应用前节OCT分析白内障透明角膜切口内口位置对术后散光的影响

Effect of the inside incision positions of clear corneal incisions of cataract on astigmatism after surgery using anterior segment optical coherence tomography

目的:运用前节OCT扫描仪(anterior segment optical coherence tomography AS-OCT)分析白内障超声乳化术后透明角膜切口内口的位置对术源性散光(surgery induced astigmatism,SIA)的影响。方法:选择年龄相关性白内障患者40例43眼,做2.8mm透明角膜切口,行白内障超声乳化联合折叠型人工晶状体植入术。术前及术后1wk,1、3mo进行矫正视力检查,术后1wk,1、3mo应用AS-OCT对角膜切口内口的位置及切口长度进行测量。根据切口位置的不同分为:1组:20例23眼,切口内口距离角膜顶点中线>3mm;2组:20例20眼,切口内口距离角膜顶点中线≤3mm。结果:1组和2组术前1d矫正视力及角膜散光的比较无统计学差异(P>0.05);术后1wk,1、3mo两组矫正视力不断增加,散光及切口长度均不断减小,但是差异有统计学意义(P<0.05)。结论:内口位于角膜中央3mm半径内的透明角膜切口长度偏长,术后产生的SIA较内口在3mm以外的切口偏大,且术后获得的矫正视力也可能低于后者。

AIM：To analyze effect of the inside incision positions of clear corneal incisions of cataract on astigmatism after surgery was analysis using anterior segment optical coherence tomography. METHODS： A total of 40 patients of 43 eyes of age-related cataract were chosen. All of them were done 2.8mm clear corneal incision and phacoemulsification with foldable intraocular lens implantation. Preoperative and postoperative 1wk, 1 and 3mo, the corrected visual acuity were examined. Postoperative 1wk, 1 and 3mo, the positions and lengths of the incisions were measured. Depending on the location of the incisions, the patients were divided into two groups. Group 1：the inside mouth of the incisions（22 patients of 23 eyes） were far from the corneal vertex central line〉 3mm. Group 2： the inside mouth of the incisions （ 20 patients of 20 eyes ） were far from the corneal vertex central line ≤3mm. RESULTS：One day before the surgery between Group 1 and Group 2 patients, there were no statistically significant difference（P〉0. 05） in corrected visual acuity and corneal astigmatism. After the surgery, corrected visual acuity gradually increased, astigmatism and cut lengths gradually decreased. But, there were no statistically significant difference at 1wk, 1 and 3mo （ P〈0.05）. CONCLUSION：The length of the inside mouth locatedwithin radius of the central cornea 3mm was rather longer than the length of the inside mouth located without radius of the central cornea 3mm. The SIA after surgery is greater, and postoperative visual acuity gained maybe less than the latter.