目的:对比评估白内障术中植入AcrySof Toric人工晶状体及植入球面人工晶状体联合角膜缘松解术在矫正角膜散光的术后效果。方法:选取2008-03/2009-03于我院白内障治疗中心行白内障手术患者共53例60眼,所有患者均合并有规则性角膜散光,且散光大于1D。根据手术方式的不同,将受试对象分成两组,其中单纯行超声乳化白内障摘除联合AcrySof Toric人工晶状体植入组有26例30眼(其中老年性白内障24例27眼,并发性白内障2例3眼),而行球面人工晶状体植入联合角膜缘松解术组27例30眼(其中老年性白内障24例27眼,并发性白内障3例3眼)。两组受试对象均在白内障术前及白内障术后第1d;1wk及3mo测量裸眼视力、最佳矫正视力,电脑验光及主觉验光并记录球镜度数,柱镜度数及散光轴向等数据,然后进行统计分析并观察AcrySof Toric人工晶状体晶状体囊袋内稳定性。结果:随访6mo,AcrySof Toric组:裸眼视力超过0.5的占93%,超过0.8的占67%。角膜缘松解术组:裸眼视力超过0.5的占73%,超过0.8的占50%。术前验光与术后3mo验光结果比较得,两组受试者术后3mo小瞳验光柱镜度数明显降低,AcrySof Toric组术后角膜散光低于角膜缘松解术组,两组间差别具有显著的统计学意义(P<0.05),且AcrySof Toric IOL植入囊袋内稳定性良好,随访3mo未发现有超过6度的旋转度。结论:AcrySof Toric人工晶状体植入能显著提高患者术后裸眼视力及最佳矫正视力,同时能有效地降低术后散光,提高视觉质量,手术效果稳定,是目前治疗白内障合并角膜散光的有效办法。

AIM:To conduct a comparative assessment of effects of AcrySof Toric intraocular lens(IOL) implantation and spherical IOL implantation combined with corneal limbus lysis in cataract surgery for the correction of corneal astigmatism.METHODS:A total of 53 patients(60 eyes)who underwent cataract surgery in cataract treatment center of our hospital from March 2008 to March 2009 were selected,all patients were complicated with regular corneal astigmatism,and their astigmatism was greater than 1D.According to the different surgical procedures,the subjects were divided into two groups.26 patients(30 eyes) were in simple phacoemulsification cataract extraction combined with AcrySof Toric IOL implantation group(including senile cataract of 24 patients(27 eyes),complicated cataract of 2 patients(3 eyes),while 27 patients(30 eyes) were in spherical IOL implantation combined with corneal lumbus lysis group(including senile cataract of 24 patients(27 eyes),complicated cataract of 3 patients(3 eyes).Before and 1st day,1st week and 3rd month after cataract surgery,two groups of subjects were measured uncorrected visual acuity,best corrected visual acuity(BCVA),computer optometry,and subjective refraction and recorded the spherical degree,cylinder degree and astigmatism axis and other data.And statistical analysis and observation of intracapsular stability of AcrySof Toric IOL were conducted.RESULTS:Followed-up for 6 months,AcrySof Toric group:uncorrected visual acuity more than 0.5 accounted for 93%,more than 0.8 accounted for 67%.Limbus lysis group:uncorrected visual acuity more than 0.5 accounted for 73%,more than 0.8 accounted for 50%.Optometry results before and 3 months after operation were compared and showed cylinder degree of small pupil optometry significantly reduced in both groups 3 months after operation,postoperative corneal astigmatism in AcrySof Toric group was lower than limbal lysis group,differences between the two groups was statistically significant(P<0.05),and stability of AcrySof Toric IOL implantation in the capsular bag was good,no more than 6 degrees of rotation was found during the follow-up of 3 months.CONCLUSION:AcrySof Toric IOL implantation can significantly improve uncorrected visual acuity and best corrected visual acuity in patients,at the same time can effectively reduce the postoperative astigmatism and improve visual quality.It has stable effect of surgery and is an effective way for treatment of cataract patients with astigmatism.

R779.66