小切口非超声乳化白内障手术中不同切口矫正术前角膜散光及角膜内皮细胞变化的研究

发布时间：2019-05-29 06:43

【摘要】：目的：研究小切口非超声乳化白内障手术中,在角膜最大屈光度径线上,距角膜缘不同距离的直线型巩膜隧道切口对术前角膜散光及术后角膜内皮细胞变化的影响。方法：选取术前角膜散光值1.0D-2.0D的白内障患者72例72眼,所有患者均采用小切口非超声乳化白内障摘除联合后房型硬性人工晶体植入术,切口均为位于角膜最大屈光度径线的长度为6mm的直线形巩膜隧道切口,按切口距角膜缘距离1.5、2.0和2.5mm随机分为A、B和C3组.每组24例24眼分别于术前及术后1周、1个月、3个月测量3组平均角膜散光度、裸眼视力和角膜内皮细胞计数,观察术后角膜散光和角膜内皮细胞数量的变化,研究三种切口对术前角膜散光的矫正和术后角膜内皮细胞变化的影响。结果：术后3组各时间点的平均角膜散光度均比术前明显减少,相比有显著性差异。术后平均角膜散光度C组B组A组,术后1周、1月、3个月3组之间的平均角膜散光度均有显著性差异(p0.05),随着时间延长,3组之间差异逐渐减小。术后1周及1个月时患者裸眼视力3组间有明显差异,3个月时患者裸眼视力3组间无明显差异。术后角膜内皮细胞数量变化3组无明显差异(P0.05)。结论：小切口非超声乳化白内障手术中,在角膜最大屈光度径线上的巩膜隧道切口可以在一定程度上矫正术前散光。并且,切口所处位置距角膜屈光中心的距离越近,早期矫正术前角膜散光的效果越好。小切口非超声乳化白内障手术切口位置与角膜内皮细胞丢失无直接关系。
[Abstract]:Objective: to study the effect of linear scleral tunnel incision with different distance from corneal limbus on corneal astigmatism and corneal endothelial cells in small incision non-phacoemulsification cataract surgery. Methods: 72 patients (72 eyes) with corneal astigmatism 1.0D-2.0D before operation were selected. All patients were treated with small incision non-phacoemulsification cataract extraction combined with posterior chamber hard intraocular lens implantation. The incisions were linear scleral tunnel incisions with the maximum corneal diopter diameter of 6mm. According to the distance from the incision to the limbus, 2.0 and 2.5mm were randomly divided into A, B and C groups. 24 eyes of 24 patients in each group were measured before operation and 1 week, 1 month and 3 months after operation, respectively. The mean corneal astigmatism, uncorrected visual acuity and corneal endothelial cell count were measured before and 1 week, 1 month and 3 months after operation, and the changes of corneal astigmatism and the number of corneal endothelial cells were observed. To study the effects of three incisions on the correction of corneal astigmatism and the changes of corneal endothelial cells after operation. Results: the average corneal astigmatism of the three groups at each time point after operation was significantly lower than that before operation, and there was significant difference between the three groups. There were significant differences in mean corneal astigmatism between group B and group A at 1 week, 1 month and 3 months after operation (p0.05). With the prolongation of time, the difference among the three groups decreased gradually. At 1 week and 1 month after operation, there was significant difference in uncorrected visual acuity among the three groups, but there was no significant difference in uncorrected visual acuity among the three groups at 3 months after operation. There was no significant difference in the number of corneal endothelial cells among the three groups (P 0.05). Conclusion: in small incision non-phacoemulsification cataract surgery, scleral tunnel incision on the maximum corneal diopter can correct preoperative astigmatism to a certain extent. Moreover, the closer the location of the incision to the refractive center of the cornea, the better the effect of early correction of corneal astigmatism before operation. There was no direct relationship between the location of small incision non-phacoemulsification cataract and the loss of corneal endothelial cells.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R779.66

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