两种不同切口人工晶状体植入术后角膜地形图对比分析

Comparative analysis of topographic change after intraocular lens implantation through two different incision

目的 研究两种不同切口人工晶状体植入后角膜形态和散光的变化。方法 通过 3 2mm透明角膜切口植入折叠人工晶状体 5 0眼和 6 0mm巩膜隧道切口植入PMMA人工晶状体 48眼 ,术后应用计算机辅助角膜地形图仪对这些病人的角膜形态进行检查。结果 角膜组术后早期角膜地形图垂直于切口径线的角膜轻度变平 ,于术后 1个月即可稳定。巩膜组角膜垂直轴上出现蝴蝶结样改变 ,而后蝴蝶结逐渐变小 ,或向水平方向转变而减小 ,至 3个月时基本稳定。两组在术后 1天至 1个月的角膜散光和手术性角膜散光巩膜组大于角膜组 (P <0 0 5 )。结论 3 2mm透明角膜切口组术后角膜形态改变小 。

ObjectiveTo compare the corneal shape and astigmatism between two groups of cataract patients operated with different incisions.Methods50 eyes of 48 cataract patients were operated with foldable intraocular lens through 3 2 mm clear corneal incision and 48 eyes of 46 cataract patients were performed with PMMA intraocular lens implantation through 6 0 mm scleral tunnel incision We used computer assisted corneal topography to examine the corneal shape of these patients at one day,three days,one week,one month and three months postoperatively.ResultsThe topographic map in clear cornea incision(CCI) group showed slight surgically induced alterations in corneal shape,there was mild flattening along the meridian of the incision and slight against the rule astigmatism at early postoperative period.The change was stable at one month postoperatively.There was relatively greater shift in corneal shape in scleral tunne incision(STI) group,the corneal topography showed a bow tie pattern in vertical meridian,and there was slightly increased with the rule astigmatism.Afterwards,the bow tie pattern reduced gradually or changed towards horizontal meridian and reduced gradually,The change was steady at three months after surgery.The corneal astigmatism and surgically induced astigmatism of the STI were significantly greater than that of CCI group at one day,three days,one week and one month postoperatively( P <0 05).there was no significant difference after three months.ConclusionIn CCI group,there is relatively slighter shift in corneal shape,and more rapid restoration.But in STI group,rehabilitation of corneal shape and visual acuity require more time.