白内障术前两种角膜散光标记方法的对比研究

Comparative study of two corneal astigmatism marker methods before cataract surgery

目的评价在行白内障超声乳化吸出联合Toric人工晶状体植入术前,2种常用的角膜散光标记方法的准确性。方法本研究为前瞻性随机对照研究。60例(60眼)患者被随机分为2组,每组各30例,分别按2种不同方法进行术前角膜散光标记。一种方法是裂隙灯显微镜下1 m L注射器针头标记法,另一种为toric专用标记器标记法,标记后裂隙下用数码照相机在后反射光下拍摄眼前节数字图像,记录标记,并用Photoshop软件对数字图像进行分析,对2组旋转偏差和垂直偏差进行评估。结果裂隙灯标记组旋转偏差较小,为(3.2±1.9)°;标记器组旋转偏差为(5.9±4.1)°,2组差异有统计学意义(P<0.01)。裂隙灯标记组垂直偏差也较小,为(0.27±0.18)mm,标记器组垂直偏差为(0.57±0.31)mm,2组差异也有统计学意义(P<0.01)。结论裂隙灯标记法旋转偏差和垂直偏差均小于toric标记器法,因此建议尽量采用裂隙灯标记法来标记患者的水平子午线,可保证散光轴线定位的精确性。

Objective To compare the accuracy of two corneal astigmatism marker methods before phacoemulsification and Toric intraocular lens implantation. Methods This study was a prospective randomized controlled study. 60 patients were randomly divided into tw o groups,30 cases in each group,and tw o corneal astigmatism marker methods were used. The first methods were marked with an 1 m L syringe needle under the slit lamp,and the second device with Toric marker used specially for marking corneal astigmatism. The corneal astigmatic axis was marked and then a digital camera was used to capture the anterior segment of digital image in the post reflective light. The marker was documented and the digital images were analyzed by photoshop softw are,and the rotational deviation and vertical misalignment were also assessed. Results The least rotational misalignment was observed in the slit lamp group with the mean deviation（ 3. 2 ±1. 9） °,which in the Toric marker group was（ 5. 9 ± 4. 1） °,the difference betw een the tw o groups was statistically significant（ P〈 0. 01）. The least vertical misalignment was also observed in the slit lamp group with the mean deviation（ 0. 27 ± 0. 18） mm,which in the Toric marker group was（ 0. 57 ± 0. 31） mm,there was significant difference betw een tw o groups（ P〈 0. 01）. Conclusion The least vertical misalignment and rotational misalignment with slit lamp methods are all smaller than those with Toric marker,so suggest use slit lamp to mark the meridian,which can improve the accuracy of the astigmatism axis.