Nikose Archana Sunil, Saha Dhrubojyoti, Laddha Pradnya Mukesh, Patil Mayuri
Department of Ophthalmology, N.K.P. Salve Institute and LMH, Nagpur, Maharashtra, India.
Clin Ophthalmol. 2018 Jan 3;12:65-70. doi: 10.2147/OPTH.S149709. eCollection 2018.
Cataract surgery has undergone various advances since it was evolved from ancient couching to the modern phacoemulsification cataract surgery. Surgically induced astigmatism (SIA) remains one of the most common complications. The introduction of sutureless clear corneal incision has gained increasing popularity worldwide because it offers several advantages over the traditional sutured limbal incision and scleral tunnel. A clear corneal incision has the benefit of being bloodless and having an easy approach, but SIA is still a concern.
In this study, we evaluated the SIA in clear corneal incisions with temporal approach and superior approach phacoemulsification. Comparisons between the two incisions were done using keratometric readings of preoperative and postoperative refractive status.
It was a hospital-based prospective interventional comparative randomized control trial of 261 patients conducted in a rural-based tertiary care center from September 2012 to August 2014. The visual acuity and detailed anterior segment and posterior segment examinations were done and the cataract was graded according to Lens Opacification Classification System II. Patients were divided for phacoemulsification into two groups, group A and group B, who underwent temporal and superior clear corneal approach, respectively. The patients were followed up on day 1, 7, 30, and 90 postoperatively. The parameters recorded were uncorrected visual acuity, best-corrected visual acuity, slit lamp examination, and keratometry. The mean difference of SIA between 30th and 90th day was statistically evaluated using paired -test, and all the analyses were performed using SPSS 18.0 (SPSS Inc.) software.
The mean postoperative SIA in group A was 0.998 D on the 30th day, which reduced to 0.768 D after 90 days, and in group B the SIA after 30 days was 1.651 D, whereas it reduced to 1.293 D after 90 days.
Temporal clear corneal incision is evidently better than superior clear corneal incision as far as SIA is concerned.
自白内障手术从古代的针拨术发展到现代的超声乳化白内障手术以来，已经取得了各种进展。手术源性散光（SIA）仍然是最常见的并发症之一。无缝线透明角膜切口的引入在全球范围内越来越受欢迎，因为它比传统的缝合角膜缘切口和巩膜隧道切口具有多种优势。透明角膜切口具有无血且操作简便的优点，但SIA仍然是一个问题。
在本研究中，我们评估了颞侧入路和上方入路超声乳化透明角膜切口中的SIA。使用术前和术后屈光状态的角膜曲率读数对两种切口进行比较。
这是一项于2012年9月至2014年8月在一家农村三级护理中心对261例患者进行的基于医院的前瞻性干预性比较随机对照试验。进行了视力以及详细的眼前段和眼后段检查，并根据晶状体混浊分类系统II对白内障进行分级。患者被分为A组和B组进行超声乳化手术，分别接受颞侧和上方透明角膜入路。在术后第1天、第7天、第30天和第90天对患者进行随访。记录的参数包括未矫正视力、最佳矫正视力、裂隙灯检查和角膜曲率测量。使用配对t检验对第30天和第90天之间SIA的平均差异进行统计学评估，所有分析均使用SPSS 18.0（SPSS公司）软件进行。
A组术后第30天的平均SIA为0.998 D，90天后降至0.768 D；B组术后30天的SIA为1.651 D，90天后降至1.293 D。
就SIA而言，颞侧透明角膜切口明显优于上方透明角膜切口。
