散光矫正型人工晶状体植入术后的临床疗效观察
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Clinical study of Acrysof Toric intraocular lens implantation
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    摘要:

    目的:观察白内障超声乳化吸出术中联合植入散光矫正型人工晶状体治疗伴有角膜散光白内障的临床效果。

    方法:前瞻性不同病例前-后对照研究。将59例83眼术前角膜散光值≥0.75D的白内障患者分为Toric IOL组(39例53眼)和非Toric IOL组(20例30眼),所有患者均行白内障超声乳化吸出联合人工晶状体植入术,分别植入Toric IOL(Toric IOL组)或非Toric IOL(非Toric IOL组)。分别于术前及术后检测Toric IOL组术眼的裸眼远视力、屈光状态、IOL轴位、对比敏感度(contrast sensitivity, CS)、波前像差,并与非Toric IOL组术后结果进行比较分析。

    结果:(1)裸眼远视力:Toric IOL组术后术眼视力≥1.0的比例大于非Toric IOL组;(2)术后残余散光度:Toric IOL组术前预测的术后残余散光度与术后测得结果相比无明显差异。(3)人工晶状体旋转:Toric IOL组在术后3mo有22.2%的IOL发生了1°~4°的旋转,没有1例IOL旋转>5°;(4)CS:Toric IOL组患者术后不同空间频率CS均较术前提高,提高程度比非Toric IOL组术后同期相比更为明显;(5)波前像差:Toric IOL组术后彗差(C7和C8)、 球差(C12)、高阶像差均方根均较术前减小,非Toric IOL组C7和C8与RMSh较Toric IOL组高,C12在两组间无明显差异。

    结论:在白内障超声乳化吸出联合人工晶状体植入术中植入散光矫正型人工晶状体(Toric IOL)能够有效地矫正术前存在的角膜散光,从而提高白内障患者的裸眼远视力,并能改善其术后的视觉质量。

    Abstract:

    AIM: To observe visual acuity, refractive outcomes and rotational stability after phacoemulsification combined Acrysof Toric intraocular lens(IOL)implantation for treating cataract and preexisting astigmatism.

    METHODS: Totally 59 patients(83 eyes)with ≥0.75 diopter(D)of preexisting corneal astigmatism were divided into 2 groups: one group 39 patients(53 eyes)with Toric IOL implantation and the other group 20 patients(30 eyes)with non-Toric IOL. All patients were operated with phacoemulsification and IOL implantation. We examined uncorrected visual acuity(UCVA), refractive outcomes, IOL axis shift, contrast sensitivity and wavefront aberration of Toric IOL group at 1 week, 1 month, 3 months after surgery. And we contrasted UCVA, refractive outcomes, contrast sensitivity and wavefront aberration of Toric IOL group with non-Toric IOL group at 3 months postoperatively.

    RESULTS:(1)Visual acuity: The rate of achieving ≥1.0 in Toric IOL group was larger than non-Toric IOL group postoperatively.(2)Corneal astigmatism: The mean corneal astigmatism before surgery was similar with the one postoperatively in Toric IOL group.(3)Toric IOL stability: At 3 months postoperatively, the axis of IOL shift to 1-4 degree was in 22% of the eyes.(4)Contrast sensitivity(CS): The CS with different spatial frequency of all of eyes was raised significantly in Toric IOL group, and was higher than the CS of non-Toric IOL group.(5)Wavefront aberration: The mean C12, C7, C8, RMSh of post-operation were significantly lower than those of pre-operation in Toric IOL group, and C7,C8, RMSh were both lower than non-Toric IOL group.C12 of Toric IOL group were similar with non-Toric IOL group.

    CONCLUSION: Toric IOL implantation showed good visual and refractive outcomes for correcting regular corneal astigmatism.

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万新娟,丁琳,刘谊.散光矫正型人工晶状体植入术后的临床疗效观察.国际眼科杂志, 2012,12(12):2288-2292.

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  • 收稿日期:2012-10-17
  • 最后修改日期:2012-11-20
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