目的：采用标准矢量分析法比较平板襻式复曲面人工晶状体(AT TORBI 709M)和双C襻式复曲面人工晶状体(Tecnis ZMT)对角膜散光患者术后3 mo的散光矫正效果。

方法：回顾性病例对照研究。收录2021-06/12在我院日间手术中心接受超声乳化白内障吸除联合散光矫正型人工晶状体植入术治疗的患者69例69眼，把患者按植入不同晶状体分为两组：一组植入AT TORBI 709M(AT TORBI 709M组，38例38眼)，一组植入Tecnis ZMT(Tecnis ZMT组，31例31眼)。记录眼轴长度、术前散光和轴位及人工晶状体的度数； 术前，术后1 wk，1、3 mo的裸眼远视力(UCDVA)、最佳矫正远视力(BCDVA)、屈光度、残余散光和轴位。采用标准散光矢量分析法评估术后指标，包括等效球镜度(SE)、目标散光矢量(TIA)、散光矢量(SIA)、误差的幅度(ME)、误差角度的绝对值(|AE|)、差异矢量的绝对值(|DV|)、矫正指数(CI)及成功指数(IOS)等指标。

结果：两组手术后UCDVA、BCDVA显著提高(均P<0.001)，与术前比较有差异(均P<0.001)，两组间UCDVA、BCDVA总体比较无差异(P=0.275、0.124)。矢量分析显示，两组都有较好的散光矫正能力，|DV|和IOS均接近0(P=0.329、0.288)； AT TORBI 709M组的CI更接近1，更接近预期的矫正散光，Tecnis ZMT组CI>1，散光过矫，两组比较无差异(P=0.193)。术后3 mo，AT TORBI 709M组、Tecnis ZMT组残余散光分别为-0.11±0.91、-0.46±0.76 D，两组无差异(t=1.732，P=0.088)。

结论：平板襻式和双C襻式复曲面人工晶状体都可显著提高规则性角膜散光患者的术后视力，具有良好的旋转稳定性，对顺规、逆规散光矫正能力相当。

METHODS: This was a retrospective case-control study. The clinical data of 69 patients(69 eyes)with corneal astigmatism who underwent phacoemulsification and implantation of toric intraocular lens(IOL)from June 2021 to December 2021 in Day Surgery Center of Xi'an No.1 Hospital was analyzed. The patients were divided into two groups. In group one, 38 cases(38 eyes)were implanted with AT TORBI 709M, and 31 patients(31 eyes)with Tecnis ZMT in group two. The axial length, preoperative astigmatism and axis, and the degree of intraocular lens were recorded. The uncorrected distance visual acuity(UCDVA), best corrected distance visual acuity(BCDVA), diopter, residual astigmatism and axis were recorded preoperatively and at 1 wk, 1 and 3 mo postoperatively. The postoperative surgical indicators, including spherical equivalent(SE), target induced astigmatism vector(TIA), surgically induced astigmatism vector(SIA), magnitude of error(ME), absolute value of angle of error(|AE|), absolute value of difference vector(|DV|), correction index(CI), and index of success(IOS)were evaluated by the standard astigmatism vector analysis.

RESULTS:Postoperative UCDVA and BCDVA were significantly improved(all P<0.001), and there were statistically significant differences compared to preoperative UCDVA and BCDVA(all P<0.001). While, there was no significant difference in UCDVA and BCDVA between the two groups(P=0.275, 0.124). The standard astigmatism vector analysis showed that a good astigmatism correction was achieved in both AT TORBI 709M group and Tecnis ZMT group, and both |DV| and IOS were close to 0(P=0.329, 0.288). The CI of the AT TORBI 709M group was closer to 1, indicating a better astigmatism correction, while the CI of the Tecnis ZMT group was higher than 1, suggesting an overcorrection of astigmatism. However, the difference between the two groups was not statistically significant(P=0.193). The mean residual astigmatism at 3 mo postoperatively was -0.11±0.91 D in the AT TORBI 709M group and -0.46±0.76 D in the Tecnis ZMT group, respectively, showing no statistically significance difference(t=1.732, P=0.088).

CONCLUSION:Both the flat loop AT TORBI 709M and the double C-loop Tecnis ZMT intraocular lenses can effectively improve postoperative visual acuity in patients with regular corneal astigmatism, showing good rotational stability and comparable correction abilities for both astigmatism with the rule and against-the-rule astigmatism.