Rainer G, Menapace R, Vass C, Annen D, Findl O, Schmetterer K
Department of Ophthalmology, University of Vienna, Austria.
J Cataract Refract Surg. 1999 Aug;25(8):1121-6. doi: 10.1016/s0886-3350(99)00132-7.
To compare the corneal topographic changes after temporal and superolateral 3.0 mm clear corneal incisions (CCIs) and implantation of foldable silicone intraocular lenses (IOLs).
Department of Ophthalmology, University of Vienna, Austria, and a private clinic, Winterthur, Switzerland.
This prospective study comprised 54 eyes of 54 patients scheduled for cataract surgery. After a 0.3 mm deep precut, a temporal 3.0 mm CCI was made in 26 eyes and a superolateral (at 10:30) 3.0 mm CCI in 28 eyes. Corneal topography was recorded preoperatively and 1 week and 1 and 3 months postoperatively using the TMS-1 computer-assisted videokeratoscope (Computed Anatomy, Inc.). Surgically induced corneal shape changes were evaluated by batch-by-batch analyses of the paired differences between the records. The significance of topographic changes was calculated by the paired Wilcoxon test; group comparisons were made using the Wilcoxon group comparison test.
Both groups had incision-related corneal flattening at 1 week and 1 and 3 months postoperatively. The extent of this flattening at 1 week and 1 and 3 months postoperatively was up to 1.0, 0.9, and 0.7 diopter (D), respectively, in the temporal group and up to 1.2 D at each observation time in the superolateral group. There was statistically significantly more incision-related corneal flattening in the superolateral incision group than in the temporal incision group; the difference was up to 0.3 D after 1 month and 0.5 D after 3 months.
The superolateral incision induced statistically significantly more incision-related corneal flattening than the temporal incision.
比较颞侧和颞上侧3.0mm透明角膜切口（CCI）及折叠式硅酮人工晶状体（IOL）植入术后的角膜地形图变化。
奥地利维也纳大学眼科及瑞士温特图尔一家私人诊所。
这项前瞻性研究纳入了54例计划行白内障手术患者的54只眼。在进行0.3mm深的预切口后，26只眼制作颞侧3.0mm CCI，28只眼制作颞上侧（10:30）3.0mm CCI。术前以及术后1周、1个月和3个月使用TMS-1计算机辅助角膜地形图仪（Computed Anatomy公司）记录角膜地形图。通过对记录的配对差异进行逐批分析来评估手术引起的角膜形状变化。地形变化的显著性通过配对Wilcoxon检验计算；组间比较采用Wilcoxon组间比较检验。
两组在术后1周、1个月和3个月均出现与切口相关的角膜扁平化。颞侧组术后1周、1个月和3个月这种扁平化程度分别高达1.0、0.9和0.7屈光度（D），颞上侧组在每个观察时间点高达1.2D。颞上侧切口组与切口相关的角膜扁平化在统计学上显著多于颞侧切口组；1个月后差异高达0.3D，3个月后差异高达0.5D。
颞上侧切口引起的与切口相关的角膜扁平化在统计学上显著多于颞侧切口。
