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目的探讨2种长度切口对手法小切口白内障摘除联合人工晶状体植入术(manual small incisioncataract surgery with intra-ocular lens implantation,MSICS+IOL)后角膜地形图的影响。方法将拟行MSICS+IOL的患者89例89只眼(核硬度Ⅳ~Ⅴ级)分为2组,A组45只眼核硬度Ⅳ级,B组44只眼核硬度Ⅴ级,分别行5.5 mm、6.5 mm巩膜隧道切口的MSICS+IOL,用角膜地形图仪观察手术前、手术后1周及1个月时的角膜形态变化。结果术后1周及1个月时,B组角膜表面散光值(cylinder,CYL)、平均角膜曲率(average cornealpower,ACP)值均大于A组,差异有统计学意义(P<0.05);术后1周,B组角膜表面非对称指数(surface asym-metry index,SAI)较A组增加,差异有统计学意义(P<0.05),术后1个月时则与A组大致相同(P>0.05);2组术后1周、1个月的角膜表面规则指数(surface regularity index,SRI)差异无统计学意义(P>0.05)。结论切口长度为5.5 mm的MSICS+IOL手术较6.5 mm对术后早期角膜散光影响小;切口长度为5.5 mm的MSICS+IOL手术和6.5 mm长度切口者对术后早期角膜的规则性影响相似。
Objective To explore the effect of two kinds of incision on the corneal topography after manual small incision cataract surgery with intra-ocular lens implantation (MSICS + IOL). Methods Eighty-nine eyes (hardness grade Ⅳ ~ Ⅴ) of 89 patients who underwent MSICS + IOL were divided into two groups. 45 eyes of group A had grade ¢ ñ of grade ¢ ó, 44 eyes of group B ¢ ñ of grade ¢ ñ 5.5 mm, 6.5 mm scleral tunnel incision MSICS + IOL, corneal topography instrument before surgery, 1 week after surgery and 1 month after the corneal morphological changes. Results The values of cylinder (CYL) and average corneal power (ACP) in group B were significantly higher than those in group A at 1 week and 1 month after operation (P <0.05) After 1 week, the surface asym-metry index (SAI) in group B was significantly higher than that in group A (P <0.05), and was similar to group A at 1 month > 0.05). There was no significant difference in the surface regularity index (SRI) between the two groups at 1 week and 1 month after operation (P> 0.05). Conclusions MSIMS + IOL with an incision length of 5.5 mm has less effect on early postoperative corneal astigmatism than a 6.5 mm incision. MSICS + IOL and 6.5 mm incision length 5.5 mm have similar regular effects on early postoperative cornea.