角膜散光手术矫正在白内障手术中应用.doc

角膜散光手术矫正在白内障手术中应用 　［摘要］ 目的 本研究着重就白内障超声乳化术中，同时行角膜边缘切开松解术来矫正术前即存在的较大角膜散光（gt;1.0 D）的效果做一初步分析。方法 联合手术组在角膜散光最大轴向上用带刻度的金刚刀加做长6 mm、宽1.5 mm角膜缘内1 mm成对松解切口，深度分别为角膜中心厚度的40%（1.0～2.0 D）、60%（～3.0 D）、80%（gt;3.0 D）。结果 (1)联合手术组术后最佳矫正视力0.02～0.1者2眼，0.1～0.3者4眼，0.3～0.5者16眼，0.5～1.0者31眼。（2）联合手术组术前散光与术后1周、1个月，3个月角膜散光均值经方差分析，各组总体Plt;0.01，差异有非常显著性。各组组间两两比较，除术后1个月、3个月间Pgt;0.05，差异无显著性外，其余各组间Plt;0.01。（3）术后3个月联合手术组角膜散光轴向有9眼出现90°±30°偏离。结论 该法可以有效矫正老年性白内障患者术前即将存在的散光，其中对1.0～2.0 D范围散光矫正效果好。术后视力明显提高。 ［关键词］ 角膜散光；角膜缘松解术；白内障；手术 Application of astigmatism keratotomy correcting Pre-existing astigmatism in cataract surgery ［Abstract］ Objective To evaluate effects of the astigmatism keratotomy correcting pre-existing astigmatism (gt;1.0 D)in cataract surgery.Methods A retrospective analysis was performed of 67 cataract patients (100 eyes) without having been suffered injury or performed operation.54 eyes with more than 1.0D astigmatism accepted AK(astigmatism keratotomy) combined with phacoemulsification.46 eyes with less than 1.0D astigmatism accepted cataract phacoemulsification only.AK with limbus，one 6 mm length incision and a length of 1.5 mm of the diameter was performed on all subjects.A depth of 40% of the central thickness was performed in （1.0～2.0）D，60% in （2.0～3.0）D，80% in over 3.0D.The changes in corneal shape and the degrees of astigmatism were analyzed using corneal topography.The parameters also included uncorrected vision，mean radius of corneal curvature，axial misalignment，non-contacted intraocular pressure.The following-up time is 1 week，2 months，3 months in post-operation.Results Uncorrected vision of 47 eyes was over 0.3 after surgery in “combined” group.Analysis of variance showed that the preoperative astigmatism were significantly correlated with the surgical effects in one month and three months of post-operation(Plt;0.05).Conclusion AK with phacoemulsification is effective and safe in reducing the pre-existing astigmatism，especially to (1.0～2.0)D group. ［Key words］ astigmati