Alió Jorge L, Elkady Bassam, Ortiz Dolores
VISSUM, Instituto Oftalmologico de Alicante, Spain.
Middle East Afr J Ophthalmol. 2010 Jan;17(1):94-9. doi: 10.4103/0974-9233.61225.
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.
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.
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.
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.
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。
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。
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。
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。