叶　霞，宋　平，郭长梅

作者单位：1(316000)中国浙江省舟山市，解放军413医院眼科；2(710199)中国陕西省西安市，第四军医大学附属西京医院眼科



·临床研究·

高度近视白内障患者小切口非超声乳化术后角膜屈光力的变化

叶霞1，宋平1，郭长梅2

作者单位：1(316000)中国浙江省舟山市，解放军413医院眼科；2(710199)中国陕西省西安市，第四军医大学附属西京医院眼科

Analysis of corneal refractive power after small incision surgery of non-phacoemmulsification for high myopic eyes with cataract

Xia Ye1, Ping Song1, Chang-Mei Guo2

1Department of Ophthalmology, the No. 413 Hospital of the People’s Liberation Army, Zhoushan 316000, Zhejiang Province, China;2Department of Ophthalmology, Xijing Hospital, the Fourth Military Medical University, Xi’an 710199, Shaanxi Province, China

Correspondence to:Ping Song. Department of Ophthalmology, the No. 413 Hospital of the People’s Liberation Army, Zhoushan 316000,Zhejiang Province, China. cddysp@163.com

Received：2015-12-12Accepted：2016-03-16

Abstract

•AIM: To evaluate the changes of corneal refractive power and surgically induced astigmatism (SIA) after small incision non-phacoemmulsification surgery for high myopic eyes with cataract in middle aged and senile people.

•METHODS: A retrospective study was done in 145 eyes of 103 middle aged and senile patients with high myopia and cataract who underwent small incision non-phacoemulsification surgery in our hospital. The keratometer was used to measure corneal horizontal refractive power (K1), vertical corneal refractive power(K2)and their axial on postoperative 3d, 1wk, 1 and 3mo. SIA was calculated by sine law and cosine law method.

•RESULTS: There was statistically significant difference on average corneal astigmatism at 3d and 1wk compared with that before surgeries (P<0.05). SIA were respectively +1.34±0.12, +0.89±0.27 and -0.42±0.26 at 1wk, 1 and 3mo postoperatively, and the differences were statistically significant(P<0.05). K1 increased by 1.59D and K2 decreased by 1.98D at 3d postoperatively, and there was significant difference between them (P<0.01). The difference between before surgery and after surgeries of K1 decreased in 3mo, which was also similar with the K2. The absolute value of differences between K1 in 3mo were smaller than those of K2, and there were significant differences between them at different time points (P<0.05).

•CONCLUSION: Corneal astigmatism is a little larger in short term after small incision non-phacoemulsification surgery for high myopia patients with cataract. The surgery method needed to be improved.

KEYWORDS:•high myopia with cataract;small incision;corneal refractive power;surgery

Citation:Ye X, Song P, Guo CM. Analysis of corneal refractive power after small incision surgery of non-phacoemmulsification for high myopic eyes with cataract.GuojiYankeZazhi(IntEyeSci) 2016;16(4):722-725

摘要

关键词：高度近视白内障；小切口；角膜屈光力；手术

引用：叶霞，宋平，郭长梅.高度近视白内障患者小切口非超声乳化术后角膜屈光力的变化.国际眼科杂志2016;16(4):722-725

0引言

中老年高度近视患者，晶状体的调节能力显著减弱，难以适应视远、视近，若合并白内障，视力更为低下，严重影响生活质量。小切口非超声乳化白内障囊外摘除联合人工晶状体植入手术(以下简称小切口白内障手术)，目前在我国基层医院比较普及,该手术优点是相对简单、安全可靠、手术效果好，具有既能矫正屈光又能将白内障摘除的双重功效，但术后早期角膜散光较大,明显影响了术眼的视力。本研究拟测量小切口白内障手术后角膜水平屈光力(K1) 和角膜垂直屈光力(K2)的变化,探讨手术源性角膜散光的特点,为改良小切口白内障手术的术式提供理论依据。

1对象和方法

1.1对象回顾性分析了2012-10/2015-05在我院眼科进行小切口非超声乳化白内障囊外摘除联合人工晶状体植入手术的中老年高度近视白内障患者103例145眼。其中男58例76眼,女45例69眼,右眼87只,左眼58只,年龄45～78(平均53.2 ±19.7)岁。……