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目的比较与评价不同方向巩膜隧道切口对白内障术后角膜散光的影响。方法回顾性研究78例(80只眼)白内障,行巩膜隧道切口白内障摘除联合硬性人工晶状体植入术,切口在颞上方为A组,切口在鼻上方为B组。设定从巩膜反眉状隧道切口的顶点作一条切线,该切线与术前角膜散光轴形成的夹角,称之为切角。按照切角的度数将上述病例分为C组(小切角组,0°～45°)和D组(大切角组,45°～90°)。比较术后1周、1个月、3个月裸眼视力及角膜散光数值。结果 A组与B组在术后视力和手术后各时期角膜散光度数变化的差异均无统计学意义。C组术后3个月视力优于D组(P<0.05),且手术后各时期角膜散光度数变化的差异均有统计学意义(P<0.05)。结论对于采用小切口无缝线白内障摘除术,根据术前散光轴位选择小切角,可减小术后角膜散光,获得更好的裸眼视力。
Objective To compare and evaluate the effect of different directions scleral tunnel incision on corneal astigmatism after cataract surgery. Methods Retrospective study of 78 cases (80 eyes) of cataract, scleral tunnel incision cataract extraction combined with intraocular lens implantation, incision in the upper temporal group A, incision in the nose above the B group. Set from the sclera vertex eyebrow tunnel incision for a tangent, the tangent and the angle formed by the preoperative corneal astigmatism, known as the chamfer angle. The above cases were divided into C group (small incision angle group, 0 ° ~ 45 °) and D group (big angle incision group, 45 ° ~ 90 °) according to the degree of incision. Visual acuity and corneal astigmatism were compared at 1 week, 1 month and 3 months after operation. Results There was no significant difference in postoperative visual acuity and corneal astigmatism between groups A and B after operation. The visual acuity of group C was better than that of group D at 3 months (P <0.05), and the difference of corneal astigmatism after operation was statistically significant (P <0.05). Conclusion For small incision sutureless cataract extraction, small incision angle can be reduced according to preoperative astigmatism axis, postoperative corneal astigmatism can be reduced and better naked eye vision can be obtained.