【摘要】：目的：研究小切口非超聲乳化白內(nèi)障手術(shù)中,在角膜最大屈光度徑線上,距角膜緣不同距離的直線型鞏膜隧道切口對(duì)術(shù)前角膜散光及術(shù)后角膜內(nèi)皮細(xì)胞變化的影響。 方法：選取術(shù)前角膜散光值1.0D-2.0D的白內(nèi)障患者72例72眼,所有患者均采用小切口非超聲乳化白內(nèi)障摘除聯(lián)合后房型硬性人工晶體植入術(shù),切口均為位于角膜最大屈光度徑線的長度為6mm的直線形鞏膜隧道切口,按切口距角膜緣距離1.5、2.0和2.5mm隨機(jī)分為A、B和C3組.每組24例24眼分別于術(shù)前及術(shù)后1周、1個(gè)月、3個(gè)月測量3組平均角膜散光度、裸眼視力和角膜內(nèi)皮細(xì)胞計(jì)數(shù),觀察術(shù)后角膜散光和角膜內(nèi)皮細(xì)胞數(shù)量的變化,研究三種切口對(duì)術(shù)前角膜散光的矯正和術(shù)后角膜內(nèi)皮細(xì)胞變化的影響。 結(jié)果：術(shù)后3組各時(shí)間點(diǎn)的平均角膜散光度均比術(shù)前明顯減少,相比有顯著性差異。術(shù)后平均角膜散光度C組B組A組,術(shù)后1周、1月、3個(gè)月3組之間的平均角膜散光度均有顯著性差異(p0.05),隨著時(shí)間延長,3組之間差異逐漸減小。術(shù)后1周及1個(gè)月時(shí)患者裸眼視力3組間有明顯差異,3個(gè)月時(shí)患者裸眼視力3組間無明顯差異。術(shù)后角膜內(nèi)皮細(xì)胞數(shù)量變化3組無明顯差異(P0.05)。 結(jié)論：小切口非超聲乳化白內(nèi)障手術(shù)中,在角膜最大屈光度徑線上的鞏膜隧道切口可以在一定程度上矯正術(shù)前散光。并且,切口所處位置距角膜屈光中心的距離越近,早期矯正術(shù)前角膜散光的效果越好。小切口非超聲乳化白內(nèi)障手術(shù)切口位置與角膜內(nèi)皮細(xì)胞丟失無直接關(guān)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.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R779.66

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