白内障超声乳化术后角膜地形图和屈光状态的观察

Clinical study on cornea topography and refractive status after phacoemulsification

目的 观察白内障超声乳化人工晶状体植入术后 ,患者角膜地形图和屈光状态的变化。方法 对2 0 0 0年～ 2 0 0 1年行白内障超声乳化的 136例 (15 1只眼 )患者术前、术后随访一年的资料进行回顾性分析。结果 术后 1、3、6、12月术眼的球镜、散光、角膜地形图曲率和散光 sim k值统计结果无明显差异 ;术后 1～ 12月视力和屈光状态稳定 (方差分析 P >0 .0 5 )。术后 6月平均视力为 0 .5 9± 0 .2 3,矫正视力为 0 .82± 0 .19,术后 6月 ,球镜为 (-0 .2 4± 0 .88) D,散光为 (- 0 .5 6± 1.0 1) D,在± 1.0 D之内球镜和散光眼分别为 84.0 %和 6 4.0 % ,≥ 0 .5和≥ 0 .8的视力分别为 70 .0 %和 2 8.0 % ,≥ 0 .5和≥ 0 .8的矫正视力分别为 94.0 %和 72 .0 %。≥ 0 .5和≥ 0 .8裸眼视力和矫正视力的平均百分率分别由 6 1.96 %和 2 3.49%提高到配镜矫正后的 92 .35 %和 6 3.0 9%。结论 超声乳化术后角膜形态和屈光状态保持良好的稳定性 ,患者可以达到良好的视力。由于植入的人工晶状体无调节功能和测量误差 ,目前部分患者需要配戴较低度数的眼镜矫正远或近视力 ,达到更好的视觉效果。

Objective To investigate the changes of cornea topography and refractive status after the operation of phacoemulsification (PHACO) and intraocular lens (IOL) implantations.Methods During the period of 2000～2001,136 patients (151 eyes) had PHACO and IOL implantations were followed for one year and the data were analyzed.Results No significant changes were found in sphere refractiev power,astigmatism,curvature and astigmatism of cornea topography,acuity visual and refractive statue at 1,3,6,12 months after operations respectively (P>0.05,F test).The average acuity visual and corrected acuity visual were 0.59±0.23 and 0.82±0.19 at 6 months after operations.The sphere refractive power and astigmatism were (-0.24±0.88)D and (-0.56±1.01)D and there were 84.0% and 64.0% sphere and astigmatism within±1.0D at 6 months after operations respectively.The percent of acuity visual and corrected acuity visual of ≥0.5 and ≥0.8 were 70.0%,28.0% and 94.0%,72.0% at 6 months and the average percent of acuity visual of ≥0.5 and ≥0.8 were increased from 61.96%,23.49% to 92.35%,63.09% after corrected respectively.Conclusions The cornea formation and refractive statue were stable and patients got better acuity visual after PHACO and IOL implantations.But some patients should have low diopters eyeglasses to correct refractive error because of the noaccommodation of artifical IOL and the measure errors of IOL.