Tejedor Jaime, Pérez-Rodríguez José A
Department of Ophthalmology, Hospital Ramón y Cajal, Madrid, Spain.
Invest Ophthalmol Vis Sci. 2009 Mar;50(3):989-94. doi: 10.1167/iovs.08-2778. Epub 2008 Nov 14.
To study the induced refractive change caused by different 2.8-mm corneal incision locations in phacoemulsification.
One hundred ten patients were randomly assigned to nasal or temporal incision or to superior incision, depending on preexisting astigmatism. The authors fulfilled visual acuity, refraction, keratometry, and eye scanner analysis before and after phacoemulsification. Outcome measures were induced corneal refractive change (Fourier power vector analysis), index of surface variance (ISV) change, and visual acuity at 6 months. A comparative interventional case series was used for the study design.
Induced refractive change caused by different incision locations showed differences in parameter J0 (JCC at axis 0 degrees ), which was smaller after temporal than after nasal or superior incision, with marginal clinical significance and influence in uncorrected visual acuity. ISV changes did not differ between incisional groups.
Small differential effects of incisions by location may be useful, depending on preexisting astigmatism. Temporal incisions are recommended for negligible astigmatism, whereas nasal and superior incisions are preferable when the steep axis is located at approximately 180 degrees and 90 degrees, respectively. (ClinicalTrials.gov number, NCT00742950).
研究白内障超声乳化术中不同2.8毫米角膜切口位置所引起的诱导性屈光变化。
110例患者根据术前散光情况被随机分配至鼻侧切口、颞侧切口或上方切口组。作者在白内障超声乳化术前及术后进行了视力、验光、角膜曲率测量及眼部扫描分析。观察指标为诱导性角膜屈光变化（傅里叶功率矢量分析）、表面方差指数（ISV）变化及6个月时的视力。本研究设计采用比较性干预病例系列。
不同切口位置引起的诱导性屈光变化在参数J0（0度轴向上的交叉柱镜）方面存在差异，颞侧切口后该参数小于鼻侧或上方切口后，对裸眼视力有边缘性临床意义和影响。各切口组间ISV变化无差异。
根据术前散光情况，不同位置切口的微小差异效应可能有用。对于可忽略不计的散光，推荐颞侧切口；而当陡峭轴分别位于约180度和90度时，鼻侧和上方切口更可取。（临床试验注册号，NCT00742950）
