摘要
目的:探讨高度近视性白内障和正常白内障患者行白内障囊外摘除术(ECCE)或超声乳化术(Phaco)联合人工晶体植入手术前后角膜曲率的变化。方法:选取2018年4月~2019年4月在弋矶山医院眼科行手术治疗的白内障患者120例(120眼),根据手术类型分为ECCE组和Phaco组,再根据患眼是否合并高度近视进一步分为ECCE高近组、ECCE非高近组和Phaco高近组、Phaco非高近组。所有患者分别于术前、术后1个月测量角膜前后表面各方位曲率及最佳矫正视力(BCVA)。结果:高度近视性白内障患者术后BCVA差于非高度近视白内障患者(P<0.05);ECCE高近组和ECCE非高近组手术前后在前表面颞上曲率变化值比较差异有统计学意义(P<0.05),两组手术前后的前、后表面散光变化值比较差异均无统计学意义(P>0.05);ECCE高近组和Phaco高近组手术前后角膜后表面散光类型比较差异有统计学意义(P<0.05);Phaco高近组和Phaco非高近组手术前后的前表面鼻上、颞下方及后表面中心曲率变化值比较差异有统计学意义(P<0.05),两组间手术前后的前、后表面散光变化值比较差异均无统计学意义(P>0.05)。结论:高度近视性白内障患者与正常白内障患者相比术后初期视力差,合并高度近视影响ECCE手术前后前表面颞上方曲率变化,影响Phaco术后前表面鼻上、颞下方及后表面中心曲率变化,改变白内障术后角膜后表面散光类型;白内障手术会增加角膜前、后表面散光,但较少影响角膜前表面散光类型。
Objective:To observe the changes of corneal curvature in high myopic patients with cataract and in patients with simple cataract before and after extracapsular cataract extraction(ECCE)or phacoemulsification(Phaco)combined with intraocular lens implantation(IOL).Methods:A total of 120(120 eyes)undergone cataract removal in the ophthalmology department of our hospital were included from April of 2018 to 2019,and allocated to ECCE group and Phaco group by treatment modality.Then the patients were sub-grouped into ECCE for high or non-high myopia,Phaco for high or non-high myopia by the affected eyes.Anterior and posterior corneal curvatures were maintained before surgery,and corneal curvature change and best corrected visual acuity(BCVA)were measured one month following treatment.Results:High myopic patients with cataract had poorer BCVA than those with simple cataract following surgery(P<0.05).The changes of supratemporal curvature at anterior surface were significant between ECCE high-myopia group and ECCE non-high-myopia group before and after surgery(P<0.05),yet the difference was insignificant in the changes of astigmatism at anterior and posterior surface between the two groups(P>0.05).High myopic patients treated with ECCE were different from those treated with Phaco in types of astigmatism at the posterior surface before and following operation(P<0.05).Patients of high myopia were different from those with non-high myopia managed by Phaco regarding supranasal and subtemporal curvature at anterior surface as well as center curvature at posterior surface(P<0.05),yet the difference was not significant in changes of astigmatism at anterior and posterior surface between the two groups before and after operation(P>0.05).Conclusion:Poorer BCVA was seen in high myopic patients with cataract and in patients with simple cataract in the initial stage following surgery.Cataract concomitant with high myopia may affect supratemporal curvature at anterior surface before and after ECCE as well as the changes of supranasal and subtemporal curvature at anterior surface and center curvature at posterior surface after Phaco,and types of astigmatism at posterior surface following removal of the cataract.In addition,removing cataract may worsen astigmatism at the anterior and posterior surface after surgery,yet produce no effect on the type of astigmatism at corneal anterior surface.
作者
胡凌飞
刘银萍
梅立新
吴昌凡
HU Lingfei;LIU Yinping;MEI Lixin;WU Changfan(Department of Ophthalmology,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001,China)
出处
《皖南医学院学报》
CAS
2020年第2期153-157,共5页
Journal of Wannan Medical College
基金
国家自然科学基金项目(81700867)。
关键词
高度近视
白内障
角膜曲率
散光
high myopia
cataract
corneal curvature
astigmatism
作者简介
胡凌飞(1983-),女,主治医师,电话:15255381575,电子信箱:hlf19831120@yeah.net;通信作者:吴昌凡,男,主任医师,副教授,硕士生导师,电子信箱:wucangfan@sina.com。
