Comparison of surgically induced astigmatism in various incisions in manual small incision cataract surgery

AIMTo determine the surgically induced astigmatism (SIA) in Straight, Frown and Inverted V shape (Chevron) incisions in manual small incision cataract surgery (SICS).

Comparison of surgically induced astigmatism among different surgeons performing the same incision

To compare surgically induced astigmatism （SIA） of different surgeons, who perform the same main incision. Two hundred and seventy eyes underwent cataract surgery with phacoemulsification by four different surgeons （A, B, C, and D）. A 3-step, 3.0 mm, superotemporal for the right eye and superonasa! for the left eye clear corneal incision was performed. A comparison in SlA among A, B, C and D surgeon was made. No significant difference was found in SlA at both first and sixth postoperative month between different surgeons （P〉0.05）. SIA is more dependent on incisional characteristics and preoperative astigmatism and less on the surgeon.

Incision Site in Manual Small Incision Cataract Surgery in Case of Preoperative Direct Astigmatism

We compared surgically induced astigmatism (SIA) by a superior incision with a temporal incision in manual small incision cataract surgery (MSICS), in patients with bilateral direct (regular) preoperative corneal astigmatisms. Patients and method: We carried out a prospective study from July 1st 2018 to September 30th 2019 in the department of ophthalmology at the University Hospital of Brazzaville. Keratometric readings were recorded before surgery to assess preoperative corneal astigmatisms. Keratometric evaluation was done 45 days post-operatively. Patients were followed 90 days after surgery in order to assess the healing of the surgical site. The surgically induced astigmatism (SIA) is the difference in the magnitude vectors between the preoperative and postoperative astigmatism. The result was positive if the postoperative astigmatism was greater than the preoperative astigmatism and negative if the postoperative astigmatism was less than the preoperative astigmatism. Results: Our study sample included 48 eyes from 24 patients, including 24 operated on temporal incision and 24 in superior incision. The average SIA for superior incisions was 0.33 ± 1.55 diopters (D), versus 0.33 ± 1.44 for temporal incisions. For superior incisions the SIA was 0.81 for astigmatisms lower than 2D, against 0.16D for the temporal incisions. On the other hand, for preoperative astigmatisms greater than 2D, the surgically induced astigmatism was ±0.62D, marking a decrease in preoperative astigmatism for the superior incisions against an increase of 0.5D for the temporal incisions. The healing was delayed for the temporal incisions responsible for discomfort persisting beyond 45 days. Conclusion: The temporal incision had better results than the superior incision for astigmatisms lower than 2D, and less good for astigmatisms higher than 2D. The temporal incision healed less well.

Surgically induced astigmatismCorneal astigmatismMeanSummated vector meanCentroidVector analysisTemporal incisionSuperior incisionICL implantation

BackgroundTo compare the arithmetic mean (M-SIA) and the summated vector mean of surgically induced astigmatism (SVM-SIA) according to the incision site after phakic intraocular lens (Visian implantable collamer lens (ICL), STAAR Surgical) implantation.MethodsThis study comprised 121 eyes of 121 consecutive patients undergoing ICL surgery through a 3.0-mm temporal or superior clear corneal incision. The magnitude and the axis of corneal astigmatism preoperatively and 3 months postoperatively were measured using an automated keratometer. The M-SIA and the SVM-SIA were determined according to the incision site.ResultsThe magnitude of corneal astigmatism significantly increased from 1.23 ± 0.59 D preoperatively to 1.46 ± 0.72 D postoperatively in the temporal incision group (Wilcoxon signed-rank test, P < 0.001), but it significantly decreased from 1.09 ± 0.36 D preoperatively to 0.86 ± 0.41 D postoperatively in the superior incision group (P < 0.001). The M-SIA was 0.48 ± 0.30 D, and the SVM-SIA was 0.23 ± 0.52 D at a meridian of 82° in the temporal incision group. The M-SIA was 0.57 ± 0.30 D, and the SVM-SIA was 0.47 ± 0.45 D at a meridian of 1° in the superior incision group.ConclusionsICL implantation induces the M-SIA by approximately 0.5 D, but the SVM-SIA decreased to 50% and 80% of the M-SIA in magnitude through temporal and superior incisions, respectively. The direction of the SVM-SIA showed a tendency toward corneal flattening to the incisional site. It should be noted that the M-SIA is somewhat different from the SVM-SIA according to the incision site.

Surgically Induced Corneal Astigmatism Following Cataract Surgery

Aim: To study the surgically induced astigmatism (SIA) caused by two different type main incisions in phacoemulsification. Methods: Sixty-eight eyes of 65 patients who underwent phacoemul-sification were randomly divided into two groups according to main incision type: 2.8 mm superior limbal incision (in Group 1) and 2.8 mm upper clear corneal incision (in Group 2). Surgical techniques did not differ between the groups except for the main incisions. All patients received detailed ophthalmological examination in addition to keratometry at the pre- and post-operatively. The preoperative and postoperative astigmatisms were calculated by the vector analysis method and the SIA was compared between the groups. Results: The mean SIA values were 1.3 ± 0.67 D, 0.89 ± 0.47 D, 0.77 ± 37 D in Group 1 and 1.42 ± 0.62 D, 1.15 ± 0.54 D, 0.94 ± 0.47 D in Group 2 on the first day, first week and first month postoperatively, respectively. According to the vector analysis, SIA was less in Group 1 than Group 2;although the difference was not statistically significant (p > 0.05). Conclusion: Although less astigmatism was detected in the superior limbal incision group, this difference was not statistically significant.

Astigmatism following Small Incision Cataract Extraction through Superotemporal Incision

Purpose:.To investigate the occurrence of corneal incision-induced astigmatism following small incision extracapsular cataract extraction through a superotemporal incision combined with intraocular lens (IOL) implantation. Methods:.A total of 255 cases (301 eyes) who received small incision extracapsular cataract extraction through a superotemporal incision with IOL implantation in the Department of Ophthalmology, Yuyan District Hospital of Guiyang were enrolled in this clinical trial..Postoperative best-corrected visual acuity and astigmatism were measured. The patients underwent 24-week follow-up. Results: In total, 166 patients (65.1%, 166 eyes) completed follow-up..Astigmatism gradually declined between 1 and 12-week postoperatively, and stabilized after 12 weeks. Among 166 patients,.125(75.3%).had astigmatism > 0.5 D at 24 weeks post-operatively,.showing mostly with-the-rule astigmatism. Visual acuity steadily improved up to 12 weeks, and tended to stabilize subsequently..Over the period of 24-week postoperatively,.visual acuity was negatively correlated with astigmatism (r=-0.691,P<0.05). Conclusion:Superotemporal small incision extracapsular extraction combined with IOL implantation is associated with modest astigmatism which declines over the post-operative period.

Effects of steep-axis incision on corneal curvature in onehanded phacoemulsification

AIM: To examine the effects of one-handed phacoemulsification with steep-axis incision on corneal curvature and analyze surgically induced astigmatism(SIA) on the true net power, anterior and posterior corneal surfaces. METHODS: Patients with cataracts underwent onehanded phacoemulsification with a 2.4-mm steep-axis of clear corneal incision(CCI) based on true net power. CCI was created under the guidance of Verion. Central corneal thickness(CCT), keratometry readings of the true net power and anterior and posterior corneal surface were obtained using Pentacam. Biometry, such as axial length, anterior chamber depth(ACD) and white-to-white(WTW) were performed using Lenstar pre-and 3 mo postoperatively. RESULTS: The study evaluated 68 eyes of 65 patients. The mean age was 65.93±9.40 y;CCT was 529.21±37.40 μm;WTW was 11.59±0.35 mm. Regarding true net power, keratometric value at the flattest corneal meridian for the 3-mm central zone(Ks) was significantly decreased postoperatively(P=0.031). Keratometric value at the steepest corneal meridian for the 3-mm central zone(Kf) was increased postoperatively(P>0.05). Astigmatism of true net power was 1.21±0.56 D preoperatively and significantly decreased to 1.02±0.58 D postoperatively(P=0.021). On the anterior corneal surface, no significant difference in Ks and Kf was noted pre-versus postoperatively. Anterior corneal astigmatism was 1.08±0.51 D preoperativelyand significantly decreased to 0.87±0.46 D postoperatively(P=0.002). On the posterior corneal surface, Ks and Kf were significantly increased postoperatively(all P<0.05), and posterior corneal astigmatism also increased(P=0.008). The SIA values of true net power and the anterior and posterior corneal surfaces at 3 mo postoperatively were 1.26±0.63 D(range: 0.11 to 2.80 D), 1.05±0.54 D(range: 0.23 to 2.40 D), and 0.21±0.17 D(range: 0.01 to 0.07 D), respectively. CONCLUSION: One-handed phacoemulsification with steep-axis incision can effectively decrease astigmatism of true net power and anterior corneal astigmatism. In the same surgery, the difference in personal SIA potentially originated from a difference in personal corneal thickness and diameter, both CCT and WTW distance should always be measured preoperatively when planning steep-axis phacoemulsification.

Comparison of magnitude and summated vector mean of surgically induced astigmatism vector according to incision site after phakic intraocular lens implantation

Background:To compare the arithmetic mean(M-SIA)and the summated vector mean of surgically induced astigmatism(SVM-SIA)according to the incision site after phakic intraocular lens(Visian implantable collamer lens(ICL),STAAR Surgical)implantation.Methods:This study comprised 121 eyes of 121 consecutive patients undergoing ICL surgery through a 3.0-mm temporal or superior clear corneal incision.The magnitude and the axis of corneal astigmatism preoperatively and 3 months postoperatively were measured using an automated keratometer.The M-SIA and the SVM-SIA were determined according to the incision site.Results:The magnitude of corneal astigmatism significantly increased from 1.23±0.59 D preoperatively to 1.46±0.72 D postoperatively in the temporal incision group(Wilcoxon signed-rank test,P<0.001),but it significantly decreased from 1.09±0.36 D preoperatively to 0.86±0.41 D postoperatively in the superior incision group(P<0.001).The M-SIA was 0.48±0.30 D,and the SVM-SIA was 0.23±0.52 D at a meridian of 82°in the temporal incision group.The M-SIA was 0.57±0.30 D,and the SVM-SIA was 0.47±0.45 D at a meridian of 1°in the superior incision group.Conclusions:ICL implantation induces the M-SIA by approximately 0.5 D,but the SVM-SIA decreased to 50%and 80%of the M-SIA in magnitude through temporal and superior incisions,respectively.The direction of the SVM-SIA showed a tendency toward corneal flattening to the incisional site.It should be noted that the M-SIA is somewhat different from the SVM-SIA according to the incision site.

Effect of phacoemulsification on vision and intraocular pressure and corneal astigmatism

Objective:To explore the effect of phacoemulsification in combined with intraocular lens implantation incision site selection on the visual function, intraocular pressure, and corneal astigmatism in patients with cataract.Methods:A total of 72 patients (85 eyes) with cataract who were admitted in our hospital from April, 2015 to October, 2016 were included in the study. All the patients were performed with phacoemulsification in combined with intraocular lens implantation. The patients were divided into the observation group (n=36, 43 eyes) and the control group (n=36, 42 eyes) according to different surgical incision sites. A transparent corneal incision with a length of 3.0 mm was made along the meridian axial position with the maximum corneal refractive power in the observation, while a transparent corneal incision with a length of 3.0 mm was made above the temple or nose in the control group. Routine disposition and follow-up visit were given for the patients in the two groups after operation. BCVA, intraocular pressure, corneal astigmatism, and corneal endothelial cell count in the two groups before and after operation were compared.Results:BCVA after operation in the two groups was significantly elevated, while the corneal endothelial cell count was significantly reduced, but the comparison of BCVA and corneal endothelial cell count between the two groups was not statistically significant. The intraocular pressure after operation in the two groups was elevated first and reduced later. The intraocular pressure 2 h and 1 d after operation was significantly elevated when compared with before operation. The intraocular pressure 2 d after operation was not significantly different from that before operation. The comparison of intraocular pressure at each timing point after operation between the two groups was not statistically significant. The corneal astigmatism after operation in the two groups was elevated first and reduced later. The surgically induced astigmatism 7 d-6 months after operation was significantly reduced, and the average corneal astigmatism 7 d-6 months after operation in the observation group was significantly lower than that in the control group. The surgically induced astigmatism 1-6 months after operation in the observation group was significantly lower than that in the control group.Conclusions: Phacoemulsification in combined with intraocular lens implantation incision site selection including maximum corneal refractive power site and routine surgical incision can improve the patients' vision, but the maximum corneal refractive power site surgical incision can reduce the postoperative corneal astigmatism, and has a certain advantage.

Modified Scleral Flap Incision to Reduce Corneal Astigmatism after Intraocular Lens Implantation

Purpose:To investigate a simple method during extracapsular cataract extraction with posteior chamber intraocular lens implantation in order to reduce surgically induced corneal astig-matism.Methods:A modified scleral flap incision was used in the extracapsular cataract extraction with intraocular lens implantation and the postoperative changes in conreal astigmatism was observed.Results:The peak value of postoperative corneal astigmatism was3.60D,and the corneal astigmatism regression was 2.11D,surgically induced astigmatism was less significant in modified scleral flap incision group than that in convention-al limbal incison group(P<0.05).Conclusions:The modified scleral flap inciston is an ideal incision for cataract ex-traction with intraocular lens implantation when phacoemulsifier is not avaliable.Eye Science1995;11:136-139.

MITOMYCIN C “STRAIGHT SCLERAL TUNNEL INCISION”-TRABECULECTOMY WITH A RELEASABLE SUTURE

Objective To evaluate the efficacy of “straight scleral tunnel incision”-trabeculectomy with a releasable suture supplemented with mitomycin C (MMC) on reducing intraocular pressure (IOP), complications, and corneal astigmatism in patients with primary angle-closure glaucoma (PACG). Methods Totally 217 acute or chronic PACG patients with occludable angle above 180° and IOP above 21mmHg were divided into 3 groups. Patients in group A (98 cases, 128 eyes), B (71 cases, 95 eyes), and C (48 cases, 60 eyes) were treated with “straight scleral tunnel incision”-trabeculectomy with a releasable suture supplemented with MMC, releasable suture trabeculectomy with MMC, and trabeculectomy with MMC, respectively. IOP, complications, and surgically induced astigmatism (SIA) were evaluated preoperatively and up to 12 months postoperatively. [JP+2]Results IOP of 2 weeks after treatment was significantly lower than preoperative IOP in all the 3 groups (all P<0.001). Success rates (IOP≤20 mmHg) in group A, B, and C were 87.91%, 89.23%, and 83.72% respectively at 12 months after treatment (P=0.256). The incidence of shallow anterior chamber and hypotony had no significant difference between group A and B, but both of them were lower than that in group C (P<0.05). There were no significant differences in preoperative corneal astigmatism among the 3 groups. The corneal astigmatism after 2 weeks in group A (1.71±1.47D) was higher than that before operation (1.28±1.05D,P=0.126). With 12 months gone, the astigmatism almost returned to preoperative levels. The corneal astigmatisms after 2 weeks in group B and C (1.99±1.20D and 2.22±1.39D) were significantly higher than those before operation (1.20±0.85D and 1.18±0.93D,P=0.002, P=0.001), respectively. With 12 months gone, the mean astigmatisms in group B and C (1.87±0.91D and 1.90±1.16D) were still significantly higher than those before operation ( P=0.001, P=0.003). The highest astigmatic polar values in group A, B, and C (1.00D, 1.89D, and 1.77D) occurred after 2 weeks, 1 month, and 1 month postoperation, respectively, which were significantly higher than those before operation (0.19±1.32D, 0.12±1.22D, and 0.17±1.25D,P<0.01), respectively. With 12 months gone, they were 0.03D, -0.18D, and -0.13D higher than those before operation, respectively. The rates of function bleb and thin-wall bleb were 71.43% and 26.37% in group A, 75.38% and 29.23% in group B, 72.09% and 25.58% in group C, respectively at 12 months after treatment. There were no significant differences among the 3 groups.

人工晶状体保护下超声乳化白内障吸除术疗效及安全性评价:一项随机对照临床研究

目的观察人工晶状体(IOL)保护下超声乳化手术(PHACO)对硬核白内障患者的治疗效果。方法采用随机对照临床研究方法,连续纳入2019年1月至2022年5月于延边大学附属医院收治的Emery分级Ⅳ~Ⅴ级的硬核白内障患者120例120眼,按照随机数字表法分为PHACO组、IOL保护PHACO组和囊外白内障摘除术(ECCE)组,分别行常规PHACO、IOL保护下的PHACO和ECCE,每组40例40眼。最终99例受试者完成随访,其中PHACO组30例30眼,IOL保护PHACO组35例35眼,ECCE组34例34眼。记录各组总手术时间、术中超声乳化时间、累计释放能量。术后随访3个月,检测并比较3个组患眼角膜内皮细胞密度(ECD)、角膜内皮细胞面积变异系数(CV)、角膜六角形内皮细胞比率(6A)、角膜散光值,不同等级裸眼远视力的眼数分布;记录术中和术后并发症发生情况。结果IOL保护PHACO组与PHACO组超声能量及超声时间比较差异均无统计学意义(P=0.691、0.982)。IOL保护PHACO组和PHACO组总手术时间分别为(38.81±2.73)和(36.45±3.45)min,明显短于ECCE组的(69.60±4.35)min,差异均有统计学意义(均P<0.001)。术前3个组患者年龄、性别、晶状体核硬度等基本资料比较,差异均无统计学意义(均P>0.05)。术后3个月,PHACO组和IOL保护PHACO组裸眼视力较高的人数较ECCE组高(P=0.006、0.007);IOL保护PHACO组的ECD和6A分别为(2155.57±177.88)/mm^(2)和(41.31±5.18)%,均显著高于PHACO组的(1912.64±224.11)/mm^(2)和(36.18±3.27)%,IOL保护PHACO组的CV为(50.34±5.90)%,低于PHACO组的(55.67±3.30)%,差异均有统计学意义(P=0.007、0.003、0.005)。术后1周和3个月,IOL保护PHACO组的角膜散光度数均显著低于ECCE组,且高于PHACO组,差异均有统计学意义(均P<0.05)。结论IOL保护下的PHACO相对常规PHACO可有效减少超声能量对角膜内皮的损伤,相对ECCE能明显缩短手术时间,减轻术后炎症反应,且并未明显增加术后角膜散光。IOL保护下的PHACO是硬核白内障患者一种有效的改良手术方式。

Phaco drill与小切口非超声乳化白内障摘除术治疗硬核白内障患者的效果

目的:探讨Phaco drill与小切口非超声乳化白内障摘除术治疗硬核白内障患者的效果。方法:回顾性选取2020年10月—2022年4月麻城市中医医院收治的60例硬核白内障患者。根据不同手术治疗方法将其分为Phaco组(n=25)和小切口组(n=35)。小切口组给予小切口非超声乳化白内障摘除术,Phaco组给予Phaco drill。比较两组术前、术后1个月眼睛恢复情况,术前,术后3 d、术后1个月及术后3个月角膜散光度,并发症。结果:术后1个月,Phaco组最佳矫正视力(best corrected visual acuity,BCVA)、眼压(intraocular pressure,IOP)、角膜内皮细胞(corneal endothelial cell,CEC)密度均高于小切口组,差异有统计学意义(P<0.05),两组中央角膜厚度(central corneal thickness,CCT)比较,差异无统计学意义(P>0.05)。重复测量方差分析显示,角膜散光度组间、时间、交互比较,差异有统计学意义(P<0.001)。术后3 d、术后1个月,Phaco组角膜散光度均低于小切口组,差异有统计学意义(P<0.05)。Phaco组术后并发症发生率低于小切口组,差异有统计学意义(P<0.05)。结论:Phaco drill治疗硬核白内障可促进患者恢复,近期对角膜散光度的影响较小,对角膜内皮损伤较小,且术后并发症发生率低。

不同术式联合Toric IOL植入术治疗硬核年龄相关性白内障

目的:比较不同术式联合Toric IOL植入术治疗硬核年龄相关性白内障的疗效。方法:回顾性研究。选取2020-01/2021-12我院确诊为硬核年龄相关性白内障患者104例104眼,按照不同手术方式分为超声乳化组52眼采用超声乳化术联合Toric IOL植入术,小切口组52眼采用小切口水平空间劈核术联合Toric IOL植入术。比较两组患者手术前后最佳矫正远视力(BCDVA)、角膜散光、角膜内皮细胞数量和正常六边形细胞比例、泪膜功能及并发症情况。结果:术前和术后3mo两组患者BCDVA(LogMAR)比较均无差异(均P>0.05);术后1wk,小切口组患者BCDVA(LogMAR)优于超声乳化组(0.15±0.04 vs 0.20±0.05,P<0.001)。两组患者各组内术后1wk,3mo角膜散光均低于术前,术后3mo低于术后1wk(均P<0.05),而两组间手术前后角膜散光比较均无差异(均P>0.05)。术后1wk、3mo,小切口组患者角膜内皮细胞数量高于超声乳化组(术后1wk:2363.8±315.3 vs 2231.4±326.4cells/mm2,P<0.05;术后3mo:2414.6±245.7 vs 2322.9±221.0cells/mm2,P<0.05)。术前、术后1wk两组角膜正常六边形细胞比例比较均无差异(均P>0.05);术后3mo,小切口组正常六边形细胞比例高于超声乳化组(21.77%±1.91%vs 20.59%±1.65%,P<0.001)。术前、术后3mo时两组BUT和OSDI评分的比较无差异(P>0.05);术后1wk小切口组患者BUT长于超声乳化组(6.8±0.8 vs 5.9±1.0s,P<0.001),OSDI评分低于超声乳化组(17.62±5.47 vs 20.34±6.18分,P<0.05)。小切口组术后并发症发生率低于超声乳化组(3.9%vs 17.3%,P<0.05)。结论:小切口水平空间劈核术联合Toric IOL植入术可明显改善硬核年龄相关性白内障患者视力及散光,对角膜内皮和泪膜功能损伤轻微。

白内障超声乳化术源性散光影响因素分析

目的观察白内障超声乳化术源性散光(surgically induced astigmatism,SIA)的影响因素。方法对2021年12月-2022年3月的69例具有角膜规则散光的白内障患者进行白内障超声乳化手术,术后观测以角膜顶点为中心3 mm、5 mm、7 mm直径范围内的角膜前表面、后表面以及角膜前表面的模拟角膜屈率(Sim K)的SIA,使用矢量分析计算XSIA、YSIA和SIA均值(|SIA|),并对SIA与年龄、眼轴长度(axial length,AL)、前房深度(anterior chamber depth,ACD)、角膜直径(white-to-white,WTW)、中央角膜厚度(central corneal thickness,CCT)使用Pearson相关性分析,使用多元线性回归进行SIA影响因素的分析。结果69例患者的平均年龄为(63.25±14.74)岁,其中男性28例(40.58%)。分析发现,Sim K的|SIA|与WTW呈负相关(r=-0.265,P=0.028);3 mm、5 mm、7 mm前表面|SIA|与WTW呈负相关(r=-0.320,P=0.007;r=-0.337,P=0.005;r=-0.287,P=0.017);3 mm、5 mm、7 mm后表面|SIA|与AL呈负相关(r=-0.390,P=0.001;r=-0.352,P=0.003;r=-0.317,P=0.008)。多元回归分析结果显示,WTW与Sim K、3 mm、5 mm、7 mm前表面及3 mm后表面的|SIA|呈负相关(B=-0.261,P=0.047;B=-0.387,P=0.016;B=-0.323,P=0.009;B=-0.297,P=0.041;B=-0.085,P=0.049),而与3 mm前表面XSIA、5 mm、7 mm前表面YSIA呈正相关(B=0.347,P=0.040;B=0.318,P=0.034;B=0.403,P=0.010);AL与3 mm、5 mm后表面的|SIA|呈负相关(B=-0.023,P=0.021;B=-0.034,P=0.030)。结论在进行白内障超声乳化手术时,应考虑患者的眼部生物参数,如眼轴长度、角膜直径等对SIA的影响。

小切口囊外摘除术与超声乳化术治疗白内障疗效比较

目的:探究小切口囊外摘除术与超声乳化术对白内障患者角膜内皮细胞数目、黄斑区厚度及手术源性角膜散光的影响。方法:回顾性研究。选取我院2019-05/2023-02收治的年龄相关性白内障患者296例296眼。根据手术方式分为小切口囊外摘除术组144眼与超声乳化术组152眼。比较两组患者术前,术后7d,1、3mo裸眼视力、最佳矫正视力、角膜内皮细胞数目、黄斑区厚度、手术源性角膜散光及术后并发症发生情况。结果:小切口囊外摘除术组患者术后7d裸眼视力和最佳矫正视力均优于超声乳化术组,术后7d,1、3mo角膜内皮细胞数目均高于超声乳化术组,术后7d,1mo黄斑区厚度均低于超声乳化术组,术后角膜水肿发生率及总并发症发生率均低于超声乳化术组(均P<0.05),但术后1、7d,1、3mo手术源性角膜散光值与超声乳化术组比较均无差异(P>0.05)。结论:相较于超声乳化术,小切口囊外摘除术术后角膜内皮细胞数目及黄斑区厚度变化较小,视力恢复更快,并发症减少。

2.6mm与3.0mm透明角膜隧道式主切口超声乳化白内障吸除术治疗老年性白内障患者的效果比较

目的:比较2.6 mm与3.0 mm透明角膜隧道式主切口超声乳化白内障吸除术治疗老年性白内障患者的效果。方法:回顾性分析2019年12月至2022年3月该院收治的374例老年性白内障患者的临床资料,按照治疗方法不同将其分为观察组和对照组各187例。两组均行透明角膜隧道式主切口超声乳化白内障吸除术治疗,对照组切口长度为3.0 mm,观察组切口长度为2.6 mm。比较两组术前和术后3个月眼压、裸眼视力、最佳矫正视力(BCVA)水平,角膜散光度、角膜敏感度、角膜表面不对称指数(SAI)和泪膜功能指标[泪膜破裂时间(BUT)、泪液分泌试验(Sit)]水平,以及并发症发生率。结果:术后3个月,观察组眼压、BCVA水平均低于对照组,裸眼视力水平高于对照组,差异有统计学意义(P<0.05);两组角膜散光度均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);两组BUT、Sit水平均低于术前,但观察组高于对照组,差异有统计学意义(P<0.05);两组并发症发生率和手术前后角膜敏感度、SAI水平比较,差异无统计学意义(P>0.05)。结论:2.6 mm透明角膜隧道式主切口超声乳化白内障吸除术治疗老年性白内障患者可降低眼压及术后角膜散光度,促进视力恢复,减轻泪膜功能损伤,效果优于3.0 mm透明角膜隧道式主切口超声乳化白内障吸除术治疗。

小切口非超声乳化白内障手术治疗硬核白内障的疗效及安全性分析

目的观察分析硬核白内障患者临床施行小切口非超声乳化白内障手术治疗对临床疗效及症状的改善作用。方法根据随机数表法将2020年1月-2021年12月本院60例硬核白内障患者分为对照组(30例,应用行超声乳化白内障术)、观察组(30例,应用小切口非超声乳化白内障手术)。对比两组手术效果、术后裸眼视力、手术时间及角膜散光度、并发症情况。结果观察组总有效率96.67%高于对照组76.67%,P<0.05;两组术后3个月的裸眼视力比较差异不显著,P>0.05;术前,对比角膜散光程度及内皮细胞计数,两组之间的差异均不显著,P>0.05;观察组的手术时间短于对照组,且术后1个月的角膜散光程度及内皮细胞计数低于对照组,P<0.05;观察组并发症情况经评估为6.67%,对照组为26.67%,差异较大,P<0.05。结论小切口非超声乳化白内障手术用于硬核白内障患者治疗,手术时间较短,且可改善其术后裸眼视力及角膜散光度,且术后并发症风险降低,临床疗效及安全性较高,此方案值得临床推广。

小切口白内障囊外摘除术与超声乳化白内障吸出术治疗高龄白内障患者的效果比较

目的:比较小切口白内障囊外摘除术与超声乳化白内障吸出术治疗高龄白内障患者的效果。方法:选取2019年1月至2021年4月该院收治的78例高龄白内障患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各39例。对照组采用超声乳化白内障吸出术治疗,观察组采用小切口白内障囊外摘除术治疗。比较两组临床疗效,手术前后散光度、裸眼视力、眼压水平,以及并发症发生率。结果:观察组治疗总有效率为87.18%,高于对照组的64.10%,差异有统计学意义(P<0.05);术后1、4、12周,两组散光度均低于术前,且观察组低于对照组,两组裸眼视力水平均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05);术后2、6、12、24 h,两组眼压水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为10.26%,低于对照组的23.08%,差异有统计学意义(P<0.05)。结论:小切口白内障囊外摘除术治疗高龄白内障患者可提高治疗总有效率和裸眼视力水平,降低散光度、眼压和并发症发生率,优于超声乳化白内障吸出术治疗效果。

不同部位透明角膜切口超声乳化术对角膜散光的影响

目的探讨不同部位、不同方式透明角膜切口白内障超声乳化联合后房型折叠式人工晶状体植入术对角膜散光的影响。方法收集老年性白内障患者65例81眼。随机分为3组:A组实施颞侧透明角膜斜行切口22例(28眼),B组实施1100钟位透明角膜斜形切口22例26眼,C组实施1100钟位透明角膜隧道切口21例27眼。3组切口均长3.2mm,由同一医师实行常规的超声乳化手术。在术前,术后1d、1周、1个月和3个月分别进行视力、裂隙灯、检影验光检查,对获得的各项指标进行统计学分析。结果各组术后视力较术前均有大幅度提高,其中术后1d、1周A组与B、C组间视力差别有统计学意义,B、C组间无统计学意义;术后1个月、3个月A、B、C3组视力均无统计学意义。术后各时间点,A组的散光均小于B、C2组,差别有统计学意义(P<0.05),B、C2组间差别均无统计学意义(P>0.05)。结论透明角膜颞侧切口操作方便,术后对角膜散光影响最小,术后早期视力恢复好,是较理想的手术切口方位。角膜隧道切口和斜行切口对角膜屈光的影响无统计学差别,但斜行切口操作更简便。