[1]李娜,王剑锋,郝泽宇,等.陡峭轴切口联合对侧角膜缘松解术矫正白内障合并角膜散光患者的疗效[J].眼科新进展,2023,43(5):397-400.[doi:10.13389/j.cnki.rao.2023.0080]
 LI Na,WANG Jianfeng,HAO Zeyu,et al.Efficacy of the steep-axis incision in combination with the contralateral limbal relaxing incision on the cataract accompanied by corneal astigmatism[J].Recent Advances in Ophthalmology,2023,43(5):397-400.[doi:10.13389/j.cnki.rao.2023.0080]
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陡峭轴切口联合对侧角膜缘松解术矫正白内障合并角膜散光患者的疗效/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
43卷
期数:
2023年5期
页码:
397-400
栏目:
应用研究
出版日期:
2023-05-05

文章信息/Info

Title:
Efficacy of the steep-axis incision in combination with the contralateral limbal relaxing incision on the cataract accompanied by corneal astigmatism
作者:
李娜王剑锋郝泽宇陈悦韩雪
233000 安徽省蚌埠市,蚌埠医学院第一附属医院眼科(李娜,王剑锋,陈悦,韩雪);233000 安徽省蚌埠市,蚌埠市第三人民医院眼科(郝泽宇)
Author(s):
LI Na1WANG Jianfeng1HAO Zeyu2CHEN Yue1HAN Xue1
1.Department of Ophthalmology,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,Anhui Province,China
2.Department of Ophthalmology,the Third People’s Hospital of Bengbu,Bengbu 233000,Anhui Province,China
关键词:
白内障角膜散光陡峭轴切口角膜缘松解术
Keywords:
cataract corneal astigmatism steep-axis incision limbal relaxing incision
分类号:
R776.1
DOI:
10.13389/j.cnki.rao.2023.0080
文献标志码:
A
摘要:
目的 观察白内障患者行陡峭轴切口联合对侧角膜缘松解术后角膜散光和视力的变化。
方法 选取2020年1月至12月在蚌埠医学院第一附属医院眼科就诊的年龄相关性白内障合并角膜散光(>1.50 D)患者29例(30眼)为研究对象,所有患者均行陡峭轴切口联合对侧角膜缘松解术,观察术前及术后1周、1个月、3个月患者的裸眼视力(UCVA)、最佳矫正视力(BCVA)及角膜散光情况,并进行统计学分析。
结果 患眼术前角膜散光为(2.16±0.65)D,术后1周、1个月、3个月角膜散光分别为(0.97±0.46)D、(0.84±0.49)D、(0.87±0.47)D;术后各时间点患眼角膜散光均较术前明显降低(均为P<0.05);术后各时间点间两两相比,患眼角膜散光差异均无统计学意义(均为P>0.05)。术前UCVA为0.11±0.08,术后1周、1个月、3个月分别为0.56±0.18、0.71±0.16、0.73±0.16。术前BCVA为0.18±0.11,术后1周、1个月、3个月分别为0.67±0.15、0.82±0.11、0.83±0.09。术后各时间点患眼UCVA及BCVA均较术前明显提高(均为P<0.05);术后1周与术后1个月、3个月患眼UCVA及BCVA相比,差异均有统计学意义(均为P<0.05) ;术后 1个月与术后 3 个月的UCVA及BCVA相比差异无统计学意义(P>0.05) 。术后1个月UCVA≥0.6的患眼占90.0%。
结论 陡峭轴切口联合对侧角膜缘松解术能够有效矫正白内障合并角膜散光,使患者获得更佳的术后视觉质量。
Abstract:
Objective To observe the changes in corneal astigmatism and vision of cataract patients after the steep-axis incision in combination with the limbal relaxing incision on the opposite side.
Methods Totally 29 patients (30 eyes) with age-related cataracts and corneal astigmatism (>1.50 D) who visited the Ophthalmology Department of the First Affiliated Hospital of Bengbu Medical College from January to December 2020 were selected as the subjects. All patients received the steep-axis incision in combination with the limbal relaxing incision on the opposite side. The uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and corneal astigmatism of patients before surgery and 1 week, 1 month, and 3 months after surgery were observed. Meanwhile, a statistical analysis was conducted.
Results Corneal astigmatism before surgery was (2.16±0.65)D. The corneal astigmatism was (0.97±0.46)D, (0.84±0.49)D, (0.87±0.47)D 1 week, 1 month and 3 months after surgery, respectively. Corneal astigmatism significantly decreased at each time point after surgery (all P<0.05). In pairwise comparison, there was no statistically significant difference in corneal astigmatism at each time after surgery (all P>0.05). The UCVA was 0.11±0.08 before surgery and was respectively 0.56±0.18, 0.71±0.16 and 0.73±0.16 1 week, 1 month and 3 months after surgery. The BCVA was 0.18±0.11 before surgery and was respectively 0.67±0.15, 0.82±0.11 and 0.83±0.09 1 week, 1 month and 3 months after surgery. UCVA and BCVA significantly increased at each time point after surgery (all P<0.05). There were statistically significant differences in UCVA and BCVA of the affected eyes between 1 week after surgery and 1 month and 3 months after surgery (all P<0.05). There was no statistically significant difference in UCVA and BCVA of the affected eyes between 1 month and 3 months after surgery (all P>0.05). The affected eyes with UCVA≥0.6 were founded in 90.0% of patients 1 month after surgery.
Conclusion The steep-axis incision in combination with the contralateral limbal relaxing incision can effectively improve the cataract combined with corneal astigmatism, enabling patients to achieve better visual quality after surgery.

参考文献/References:

[1] DIAKONIS V F,YESILIRMAK N,CABOT F,KANKARIYA V P,KOUNIS G A,WARREN D,et al.Comparison of surgically induced astigmatism between femtosecond laser and manual clear corneal incisions for cataract surgery[J].J Cataract Refract Surg,2015,41(10):2075-2080.
[2] DE BERNARDO M,ZEPPA L,CENNAMO M,IACCARINO S,ZEPPA L,ROSA N.Prevalence of corneal astigmatism before cataract surgery in Caucasian patients[J].Eur J Ophthalmol,2014,24(4):494-500.
[3] BORASIO E,MEHTA J S,MAURINO V.Surgically induced astigmatism after phacoemulsification in eyes with mild to moderate corneal astigmatism:temporal versus on-axis clear corneal incisions[J].J Cataract Refract Surg,2006,32(4):565-572.
[4] HAYASHI K,YOSHIDA M,HIRATA A,YOSHIMURA K.Changes in shape and astigmatism of total,anterior,and posterior cornea after long versus short clear corneal incision cataract surgery[J].J Cataract Refract Surg,2018,44(1):39-49.
[5] 郝泽宇,王剑锋,蒋胜群,周琦,李娟.IOL Master700指导陡峭轴切口白内障超声乳化术后患者的眼前节变化[J].临床眼科杂志,2021,29(5):406-409.
HAO Z Y,WANG J F,JIANG S Q,ZHOU Q,LI J.Changes of anterior segment in patients after phacoemulsification with steep axial incision guided by IOL Master700[J].J Clin Ophthalmol,2021,29(5):406-409.
[6] HASHEMI H,KHABAZKHOOB M,SOROUSH S,SHARIATI R,MIRAFTAB M,YEKTA A.The location of incision in cataract surgery and its impact on induced astigmatism[J].Curr Opin Ophthalmol,2016,27(1):58-64.
[7] LAKE J C,VICTOR G,CLARE G,PORFRIO G J,KERNOHAN A,EVANS J R.Toric intraocular lens versus limbal relaxing incisions for corneal astigmatism after phacoemulsification[J].Cochrane Database Syst Rev,2019,12(12):CD012801.
[8] HIRNSCHALL N,GANGWANI V,CRNEJ A,KOSHY J,MAURINO V,FINDL O.Correction of moderate corneal astigmatism during cataract surgery:Toric intraocular lens versus peripheral corneal relaxing incisions[J].J Cataract Refract Surg,2014,40(3):354-361.
[9] TITIYAL J S,KHATIK M,SHARMA N,SEHRAS V,MAHARANA P K,GHATAK U,et al.Toric intraocular lens implantation versus astigmatic keratotomy to correct astigmatism during phacoemulsification[J].J Cataract Refract Surg,2014,40(5):741-747.
[10] KIM D H,WEE W R,LEE J H,KIM M K.The short term effects of a single limbal relaxing incision combined with clear corneal incision[J].Korean J Ophthalmol,2010,24(2):78-82.
[11] 徐冰,褚利群,肖林,刘晶,董宁.透明角膜切口联合对侧单切口角膜缘松解术矫正散光的临床效果[J].眼科新进展,2012,32(3):249-252.
XU B,CHU L Q,XIAO L,LIU J,DONG N.Cataract surgery with a single limbal relaxing incision combined with clear corneal incision on correction of astigmatism[J].Rec Adv Ophthalmol,2012,32(3):249-252.
[12] ABU-AIN M S,ALLATAYFEH M M,KHAN M I.Do limbal relaxing incisions during cataract surgery still have a role?[J].BMC Ophthalmol,2022,22(1):102.
[13] LEVER J,DAHAN E.Opposite clear corneal incisions to correct pre-existing astigmatism in cataract surgery[J].J Cataract Refract Surg,2000,26(6):803-805.
[14] 叶霞,宋平,刘震.不同切口角膜缘松解术矫正白内障手术前角膜散光效果对比观察[J].人民军医,2020(10):1004-1008.
YE X,SONG P,LIU Z.Comparison of corneal astigmatism before cataract surgery with limbal dissection with different incisions[J].People Milit Surg,2020(10):1004-1008.
[15] BUDAK K,YILMAZ G,ASLAN B S,DUMAN S.Limbal relaxing incisions in congenital astigmatism:6 month follow-up[J].J Cataract Refract Surg,2001,27(5):715-719.

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更新日期/Last Update: 2023-05-05