不同手术切口对超声乳化白内障术后角膜散光的影响

Impact of two different surgical incisions of phaco- cataract exaction on the cornealastigmatism

摘要:

目的:研究两种不同的超声乳化手术切口对年龄相关性白内障术后患者角膜散光的影响。方法:将2011-08/12期间行超声乳化吸除术的白内障患者随机分为2组,上方巩膜缘11∶00~12∶00处手术切口组（A组）30例32眼；颞侧（9∶00或3∶00）3.2mm宽的透明角膜切口组（B组）32例35眼；利用角膜曲率仪测量白内障术前、术后不同时间的角膜屈光状态,比较A组与B组不同的超声乳化手术切口对术后角膜散光的影响,分别比较两组术前,术后1wk;1,3mo的角膜散光改变,所有实验数据以平均值±标准差表示,统计分析采用t检验,以P＜0.05表示差异有统计学意义。结果:两组术前、术后1wk的角膜曲率差异无统计学意义（P＞0.05）,术后1,3mo的差异经统计分析P＜0.05,A组的手术源性散光大于B组。结论:选择颞侧透明角膜切口的白内障超声乳化术,手术用时短,手术并发症少,术后对角膜散光影响小。不同手术切口的白内障超声乳化对角膜内皮细胞的影响无显著差异。

Abstract:

AIM:To study the impact of two different phacoe- mulsification incisions on the surgically induced postoperative corneal astigmatism inage-related cataract patients.METHODS:Patients who had undergone the phaco-surgery from August 2011 to December 2011 were randomly divided into two groups. And those with incisions on the edge of the upper sclera (11∶00 to 12∶00) were group A, thirty cases 32 eyes. And group B, thirty-two cases (35 eyes) were those with the 3.2mm wide transparent cornea of the temporal side. In order to compare the impact of two different phacoemulsification incisions on the surgically induced corneal astigmatism in group A and B, we observed and measured carefully the corneal astigmatism status in various stages of pre-operation and post-operation (we sampling four stages:pre-surgery, one week, one month and three months after surgery) under the help of the corneal curvature instrument. All experimental data were showed by the means of average value±standard D-value. We adopted ttest to make statistical analysis, which means only when P<0.05 could those differences get statistical significance.RESULTS:By comparing the corneal curvature rate of those two groups in their stage of pre-operation and one week after surgery respectively, there was no significant difference and also no statistical meaning for their results P>0.05. However, the statistical comparison of the data got from the stage of one month and three months after surgery indicated that the surgically induced corneal astigmatism of group A was more significant than group B.CONCLUSION:The phacoemulsification incisions on the transparent cornea of the temporal side owns the advantages of relatively short time, minor surgical complications and less adverse effects on corneal astigmatism. 