植入硬晶体的中等度透明角膜隧道切口所致手术源性角膜散光及其处理

Correction of the astigmatism induced by clear corneal tunnel incision in phacoemulsification

目的 :探讨白内障超声乳化吸除术中植入硬晶体的中等度透明角膜隧道切口所致的手术源性角膜散光及其术中矫正处理。方法 :表面麻醉下对 161例白内障行超声乳化吸除 ,扩大透明角膜隧道切口至 5 5mm～ 6 0mm ,植入一片式PMMA硬性人工晶体 ,切口不缝合者 89例 ,缝合切口 1针者 72例 ,检查角膜地形图 ,测量术前及术后不同时期缝合与不缝合者的角膜散光。结果 :术后 1周不缝合与缝合组的平均手术源性角膜散光分别为 1 97± 1 2 5D和 1 0 6± 0 73D ;术后 1月不缝合与缝合组的平均手术源性角膜散光分别为 1 43± 0 95D和 0 76± 0 5 6D ;术后 6个月不缝合与缝合组的平均手主源性角膜散光分别为 1 3 0±0 71D和 0 71± 0 45D。结论 :对植入硬晶体的中等度透明角膜隧道切口的 1针缝合可有效减少其手术源性角膜散光 ,明显提高患者术后的裸眼视力 ,获得接近小切口折叠晶体植入的手术效果 ,对无条件植入折叠晶体而又习惯于行透明角膜隧道切口的术者来说值得采用。

Objective:To investigate the correction of astigmatism induced by clear corneal tunnel incision in phacoemulsification and intraocular hard lens implantation. Methods:For 5.5mm～6.0mm clear corneal tunnel incision closed sutureless in 89 eyes and closed with one radial suture in 72 eyes,the corneal astigmatism were measured with corneal topography preoperatively and at 1 week,3 months,6 months postoperatively. Results:1 week after operation,the surgically induced astigmatism (SIA) of the suture and sutureless incision were 1.06±0.73D and 1.97±1.25D;3 months after operation were 0.76±0.56D and 1.43±0.95D;6 months after operation,the SIA of the suture and sutureless incision were 0.71±0.45D and 1.30±0.71D. Conclusions:The one radial suture of the 5.5mm～6.0mm clear corneal tunnel incision can effectively reduce the SIA.