白内障小切口超声乳化联合角膜缘松解术矫正角膜散光的疗效分析

Curative effect of small incision phacoemulsification and corneal limbus lysis on original corneal astigmatism

目的分析白内障小切口超声乳化联合角膜缘松解术矫正角膜散光的疗效。方法 选取我院住院并行手术治疗的单纯性白内障患者30例（38眼）,根据手术方式分为两组：A组行小切口白内障超声乳化联合角膜缘松解术（15例,18眼）,B组行小切口白内障超声乳化术（15例,20眼）。观察两组患者术前、术后1周、3周、2个月的最佳矫正视力（best corrected visualacuity,BCVA）、角膜散光的变化,同时观察术后两组患者散光矫正量和术后并发症的情况。结果 A、B组患者术后1周、3周、2个月的BCVA与术前比较均显著提高,差异均有显著统计学意义（均为P〈0.01）;术后随着时间的延长,BCVA逐渐提高,三个时间点间比较,差异均有显著统计学意义（均为P〈0.01）;A组术后3周、2个月BCVA均明显高于B组,差异均有统计学意义（均为P〈0.05）。A、B组患者术后1周、3周、2个月的角膜散光值与术前比较均显著降低,差异均有显著统计学意义（均为P〈0.01）;术后随着时间的延长,角膜散光值逐渐降低,三个时间点间比较,差异均有显著统计学意义（均为P〈0.01）;A组术后1周、3周、2个月的角膜散光值明显低于B组,差异均有显著统计学意义（均为P〈0.01）。A组术后散光矫正量为（1.96±0.12）D,明显高于B组的（1.19±0.09）D,差异有显著统计学意义（P〈0.01）。A组和B组术后分别有1眼和2眼出现明显的角膜雾状混浊,术后3～4d消失;A组和B组各有1眼出现眼部异物感,术后4～5d消失。结论 白内障小切口超声乳化联合角膜缘松解术可以明显减少术后患者的角膜散光,改善术后视力,安全性高。

Objective To investigate the curative effects of small incision phacoemulsification and corneal limbus lysis on original corneal astigmatism. Methods Thirty patients （38 eyes） with cataract underwent surgery in our hospital were chosen,based on the surgery types,the patients were divided into two groups：group A （15 cases, 18 eyes） received the small incision phacoemuisification and corneal limbus lysis, and group B （15 cases ,20 eyes） with single phacoemuisilication. The best corrected visual acuity （BCVA） and corneal astigmatism at pre-operation and postoperative 1 week, 3 weeks, 2 months were observed, and the corrected value of corneal astigmatism and complications in two groups were also observed. Results The BCVA at postoperative 1 week, 3 weeks, 2 months in two groups were all higher than pre-operation （ all P 〈 0.01 ）. The BCVA increased with the postoperative time prolonged,there were statistical differences among three time points （all P 〈 0.01 ）. The BCVA at postoperative 3 weeks ,2 months in group A were higher than those in group B,there were statistical differences （all P 〈0.05）. The corneal astigmatism at postoperative 1 week,3 weeks,2 months in two groups were all lower than pre-operation （ all P 〈 0.01 ）. The BCVA decreased with the postoperative time prolonged, there were statistical differences among three time points （ all P 〈 0.01 ）. The BCVA at postoperative 1 week, 3 weeks,2 months in group A were lower than those in group B,there were statistical differences （all P 〈0.01 ）. The corrected value of corneal astigmatism in group A and group B were （ 1.96 ± 0. 12） D and （ 1.19 ± 0.09 ） D, respectively, there was statistical difference （P 〈 0.01 ）. The corneal edema appeared in 1 eye of group A and 2 eyes of group B, all disappeared at postoperative 3 -4 days;The corneal foreign body sensation appeared in 1 eye of group A and 1 eye of group B, all disappeared at postoperative 4 - 5 days. Conclusion Small incision phacoemulsification and corneal limbus lysis can reduce the corneal astigmatism and improve the visual acuity with high safety in cataract patients.