经角膜缘人工晶体悬吊术后角膜地形图的变化

A CLINICAL STUDY OF CORNEAL SHAPE AND ASTIGMATISM AFTER VENTROFIXATION OF COLLAPSIBLE INTRAOCULAR LENS

目的 观察经角膜缘切口的无晶体眼行人工晶体悬吊术后角膜表面形态以及屈光状态变化.方法无晶体眼病人19例（19只眼）,采用英国RAYNER公司620H折叠式人工晶体对患眼行经角膜缘切口的折叠式人工晶体悬吊术,使用角膜地形图分析仪观察其术前、术后1周、术后1个月及术后2个月的角膜表面形态以及角膜表面非对称指数（SAI）、角膜表面散光值（CYL）、角膜表面规则指数（SRI）的改变.结果 术后1周及术后1个月CYL、SAI与术前相比均明显增大,差异有显著性（F=19.563、22.352,t=3.359~7.253,P〈0.05）.SRI与术前相比差异无显著性（P〉0.05）.三者在术后2个月与术前相比差异无显著性（P〉0.05）.结论 经角膜缘切口行人工晶体悬吊术后SRI、SAI、CYL变化小、散光小、愈合快,可获得较满意的手术效果,该术式是治疗无后囊膜无晶体眼的一种较好的、可选择的手术方式.

Objective To investigate the changes of corneal shape and astigmatism after ventrofixation of collapsible in- traocular lens. Methods 620H foldable intraocular lens, made by RAYNER company in UK, were implanted into 19 aphakia in 19 patients via limbal incision for foldable intraocular lens ventrofixation. The cornea and corneal surface morphology asymmetric index （SAD, the corneal surface astigmatism values （CYL）, the corneal surface regularity index （SRI） were detected preopera- tively, and one week,one month and two months after surgery. Results The CYL and SAI were larger in the topography one week and one month after surgery than before, the difference being significant （F = 19.563,22.352 t = 3.359- 7.253 P 〈0.05）, and SRI was not significantly different as compared between before and after surgery （P〉0.05）. The differences of the above three parameters between two months after surgery and before surgery were not statistically significant （P〉0.05）. Conclusion The limbal incision for foldable intraocular lens ventrofixation can obtain satisfactory result with postoperative little changes of SAI, CYL, SR1, mild astigmatism, and fast healing. This technique is a better and selectable surgery in the treatment of aphakia wi- thout posterior capsular.