目的:探讨根据患者术前角膜散光差异,在不同部位选择性预设散光轴透明角膜切口行白内障超声乳化联合后房型折叠式人工晶状体植入术,对术后患者角膜散光的影响。方法:收集老年性白内障患者96例112眼,随机分为三组:A组颞侧透明角膜切口,34例39眼;B组11:00位透明角膜切口,26例31眼;C组角膜曲率引导下于角膜屈光力最大轴向上行个体化高选择性透明角膜切口,36例42眼。结果:术前、术后1wk,3组裸眼视力的差异无统计学意义(P>0.05);而术后1,3mo,C组裸眼视力显著优于A,B组(均P<0.05),而A组与B组间差异无统计学意义(P>0.05)。C组在术后1,3mo的角膜散光度显著小于A,B组(P<0.05)。结论:角膜曲率引导下行位于角膜屈光力最大轴方向切口,对白内障超声乳化术后角膜散光影响最小,并有利于患者术后视力较快恢复,有效控制术后术源性角膜散光,进一步提高患者术后视力。

AIM:To investigate the surgically induced refractive change after phacoemulsification with selective maximum astigmatic axis clear corneal incision.METHODS:All 96 cases (112 eyes) with cataract were randomly divided into three groups,group A received temporal transparent corneal incision (34 cases,39 eyes);group B received transparent corneal incision at 11 O’clock(26 cases,31 eyes);group C received highly selective transparent corneal incision at steepest corneal meridian guided by corneal curvature (36 cases,42 eyes).RESULTS:There was no statistically significant difference in visual acuity in three groups before and 1 week after operation (P>0.05).The visual acuity in group C was much better than that in group A and B before and 1 month,3 months after operation (P<0.05),but there was no statistically significant difference between group A and B(P>0.05).The corneal astigmatism degree of group C was much lower than that of group A and B 1 month and 3 months after operation (P<0.05).CONCLUSION:The incision at the steepest corneal meridian guided by corneal curvature has the least effect on corneal astigmatism and can improve visual acuity rapidly.The surgically induced astigmatism can be controlled effectively and patients can gain better visual acuity.

R779.66