白内障手术技巧对术源性散光的影响

Effect of surgical skill on surgically-induced astigmatism in cataract surgery

摘要:

目的：评估行普通白内障超声乳化术，手术经验对术源性散光(SIA)的影响。

方法：选取患者50例53眼，平均年龄64.5±10.8a，随机分为两组，一组23眼，二组30眼。手术方式均采用透明角膜切口白内障超声乳化吸除联合人工晶状体植入术。第一组由白内障专家手术，第二组则由住院医师手术。术前所有患者均接受全面眼科检查，包括角膜曲率和自动屈光检测。SIA应用向量分析程序-Alpins法计算，于术后1d，1mo及2mo重复上述检查并记录结果变化。应用Shapiro Wilk和Mann-Whitney检验判断两组间SIA的统计学差异。

结果：两组患者人口资料差异无统计学意义。组间分析显示，一组术后1d，1mo及2mo的SIA分别为0.79±0.41 D，0.54±0.41 D及0.47±0.37 D； 二组分别为1.27±0.66 D， 0.98±0.56 D及0.94±0.54 D。 可见一组术后1d(P=0.002)，1mo(P=0.004)及2mo(P=0.001)的SIA更小。

结论：手术经验是影响SIA的因素之一。住院医师应增加超声乳化术手术量以获取更多手术经验。

Abstract:

AIM:To evaluate the effect of surgical experience on surgically-induced astigmatism(SIA)in patients with uncomplicated phacoemulsification surgery.

METHODS:Fifty-three eyes of fifty patients, mean age 64.5±10.8y, were randomly divided into two groups(23 eyes and 30 eyes). First group was underwent surgery by cataract specialists and the second was by residents. At baseline all the patients were underwent a complete opthalmological examination including keratometry and autorefractometer measurements. Vector analysis programme including the Alpins' method was used for the calculation of SIA. All the measurements were repeated postoperative first day, first month and second month and changes were recorded. Shapiro Wilk and Mann-Whitney tests were applied for determining the statistical differences between the SIA with two groups.

RESULTS:There were no significant differences in demographic data of the groups. Intergroup analysis showed, first group was more effective results in SIA postoperative first day(P=0.002), first month(P=0.004)and the second month(P=0.001). For the first group, SIA were 0.79±0.41 diopter(D)at the first postoperative day, 0.54±0.41 D at the first postoperative month and 0.47±0.37 D at the second postoperative month. Second one was 1.27±0.66 D, 0.98±0.56 D and 0.94±0.54 D, respectively.

CONCLUSION:According to the results, surgical experience was one of the factors that affects SIA. Residents would perform more phacoemilcification surgery to obtain more surgical experience.