两种不同切口的白内障超声乳化吸除及人工晶体

目的比较经透明角膜与角巩膜隧道切口的白内障超声乳化吸除、PMMA晶体植入术后手术源性散光(surgicallyinducedastigmatism,SIA)度数及其变化规律,并评价其手术效果.方法在上方角膜缘或透明角膜缘处作5.0mm梯形隧道切口,将566例(566只眼)白内障分成A、B两组,行超声乳化吸除并植入人工晶体,测量术后1周、1个月、3个月和6个月的角膜曲率,计算SIA度数及其方向,比较两组术后不同时间的平均SIA度数及结果.结果平均SIA度数和裸眼视力,术后1个月、3个月和6个月两组比较,差异无显著性(P>0.05);术后并发症B组明显高于A组(P<0.05).结论以5.0mm角膜隧道切口行超声乳化白内障吸除后SIA度数小且稳定,早期可获得良好而稳定的裸眼视力;而透明角膜切口手术便捷,术后1个月散光与角巩膜切口基本相似且稳定,可获得与角膜隧道切口几乎同样的手术效果.

The Dynamic Study of Astigmatism after Phacoemu lsification with Two Different Incision and Intraocular Lens Implantation

Objective:To compare the changes in the values and directions of surgically induced astigmatism(SIA)after phacoemulsification with PMMA intraocular lens implantation through a limbus or incision clear comeal tunnel incision and to evaluate their clinical results.Methods:The surgery was performed through a 5.0 mm limbus tunnel incision or a 5.0 mm clear comeal incision on 566 eyes of 566 patients with senile,complicated congenital and traumatic cataracts.The patients were divided into two groups;the limbus tunnel (A) and the clear comeal tunnel (B) incision respectively.Keratonmetry measurements were performed preoperatively,at postoperative 1 week,1 month,3 months and 6 months respectively.The mean SIA and uncorrected visuity were compared among the groups up to 6 months postoperatively.Results:Eyes in A group displayed significantly less mean SIA and better uncorrected visual acuity than B at 1 week postoperatively(P<0.05),but there were no significant differences between two groups at 1 month,3 months and 6 months postoperatively(P>0.05).Conclusion:SIA in eyes of 5.0 mm incision group of the limbus of comeal tunnel incision phacoemulsification are less and more stable, a better and quicker rehabilitation of uncorrected visual acuity can be obtained in the early postoperative period,but a clear comeal incision of the operation is more convenient and quicker;at postoperative 1 month,the mean postoperative astigmatism and the result was almost the same as the operation through a limbus tunnel incision.