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3.0毫米斜角和铰链式透明角膜切口术后角膜地形图变化的比较研究

Comparative study of corneal topographic changes after 3.0 mm beveled and hinged clear corneal incisions.

作者信息

Vass C, Menapace R, Rainer G, Findl O, Steineck I

机构信息

University of Vienna, Department of Ophthalmology, Austria.

出版信息

J Cataract Refract Surg. 1998 Nov;24(11):1498-504. doi: 10.1016/s0886-3350(98)80173-9.

Abstract

PURPOSE

To compare the corneal topographic changes after cataract surgery using 2 types of clear corneal incisions (CCIs).

SETTING

Department of Ophthalmology, University of Vienna, Austria.

METHODS

This prospective, unmasked, nonrandomized study comprised 64 eyes scheduled for cataract surgery; 29 eyes received a temporal sutureless 3.0 mm corneal beveled CCI and 35 eyes, a temporal sutureless 3.0 mm hinged CCI. Preoperatively and 1 week, 1 and 3 months, and 1 year postoperatively, corneal topography was recorded by computer-assisted videokeratoscopy (TMS-1, Computed Anatomy, Inc.). Data were evaluated by batch-by-batch analyses of the paired differences between these records. The significance of topographic changes was calculated by paired Wilcoxon tests, and group comparisons were made using Wilcoxon tests.

RESULTS

In both groups, there was statistically significant horizontal flattening and lower corneal steepening (P < .01). The horizontal flattening decreased between 1 week and 1 year, from -0.6 to -0.3 diopter (D) in the beveled-incision group and -0.7 to -0.4 D in the hinged-incision group. Vertical steepening was significant in the lower corneal region and decreased between 1 week and 1 year, from 0.3 to 0.2 D. Group comparisons revealed significant differences in an oblique lower temporal semimeridian, with 0.1 to 0.3 D more steepening after the hinged incision than after the beveled incision (P < .05).

CONCLUSION

There were only minimal differences between beveled and hinged CCIs in surgically induced corneal shape changes.

摘要

目的

比较使用两种透明角膜切口(CCI)进行白内障手术后的角膜地形图变化。

设置

奥地利维也纳大学眼科。

方法

这项前瞻性、非盲、非随机研究纳入了64只计划进行白内障手术的眼睛;29只眼睛接受了颞侧无缝线3.0 mm角膜斜切CCI,35只眼睛接受了颞侧无缝线3.0 mm铰链式CCI。术前以及术后1周、1个月、3个月和1年,通过计算机辅助视频角膜镜检查(TMS-1,Computed Anatomy公司)记录角膜地形图。通过对这些记录之间的配对差异进行逐批分析来评估数据。通过配对威尔科克森检验计算地形变化的显著性,并使用威尔科克森检验进行组间比较。

结果

在两组中,均有统计学上显著的水平变平和角膜变陡程度降低(P <.01)。水平变平在1周和1年之间有所减轻,斜切切口组从-0.6屈光度(D)降至-0.3 D,铰链式切口组从-0.7 D降至-0.4 D。垂直变陡在角膜下部区域显著,并在1周和1年之间从0.3 D降至0.2 D。组间比较显示,在颞下斜半子午线存在显著差异,铰链式切口后比斜切切口后的变陡程度多0.1至0.3 D(P <.05)。

结论

斜切和铰链式CCI在手术引起的角膜形状变化方面仅有极小差异。

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