白内障超声乳化手术不同切口对角膜散光和术后视力的影响对比

Effect of Different Incision on Corneal Astigmatism and Postoperative Visual Acuity in Phacoemulsification

目的探究不同切口白内障超声乳化手术对角膜散光以及视力提升的影响。方法随机选择2020年9月—2022年5月在南京市高淳人民医院眼科治疗的100例白内障患者为研究对象,根据随机数表法将患者分成对照组和观察组,每组50例。两组患者采取白内障超声乳化手术时,对照组采取巩膜隧道切口,观察组则实施透明角膜切口,分别对比两组患者在术前和术后1周、手术后6个月的角膜散光度和裸眼视力、矫正视力。结果术前、术后1周与术后6个月时,观察组角膜散光度分别为(0.78±0.51)°、(1.28±0.56)°、(0.83±0.55)°,与对照组(0.80±0.53)°、(1.35±0.54)°、(0.81±0.59)°比较,差异无统计学意义(t=0.192、0.636、0.175,P=0.848、0.526、0.861)。两组术后裸眼视力与矫正视力均较术前明显提高,差异有统计学意义(P<0.05),但两组间同期裸眼视力与矫正视力比较,差异无统计学意义(P>0.05)。结论在采取白内障超声乳化手术时,采用透明角膜切口和巩膜隧道切口均可改善白内障患者手术后角膜散光度、裸眼视力和矫正视力,但透明角膜切口手术更为便捷,术中无出血,临床可根据实际情况酌情选用。

Objective To explore the effect of different incision cataract phacoemulsification on corneal astigmatism and visual acuity improvement.Methods A total of 100 cataract patients treated in the Department of Ophthalmology,Nanjing Gaochun People's Hospital from September 2020 to May 2022 were randomly selected as the research objects.According to the random number table method,the patients were divided into control group and observation group,with 50 cases in each group.The two groups of patients were treated with phacoemulsification,the control group was treated with scleral tunnel incision,and the observation group was treated with transparent corneal incision.The corneal astigmatism,naked eye vision and corrected vision of the two groups of patients before and 1 week and 6 months after surgery were compared.Results The corneal astigmatism in the observation group was(0.78±0.51)°,(1.28±0.56)°,(0.83±0.55)°before operation,1 week and 6 months after operation,respectively,compared with the control group(0.80±0.53)°,(1.35±0.54)°,(0.81±0.59)°,and the difference was not statistically significant(t=0.192,0.636,0.175,P=0.848,0.526,0.861).The postoperative uncorrected visual acuity and corrected visual acuity of the were significantly improved compared with those before operation,and the difference was statistically significant(P<0.05),but there was no statistically significant difference between the two groups in the same period(P>0.05).Conclusion In cataract phacoemulsification surgery,the use of clear corneal incision and scleral tunnel incision can improve the postoperative corneal astigmatism,naked eye vision and corrected vision of cataract patients,but the transparent corneal incision is more convenient,no bleeding during the operation,and can be selected according to the actual situation in the clinic.