CAJ | 학술논문

目的分析白内障患者术前角膜散光情况评估经不同位置透明角膜切口行超声乳化术后的角膜散光变化情况.方法 218例(295只眼)白内障患者分为三组,第一组选择颞侧切口,第二组选择颞上方切口,第三组选择上方切口,三组患者通过透明角膜切口行白内障超声乳化及折叠式后房型人工晶体植入术.术前及术后一周、一月、三月分别检测患者角膜散光情况,并通过Holladay-Cravy-Koch方法计算术源性散光.结果术前角膜散光0.5至1.5D的占60.68%,大于等于1.5D的占11.86%,顺归散光占29.49%,逆归散光占51.19%,其余为斜轴散光.术后三次随访颞侧切口组的术源性散光最低,上方切口组的术源性散光最高,具有统计学差异(P<0.05).另外,在上方切口组中发现患者术后角膜散光有向逆归散光转变的趋势.结论白内障患者术前大多存在小于1.5D的角膜散光.在白内障术后早期阶段,颞侧透明角膜切口引起的术源性散光较小,而上方透明角膜切口不仅可引起较显著的术源性散光,并且术后角膜散光有向逆归散光转变的趋势.
목적 분석백내장환자술전각막산광정황평고경불동위치투명각막절구행초성유화술후적각막산광변화정황.방법 218례(295지안)백내장환자분위삼조,제일조선택섭측절구,제이조선택섭상방절구,제삼조선택상방절구,삼조환자통과투명각막절구행백내장초성유화급절첩식후방형인공정체식입술.술전급술후일주、일월、삼월분별검측환자각막산광정황,병통과Holladay-Cravy-Koch방법 계산술원성산광.결과 술전각막산광0.5지1.5D적점60.68%,대우등우1.5D적점11.86%,순귀산광점29.49%,역귀산광점51.19%,기여위사축산광.술후삼차수방섭측절구조적술원성산광최저,상방절구조적술원성산광최고,구유통계학차이(P<0.05).령외,재상방절구조중발현환자술후각막산광유향역귀산광전변적추세.결론 백내장환자술전대다존재소우1.5D적각막산광.재백내장술후조기계단,섭측투명각막절구인기적술원성산광교소,이상방투명각막절구불부가인기교현저적술원성산광,병차술후각막산광유향역귀산광전변적추세.
Objective To analyze the corneal astigmatism before cataract surgery and evaluate the astigmatism changes after cataract surgery performed using clear corneal incisions with different locations.Methods: This randomized prospective clinical study comprised 295 eyes of 218 patients having phacoemulsification and implantation of foldable intraocular lens through a corneal tunnel incision. Patients were randomly divided into three groups depending on the different locations of the incision: temporal, superotemporal and superior. Corneal topography was performed preoperatively and 1 week, 1 month, and 3 months postoperatively. Surgically induced changes were calculated by vector analyses using the Holladay-Cravy-Koch method. Results: Preoperatively, in 60.68% of eyes, corneal astigmatism was between 0.5 and 1.5 diopters (D) and in 11.86%, it was 1.5 D or higher. Meanwhile, about 29.49 percent of eyes had with-the-rule (WTR) astigmatism, while 51.19% had against-the-rule (ATR) astigmatism, and the others had oblique astigmatism. At three follow-up visits postoperatively, the mean magnitude of surgically-induced astigmatism (SIA) was lowest in the temporal incision group and highest in the superior incision group. In addition, an ATR shift was found in the superior incision group. Conclusions: Corneal astigmatism less than 1.5 D was present in most cataract surgery candidates. Cataract surgery using temporal clear corneal incision induced significantly less SIA in the early postoperative period. Superior incision may lead to an ATR astigmatism shift.