Hayashi Eye Hospital, Fukuoka, Japan
Hayashi Eye Hospital, Fukuoka, Japan.
Br J Ophthalmol. 2019 Feb;103(2):181-185. doi: 10.1136/bjophthalmol-2017-311710. Epub 2018 May 18.
To compare changes in the shape and astigmatism of the total and posterior cornea between eyes with a nasal clear corneal incision (CCI) and eyes with a temporal CCI in cataract surgery.
The left eyes of 100 patients undergoing phacoemulsification were randomly assigned to undergo a 2.4 mm nasal (nasal CCI group) or temporal CCI (temporal CCI group). Corneal astigmatic changes were compared between groups using power vector analysis, and corneal shape changes were compared using videokeratography maps at 2 days, and at 2, 4 and 8 weeks postoperatively.
The mean J and J values of the total cornea were significantly greater in the nasal CCI group than in the temporal CCI group at 2 and 4 weeks postoperatively (p≤0.0392), but did not differ significantly between groups at 2 days and 8 weeks. The videokeratography maps revealed a wedge-shaped flattening in the total cornea and a steepening in the posterior cornea around the CCIs in both groups at 2 days postoperatively; those were more prominent in the nasal CCI group than in the temporal CCI group. The wound-related changes diminished by 8 weeks postoperatively in the total and posterior cornea, and were not markedly different between groups at 8 weeks postoperatively.
Corneal shape and astigmatic changes were comparable between groups at 8 weeks postoperatively, although the changes were greater after nasal CCI than after temporal CCI in the early postoperative periods, indicating that nasal or temporal CCI can be selected based on the surgeon's preference.
比较白内障手术中鼻侧透明角膜切口（CCI）与颞侧 CCI 对总角膜和后角膜形态及散光的影响。
将 100 例行白内障超声乳化术的患者的左眼随机分为行 2.4mm 鼻侧（鼻侧 CCI 组）或颞侧 CCI（颞侧 CCI 组）。术后 2 天、2、4 和 8 周时，采用矢量分析比较两组的角膜散光变化，应用角膜地形图比较两组的角膜形态变化。
术后 2 周和 4 周时，鼻侧 CCI 组总角膜的 J 和 J 值均明显大于颞侧 CCI 组（p≤0.0392），但两组在术后 2 天和 8 周时无显著差异。术后 2 天，两组角膜地形图均显示全角膜呈楔形变平，CCI 周围后角膜变陡；鼻侧 CCI 组比颞侧 CCI 组更明显。术后 8 周时，总角膜和后角膜的伤口相关变化均减轻，且术后 8 周时两组间无明显差异。
尽管术后早期鼻侧 CCI 比颞侧 CCI 引起的变化更大，但术后 8 周时两组的角膜形态和散光变化无显著差异，表明可以根据术者的喜好选择鼻侧或颞侧 CCI。
