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巩膜扣带术后角膜前表面地形学变化

[Anterior corneal topographic changes after scleral buckling surgery].

作者信息

Li Yu-min, Xu Ye-sheng, Shen Li-ping, Lou Ding-hua, Shen Ye, Huang Zhi-min

机构信息

Eye Center, the First Affiliated Hospital, College of Medical Science, Zhejiang University, Hangzhou 310003, China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2005 Dec;27(6):734-8.

Abstract

OBJECTIVE

To investigate corneal refractive changes after scleral buckling surgery.

METHODS

In a prospective self-controlled clinical study, we investigated the changes of refractive power, astigmatic power, astigmatic axis, and irregular astigmatic power of anterior corneal surface following scleral buckling surgery for retinal detachment in 30 patients (30 eyes). The corneal shapes were detected by Orbscan II topography at 1 day before surgery, and 1 week, 1 month, and 3 months after surgery. The effects of some surgical factors on the anterior corneal refractive changes were analyzed.

RESULTS

After surgery, refractive power on corneal anterior surface decreased significantly in peripheral zone at 1 week (P < 0.01). Astigmatic power increased obviously in central zone. The direction of astigmatic axis matched the direction of the buckle, and changed obviously in central zone after 1 week (P < 0.05). Irregular astigmatic power did not change significantly. There was a significant correlation between the encircling length/the buckle width and the refractive changes of corneal anterior surface.

CONCLUSION

Refractive changes of corneal anterior surface following scleral buckling surgery was mainly temporary. Changes in the shape of corneal should be minimized to ensure a favorable postoperative visual acuity.

摘要

目的

研究巩膜扣带术后角膜屈光变化。

方法

在一项前瞻性自身对照临床研究中,我们调查了30例视网膜脱离患者(30只眼)巩膜扣带术后角膜前表面屈光力、散光力、散光轴及不规则散光力的变化。术前1天及术后1周、1个月和3个月用Orbscan II地形图检测角膜形态。分析了一些手术因素对角膜前表面屈光变化的影响。

结果

术后1周周边区角膜前表面屈光力显著下降(P<0.01)。中央区散光力明显增加。散光轴方向与扣带方向一致,术后1周中央区明显改变(P<0.05)。不规则散光力无明显变化。环扎长度/扣带宽度与角膜前表面屈光变化之间存在显著相关性。

结论

巩膜扣带术后角膜前表面屈光变化主要是暂时的。应尽量减少角膜形状的改变,以确保良好的术后视力。

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