不同位置角膜切口对白内障术前散光矫正的研究

Research of the Different Location of Clear Corneal Incision in Phacoemulsification to Correct the Pre-existing Astigmatism

目的:探讨不同位置角膜切口对白内障术前散光矫正的临床效果。方法:对老年性白内障患者49例49只眼进行研究。A组22名患者,术前根据患者散光轴位行12点(顺规)及9点(逆规)位的角膜切口超声乳化白内障吸除人工晶状体植人术。B组27名患者行常规颞上方(右眼)或鼻上方(左眼)角膜切口超声乳化白内障吸除人工晶状体植入术。术前及术后记录最佳矫正视力、角膜屈光度及散光轴位,比较两组术后角膜散光的变化。结果:术后A组视力平均提高0.66,B组平均提高0.57,结果不具有统计学意义。A组平均矫正散光1.1D,B组矫正了0.4D,两组有显著性差异。应用Holladay方法计算SIA(Surgically-induced astigmatism,手术源性散光),A组SIA高于B组(1.0 D对0.6 D),但不具统计学意义。在随访过程中未有并发症发生。结论:根据术前散光轴位,在超声乳化白内障吸除人工晶状体植入术中选择不同位置的透明角膜切口,可安全有效的矫正术前散光。

Objective： To Compare the Iocation of clear corneal incision in phacoemulsification on correcting the pre-existing astigmatism. Methods ：49 patients with pre-existing astigmatism, whose pre-existing astigmatism is greater than 1.0D. Group A have 22 patient, Which were assigned to the following incisions：superior incision for with the rule and temporal for against the rule. Group B have 27 patients, which incisions based on custom, nasal for left eye and temporal for right eye. Visual acuity, refraetion, biomicroscopy, keratometry, and videokeratography were performed before and after phacoemulsification and intraoeular lens implantation. Results： Group A was less with at least 1.1 diopters of astigmatism, Group B was less at 0. 4D. Using holladay fotmular, the SIA （ Surgically-induced astigmatism ） of group A is more than group B, but the thus was no statistically significant. No complication occurred during the follow-up period. Conclusions：Choosing the location of clear corneal incision in phacoeatulsification could correct the pre-exiSting astigmatism.