应用前节光相干断层扫描分析不同部位透明角膜切口的构型变化

Dynamic analysis of architecture of clear corneal incisions using anterior segment optical coherence tomography

目的:探讨白内障超声乳化术不同部位透明角膜切口(CCI)构型变化。方法:选择年龄相关性白内障患者73例(73眼),依据切口位置不同分为两组,颞侧9点位切口组共38例(38眼),上方12点位切口组共35例(35眼)。术前1 d、术后1 d、1周及1个月应用前节光相干断层扫描(AS-OCT)对切口区域角膜进行扫描及综合验光检查。应用SPSS13.0统计软件进行统计学分析。结果:术后1d、1周及1个月两组切口区域角膜厚度增加值、切口角度及切口长度差异均有统计学意义(P均<0.05),术后1d及1周切口区域内口哆开及内皮水疱发生率的差异均有统计学意义(P均<0.05),术后1 d两组上皮水疱及后弹力层脱离发生率的差异有统计学意义(P均<0.05);两组裸眼视力(UCVA)、最佳矫正视力(BCVA)及柱镜度数差异均有统计学意义(P均<0.05)。结论:AS-OCT是一种非接触式的、有效评估白内障透明角膜切口构型改变的检查方法。白内障颞侧切口较上方切口局部水肿轻,其构型更有利于形成密闭性切口,术后医源性散光小,是较理想的手术切口方位。

Objective： To analyze dynamic architectural changes and astigmatism of clear corneal incisions with diffrernt locations. Methods： Corneal incision quality was analyzed on 73 eyes of 73 patients using anterior segment optical coherence tomography （AS-OCT） on the first preoperative day and the first postoperative day, week, and month. According to the site of different incision, the patients were divided into two groups ：temporal incosion group 38 patients （38 eyes）, superior incosion group 35 patients （35 eyes）. SPSS13.0 statistical software was used to analyze experi mental datum. Results： There were statistical significance between-group differences in corneal thickness of incision, incision length and incision angle, （P 〈0.05）at 1 day, 1 week, 1 month after surgery, in percentage of the endothelial gaping and endothelial bullae （P 〈0.05）at 1 day, 1 week after surgery, and in percentage of the epithelial bullae and Descemet＇s membrane detachment（P 〈0.05 ） at 1 day.UCVA, BCVA and cylinder degree＇s differences between-group all had statistical significance （P 〈0.05）. Conclusion： AS-OCT is a useful and uncontaeted tool in assessing architecture of clear corneal incisions of cataract surgery. The temporal incisions of cataract helps to the development of a consistent technique to create self-sealing incisions and decrease the astigmatism after surgery.