Müller-Jensen K, Schüler M
Augenklinik des Städtischen Klinikums, Karlsruhe.
Klin Monbl Augenheilkd. 1998 Jun;212(6):428-32.
Refractive cataract surgery using corneal incisions is aiming at neutralization of preoperative astigmatism.
61 patients with preoperative astigmatism of 2.25 +/- 0.98 were included in the treatment. A self-sealing corneal tunnel incision measuring 4.0 to 4.1 mm in external diameter and 6.5 to 7.0 mm in internal diameter (stretch incision) was performed on the steeper axis. After capsulorhexis and phacoemulsification a 5 mm PMMA lens was implanted without suturing. Keratometry and corneal topography were performed preoperatively, 3 days and 1 year respectively following surgery. The statistical analysis was based on the Wilcoxon signed ranks test.
Surgical induced astigmatism (IA) following superior incisions in cases of astigmatism with the rule (n = 29) amounted to 1.93 +/- 0.97, while lateral incisions in cases of astigmatism against the rule (n = 29) led to an IA of 1.35 +/- 0.73. Axial shifts by more than 30 degrees were 23% following superior incisions and 17%, after lateral incisions. We observed. astigmatic reduction of 1.3 D after superior incisions and 0.7 D following lateral incisions.
By 4 mm corneal cataract incisions on the steeper axis a high preoperative astigmatism can be reduced significantly without additional keratotomies.
采用角膜切口的屈光性白内障手术旨在中和术前散光。
纳入61例术前散光为2.25±0.98的患者进行治疗。在较陡轴线上做一个外径4.0至4.1毫米、内径6.5至7.0毫米的自闭式角膜隧道切口（伸展切口）。连续环形撕囊和超声乳化术后，植入一枚5毫米的聚甲基丙烯酸甲酯（PMMA）人工晶状体，无需缝合。分别于术前、术后3天和1年进行角膜曲率测量和角膜地形图检查。统计分析采用Wilcoxon符号秩检验。
顺规散光（n = 29）患者采用上方切口后的手术源性散光（IA）为1.93±0.97，逆规散光（n = 29）患者采用侧方切口后的IA为1.35±0.73。上方切口后轴向移位超过30度的比例为23%，侧方切口后为17%。我们观察到，上方切口后散光降低1.3 D，侧方切口后降低0.7 D。
通过在较陡轴线上做4毫米的角膜白内障切口，可显著降低高度术前散光，无需额外的角膜切开术。
