| 摘要: |
| 目的 探讨超声乳化伴人工晶体植入联合角膜缘松解切开术（LRI）对白内障合并角膜散光患者的矫正效果。方法 选择2023年9月至2024年5月在海军军医大学第一附属医院眼科就诊的白内障合并角膜散光（散光－2.0～－0.5 D）患者39例（41眼）作为研究对象，所有患者均接受超声乳化伴人工晶体植入术，术中均行LRI来矫正角膜散光。术前通过角膜地形图和IOLMaster生物测量仪测量角膜散光，术后1、3个月时复查角膜散光，并用Alpins法对患眼术前及术后1个月角膜散光的变化进行矢量分析，主要观察指标为目标诱导散光向量、手术诱导散光向量、差异向量、矫正指数和变平指数等矢量参数。结果 术前患者角膜散光为（－1.07±0.27）D，术后1个月下降到（－0.53±0.23）D，术后3个月为（－0.55±0.24）D，与术前比较差异均有统计学意义（均P＜0.05）。散光矢量分析显示，目标诱导散光向量为（1.07±0.27）D，手术诱导散光向量为（0.99±0.42）D，差异向量为（0.53±0.24）D；矫正指数为0.93±0.36（理想值为1），提示总体为少许欠矫；错位角绝对值为18.15°（15.19°），变平效果为（0.70±0.45）D，变平指数为0.65±0.42，散光矫正成功率为（50.42±19.29）%。结论 对于白内障合并角膜散光患者，超声乳化伴人工晶体植入术中联合LRI矫正角膜散光具有良好的矫正效果，尤其适用于低中度角膜散光的矫正。 |
| 关键词: 角膜缘松解切开术 角膜散光 白内障 超声乳化白内障吸除术 人工晶体植入 |
| DOI：10.16781/j.CN31-2187/R.20240578 |
| 投稿时间：2024-08-19修订日期：2024-12-17 |
| 基金项目: |
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| Efficacy of phacoemulsification with intraocular lens implantation combined with limbal relaxing incision in treatment of cataract patients with corneal astigmatism |
| GAO Guangping1,ZHANG Xiaoliang1,ZHANG Rui1,SANG Yanzhi1,2* |
(1. Department of Ophthalmology, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China;
2. Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
*Corresponding author) |
| Abstract: |
| Objective To investigate the corrective effect of phacoemulsification with intraocular lens implantation combined with limbal relaxing incision (LRI) on cataract patients with corneal astigmatism. Methods A total of 39 patients (41 eyes) with cataract complicated by corneal astigmatism (the astigmatism was －2.0 to －0.5 D) who visited Department of Ophthalmology of The First Affiliated Hospital of Naval Medical University from Sep. 2023 to May 2024 were enrolled. During phacoemulsification with intraocular lens implantation, LRI was performed to correct corneal astigmatism. Preoperative corneal astigmatism was measured using corneal topography and IOLMaster. Corneal astigmatism was re-examined 1 and 3 months after surgery, and Alpins method was used to analyze the changes of corneal astigmation before surgery and 1 month after surgery. The primary vector parameters, such as target induced astigmatism vector (TIA), surgically induced astigmatism vector (SIA), difference vector (DV), correction index and flattening index (FI), were observed. Results The preoperative corneal astigmatism was (－1.07±0.27) D, which was decreased to (－0.53±0.23) D 1 month postoperatively and (－0.55±0.24) D 3 months postoperatively (both P＜0.05). Vector analysis of corneal astigmatism showed that the TIA was (1.07±0.27) D, SIA was (0.99±0.42) D, DV was (0.53±0.24) D; correction index was 0.93±0.36 (the ideal value is 1), suggesting slight undercorrection; the median of the angle of error had an absolute value of 18.15°, and the interquartile range was 15.19°; and the flattening effect was (0.70±0.45) D, the FI was 0.65±0.42, and the success rate was (50.42±19.29)%. Conclusion The combination of LRI with cataract surgery for correcting corneal astigmatism has demonstrated favorable corrective outcomes, especially for the correction of low to moderate corneal astigmatism. |
| Key words: limbal relaxing incision corneal astigmatism cataract phacoemulsification intraocular lens implantation |
