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中央角膜厚度对白内障手术中手术源性散光的影响。

Effect of central corneal thickness on surgically induced astigmatism in cataract surgery.

作者信息

Woo Se Joon, Lee Jin-Hak

机构信息

Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea.

出版信息

J Cataract Refract Surg. 2003 Dec;29(12):2401-6. doi: 10.1016/s0886-3350(03)00254-2.

Abstract

PURPOSE

To evaluate the effect of central corneal thickness (CCT) on surgically induced astigmatism (SIA) in cataract surgery using temporal clear corneal incisions.

SETTING

Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.

METHODS

The retrospective nonrandomized clinical study comprised 129 eyes that had cataract surgery performed through a sutureless temporal clear corneal incision. Eyes were categorized according to the axis of the preoperative astigmatism: against the rule (ATR, 0 to 45 degrees; n = 64) or with the rule (WTR, 46 to 90 degrees; n =65). Corneal topography was taken preoperatively and 1 day and 2 months postoperatively to evaluate the change in the cornea. The SIA was calculated using the polar method from simulated keratometric readings obtained with topography. Correlations between SIA and CCT were analyzed by linear regression analysis and compared between the ATR and the WTR groups.

RESULTS

One day postoperatively, the SIA was negatively correlated with CCT in the ATR group but not in the WTR group (P =.050 versus P =.92; linear regression analysis). At 2 months, the correlation between CCT and SIA was no longer statistically significant.

CONCLUSIONS

Central corneal thickness was negatively correlated with the amount of SIA immediately postoperatively when the preoperative astigmatism was ATR. The correlation was not present 2 months after surgery. These results may be applied to abnormally thin corneas such as those after keratorefractive surgery.

摘要

目的

评估采用颞侧透明角膜切口的白内障手术中,中央角膜厚度(CCT)对手术性散光(SIA)的影响。

设置

韩国首尔国立大学医院眼科。

方法

这项回顾性非随机临床研究纳入了129只通过无缝合颞侧透明角膜切口进行白内障手术的眼睛。根据术前散光轴将眼睛分类:逆规散光(ATR,0至45度;n = 64)或顺规散光(WTR,46至90度;n = 65)。术前、术后1天和2个月进行角膜地形图检查,以评估角膜变化。使用极坐标法根据地形图获得的模拟角膜曲率读数计算SIA。通过线性回归分析分析SIA与CCT之间的相关性,并在ATR组和WTR组之间进行比较。

结果

术后1天,ATR组中SIA与CCT呈负相关,而WTR组中无此相关性(P = 0.050对P = 0.92;线性回归分析)。在2个月时,CCT与SIA之间的相关性不再具有统计学意义。

结论

当术前散光为ATR时,术后即刻中央角膜厚度与SIA量呈负相关。术后2个月不存在这种相关性。这些结果可能适用于角膜异常薄的情况,如角膜屈光手术后的角膜。

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