Müller-Jensen K, Buchholz A, Barlinn B
Städtisches Klinikum, Augenklinik, Karlsruhe, Germany.
J Refract Surg. 1998 Jul-Aug;14(4):455-9. doi: 10.3928/1081-597X-19980701-12.
To assess long-term corneal stability of self-sealing clear corneal stretch incisions with implantation of 5 mm polymethylmethacrylate (PMMA) intraocular lenses.
Two hundred consecutive eyes of 3500 cataract patients who had capsulorhexis, phacoemulsification, and preparation of a 1.5 to 2.0 mm corneal tunnel that had an external width of 4.0 to 4.1 mm and an internal width of 6.5 to 7.0 mm (stretch incision), and implantation of a 5 mm PMMA intraocular lens were evaluated clinically and statistically. Slit-lamp microscopy, keratometry, and corneal topography were performed preoperatively and postoperatively after 1 week, 1, 2, and 3 years.
The mean surgically induced astigmatism following superior corneal incision amounted to 1.59 +/- 1.06 D after 3 years; following lateral corneal incision, mean surgically induced astigmatism was 0.84 +/- 0.68 D. There were no corneal complications in the long-term follow-up study.
Our 5-year experience shows that the self-sealing clear corneal stretch incision in connection with implantation of a 5 mm polymethylmethacrylate intraocular lens induces approximately 1.00 D of astigmatism. We prefer the lateral incision and recommend the superior incision only for high preoperative with-the-rule astigmatism.
评估植入5毫米聚甲基丙烯酸甲酯（PMMA）人工晶状体的自密封透明角膜拉伸切口的长期角膜稳定性。
对3500例白内障患者的200只连续眼进行了临床和统计学评估，这些患者接受了撕囊、超声乳化，并制备了一个1.5至2.0毫米的角膜隧道，其外部宽度为4.0至4.1毫米，内部宽度为6.5至7.0毫米（拉伸切口），并植入了5毫米的PMMA人工晶状体。术前以及术后1周、1年、2年和3年进行裂隙灯显微镜检查、角膜曲率测量和角膜地形图检查。
3年后，上方角膜切口术后平均手术性散光为1.59±1.06 D；外侧角膜切口术后，平均手术性散光为0.84±0.68 D。长期随访研究中未出现角膜并发症。
我们5年的经验表明，与植入5毫米聚甲基丙烯酸甲酯人工晶状体相关的自密封透明角膜拉伸切口会引起约1.00 D的散光。我们更倾向于外侧切口，仅在术前有高度顺规散光时推荐上方切口。
