不同切口位置行小切口白内障摘除术对术后视力及眼压的影响

Effects of small incision cataract extraction with different incision positions on postoperative vision and intraocular pressure

目的探讨不同切口位置行小切口白内障摘除术对术后视力及眼压的影响。方法选取2018年1月至2020年1月收治的150例行小切口白内障摘除术+人工晶体植入的患者展开分析,根据切口位置不同分为对照组(84眼,颞上方巩膜位置做切口)和观察组(80眼,角巩膜缘上最大角膜屈光度子午线方位做切口),各75例。比较两组的裸眼视力、眼压、手术源性角膜散光度、泪膜功能及并发症发生情况。结果术后1、3个月,观察组的裸眼视力明显优于对照组(P<0.05)。术前、术后7 d、术后1、3个月,两组的眼压比较无明显差异(P>0.05)。术后7 d、术后1、3个月,观察组的手术源性角膜散光度明显低于对照组(P<0.05)。术后1、3个月,观察组的BUT明显长于对照组,SⅠt明显短于对照组,SDES评分明显低于对照组(P<0.05)。两组的患眼并发症总发生率比较无明显差异(P>0.05)。结论临床在实施小切口白内障摘除术中以角巩膜缘上最大角膜屈光度子午线方位为切口位置能够使患者裸眼视力得到更显著的改善,促进手术源性角膜散光度降低,减轻对泪膜功能的影响。

Objective To explore the effects of small incision cataract extraction with different incision positions on postoperative vision and intraocular pressure.Methods A total of 150 patients with small incision cataract extraction and intraocular lens implantation admitted in our hospital from January 2018 to January 2020 were selected for analysis,and they were divided into control group(84 eyes,incision was made at the position of supratemporal sclera)and observation group(80 eyes,incision was made at the meridian position of maximum corneal refraction on the corneoscleral limbus)according to different location of incision,with 75 cases in each group.The naked visual acuity,intraocular pressure,surgical corneal astigmatism,tear film function and complications were compared between the two groups.Results At 1 and 3 months after operation,the naked visual acuity of the observation group was significantly better than that of the control group(P<0.05).There was no significant difference in intraocular pressure between the two groups before surgery,7 d after surgery,and 1 and 3 months after surgery(P>0.05).At 7 d and 1 and 3 months after surgery,the surgical corneal astigmatism in the observation group was significantly lower than that in the control group(P<0.05).At 1 and 3 months after operation,the BUT of the observation group was significantly longer than that of the control group,SⅠt was significantly shorter than that of the control group,and SDEA score of the observation group was significantly lower than that of the control group(P<0.05).There was no significant difference in the total incidence of complications of affected eye between the two groups(P>0.05).Conclusion In clinical small incision cataract extraction,taking the meridian position of maximum corneal refraction on the corneoscleral limbus as the incision position can make the naked eye vision of patients get more significant improvement,promote the reduction of surgical corneal astigmatism,and reduce the impact on tear film function.