CAJ | 학술논문

目的：对老年性白内障合并角膜散光患者采用超声乳化白内障摘除术联合散光型人工晶状体( intraocular lens,IOL)植入的临床疗效进行评估。方法：采用随机数字表法将本院眼科中心收治的64例84眼老年性白内障合并散光患者分为散光型IOL组33例42眼和球面IOL组31例42眼,散光IOL组采用超声乳化白内障摘除术联合散光型人工晶状体植入术治疗,球面IOL组采用常规颞侧透明角膜切口超声乳化白内障摘除球面人工晶状体植入联合陡峭轴位上一对角膜缘松解切口治疗。观察两组手术前、术后3 mo 的视力分布、角膜散光度、球镜及柱镜指标(曲率、轴向、小瞳验光球镜、小瞳验光柱镜、散光轴向)的变化情况。结果：散光型IOL组和球面IOL组在术后第3 mo复查裸眼视力,与同组术前比较视力均提高(P<0.05),术后散光型IOL组和球面IOL组裸眼视力比较,散光型IOL组裸眼视力分布优于球面IOL组( Z=-2.172, P=0.030<0.05)。术后3 mo散光型IOL组、球面IOL组患者的角膜散光度与同组患者术前比较减小,差异具有统计学意义(P<0.05)。散光型IOL组和球面IOL组的小瞳验光球镜、小瞳验光柱镜较术前均减小(P<0.05),散光轴向较术前变化无统计学差异( P>0.05)；术后3 mo散光型IOL组的小瞳验光球镜、小瞳验光柱镜值显著低于球面IOL组( P<0.05)。结论：老年性白内障合并散光患者采用超声乳化白内障摘除术联合散光型人工晶状体植入具有较好的临床效果。
목적：대노년성백내장합병각막산광환자채용초성유화백내장적제술연합산광형인공정상체( intraocular lens,IOL)식입적림상료효진행평고。방법：채용수궤수자표법장본원안과중심수치적64례84안노년성백내장합병산광환자분위산광형IOL조33례42안화구면IOL조31례42안,산광IOL조채용초성유화백내장적제술연합산광형인공정상체식입술치료,구면IOL조채용상규섭측투명각막절구초성유화백내장적제구면인공정상체식입연합두초축위상일대각막연송해절구치료。관찰량조수술전、술후3 mo 적시력분포、각막산광도、구경급주경지표(곡솔、축향、소동험광구경、소동험광주경、산광축향)적변화정황。결과：산광형IOL조화구면IOL조재술후제3 mo복사라안시력,여동조술전비교시력균제고(P<0.05),술후산광형IOL조화구면IOL조라안시력비교,산광형IOL조라안시력분포우우구면IOL조( Z=-2.172, P=0.030<0.05)。술후3 mo산광형IOL조、구면IOL조환자적각막산광도여동조환자술전비교감소,차이구유통계학의의(P<0.05)。산광형IOL조화구면IOL조적소동험광구경、소동험광주경교술전균감소(P<0.05),산광축향교술전변화무통계학차이( P>0.05)；술후3 mo산광형IOL조적소동험광구경、소동험광주경치현저저우구면IOL조( P<0.05)。결론：노년성백내장합병산광환자채용초성유화백내장적제술연합산광형인공정상체식입구유교호적림상효과。
Abstract? AlM: To evaluate the clinical efficacy of phacoemulsification combined with intraocular lens ( lOL) implantation for senile cataract patients with corneal astigmatism.?METHODS:Using the random number table method were enrolled 64 cases ( 84 eyes ) with senile cataract at Eye Center of our hospital, which were divided into the astigmatism lOL group ( 42 eyes of 33 cases ) and the spherical lOL group ( 42 eyes of 31 cases ) . The astigmatism lOL group was treated phacoemulsification with intraocular lens implantation, and the spherical lOL group was treated with conventional temporal clarity cornea incision phacoemulsification and spherical intraocular lens implantation combined with limbal relaxing incisions on steep axial position. Distribution of vision at 3mo pre- and post-operation, astigmatism, the changes of spherical and cylindrical lens indicators ( curvature, axial, non - mydriatic refraction spherical, non - mydriatic refraction cylindrical, astigmatism axial) were observed between two groups.?RESULTS:Uncorrected visual acuity of the astigmatism lOL group and the spherical lOL group were follow up to 3mo post-operation, the visual acuity was significantly improved (P<0. 05) than that in pre-operation groups. Compared with the spherical lOL group of uncorrected visual acuity after operation, distribution of vision in the astigmatism lOL group was superior than that in the spherical lOL group ( Z = - 2. 172, P = 0. 030 < 0. 05 ). Compared with pre - operation groups, the corneal astigmatism was decreased in the astigmatism lOL group and the spherical lOL group at 3mo post-opearation, with statistically significant differences ( P < 0. 05 ). Non -mydriatic refraction spherical and non - mydriatic refraction cylindrical were decreased after operation ( P<0. 05), astigmatism axial had no statistically significant differences compared with pre-operation (P>0. 05). Non-mydriatic refraction spherical and non - mydriatic refraction cylindrical of the astigmatism lOL group were significant lower than than in the spherical lOL group at 3mo post-operation(P<0. 05).? CONCLUSlON: Phacoemulsification combined with intraocular lens implantation for senile cataract with corneal astigmatism have a good clinical effect.