摘要
目的研究角膜缘松解切开术治疗白内障患者术后角膜散光的临床疗效。方法前瞻性队列研究。纳入2018年1月至2020年11月期间,既往行6.0 mm切口白内障手术3个月以上且术后伴有明显角膜散光拟行视力增效手术者61例(71眼)进行研究,按患眼角膜散光大小分为A组(≤1.50 D)和B组(>1.50 D),所有患眼数据在经角膜缘松解切开术在线计算网站计算后,手工完成角膜缘松解切开术。比较两组患眼术前与术后3个月的视力及角膜散光改变,用Alpins散光矢量分析法对手术前后散光改变进行分析,同时于术后3个月对患者行主观满意度问卷调查。结果共49眼完成超过3个月的有效随访,其中A组20眼,B组29眼。两组患眼术前角膜散光度、散光陡峭轴曲率相比差异均具有统计学意义(均为P<0.01)。术后3个月,两组患眼裸眼远视力均较术前明显改善,差异均有统计学意义(均为P<0.01);B组患眼矫正远视力较术前明显改善,差异有统计学意义(P<0.01),而A组患眼矫正远视力与术前相比差异无统计学意义(P=0.50)。角膜散光矢量分析结果显示,两组患眼间目标诱导散光向量和手术诱导散光向量差异均具有统计学意义(均为P<0.05),余散光矢量分析结果差异均无统计学意义(均为P>0.05),49眼的目标诱导散光向量为0.9~2.5(1.61±0.37)D,手术诱导散光向量为0.5~3.0(1.46±0.55)D,差异向量为(-0.15±0.45)D,矫正指数为0.91±0.29,错位角α为3.57°±12.46°,变平指数为0.89±0.29,成功指数为0.28±0.09,成功率约为72%。术后3个月与术后6个月患眼角膜散光度相比差异无统计学意义(P>0.05)。所有患眼随访期内均未出现严重的手术并发症。术后3个月主观问卷调查显示满意者20眼(40.82%),尚可者19眼(38.77%)。结论角膜缘松解切开术能安全有效地降低白内障患者术后的角膜散光。
Objective To observe the clinical effect of limbal relaxing incisions(LRIs)for different astigmatism after cataract surgery.Methods Prospective cohort study.From January 2018 to November 2020,61 patients(71 eyes)who underwent 6.0 mm-incision cataract surgery for more than 3 months and who had obvious corneal astigmatism planned to undergo visual enhancement surgery were included in the study.According to the size of corneal astigmatism,the patients were divided into group A(≤1.50 D)and group B(>1.50 D).All patients completed LRIs manually after incisions data calculated by Nichamin Age Pachymetry Adjusted Nomogram.Changes in corneal astigmatism was detected by Alpins astigmatism vector and visual acuity were observed before surgery and 3 months after months between the two groups.A subjective questionnaire was conducted 3 months after surgery to evaluate satisfaction with all patients’operations.Results A total of 49 eyes were followed up effectively for more than 3 months,including 20 eyes in group A and 29 eyes in group B.Preoperative differences in steep keratometry(Ks)of the verion and corneal astigmatism between the two groups were statistically significant(both P<0.01).The reduction of astigmatism and the improvement of uncorrected distance visual acuity 3 months after surgery in the two groups were statistically significant(both P<0.01).Improved corrected distance visual acuity was statistically significant in group B(P<0.01)but not in group A(P=0.50).Alpins astigmatism vector analysis showed there were statistically significant differences between the two groups in target induced astigmatism and surgically induced astigmatism(both P<0.05),while no statistically significant differences in other astigmatism vector analysis(all P>0.05).In 49 eyes,target-induced astigmatism vector was 0.9-2.5(1.61±0.37)D,surgically induced astigmatism vector was 0.5-3.0(1.46±0.55)D,and the difference vector was(-0.15±0.45)D,the correction index was 0.91±0.29,angle of error was 3.57°±12.46°,the index of flattening w
作者
何涛
艾明
HE Tao;AI Ming(Department of Ophthalmology,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei Province,China;Shayang Kangze Eye Hospital,Shayang 448200,Hubei Province,China;Jingshan Kangze Eye Hospital,Jingshan 431800,Hubei Province,China)
出处
《眼科新进展》
CAS
北大核心
2021年第4期371-375,共5页
Recent Advances in Ophthalmology
关键词
白内障术后散光
散光治疗
角膜缘松解切开术
astigmatism after cataract surgery
astigmatism treatment
limbal relaxing incisions
