个性化复合式切口在基层扶贫白内障手术中的临床应用

Clinical application of personalized composite incision for cataract surgery on grassroots poverty alleviation

目的: 探讨根据角膜散光轴位选择复合性手术切口以降低术前角膜散光度在基层扶贫白内障手术中的作用。方法: 根据角膜曲率计选择角膜散光度数≥1.50D的白内障患者100例100眼,以角膜最大屈光力径线方向为中心做巩膜隧道主切口并在主切口的对侧做辅助切口,行白内障小切口囊外摘除联合人工晶状体植入术。分别测量术前、术后3d;1,3,6,12mo的角膜散光及裸视视力。结果: 术前、术后3d;1,3,6,12mo的平均角膜散光分别为+2.08±0.666,-1.06±0.75,+0.67±0.71,+1.11±0.77,+1.20±0.88,+1.30±0.68D;术前、术后3d;1,3,6,12mo的裸眼视力分别为0.30±0.19,0.55±0.25,0.69±0.21,0.66±0.18,0.65±0.20,0.60±0.22。结论: 个性化复合式手术切口这一技术适合在基层大批量扶贫白内障手术中广泛应用,具有疗效确切、操作简单、手术时间短、费用低廉等优点。

·AIM：To investigate whether complex surgical incision in cataract surgery based on corneal astigmatism axial can reduce preoperative corneal astigmatism. ·METHODS： Cataract patients 100 cases （100 eyes） with corneal astigmatism more than 1. 50D detected by keratometry were collected in this study. Scleral tunnel incision was made as the main incision according to diameter direction of maximum corneal refractive power, meanwhile, an auxiliary incision was performed on the other side of the main incision. Extracapsular cataract extraction with intraocular lens implantation was performed by a small- incision. The preoperative and postoperative （3 days, 1 month, 3, 6, 12 months） corneal astigmatism and uncorrected visual acuity were measured. ·RESULTS： The preoperative and postoperative （3 days, 1 month, 3, 6, 12 months） average corneal astigmatism were （＋2.08±0.666）D, （-1.06＋0.75）D, （＋0.67± 0.71）D, （＋1.11±0.77）D, （＋1.20±0.88）D and （＋1.30±0.68）D,respectively. The preoperative and postoperative （ 3 days, 1 month, 3, 6, 12 months） average uncorrected visual acuity were 0. 30±0.19, 0. 55±0. 25 , 0. 69±0. 21, 0. 66±0.18, 0.65±0.20, 0. 60±0. 22.·CONCLUSION. The use of composite and personalized incision in cataract surgery helps to reduce preoperative corneal astigmatism. Because of the advantage of simple process and low cost, this operation is suitable to popularize in poverty alleviation at the grassroots level.