切口位置对小切口非超声乳化术后角膜散光影响的观察

The effect of incision position in small incision cataract surgeryt on corneal astigmatism

目的 比较小切口非超声乳化术不同位置的切口对角膜散光的影响.方法 将60例（60只眼）欲行小切口非超声乳化人工晶状体植入术的白内障患者随机分两组各30只眼,A组顺规散光者切口选在上方,逆规散光者切口选在颞侧;B组：切口全部选在上方.均采用距角巩膜缘2mm水平6.5mm的巩膜隧道切口,不缝合.观察术前及术后3个月的视力、角膜散光及手术源性散光的情况.结果 A组、B组手术源性散光分别是：（0.94±0.12）D、（0.98±0.12）D,差异无统计学意义.A组术前和术后3月散光为：（1.24±0.46）D、（0.24±0.26）D;B组为（1.25±0.36）D、（2.54±0.45）D;A组视力≥0.5：26只眼（87%）：B组：19只眼（64%）,A、B组差异有统计学意义.结论 白内障手术切口选在角膜曲率最大的子午线上.可矫正术前已有散光并获得更好地术后视力.

Objective To compare the effect of different incision position in sics on corneal astigmatism.Methods Sixty Cases （60 eyes） who underwent sics and introcular lens implantment were randomly divided into two groups,group A：incision location was chosen at the maximum curature meridian,superior incision for with-the-rule astigmatism,temperor incision for against-the-rule astigmatism;group B：superior incision was chosen;using 6.5mm scleral tunnel incision without suture.Corneal astigmatism,uncorrected visual acuity and surgically induced astigmtism were detected pre-operation and 3 months post operation.Results Before operation and 3 months after operation,the average corneal astigmtism were 1.24±0.46D,0.24±0.26D in the group A,1.25：1：0.36D,2.54＋0.45D in the group B,the surgically induced astigmtism were 0.94＋0.12D,0.98：1：0.12D,respectively,without significant differences.Uncorrected visual acuity （P≥0.5）was observed at 3 months after operation in two groups;group A：26eyes （87%）;group B：19eyes（64%）.Visual acuity of group A was better than that of the group B.Conclusions The incision location for cataract surgery is better to choose at the maximum curvature meridian.