Martin R G, Sanders D R, Miller J D, Cox C C, Ballew C
Medical Care International Ophthalmic Research and Training Institute, Southern Pines, North Carolina 28387.
J Cataract Refract Surg. 1993;19 Suppl:170-7. doi: 10.1016/s0886-3350(13)80402-6.
A randomized prospective trial compared keratometric and visual outcomes for 196 patients receiving 3.2 mm, 5.0 mm, or 6.0 mm incisions for cataract removal and intraocular lens implantation. There were no statistically significant differences among the groups preoperatively or at one to two days or three to six months postoperatively in mean keratometric cylinder, no differences postoperatively in surgically induced cylinder, and no differences in best-corrected visual acuity. Significantly more (P < .01) 3.2 mm cases (75%) had uncorrected visual acuity of 20/40 or better at one to two days postoperatively than 5.0 mm (50%) or 6.0 mm cases (47%). Computer-assisted corneal topographic images were available for the last 56 patients enrolled. Patients receiving 3.2 mm incisions had significantly less wound-related flattening than other patients (P < .05) and tended to have fewer surgically induced changes in corneal shape overall. Changes identified by corneal topography were inconsistent with keratometrically assessed cylinder in 14 patients.
一项随机前瞻性试验比较了196例接受3.2毫米、5.0毫米或6.0毫米切口进行白内障摘除和人工晶状体植入术患者的角膜曲率测量结果和视觉效果。术前、术后1至2天或3至6个月，各组间平均角膜曲率柱镜度数无统计学显著差异，术后手术源性柱镜度数无差异，最佳矫正视力也无差异。术后1至2天，3.2毫米切口组（75%）未矫正视力达到20/40或更好的患者显著多于5.0毫米切口组（50%）和6.0毫米切口组（47%）（P <.01）。对最后纳入的56例患者获取了计算机辅助角膜地形图图像。接受3.2毫米切口的患者与其他患者相比，与伤口相关的角膜扁平化显著更少（P <.05），总体上角膜形状的手术源性改变也往往更少。角膜地形图识别出的改变与14例患者角膜曲率测量评估的柱镜度数不一致。
