應用前節OCT分析白內障透明角膜切口內口位置對術后散光的影響

張　玲

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應用前節OCT分析白內障透明角膜切口內口位置對術后散光的影響

張玲

Department of Ophthalmology, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China

?METHODS: A total of 40 patients of 43 eyes of age-related cataract were chosen. All of them were done 2.8mm clear corneal incision and phacoemulsification with foldable intraocular lens implantation. Preoperative and postoperative 1wk, 1 and 3mo, the corrected visual acuity were examined. Postoperative 1wk, 1 and 3mo, the positions and lengths of the incisions were measured. Depending on the location of the incisions, the patients were divided into two groups. Group 1: the inside mouth of the incisions(22 patients of 23 eyes) were far from the corneal vertex central line> 3mm.Group 2: the inside mouth of the incisions(20 patients of 20 eyes) were far from the corneal vertex central line ≤3mm.

?RESULTS：One day before the surgery between Group 1 and Group 2 patients, there were no statistically significant difference(P>0.05) in corrected visual acuity and corneal astigmatism. After the surgery, corrected visual acuity gradually increased, astigmatism and cut lengths gradually decreased. But, there were no statistically significant difference at 1wk, 1 and 3mo(P<0.05).

?CONCLUSION：The length of the inside mouth located within radius of the central cornea 3mm was rather longer than the length of the inside mouth located without radius of the central cornea 3mm.The SIA after surgery is greater, and postoperative visual acuity gained maybe less than the latter.

目的：運用前節OCT掃描儀(anterior segment optical coherence tomography AS-OCT)分析白內障超聲乳化術后透明角膜切口內口的位置對術源性散光(surgery induced astigmatism，SIA)的影響。

方法：選擇年齡相關性白內障患者40例43眼，做2.8mm透明角膜切口，行白內障超聲乳化聯合折疊型人工晶狀體植入術。術前及術后1wk，1、3mo進行矯正視力檢查，術后1wk，1、3mo應用AS-OCT對角膜切口內口的位置及切口長度進行測量。根據切口位置的不同分為：1組：20例23眼，切口內口距離角膜頂點中線>3mm；2組：20例20眼，切口內口距離角膜頂點中線≤3mm。

結果：1組和2組術前1d矯正視力及角膜散光的比較無統計學差異(P>0.05)；術后1wk，1、3mo兩組矯正視力不斷增加，散光及切口長度均不斷減小，但是差異有統計學意義(P<0．05)。

結論：內口位于角膜中央3mm半徑內的透明角膜切口長度偏長，術后產生的SIA較內口在3mm以外的切口偏大，且術后獲得的矯正視力也可能低于后者。

前節OCT；白內障；角膜切口；術源性散光

引用：張玲.應用前節OCT分析白內障透明角膜切口內口位置對術后散光的影響.國際眼科雜志2016;16(11):2136-2138

0　引言

這些年，隨著白內障手術的不斷完善，手術醫生及患者不再僅滿足于術后視力的提高，視覺質量的改善和功能性視力的恢復成為我們更高的追求目標。透明角膜切口術后形成的術源性散光(surgery induced astigmatism，SIA)是大家公認的影響術后視力恢復的因素之一，逐漸成為研究的焦點[1]。本研究主要分析了角膜內口位置對SIA的影響，現將結果報道如下。

1　對象和方法

1.1對象選取2015-07/2016-03在我院行白內障超聲乳化術聯合人工晶狀體植入術的患者40例43眼，根據術后前節OCT測到的切口位置的不同分為：1組：20例23眼，切口內口距離角膜頂點中線>3mm；2組：20……