两种角膜缘切口白内障超声乳化吸除联合人工晶状体植入术后角膜前后表面高阶像差的影响

摘要

目的：探讨2．2 mm、3．0 mm两种角膜缘切口白内障超声乳化吸出术联合人工晶状体植入术后角膜前后高阶像差的变化情况。方法回顾性分析我院72例（130只眼）白内障患者根据治疗方法不同分为A组（2．2 mm切口）和B组（3．0 mm切口）各36例患者，分别于术前、术后3个月测量两组患者的角膜前后表面的高阶像差[总的高阶像差（ tHOAs）、慧差（ Coma）、初级球差（ SA）]的变化情况。结果 A组、B组患者手术前、手术后3个月组内、组间角膜前表面的tHOAs、Coma、SA测定值差异均无统计学意义（ P ＞0．05）；A组患者术后3个月的角膜后表面SA值较术前显著的提高（ P ＜0．05），B组患者术后3个月的角膜后表面tHOAs值较术前显著提高（ P ＜0.05）；A组患者术后3个月角膜后表面的SA值大于B组（ P ＜0．05），B组患者术后3个月的角膜后表面tHOAs值显著高于A组（ P ＜0．05）。结论2．2 mm、3．0 mm两种角膜缘切口白内障超声乳化吸出术联合人工晶状体植入术后角膜前表面高阶像差变化不显著，角膜后表面的高阶像差指标会受到一定程度的影响，这可能与手术质量具有一定的关系。%Objective To examine the changes in corneal higher order aberration in cataract phacoemulsification and intraocular lens ( IOL) implantation operated with either 2.2 mm or 3.0 mm limbal incision.Methods This is a ret-rospective analysis of 72 cases (130 eyes) of cataract surgeries.Patients received phacoemulsification and IOL implantation with either 2.2 mm limbal incision (36 patients) or 3.0 mm limbal incision (36 patients).Corneal surface aberrations were measured before and up to 3 months after the surgery.Higher order aberrations ( HOA), including total HOA ( tHOA) , coma ( Coma) , and primary spherical aberration ( SA) were analyzed.Results Baseline tHOA, Coma and SA values were not different between two groups of patients.After surgery, SA values improved in patients who received smal-ler incisions (i.e., 2.2 mm) and were higher than those of patients who received larger incisions (3.0 mm;P <0.05). In patients who received larger incisions, tHOA improved significantly but was higher than other patients at 3 months ( P <0.05).Conclusion Corneal surface HOA did not change significantly after surgery with either 2.2 mm or 3.0 mm limbal incision.Minor alterations in higher order aberrations is more likely due to surgical quality.