摘要
目的根据放射状角膜切开术(RK)后患者的角膜切开瘢痕情况,选择不同尺寸透明角膜切口行超声乳化手术,评估患者术后视力及并发症发生情况。方法选取2015年12月至2018年8月有RK手术史的10名白内障患者(共16只眼)。其中7只眼为16刀放射状角膜切口愈合瘢痕,4只眼为12刀放射状角膜切口愈合瘢痕,5只眼为8刀放射状角膜切口愈合瘢痕。患者均行白内障超声乳化手术,对于16、12刀放射状角膜切口愈合瘢痕的患者选择1.8mm透明角膜切口,对于8刀放射状角膜切口愈合瘢痕患者选择3.0mm透明角膜切口。术后3个月对患者的裸眼视力、BCVA、眼压、角膜散光值及并发症发生情况进行随访。结果16只眼均未发生术中、术后角膜放射状切口裂开。术后3个月,患者的平均裸眼视力、BCVA均显著低于术前,角膜散光值高于术前(P<0.05);术后3个月,患者的眼压与术前比较,差异无统计学意义(P>0.05)。3.0mm切口患眼的术源性散光值为(0.58±0.32)D,高于1.8mm切口的(0.24±0.28)D(P<0.05)。结论对白内障患者RK术后行超声乳化手术安全有效,根据放射状角膜切口数选择不同大小透明角膜切口可防止原切口开裂,有效降低并发症发生率。
Objective To give phacoemulsification with different size transparent corneal incision according to the scar condition of corneal incision after radial keratotomy (RK), and to evaluate the visual acuity and complications of patients after surgery. Methods Ten cataract patients (16 eyes) with a history of RK surgery from December 2015 to August 2018 were selected. There were 7 eyes with 16 radial corneal incision healing scars, 4 eyes with 12 radial corneal incision healing scars, and 5 eyes with 8 radial corneal incision healing scars. All patients underwent phacoemulsification, 1.8 mm transparent corneal incision was selected for patients with 16 and 12 radial corneal incision healing scars, and 3.0 mm transparent corneal incision was selected for patients with 8 radial corneal incision healing scars. The naked eye vision, BCVA, intraocular pressure, corneal astigmatism and complications were followed up 3 months after operation. Results No radial incision dehiscence of cornea occurred in 16 eyes during and after operation. At 3 months after operation, the average naked eye vision and BCVA of the patients were significantly lower than those before operation, the corneal astigmatism was higher than that before operation (P<0.05);there was no significant difference in intraocular pressure of the patients before operation and at 3 months after operation (P>0.05);the surgically induced astigmatism of patients with 3.0 mm incision was (0.58±0.32) D, which was higher than (0.24±0.28) D of patients with 1.8 mm incision (P<0.05). Conclusion Phacoemulsification is safe and effective for cataract patients after RK. It can prevent the original incision from cracking and effectively reduce the incidence of complications by choosing different size transparent corneal incisions according to the number of radial corneal incisions.
作者
程丽娜
龙潭
马挺
王睿
CHENG Li-na;LONG Tan;MA Ting;WANG Rui(Xi'an No.1 Hospital, Xi'an 71000, China)
出处
《临床医学研究与实践》
2019年第25期26-28,共3页
Clinical Research and Practice
基金
陕西省重点研发计划项目(No.2018SF-082)
关键词
放射状角膜切开术
白内障超声乳化
透明角膜切口
术源性散光
radial keratotomy
phacoemulsification
transparent corneal incision
surgically induced astigmatism
作者简介
程丽娜(1986-),女,汉族,山西灵石人,主治医师,硕士。研究方向:白内障、青光眼疾病的诊治;通讯作者:龙潭,E-mail:longtan1@sina.com.
