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1.8毫米以下微小切口白内障手术与2.2毫米小切口同轴超声乳化术后的角膜光学质量

Corneal Optical Quality Following Sub 1.8 mm Micro-Incision Cataract Surgery vs. 2.2 mm Mini-Incision Coaxial Phacoemulsification.

作者信息

Alió Jorge L, Elkady Bassam, Ortiz Dolores

机构信息

VISSUM, Instituto Oftalmologico de Alicante, Spain.

出版信息

Middle East Afr J Ophthalmol. 2010 Jan;17(1):94-9. doi: 10.4103/0974-9233.61225.

Abstract

PURPOSE

To study and compare the effects of the micro-incision cataract surgery (MICS-sub 1.8 mm) and miniincision coaxial phacoemulsification (2.2 mm) on the optical quality of the cornea characterized in terms of corneal aberrations.

MATERIALS AND METHODS

Fifty eyes underwent MICS and 50 mini-incision phacoemulsification, by the same surgeon. Both types of cataract surgery were performed using low ultrasound power and through a clear corneal incision, placed on the steepest corneal meridian ranging from 1.6 to 1.8 in MICS (Group I) and from 2.12 to 2.3 mm in mini-incision coaxial phacoemulsification (Group II). Seidel and Zernike aberration coefficients and RMS values were obtained for a 6-mm pupil preoperatively and one month after surgery.

RESULTS

THE CORNEAL ASTIGMATISM DID NOT SHOW STATISTICALLY SIGNIFICANT CHANGES IN EITHER OF THE TWO GROUPS: (MICS: -0.73 +/- 0.63, -0.65 +/- 0.53 D, P = 0.25), (mini-incision phacoemulsification; -1.21 +/- 1.52, -1.00 +/- 1.19 D, P = 0.12). The total RMS remained unchanged after MICS (1.77 +/- 1.7, 1.65 +/- 1.3 mum, P = 0.18) and mini-incision phacoemulsification (2.00 +/- 1.87, 2.09 +/- 1.8 mum, P = 0.41). Statistically significant changes were found for coma (P = 0.004) and higher-order aberrations (P < 0.001), showing MICS significantly less changes in cornea.

CONCLUSIONS

Both MICS and mini-incision phacoemulsification do not degrade the optical quality of the cornea. Both surgeries do not induce a modification of the corneal astigmatism, even in the axis. It seems that 2 mm is the limit around which no optical changes are induced by cataract surgery in the human cornea.

摘要

目的

研究并比较微切口白内障手术(MICS,切口小于1.8mm)和小切口同轴超声乳化术(2.2mm)对以角膜像差为特征的角膜光学质量的影响。

材料与方法

由同一位外科医生对50只眼进行MICS手术,对另外50只眼进行小切口超声乳化术。两种白内障手术均采用低超声能量,并通过透明角膜切口进行,MICS手术(I组)的切口位于角膜最陡子午线,切口大小为1.6至1.8mm,小切口同轴超声乳化术(II组)的切口大小为2.12至2.3mm。术前及术后1个月测量6mm瞳孔直径下的赛德尔和泽尼克像差系数及均方根(RMS)值。

结果

两组的角膜散光均未出现统计学上的显著变化:(MICS组:术前-0.73±0.63D,术后-0.65±0.53D,P = 0.25),(小切口超声乳化术组:术前-1.21±1.52D,术后-1.00±1.19D,P = 0.12)。MICS手术(术前1.77±1.7μm,术后1.65±1.3μm,P = 0.18)和小切口超声乳化术(术前2.00±1.87μm,术后2.09±1.8μm,P = 0.41)后总RMS值均无变化。发现彗差(P = 0.004)和高阶像差(P < 0.001)有统计学显著变化,表明MICS手术对角膜的影响明显较小。

结论

MICS手术和小切口超声乳化术均不会降低角膜的光学质量。两种手术均不会引起角膜散光的改变,即使在散光轴向上也是如此。似乎2mm是人类角膜白内障手术不会引起光学变化的临界值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fd6/2880382/fff2dacbf80e/MEAJO-17-94-g001.jpg

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