Influence of phacoemulsification with 2.2 mm and 3.0 mm corneal incisions on postoperative corneal refractive power and astigmatism
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摘要: 目的 探讨2.2 mm及3.0 mm角膜切口白内障超声乳化术对术后角膜屈光力、散光度的影响。 方法 选择本院行白内障超声乳化术联合人工晶状体植入术的120例(120眼)患者为研究对象,采用随机数表法将其分为观察组和对照组,每组60例(60眼)。观察组给予2.2 mm角膜切口白内障超声乳化术,对照组给予3.0 mm角膜切口白内障超声乳化术。分别于术前及术后1周、1个月和3个月检查患者裸眼视力及最佳矫正视力; 使用Jaffe/Clayman分析法分别计算2组不同时点角膜前表面、角膜术源性散光(SIA)值和总SIA值变化。 结果 观察组术后1 d、1周的裸眼视力以及术后1 d、1周、1个月的最佳矫正视力均高于对照组,差异有统计学意义(P<0.05)。观察组术前、术后1个月和3个月的裸眼视力以及术前、术后3个月的最佳矫正视力与对照组比较,差异无统计学意义(P>0.05)。观察组术后1 d、1周、1个月和3个月角膜前表面、角膜后表面 SIA值低于对照组,但差异无统计学意义(P>0.05)。2组术后1周、1个月和3个月的角膜总SIA值以及后表面SIA值与术后1 d比较,差异有统计学意义(P<0.05)。观察组术后1个月和3个月的角膜前表面SIA值与术后1 d比较,差异有统计学意义(P<0.05), 对照组仅术后3个月的角膜前表面SIA值与术后1 d比较,差异有统计学意义(P<0.05)。 结论 与3.0 mm全角膜切口比较, 2.2 mm切口白内障超声乳化术联合人工晶状体植入术的透明角膜切口更稳定,术后早期切口手术屈光稳定值较好,但2种手术长远的切口屈光力、散光度差异较小。Abstract: Objective To explore the influence of phacoemulsification with 2.2 mm and 3.0 mm corneal incisions on postoperative corneal refractive power and astigmatism. Methods A total of 120 patients(120 eyes)who underwent cataract phacoemulsification combined with intraocular lens implantation in our hospital were selected, and were divided into observation group and control group according to the random number table method, with 60 cases(60 eyes)in each group. Patients in the observation group received 2.2 mm corneal incision phacoemulsification and those in the control group received 3.0 mm corneal incision. The uncorrected visual acuity and the best positive visual acuity before operation and 1 week, 1 month and 3 months after the operation were checked up, and the Jaffe/Clayman analysis method was used to observe the changes of vector change(SIA)value and total SIA value of astigmatism on the anterior and posterior corneal surface of the two groups at different time points. Results The uncorrected visual acuity at 1 day and 1 week after operation and the best corrected visual acuity at 1 day, 1 week and 1 month after operation in the observation group were higher than those in the control group, the differences were statistically significant(P<0.05); compared with the control group, there were no statistically significant differences in the uncorrected visual acuity before operation, 1 month and 3 months after operation, and the best corrected visual acuity before operation and 3 months after operation between the observation group and control group(P>0.05). The- SIA values of the anterior corneal surface and posterior corneal surface of the observation group were lower than those of the control group at 1 day, 1 week, 1 month and 3 months after surgery, but there were no significant differences between the groups(P>0.05). The corneal total SIA value and posterior surface SIA value at 1 week, 1 month, and 3 months in the two groups showed significant differences when compared with those of first postoperative day(P<0.05). SIA values of the anterior corneal surface at 1 month and 1 day after surgery showed significant differences in the observation group compared with its value in the first postoperative day(P<0.05), and SIA value of the anterior corneal surface at only 3 months after surgery in the control group showed significant significance compared with its value at 1 day after surgery(P<0.05). Conclusion Phacoemulsification with 2.2 mm corneal incision combined with implantation of artificial lens is more stable in corneal incision conditions than 3.0 mm corneal incision, and has better refractive stability in the early postoperative period. In the long run, refractive power and astigmatism between the two surgical incisions have less difference.
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