CAJ | 학술논문

目的：比较角膜地形图引导下不同部位透明角膜切口白内障超声乳化术后散光情况。方法选择行透明角膜切口超声乳化白内障吸除联合人工晶状体植入术的年龄相关性白内障患者198例（231例）为研究对象，分成A、B、C 3组，A组选择在上方11点位透明角膜切口，B组选择在颞侧透明角膜切口，C组选择在角膜最大曲率子午线上透明角膜切口，分别于术前，术后1周、1个月及3个月随访，行视力及角膜地形图检查，记录并比较3组术后视力及角膜散光的变化情况。结果术后3个月时C组裸眼视力≥1．0者多于A组和B组（ P ＜0．05）；C组患者术后3个月与术前相比，散光度明显减小（ P ＜0．05）；C组分别与A组、B组相比，术后1周、1个月及3个月时的散光度均明显减小（ P ＜0．05）；术后3个月平均手术源性角膜散光度（SIA），C组最小。结论角膜地形图引导下位于角膜最大曲率子午线上透明角膜切口有助于减小术前及术后散光，术后获得较好的裸眼视力。
목적：비교각막지형도인도하불동부위투명각막절구백내장초성유화술후산광정황。방법선택행투명각막절구초성유화백내장흡제연합인공정상체식입술적년령상관성백내장환자198례（231례）위연구대상，분성A、B、C 3조，A조선택재상방11점위투명각막절구，B조선택재섭측투명각막절구，C조선택재각막최대곡솔자오선상투명각막절구，분별우술전，술후1주、1개월급3개월수방，행시력급각막지형도검사，기록병비교3조술후시력급각막산광적변화정황。결과술후3개월시C조라안시력≥1．0자다우A조화B조（ P ＜0．05）；C조환자술후3개월여술전상비，산광도명현감소（ P ＜0．05）；C조분별여A조、B조상비，술후1주、1개월급3개월시적산광도균명현감소（ P ＜0．05）；술후3개월평균수술원성각막산광도（SIA），C조최소。결론각막지형도인도하위우각막최대곡솔자오선상투명각막절구유조우감소술전급술후산광，술후획득교호적라안시력。
Objective To compare the effects of different corneal topography guided incisions on corneal refraction after phacoemulsification.Methods Totally 198 cataract patients (231 eyes) enrolled in the study.Patients were random-ly assigned into 3 groups and clear corneal incisions were made at either superior , or temporal, or along the steepest meridi-an.Routine ophthalmic examinations and corneal topography were performed for each patient before surgery and at 1 week, 1 month, and 3 months after the surgery.Results At 3 months after the surgery,uncorrected visual acuity (≥1.0) was-significantly better in patients whose corneal incisions were made at the deepest meridian than in patients whose corneal in -cisions were made elsewhere ( P <0.05 ) .Astigmatism was also significantly reduced in this group of patients ( P <0.05) starting from 1 week after the surgery and throughout the 3-month follow-up period.Conclusion Corneal incision a-long the steepest meridian in phacoemulsificationwill reduce the postoperative astigmatism and provide better uncorrected visual acuity to cataract patients .