Corneal aberrations before and after small-incision cataract surgery
Corneal aberrations before and after small-incision cataract surgery
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DOI：
10.1167/iovs.04-0693
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发表时间：
2004-12-01
影响因子：
4.4
通讯作者：
Artal, P
中科院分区：
文献类型：
--
作者：
Guirao, A;Tejedor, J;Artal, P
目的.目的探讨小切口白内障手术对角膜光学像差的影响。本文对70例70眼白内障手术前后的角膜地形图进行了测量。超声乳化后，通过透明角膜，3.5 mm切口植入单焦点折叠式IOL，无需缝合。角膜像差，直到第五阶和6毫米瞳孔，计算光线跟踪从角膜地形图。比较每例患者术前和术后像差，并研究手术引起的光学变化。术后平均波像差的均方根略有增加（术前，0.65+/-0.46 mum;术后，0.85+/-0.63 mum）。手术前后，70名患者的平均值显示，大多数畸变项相似（球面像差：前，0.32+/-0.12 μ m，后，0.34+/-0.19 μ m;散光：前，0.9+/-0.8 D，后，1.1+/-1.0 D;彗差：前，0.27+/-0.18 μ m，后，0.32+/-0.33 μ m）。然而，在每例患者中，术后像差的幅度（增加或减少）和/或方向发生变化。手术子午线方向的平均诱导散光为-1.0+/-0.9 D。诱导的三叶草也在这个方向上表现出主导模式。鼻切口患者的变化较大。小切口手术不会系统地降低角膜前表面的光学质量。然而，它引入了一些像差的变化，特别是在非旋转对称方面，如散光，彗差和三叶草。切口部位对术后角膜的变化起主要作用。
Purpose. To study the effect of small-incision cataract surgery on the optical aberrations of the cornea.Methods. Corneal topography was measured before and after cataract surgery on 70 eyes of 70 patients. Monofocal foldable IOLs were implanted after phacoemulsification through a clear-cornea, 3.5-mm incision without suture. Corneal aberrations, up to the fifth order and 6-mm pupil, were calculated by ray-tracing from the corneal topography. Pre- and postoperative aberrations were compared in each patient and the optical changes induced by surgery investigated.Results. The root mean square of the wave aberration slightly increased on average after surgery (pre, 0.65+/-0.46 mum; post, 0.85+/-0.63 mum). Most aberration terms were similar, averaged across the 70 patients, before and after surgery (spherical aberration: pre, 0.32+/-0.12 mum, and post, 0.34+/-0.19 mum; astigmatism: pre, 0.9+/-0.8 D, and post, 1.1+/-1.0 D; coma: pre, 0.27+/-0.18 mum, and post, 0.32+/-0.33 mum). However, in each patient, there were changes after surgery in the magnitude (either increasing or decreasing) and/or orientation of aberrations. The mean induced astigmatism was -1.0+/-0.9 D at the orientation of the surgical meridian. Induced trefoil also showed a predominant pattern at this direction. Patients with nasal incisions experienced larger changes.Conclusions. Small-incision surgery does not systematically degrade the optical quality of the anterior corneal surface. However, it introduces changes in some aberrations, especially in nonrotationally symmetric terms such as astigmatism, coma, and trefoil. The incision site plays a main role in the corneal changes after surgery.