不同角膜缘切口对白内障超声乳化术后角膜前后表面散光程度的影响

Influence of different corneal limbal incision on the surface astigmatism after phacoemulsification on corneal

目的 观察不同角膜缘切口对白内障超声乳化术后角膜前后表面散光程度的影响.方法 选择白内障患者46例（76眼）,按数字表法随机分为A、B两组,A组23例40眼,经颞侧透明角膜切口行白内障超声乳化术;B组23例36眼,经上方透明角膜切口行白内障超声乳化术,比较两组术后角膜前后表面散光程度.结果 A组术前矫正视力为（0.13±0.10）D,术后3个月矫正视力为（0.79 ±0.13）D;B组术前矫正视力为（0.14±0.11）D,术后3个月矫正视力为（0.76±0.15）D,两组术后3个月矫正视力均较术前明显提高（t=4.006、4.127,均P＜0.01）,两组术后矫正视力差异无统计学意义（t=0.605,P＞0.05）.两组术后角膜前表面、后表面散光值均逐渐减少,术后3个月A组角膜前表面、后表面散光值为（0.45±0.24）D、（0.09±0.06）D;B组为（0.52±0.25）D、（0.09±0.07）D,均显著低于术后1d和术后1周（t=2.232、2.128,均P＜0.05）.术后3个月A组角膜前表面散光值显著低于B组（t=2.304、2.107,均P＜0.05）,其余时点两组角膜散光值差异均无统计学意义（均P＞0.05）.结论 经颞侧透明角膜切口行白内障超声乳化术早期视力恢复较好,且患者角膜散光改变小于经上方透明角膜切口手术.

Objective To observe the effect of limbal incision before and after phacoemulsification corneal astigmatism degree.Methods 46 patients with cataract （76 eyes） were randomly divided into two groups.23 cases （40 eyes） in group A received a temporal clear corneal incision phacoemulsification.23 cases （36 eyes） in group B received the upper clear corneal incision cataract ultrasound breast surgery.Results In group A,preoperative corrected visual acuity was （0.13 ±0.10）D,after 3 months of corrected visual acuity was （0.79 ± 0.13）D.In group B,preoperative corrected visual acuity was （0.14 ± 0.11）D,after 3 months of corrected visual acuity was （0.76 ± 0.15）D,the patients after 3 months corrected visual acuity was significantly improved than before treatment （t =4.127,P 〈0.01）,the postoperative visual acuity was not statistically significant（t =0.605,P 〉 0.05）.Two groups postoperative corneal anterior surface,surface astigmatism values were gradually reduced,3 months after operation in group A after corneal anterior surface,surface astigmatism value were （0.45 ± 0.24） D,（0.09 ± 0.06） D ; those in B group were （0.52 ± 0.25） D,（0.09 ± 0.07） D,which were significantly lower than 1 week after operation and postoperation（t =2.232,2.128,all P 〈 0.05）.The remaining time two groups of corneal astigmatism value had no significant difference （P 〉 0.05）.Conclusion Temporal clear corneal incision phacoemulsification recovery of visual acuity is better,and less than the above changes of corneal astigmatism corneal incision operation.