小切口无缝线非超声乳化术后散光的动态研究

Postoperative Astigmatism Following Small Incision Non-phacoemulsification with Unsutured Wounds

目的 探讨小切口无缝线非超声乳化白内障摘除术后角膜散光的动态变化并与超声乳化术后进行比较。方法 将 35 2例老年性白内障病人 35 2只眼分为非超声乳化组 (186例 186只眼 )和超声乳化组(16 6例 16 6只眼 ) ,进行白内障手术既术后 1周、1月、3月及 6月角膜散光的动态研究 ;并就两组手术切口及其缝线所导致术后手术源性散光 (surgicallyinducedastigmatism ,SIA)及术后不同时期的SIA及轴线变化进行了分析。结果 两组术后 1周角膜散光分别为 1.96± 0 .6 9D及 1.19± 0 .5 6D ,差异有显著性 (P <0 .0 1)。非超声乳化组术后 1月、3月及 6月角膜散光较超声乳化组无明显差异 ;两组角膜散光平均为 0 .96D和 0 .89D ,差异无显著性 (P >0 .0 1)。结论 小切口无缝线非超声乳化白内障摘除术后角膜散光小 ,手术便捷 ,适合广大基层医院推广应用。

Objective:To compare the changes in the values and directions of surgically induced astigmatism(SIA)after phacoemulsification with PMMA intraocular lens implantation through a limbus or incision clear comeal tunnel incision and to evaluate their clinical results.Methods:The surgery was performed through a 5.0 mm limbus tunnel incision or a 5.0 mm clear comeal incision on 566 eyes of 566 patients with senile,complicated congenital and traumatic cataracts.The patients were divided into two groups;the limbus tunnel (A) and the clear comeal tunnel (B) incision respectively.Keratonmetry measurements were performed preoperatively,at postoperative 1 week,1 month,3 months and 6 months respectively.The mean SIA and uncorrected visuity were compared among the groups up to 6 months postoperatively.Results:Eyes in A group displayed significantly less mean SIA and better uncorrected visual acuity than B at 1 week postoperatively(P<0.05),but there were no significant differences between two groups at 1 month,3 months and 6 months postoperatively(P>0.05).Conclusion:SIA in eyes of 5.0 mm incision group of the limbus of comeal tunnel incision phacoemulsification are less and more stable, a better and quicker rehabilitation of uncorrected visual acuity can be obtained in the early postoperative period,but a clear comeal incision of the operation is more convenient and quicker;at postoperative 1 month,the mean postoperative astigmatism and the result was almost the same as the operation through a limbus tunnel incision.