白内障超声乳化术中不同位置角膜切口对术后角膜散光的影响

Effect of corneal incision at different locations on corneal astigmatism after cataract phacoemulsification

目的研究白内障超声乳化术中不同位置角膜切口对术后角膜散光的影响。方法将行白内障超声乳化联合人工晶状体植入术治疗的98例患者按不同手术切口位置分为对照组和观察组,各49例。对照组于颞上侧或鼻上侧做角膜切口,观察组于最大角膜屈光力子午线轴位做角膜切口。比较两组的手术治疗效果。结果术后,两组的角膜内皮细胞计数均少于术前(P<0.05),且呈降低趋势;但两组间无显著差异(P>0.05)。术后1 d至6个月,两组的平均角膜散光度均呈先升高后降低趋势;且术后7 d至6个月,观察组平均角膜散光度均低于对照组(P<0.05)。术后7 d至6个月,两组手术源性散光度均呈降低趋势;且术后1、6个月,观察组手术源性散光度均低于对照组(P<0.05)。结论白内障超声乳化术中采取最大角膜屈光力子午线轴位和常规手术切口对患者术后角膜散光均有改善作用,但最大角膜屈光力子午线轴位效果更佳。

Objective To study the effect of corneal incision at different locations on corneal astigmatism after cataract phacoemulsification. Methods Ninety-eight patients treated with phacoemulsification combined with intraocular lens implantation were divided into control group and observation group according to different incision positions, with 49 cases in each group. In the control group, corneal incision was made on the superior temporal side or the superior nasal side. In the observation group, corneal incision was made on the meridian axis of maximum corneal refractive power. The operative effects of the two groups were compared. Results After operation, the corneal endothelial cell counts in both groups were lower than those before operation（P〈0.05）, and with a decreasing trend, but there was no significant difference between the two groups（P〈0.05）. From 1 day to 6 months after operation, the average corneal astigmatism of both groups showed trends of first increase and then decrease, and those in the observation group were lower than the control group from 7 days to 6 months after operation（P〈0.05）. From 7 days to 6 months after operation, the operative astigmatism of the two groups showed decreasing trends, and those in the observation group were lower than the control group at 1 and 6 months after operation（P〈0.05）. Conclusion In cataract phacoemulsification, both of incisions on the meridian axis of maximum corneal refractive power and conventional incision can improve corneal astigmatism, but the effect is better of incision on the meridian axis of maximum corneal refractive power.