翼状胬肉术中缝合方式对术后波前像差的影响

Comparison of wavefront aberration changes on two different methods of sewing after. pterygium surgery

目的比较翼状胬肉术中采用间断缝合和连续缝合两种缝合方式对术后患者波前像差的影响。方法对门诊53例（53只眼）翼状胬肉患者，施行翼状胬肉切除联合球结膜移植手术。其中一组30例（30只眼）结膜植片行连续缝合；另一组23例（23只眼）采用间断缝合术。健康眼自身对照。分别于术前、术后7天，术后1个月使用iTrace视功能分析仪，记录5mm瞳孔直径下两组患者的总高阶像差、慧差、球差、三叶草差的均方根值（RMS）。P〈0．05认为差异有统计学意义。结果（1）两组患者术后7天、术后1个月的各项高阶像差值均较术前明显下降，但与正常对照眼相比差异仍有统计学意义。（2）术后7天，术后1个月，连续缝合组的各项像差值均较间断缝合组明显下降。结论使用连续缝合法缝合球结膜植片能更加显著降低翼状胬内切除术后波前像差值，有利于提高患者的视觉质量。

Objective To compare the wavefront aberration changes before and after surgery by means of sewing the conjunctival plants with interrupted suture and successive whip suture for pte- rygium. Methods Fifty-three cases of pterygium patients （53 eyes）, which all received pterygium surgery. Among them, one group of thirty patients （30 eyes） was sewed conjunctival plants with suc- cessive suture （group A） and another group of twenty-three patients （23 eyes） used interrupted suture （group B）. Contralateral healthy eyes served as control group by themselves. The root mean square （RMS） of wavefront aberrations, such as total high order, comatic, trefoil, spherical aberration were detected for a 5.0-mm pupil using a iTrace Visual Function Analyzer. Pre-to postoperative changes of the wavefront aberration were observed before operation, 7 days and 1 month after operation. P value less than 0.05 were considered statistically significant different. Results Although the RMS value postoperative of total high order, comatic, trefoil, spherical aberration in two groups was signif- icantly smaller than preoperative, there were significant differences between the values of postopera- tive and the healthy eyes by themselves. The RMS value of wavefront aberration 7 days and 1 month after operation of group sewed with successive was significantly smaller than those sewed with interrupted suture. Conclusions The successive suture is more effective than the interrupted su- ture in the pterygium surgery.