陡峭子午线透明角膜切口白内障超乳术对视功能和角膜散光及泪膜变化的影响

Effects of phacoemulsification with steep meridian transparent corneal incision on visual function, corneal astigmatism and tear film changes

摘要:

目的：探讨陡峭子午线透明角膜切口白内障超声乳化手术对视功能、角膜散光及泪膜变化的影响。

方法：选取我院2019-01/2020-12行白内障超声乳化手术的白内障患者106例106眼作为研究对象，根据手术方式分为观察组和对照组：观察组51例患者采用陡峭子午线透明角膜切口，对照组55例患者采用经鼻上方透明角膜切口。观察比较两组术前，术后1wk，1、3mo的视功能、泪膜变化及角膜散光。

结果：两组手术情况无差异(均P>0.05)，术后1wk，1、3mo视力均明显改善，观察组明显好于对照组，视野平均缺损值(MD)均明显降低，观察组明显低于对照组(均P<0.05)； 术后3mo两组患者角膜散光极坐标值(AKP)(+0)明显降低，观察组明显低于对照组(P<0.05)，两组角膜散光AKP(+45)无差异(P>0.05)； 泪液分泌试验(SⅠt)值呈先上升后降低的趋势，谷值为术后1wk； 泪膜破裂时间(BUT)呈先降低后升高的趋势，谷值为术后1wk。观察组术后各时点SⅠt明显低于对照组(均P<0.05)； 观察组术后各时点BUT明显高于对照组(均P<0.05)。

结论：陡峭子午线透明角膜切口白内障超声乳化手术有利于提高患者术后视功能，减少术后角膜散光，降低对患者泪膜功能损伤，促进其恢复。

Abstract:

AIM: To investigate the effect of phacoemulsification with steep meridian transparent corneal incision on visual function, corneal astigmatism and tear film changes.

METHODS: A total of 106 cataract patients(106 eyes)who underwent phacoemulsification in our hospital from January 2019 to December 2020 were selected as research objects, and they were divided into observation group and control group according to the operation mode: with 51 patients in the observation group who were treated with steep meridian transparent corneal incision, and 55 patients in the control group who were treated with transnasal transparent corneal incision. The changes of visual function, corneal astigmatism and tear film between the two groups were compared before operation and at 1wk, 1 and 3mo after operation.

RESULTS: There was no statistical difference between the operation of two groups(all P>0.05). The visual acuity was significantly improved at 1wk, 1 and 3mo after operation, and it was better in the observation group than that in the control group. Mean defect(MD)of visual field was significantly lower, and it was significantly lower in the control group(all P<0.05); The corneal astigmatism AKP(+0)of the two groups was significantly lower at 3mo after operation, and the observation group was significantly lower than the control group(P<0.05). There was no statistical difference in corneal astigmatism AKP(+45)(P>0.05); Schirmer Ⅰ test(SⅠt)value increased first and then decreased, and the valley value was at 1wk after operation; Tear film break-up time(BUT)decreased first and then increased, and the valley value was at 1wk after operation. SⅠt in the observation group was lower than that in the control group at each time point(all P<0.05), while BUT in the observation group was higher than that in the control group at each time point(all P<0.05).

CONCLUSION: Steep meridian transparent corneal incision phacoemulsification surgery is beneficial to improve the postoperative visual function of patients, reduce postoperative corneal astigmatism, reduce the damage to the patient's tear film function, and promote its recovery.