Department of Ophthalmology, National Taiwan University Hospital, 7 Chung-Shan South Road,Taipei, Taiwan.
J Formos Med Assoc. 2012 May;111(5):284-9. doi: 10.1016/j.jfma.2011.03.002. Epub 2012 Apr 7.
BACKGROUND/PURPOSE: To determine whether there is a difference in surgically induced astigmatism (SIA) after phacoemulsification for unsutured temporal clear corneal incisions of 2.5 mm and 3.5 mm wound sizes.
This study comprised 36 eyes of 18 patients who received cataract surgery from a single surgeon. Patients were randomly assigned to receive a one-piece intraocular lens (IOL; Acrysof SA60AT), through a 2.5 mm incision in one eye, and a three-piece IOL (Tecnis Z9000), through a 3.5 mm incision in the contralateral eye. Corneal topography was performed preoperatively and also postoperatively at 3, 6, and 12 weeks. SIA was calculated by means of vector analysis using the Alpins' method.
The mean SIAs of the groups with 2.5 mm and 3.5 mm incisions were 0.57 diopter (D) and 0.86 D respectively (p = 0.04) at 3 weeks postoperatively, 0.60 D and 0.83 D respectively (p > 0.05) at 6 weeks postoperatively, and 0.58 D and 0.58 D respectively (p > 0.05) at 12 weeks postoperatively. At 12 weeks postoperatively, SIAs of <1.0 D were found in all eyes in the 2.5 mm group and 93% of eyes in the 3.5 mm group. Forty-four percent of eyes in both groups demonstrated SIAs > 0.5 D at 12 weeks postoperatively. The largest SIA was 1.36 D in the 3.5 mm group.
Mean SIA in the 3.5 mm group was larger than that in the 2.5 mm group in the early postoperative period, but there was no significant difference for the entire observational period.
背景/目的：确定 2.5mm 和 3.5mm 非缝合颞侧透明角膜切口行白内障超声乳化术后手术源性散光（SIA）是否存在差异。
本研究纳入了 18 例（36 只眼）由同一位医生施行白内障手术的患者。患者随机分为两组，一组行 2.5mm 切口的单焦点人工晶状体（Acrysof SA60AT）植入术，另一组行 3.5mm 切口的三焦点人工晶状体（Tecnis Z9000）植入术。术前和术后 3、6、12 周行角膜地形图检查。采用 Alpins 方法的向量分析法计算 SIA。
术后 3 周，两组切口分别为 2.5mm 和 3.5mm 的平均 SIA 分别为 0.57 屈光度（D）和 0.86 D（p=0.04），术后 6 周分别为 0.60 D 和 0.83 D（p>0.05），术后 12 周分别为 0.58 D 和 0.58 D（p>0.05）。术后 12 周，2.5mm 组所有眼的 SIA 均<1.0 D，3.5mm 组 93%的眼 SIA<1.0 D。两组各有 44%的眼术后 12 周 SIA>0.5 D。3.5mm 组最大 SIA 为 1.36 D。
术后早期 3.5mm 组的平均 SIA 大于 2.5mm 组，但整个观察期间无显著差异。
