白内障术中Toric人工晶状体植入矫正散光的长期临床疗效
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上海市卫生局课题基金项目(No.2008-161); 上海市静安区十百千学科带头人基金项目(No.2010020103)


Long-term efficacy of implantation of AcrySof Toric intraocular lens on corneal astigmatism in cataract surgery
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Foundation of Health Science Research of the Health Bureau of Shanghai, China(No. 2008-161); Foundation of Shi-Bai-Qian Plans of Jing'an District Health Bureau of Shanghai, China(No.2010020103)

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    摘要:

    目的:评价术前伴有较大角膜散光的白内障患者白内障超声乳化后植入AcrySof Toric IOL后的屈光效果及囊袋内的旋转稳定性。

    方法:收集确诊为年龄相关性白内障并伴有角膜规则散光≥1.00D的患者28例32眼,采用白内障超声乳化、植入AcrySof Toric IOL手术。观察并比较术前、术后1a裸眼视力(UCVA)及最佳矫正视力(BCVA)、术前角膜散光、预计残余散光及术后1a残余散光、IOL旋转度。

    结果:术后1a,85%患眼UCVA≥0.5,86%患眼BCVA≥0.8,BCVA≥0.6者达92%。相较术前角膜散光(2.20 ±0.65D),术后1a残余散光(0.54±0.13D)明显减少,两者差异有统计学意义(t=10.134,P<0.01); 术前预计残余散光0.52±0.14D,术后1a残余散光为0.54±0.13D,两者差异无统计学意义(t=0.364,P>0.05)。术后6mo晶状体旋转平均为3.4°±2.2°。术后1a晶状体旋转平均为3.82°±1.27°。

    结论:AcrySof Toric IOL植入术是一种矫正角膜规则散光的有效的、可预测性好、角膜损伤小、无角膜损伤的方法。谨慎的选择患者,准确的角膜曲率的测量和IOL轴位的精确调整是影响其屈光效果和旋转稳定性的因素。

    Abstract:

    AIM: To evaluate the clinical outcome of correction of corneal astigmatism and rotational stability of implantation of the AcrySof Toric intraocular lens(IOL)in cataract surgery.

    METHODS: Twenty-eight patients(thirty-two eyes)with more than 1.0 diopter(D)of preexisting astigmatism underwent similar phacoemulsification combined with AcrySof toric IOL implantation. The uncorrected visual acuity(UCVA), best-corrected visual acuity(BCVA), preoperative corneal astigmatism, anticipated residual astigmatism, postoperative residual astigmatism and toric lens axis were detected and compared.

    RESULTS: At 1 year following surgery, 85% of eyes showed the 0.5 or better in UCVA; 86% of eyes was 0.8 or better in BCVA and 92% of eyes achieved 0.6 or better in BCVA. The mean preoperative corneal astigmatism was(2.20 ±0.65)D and the postoperative residual astigmatism was(0.54±0.13)D, indicating a significant decrease in refractive cylinder after surgery(t=10.134, P<0.01). Preoperative predictive astigmatism(0.52±0.14)D and postoperative residual astigmatism(0.54±0.13)D showed no significant difference(t=0.364, P>0.05). After postoperative 6 month, the mean rotation of toric IOLs was 3.4°±2.2°, and after postoperative 1 year it was 3.82°±1.27°.

    CONCLUSION:AcrySof Toric IOL implantation is a viable and highly predictable method of correcting the corneal astigmatism, with no injury of the cornea. Careful selection of the patient, accurate keratometry and precise alignment of the cylindrical axes are some of the factors to be considered for a superior outcome.

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兰文,黄振平,侯培丽,等.白内障术中Toric人工晶状体植入矫正散光的长期临床疗效.国际眼科杂志, 2012,12(12):2384-2386.

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  • 收稿日期:2012-08-07
  • 最后修改日期:2012-11-21
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