放射状角膜切开术术后白内障手术及人工晶状体度数选择

发布时间：2018-06-29 03:43

本文选题：RK术 + 白内障　；参考：《南方医科大学学报》2015年07期

【摘要】：目的探讨放射状角膜切开术(RK)术后白内障手术的诊治特点及人工晶状体度数选择的可靠性。方法回顾性分析我院2010年3月~2013年6月RK术后的白内障患者8例(12只眼),术前对白内障患者的视力、角膜曲率及眼轴长度进行检查,比较患者用TOPCON-KR8800型自动角膜曲率计测量的3组角膜中央2.6 mm的角膜曲率值,选择较为低的K数值,选用经SRK T三元回归公式自动计算的近正视化(-1.00D~-2.00D)的人工晶状体(后房型折叠人工晶状体),行白内障超声乳化摘除联合人工晶状体植入术,术后3月随访患者的视力、屈光状态。结果 RK术后白内障患者行人工晶状体植入的12只眼术后视力均较术前提高:其中6只眼裸眼视力达到0.8~1.0,另外6只眼裸眼视力达到0.4~0.6+,矫正视力0.6~1.0;术后屈光状态:6只眼接近正视(+0.75D~-1.00D),另外6只眼的屈光度为-1.00D~-2.50D,通过术后配镜,患者均能接受。结论对RK术后的白内障患者,施行白内障超声乳化吸出术+人工晶状体植入术是可行的;比较患者的3组自动角膜曲率计测量的角膜中央2.6 mm的角膜曲率值,选择较为低的K数值,使用SRK T公式计算人工晶状体的度数,预留-1.00~-2.00D的近视较为安全,避免+3.00D的远视出现,也较为患者接受。
[Abstract]:Objective to investigate the diagnosis and treatment of cataract after radial keratotomy (RK) and the reliability of intraocular lens selection. Methods from March 2010 to June 2013, 8 patients (12 eyes) with cataract after RK operation in our hospital were retrospectively analyzed. The visual acuity, corneal curvature and axial length were examined before operation. The corneal curvature values of 2.6 mm in the center of the three groups were measured by TOPCON-KR8800 automatic keratometer, and the lower K value was selected. Intraocular lens (IOL) (posterior chamber foldable intraocular lens), which was calculated by SRK T ternary regression formula, was used for cataract phacoemulsification combined with intraocular lens implantation. The visual acuity and refractive state of the patients were followed up 3 months after operation. Results the postoperative visual acuity of 12 eyes with intraocular lens implantation after RK surgery was better than that before operation: the naked visual acuity of 6 eyes reached 0.8 ~ 1.0, and the other 6 eyes achieved 0.4 ~ 0.6 uncorrected visual acuity. The corrected visual acuity was 0.6 ~ 1.0, the refractive state of 6 eyes was close to emmetropia (0.75 DX -1.00 D), and the other 6 eyes was -1.00 DX -2.50 D, which was acceptable to all the patients. Conclusion phacoemulsification and intraocular lens implantation is feasible for patients with cataract after RK. Choosing the lower K value, using SRK T formula to calculate the degree of intraocular lens, it is safe to reserve -1.00D -2.00D myopia, to avoid the appearance of 3.00D hyperopia, but also more acceptable to the patient.
【作者单位】：四川大学华西第四医院眼科;成都363医院;华西公共卫生学院;
【分类号】：R779.66

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