepened vertically and flattened horizontally 1 d after surgery.Compared with pre operative topography,the change of corneal shape was not significant.There was no statistical difference of corneal curvature at radial distances of 1.5,2.5 and 3.5mm along the 0 ,90 ,180 and 270 degree semimeridians between pre operation and post operation.Peripheral to the upper cornea in 22 cases(91.7%)flattened postoperatively.All cases showed slight with the rule astigmatism at d 1 after operation.Afterwards,the astigmatism turned to against the rule.16 cases(66.7%)turned to against the rule one month after surgery.The corneal topography of 18 patients(75%) recovered within one month after phacoemulsification surgery.The corneal topography showed similar shape as that of pre operation.ConclusionPhacoemulsification surgery was performed through a small incision.This method causes slight astigmatism post operatively.The corneal topography changes a little in the early period after surgery.The corneal shape recovers rapidly.Computerized videokeratography system is an effective method to analyze the change of corneal topography after cataract surgery.