南方医科大学学报 ›› 2015, Vol. 35 ›› Issue (07): 1043-.

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放射状角膜切开术术后白内障手术及人工晶状体度数选择

李宇,刘娅利,陈豫川,李满,龙璐   

  • 出版日期:2015-07-20 发布日期:2015-07-20

Cataract surgery and intraocular lens power calculation after radial keratotomy: analysis of 8 cases

  • Online:2015-07-20 Published:2015-07-20

摘要: 目的探讨放射状角膜切开术(RK)术后白内障手术的诊治特点及人工晶状体度数选择的可靠性。方法回顾性分析我院2010
年3月~2013年6月RK术后的白内障患者8例(12只眼),术前对白内障患者的视力、角膜曲率及眼轴长度进行检查,比较患者用
TOPCON-KR8800型自动角膜曲率计测量的3组角膜中央2.6 mm的角膜曲率值,选择较为低的K数值,选用经SRK T三元回归公
式自动计算的近正视化(-1.00D~-2.00D)的人工晶状体(后房型折叠人工晶状体),行白内障超声乳化摘除联合人工晶状体植入术,
术后3月随访患者的视力、屈光状态。结果RK术后白内障患者行人工晶状体植入的12只眼术后视力均较术前提高:其中6只眼裸
眼视力达到0.8~1.0,另外6只眼裸眼视力达到0.4~0.6+,矫正视力0.6~1.0;术后屈光状态:6只眼接近正视(+0.75D~-1.00D),另外6
只眼的屈光度为-1.00D~-2.50D,通过术后配镜,患者均能接受。结论对RK术后的白内障患者,施行白内障超声乳化吸出术+人工
晶状体植入术是可行的;比较患者的3组自动角膜曲率计测量的角膜中央2.6 mm的角膜曲率值,选择较为低的K数值,使用SRK T
公式计算人工晶状体的度数,预留-1.00~-2.00D的近视较为安全,避免>+3.00D的远视出现,也较为患者接受。

Abstract: Objective To explore the clinical characteristics of cataract surgery after radial keratotomy (RK) and appropriate
calculation of intraocular lens (IOL) power. Methods Eight patients with cataract (12 eyes) after RK were treated in our
hospital from March, 2010 to June, 2013. The visual acuity, keratometric power and length of the ocular axis were examined
before the operation. For each patient, 3 groups of corneal curvature values were measured using a automatic keratometer
(TOPCON-KR8800) and the minimal K value was selected. Myopic or hyperopic posterior chamber IOL (-1.00 to -2.00 D) were
selected based on automatic calculations with SRK-T. Phacoemulsification and IOL implantation were then performed, and the
patients were followed up for visual acuity and refractive statuses at 3 months after the operation. Results All the 12 operated
eyes showed improved visual acuity after the operation. The uncorrected visual acuity reached 0.8 to 1.0 in 6 eyes and 0.4 to
0.6 + in the other 6, with a corrected visual acuity ranging from 0.6 to 1.0. The refractive status after operations was nearly
emmetropic (+0.75 to -1.00 D) in 6 eyes and myopic in the other 6 (-1.00 to -2.50 D). Conclusions Phacoemulsification and IOL
implantation is feasible in cataract patients with previous RK. Selecting the minimal K values for central corneal curvature and
calculation of the IOL power using the SRK T equation with a reservation of -1.00 to -2.00 D can better ensure the safety of the
procedure and avoid the occurrence of hyperopia >+3.00D.