超声乳化术中角膜缘松解切开矫正散光

Limbal relaxing incision for correcting corneal astigmatism during phacoemulsification

目的探讨在白内障超声乳化术中应用角膜缘松解切开矫正角膜散光的效果。方法年龄相关性白内障合并角膜散光60例（66眼）。角膜缘松解切开组35例（40眼），施行角膜缘松解切开联合超声乳化人工晶状体植入术；对照组25例（26眼），施行超声乳化联合人工晶状体植人术。分别于术前、术后1个月、3个月进行裸眼视力（UCVA）、最佳矫正视力（BCVA）、角膜地形图检查，观察角膜散光度改变。结果术后1个月及3个月UCVA比较，两组差异具有统计学意义（P〈0．05）；术后1月及3月角膜散光度变化，两组差异亦具有统计学意义（P〈0．05）。结论应用角膜缘松解切开在超声乳化术中矫正角膜散光，可减少角膜散光度，提高UCVA，改善视觉质量，是一种矫正角膜散光的有效方法。

Objective To evaluate the efficacy of limbal relaxing incisions （LRIs） for the correc- tion of corneal astigmatism during phacoemulsification. Methods 66 eyes of 60 patients with senile cataract and coexisting keratometric astigmatism were included in the study. Phacoemulsification with concomitant re- laxing incisions was performed in 40 eyes of 35 patients in LRIs group. 26 eyes of 25 patients only underwent phacoemulsification with intraocular lens implantation were in control group. All patients underwent ophthal- mic examination that included uncorrected visual acuity （UCVA）, best-corrected visual acuity （BCVA）and corneal topography preoperatively, 1 month and 3 months postoperatively. Results Respectively comparing UCVA of two groups 1 and 3 months postoperatively, the P values were considered statistically significant （P 〈 0.05 ）. At preoperative and postoperative time points, the average corneal astigmatism changes were also significantly different between the two groups. （ P 〈 0.05 ）. Conclusion LRIs performed during phacoe- mulsification surgery appear to be an effective procedure to reduce pre-existing corneal astigmatism and im- prove UCVA as well as the visual quality.