角膜地形图引导下白内障手术切口的改变对中度角膜散光的影响

Effect of Different Incisions on Preexisting Corneal Astigmatism During Phacoemulsification

目的:观察角膜地形图引导下白内障手术角膜切口的改变对术前中度角膜散光影响。方法:患者47例(59眼),根据角膜地形图检查结果角膜散光为1.0~2.0D,随机分为两组,每组患者选择不同手术切口。A组(30眼):手术切口为常规11:00位3.0mm透明角膜切口;B组(29眼):手术切口为角膜最陡峭子午线上的透明角膜切口。术后查角膜地形图,观察术后1周,1月,3月患者的视力、角膜散光、手术源性散光及散光轴向的情况。结果:各组视力术后较术前均有大幅度提高;A组散光与术前相比差别无统计学意义(p>0.05),B组散光较术前大幅度减小,且小于A组,差别有统计学意义(P<0.05)。A组与B组各时间点散光轴向构成比比较,差别无统计学意义(P>0.05)。结论:位于最陡峭子午线上的角膜切口可以矫正白内障术前存在的角膜中度散光。

Objective： To compare the effect of different incisions on preexisting corneal astigmatism during phacoemulsification. Methods ： According to the results of corneal topography, corneal astigmatism be- tween 1.0 D to 2.0 D, 47 patients （ 59 eyes ） were divided into 2 groups. Different incisions for cataract surger- y were made for each group. Group A （30 eyes} ： surgical incision for conventional 11：00 3.0mm transparent corneal incision; Group B （29 eyes ） ： the incision was the clear corneal incision on the steepest corneal me- ridian. After surgery, the corneal topography was observed. The visual acuity, corneal astigmatism, astigma- tism and astigmatism of the patients were observed at 1 week, 1 month, 3 months after operation. Results： The visual acuity of each group was significantly improved after operation. There was no significant difference for group A astigmatism before and after operation （ p 〉 0.05 ）. Compared with group A, the astigmatism of group B was significantly reduced, and the difference was statistically significant （p〈0.05}. There was no sig- nificant difference between group A and group B at each time point in the axial ratio of astigmatism （ p〉0.05 ）. Conclusion： The incisions on the steepest meridian can correct the midrange preexisting corneal astigmatism.