高度近视白内障患者小切口非超声乳化术后角膜屈光力的变化

Analysis of corneal refractive power after small incision surgery of non-phacoemmulsification for high myopic eyes with cataract

摘要:

目的：探讨中老年高度近视白内障患者小切口非超声乳化术后角膜屈光力的变化及手术源性角膜散光(SIA)的特点。

方法：回顾性分析我院中老年高度近视白内障行小切口非超声乳化患者103例145眼，角膜曲率计测量术前及术后3d，1wk，1、3mo的角膜水平屈光力值(K1)、垂直屈光力值(K2)及其轴位，采用正弦定律和余弦定律计算法计算SIA值。

结果：术后3d，1wk平均角膜散光度与术前相比，差别有统计学意义(P<0.05)。术后1wk，1、3mo SIA值分别为+1.34±0.12，+0.89±0.27和-0.42±0.26，差别有统计学意义(P<0.05)。与术前相比较，术后3d， K1 增大1.59D， K2 减少1.98D，两者之间有统计学差异(P<0.01)； 术后3mo内K1和K2与术前的差值均迅速减小，术后3mo内K1差值比K2 差值绝对值小，两者之间各时间点差值的绝对值有统计学差异(P<0.05)。

结论：中老年高度近视白内障患者小切口非超声乳化术后短期角膜散光较大，手术方式需进一步改进以减少散光。

Abstract:

AIM: To evaluate the changes of corneal refractive power and surgically induced astigmatism(SIA)after small incision non-phacoemmulsification surgery for high myopic eyes with cataract in middle aged and senile people.

METHODS: A retrospective study was done in 145 eyes of 103 middle aged and senile patients with high myopia and cataract who underwent small incision non-phacoemulsification surgery in our hospital. The keratometer was used to measure corneal horizontal refractive power(K1), vertical corneal refractive power(K2)and their axial on postoperative 3d, 1wk, 1 and 3mo. SIA was calculated by sine law and cosine law method.

RESULTS: There was statistically significant difference on average corneal astigmatism at 3d and 1wk compared with that before surgeries(P<0.05). SIA were respectively +1.34±0.12, +0.89±0.27 and -0.42±0.26 at 1wk, 1 and 3mo postoperatively, and the differences were statistically significant(P<0.05). K1 increased by 1.59D and K2 decreased by 1.98D at 3d postoperatively, and there was significant difference between them(P<0.01). The difference between before surgery and after surgeries of K1 decreased in 3mo, which was also similar with the K2. The absolute value of differences between K1 in 3mo were smaller than those of K2, and there were significant differences between them at different time points(P<0.05).

CONCLUSION: Corneal astigmatism is a little larger in short term after small incision non-phacoemulsification surgery for high myopia patients with cataract. The surgery method needed to be improved.