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目的探讨非同轴微小切口超声乳化白内障吸除术前后的屈光变化与矫治疗效分析。方法对老年性白内障伴有屈光不正的68例(76只眼)行非同轴微小切口超声乳化白内障吸除术。在角膜缘10点处做1.2mm角巩膜隧道主切口,以快速晶状体核劈裂技术双手配合冷超声乳化吸除白内障,用蓝宝石刀将颞侧主切口扩大至1.6mm,植入一体式后房折叠型人工晶状体(德国产Acri.Smart36A疏水性硅丙稀酸酯折叠式IOL)。观察手术前后角膜曲率、角膜地形图、屈光状态和远近视力及并发症。并与常规超声乳化手术组78例(82只眼)进行比较分析。结果角膜地形图手术后呈向非散光图形方向改变,治疗组手术前后比较差异有统计学意义(x2=4.457,P<0.05)。手术后形成散光治疗组与对照组差异无统计学意义(x2=1.324,P>0.05)。术后屈光波动1周与2周间治疗组有90%在0.20D±0.14D的变化。而对照组有40%在0.20D±0.14D的变化,两组比较差异有统计学意义(x2=3.926,P<0.05)。结论非同轴微小切口超声乳化白内障吸除术可安全、有效地通过<1.4mm的切口吸除白内障并植入卷折式人工晶状体,较常规超声乳化术屈光稳定快,两组用角膜地形图选择切口可降低散光度,使白内障超声乳化术与屈光矫正结合具有更好的疗效。
Objective To investigate the changes of refractive power and the therapeutic effect of non-coaxial micro incision phacoemulsification before and after cataract surgery. Methods A total of 68 cases (76 eyes) with senile cataract complicated with refractive errors underwent non-coaxial mini incision phacoemulsification. 1.2mm angle scleral tunnel main incision was made at 10 o’clock of the cornea margin. With rapid phacoemulsification, both hands were combined with cold phacoemulsification to remove cataract. The main temporal incision was expanded to 1.6mm with a sapphire knife and implanted into an integrated posterior chamber Folding intraocular lens (German-made Acri.Smart36A hydrophobic silicone acrylate folding IOL). Corneal curvature before and after surgery, corneal topography, refractive status and distance vision and complications. 78 patients (82 eyes) with conventional phacoemulsification were compared. Results The corneal topography showed a non-astigmatism pattern after surgery. The difference between the two groups was statistically significant (x2 = 4.457, P <0.05). There was no significant difference in astigmatism group and control group after surgery (x2 = 1.324, P> 0.05). Postoperative refractive fluctuations between 1 week and 2 weeks in the treatment group, 90% of 0.20D ± 0.14D changes. While 40% in the control group was 0.20D ± 0.14D, the difference between the two groups was statistically significant (x2 = 3.926, P <0.05). Conclusion Non-coaxial incision phacoemulsification cataract surgery can be safely and effectively through <1.4mm incision suction cataract surgery and implantation of IOL, refractive surgery than conventional phacoemulsification faster, two groups with corneal topography Figure choose incision can reduce astigmatism, cataract phacoemulsification combined with refractive correction has a better effect.