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对人工晶体植入术和穿透性角膜移植术后一年以上 ,存在中高度散光的患者行松解性弧形角膜切开术 ,观察其临床疗效。方法 :10例 (10眼 ) ,其中人工晶体植入术 4例 ,穿透性角膜移植术 5例 ,人工晶体、穿透性角膜移植联合术 1例 ,均术后一年以上 ,3mm视区内的角膜散光≥ 2 .0 0 D,近视≤ 2 .0 0 D,患者的裸眼视力均可矫正。根据角膜地形图确定角膜最高屈折力的径线位置。用 6 .5 mm环钻在角膜中央刻痕 ,在显微镜下用德国 Martin Instrument单刃红宝石刀在屈折力最大的径线上 ,沿环钻的刻痕作一对弧形切口 ,深度为角膜厚度的 1/ 2～ 2 / 3,切口长度为 2～ 3个钟点。结果 :通过角膜地形图和检影验光发现 :术前 3mm视区的平均角膜散光为 3.46± 0 .99D,术后 6个月为 2 .0 5± 0 .75 D,统计学检验有显著性差异 P<0 .0 1;术前 10例患者的裸眼视力为 4.0 5± 0 .12 ,术后 6个月的视力明显提高为 4.45± 0 .11。结论 :本文对手术适应证、技术、角膜散光变化和并发症进行讨论 ,从而证实弧形角膜切开术是一项简单安全、能快速提高视力的方法
For patients who underwent artificial lens implantation and penetrating keratoplasty for more than one year, patients with moderate to high astigmatism underwent radiographic corneal incision and were observed for clinical efficacy. Methods: 10 cases (10 eyes), including 4 cases of intraocular lens implantation, 5 cases of penetrating keratoplasty, 1 case of intraocular lens and penetrating keratoplasty combined with surgery, more than one year after operation, 3mm visual field Corneal astigmatism within ≥ 2.00 D, myopia ≤ 2. 0 D, the naked eye vision can be corrected. According to the corneal topographic map to determine the maximum refractive power of the corneal diameter position. With 6.5 mm ring drilling in the central incision, under the microscope with the German Martin Instrument single-edged ruby knife on the largest diameter of the folding line, along the perforation of a pair of arc incision at a depth of corneal thickness Of 1/2 ~ 2/3, incision length of 2 to 3 hours. Results: The corneal topography and retinoscopy showed that the average corneal astigmatism before operation was 3.46 ± 0.99D at 3mm and 2.05 ± 0.75D at 6 months after operation. The statistical test was significant The difference was P <0.01; the uncorrected visual acuity of 10 patients before surgery was 4.05 ± 0.12, and the visual acuity of 6 months after operation was significantly increased to 4.45 ± 0.11. CONCLUSIONS: This article discusses surgical indications, techniques, changes in corneal astigmatism, and complications to demonstrate that arc-shaped keratotomy is a simple and safe method of rapidly improving vision