超声乳化术中不同位置巩膜隧道切口对角膜散光的疗效

Efficacy of different locations scleral tunnel incision in phacoemulsification on preoperative corneal astigmatism

目的：比较超声乳化白内障手术中不同位置巩膜隧道切口对术前不同角膜散光的疗效。方法：收集2013-03/2014-10在我院行超声乳化白内障摘出联合人工晶状体植入术的年龄相关性白内障患者,共90例94眼,将患者分为2组,A组于10∶00~11∶00位行3.2mm巩膜隧道切口,B组在角膜最陡子午线方位行3.2mm巩膜隧道切口,切口均不缝合。用角膜地形图测量患者术前、术后不同时间的角膜散光状态,比较不同手术切口对术后角膜散光的影响,分别比较两组患者术前角膜散光〈1.00D,1.00~2.00D及〉2.00D组变化,以及术后1wk;1,3mo时裸眼视力及角膜散光改变。结果：B组术前角膜散光〈1.00D和1.00~2.00D组的患者术后裸眼视力好于A组。B组术前角膜散光〈1.00D组的患者术后角膜散光小于A组。结论：依据患者术前角膜散光状态,对于术前角膜散光〈1.00D的患者选择在角膜最陡子午线方位上行3.2mm巩膜隧道切口,可一定程度上矫正术前角膜散光,并相应提高裸眼视力。

AIM： To compare the efficacy of different locations scleral tunnel incision in phacoemulsification cataract on preoperative corneal astigmatism.METHODS： Totally 90 patients（ 94 eyes） in our hospital who had undergone the phaco- surgery from March 2013 to October 2014 were divided into two groups. The group A was those with 3. 2mm scleral tunnel incision at the direction of 10∶ 00 ~ 11∶ 00 points. The group B was those with 3. 2mm scleral tunnel incision at the steepest corneal meridian. Incision was not sutured. Corneal astigmatism status of preoperative and postoperative at different times were detected by corneal refractive. The impact of different surgical incision on postoperative corneal astigmatism was compared. In the two groups,patients with preoperative corneal astigmatism 〈 1. 00 D,1. 00 ~2. 00 D and 〉 2. 00 D were compared respectively. The changes of the uncorrected visual acuity and corneal astigmatism at postoperative 1wk, 1 and 3mo were observed.RESULTS： The uncorrected visual acuity of the patients who were in the group B preoperative corneal astigmatism 〈1. 00 D and 1. 00 ~2. 00 D was better than that in the group A. The postoperative corneal astigmatism of the patients who were in the group B preoperative corneal astigmatism 〈1. 00 D was lower than that in the group A.CONCLUSION： On the basis of preoperative corneal astigmatism,3. 2mm scleral tunnel incision at the steepest corneal meridian to some extent can correct preoperative corneal astigmatism 〈 1. 00 D,and accordingly improve the uncorrected visual acuity.