Hayashi K, Hayashi H, Nakao F, Hayashi F
Hayashi Eye Hospital, Fukuoka, Japan.
Ophthalmology. 1995 Apr;102(4):550-6. doi: 10.1016/s0161-6420(95)30983-9.
To examine the correlation between incision size and corneal shape changes in sutureless surgery using corneal topography.
Two hundred eyes undergoing sutureless cataract surgery were assigned randomly to three groups according to the incision size: group A, 3.2-mm incision; group B, 4.0-mm incision; and group C, 5.0-mm incision. All eyes were examined by corneal topography preoperatively as well as at 1 week and at 1, 3, and 6 months after surgery.
In the average of difference maps of eyes in the 3.2-mm incision group, a wound-related flattening in the peripheral cornea occurred 1 week after surgery, but decreased rapidly thereafter. Subsequently, no significant changes were observed in the cornea after 1 month. In the 4.0-mm incision group, with a reduction of the wound-related peripheral flattening, an irregular steepening appeared in the lower central cornea 6 months after surgery. In the 5.0-mm incision group, a similar steepening in the lower cornea occurred just after surgery. This steepening persisted and even extended to the upper central cornea in its later postoperative periods.
The 3.2-mm incision hardly produced any irreversible corneal shape changes, whereas both the 4.0- and 5.0-mm incisions caused a persistent irregular steepening in the central cornea.
利用角膜地形图检查无缝线手术中切口大小与角膜形态变化之间的相关性。
200例行无缝线白内障手术的眼睛根据切口大小随机分为三组：A组，3.2毫米切口；B组，4.0毫米切口；C组，5.0毫米切口。所有眼睛在术前以及术后1周、1个月、3个月和6个月时均通过角膜地形图进行检查。
在3.2毫米切口组眼睛的平均差异图中，术后1周周边角膜出现与伤口相关的扁平，但此后迅速减轻。随后，1个月后角膜未观察到明显变化。在4.0毫米切口组，随着与伤口相关的周边扁平减轻，术后6个月下角膜中央出现不规则陡峭。在5.0毫米切口组，术后即刻下角膜出现类似陡峭。这种陡峭持续存在，甚至在术后后期扩展到上角膜中央。
3.2毫米切口几乎不会产生任何不可逆的角膜形态变化，而4.0毫米和5.0毫米切口均会导致中央角膜持续出现不规则陡峭。
