CAJ | 학술논문

目的探讨白内障超声乳化术中不同透明角膜切口位置对角膜高阶像差的影响.方法临床病例对照研究.对于2012年6月至2013年3月在沈阳爱尔眼视光医院就诊的98例白内障患者(98只眼),根据角膜屈光力陡峭轴分别在180°(A组)、135°(B组)及90°(C组)做2.8 mm透明角膜切口,行超声乳化手术.采用Pentacarn三维眼前节分析仪对术眼角膜进行术前及术后3个月3～6阶的像差测量.采用单因素方差分析对三组间手术前后视力比较及各项角膜像差变化差值绝对值进行比较.结果 A组x轴方向的慧差Z(3,1),球差Z(4,0)变化较B、C组小,但Y轴方向次阶三叶草Z(5,-3)变化较大,差异有统计学意义(P＜0.05).B组Y轴方向次阶散光Z(4,2)、x轴方向次阶慧差Z(5,1)、Y轴方向次阶四叶草Z(6,-4)、x轴方向次阶四叶草Z(6,4)较A、C组变化大,差异有统计学意义(P＜0.05).结论 180°透明角膜切口术后远期引起的手术源性角膜高阶像差如球差Z(4,0)变化最小.
목적 탐토백내장초성유화술중불동투명각막절구위치대각막고계상차적영향.방법 림상병례대조연구.대우2012년6월지2013년3월재침양애이안시광의원취진적98례백내장환자(98지안),근거각막굴광력두초축분별재180°(A조)、135°(B조)급90°(C조)주2.8 mm투명각막절구,행초성유화수술.채용Pentacarn삼유안전절분석의대술안각막진행술전급술후3개월3～6계적상차측량.채용단인소방차분석대삼조간수술전후시력비교급각항각막상차변화차치절대치진행비교.결과 A조x축방향적혜차Z(3,1),구차Z(4,0)변화교B、C조소,단Y축방향차계삼협초Z(5,-3)변화교대,차이유통계학의의(P＜0.05).B조Y축방향차계산광Z(4,2)、x축방향차계혜차Z(5,1)、Y축방향차계사협초Z(6,-4)、x축방향차계사협초Z(6,4)교A、C조변화대,차이유통계학의의(P＜0.05).결론 180°투명각막절구술후원기인기적수술원성각막고계상차여구차Z(4,0)변화최소.
Objective To investigate the effect of different clear-Corneal incisions on the high-order wavefront aberrations in phacoemulsification cataract surgery.Methods Ninety-eight eyes of 98 patients were randomly selected and divided into 3 groups according to the steepest corneal meridian.Group A:the incision was placed at the 180-degree,group B:135-degree,group C:90-degree.Phacoemulsification cataract surgeries were performed through 2.8mm clear-corneal incision.The 3-6 order aberrations were measured by Pentacam HD.All the changes in Corneal aberration difference before and after operation between the absolute value were statistically analyzed by one-way ANOVA.Results The x-axes direction of corneal coma Z (3,1) and spherical aberrations Z (4,0) became smaller at group A than those in group B and group C; however the y-axes direction of Second-order clover Z (5,-3) changed most obviously in all three groups.All of the changes had significant difference.The y-axes direction of Second-order astigmatism Z (4,2),the x-axes direction of Second-order coma Z (5,1),y-axes direction of Second-order four-leaf clovers Z (6,-4) and x-axes direction of Second-order four-leaf clovers Z (6,4) changed most significantly in group B.Conclusions 180-degree corneal incision is the most stable incision considering surgery-induced high-order aberration especially for spherical aberrations Z (4,0).