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Methods: A retrospective, controlled, comparative study that involved patients who underwent toric IOL implantation. Patients were divided into two groups according to the difference between the estimated residual astigmatism and actual postoperative astigmatism [difference ≤0.5 diopters (D), Group A; difference >0.5 D, Group B]. Corneal astigmatisms with axis, and various aberration values were compared between the two groups.
Results: Total RMS and HOA RMS values in Group B were significantly higher than those in Group A (p < .001, = 0.003). The vertical coma value, and its absolute value, in Group B were significantly higher than those in Group A (p < .001, = 0.002). The total RMS and absolute value of the vertical coma showed a positive linear correlation with the degree of residual postoperative astigmatism (R-square = 0.139, 0.131; p = .027, 0.036).
Conclusions: If the residual astigmatism after insertion of the toric IOL was greater than expected, corneal aberrations, shown by total RMS and HOA RMS values before surgery, especially of the vertical coma, tended to be high. 相似文献
方法:横断面研究。收集2020-05/2021-05来院就诊的白内障患者149例181眼。术前使用iTrace、IOL Master 700和Pentacam HR三种仪器测量陡峭轴角膜曲率(Ks)、平坦轴角膜曲率(Kf)、平均角膜曲率(Km)、角膜散光度数(Cyl)、陡峭轴轴位(Axis)。分析三种仪器测量指标的差异性及一致性。
结果:三组仪器间测量Ks、Kf、Km均有差异(F=4.912、3.514、4.873,均P<0.05),Cyl与Axis均无差异(F=0.523、0.128,均P>0.05)。Bland-Altman分析提示iTrace与另两种仪器测量的Ks、Kf一致性较差,Cyl和Axis的一致性好,但Axis差值不在临床可接受范围。低度散光组(50眼)、中度散光组(34眼)和高度散光组(18眼)的iTrace与另两种仪器的测量值差值均无差异(P>0.05)。
结论:iTrace与IOL Master 700和Pentacam HR在白内障患者术前测量除散光度一致性好外,其余Ks、Kf均有差异性,Axis差值偏大,超过临床可接受范围,尤其是高度散光组。白内障术前角膜散光的测量应选择多种测量仪器,全方位规划手术方案。 相似文献
Purpose
Visual performance following toric intraocular lens implantation for cataract with moderate and severe astigmatism.Setting
Cataract services, Shroff Eye Centre, New Delhi, India.Design
Case series.Method
This prospective study included 64 eyes of 40 patients with more than 1.50 dioptre (D) of pre-existing corneal astigmatism undergoing phacoemulsification with implantation of the AcrySof® toric IntraOcular Lens (IOL). The unaided visual acuity (UCVA), best corrected visual acuity (BCVA), residual refractive sphere and refractive cylinders were evaluated. Toric IOL axis and alignment error was measured by slit lamp method and Adobe Photoshop (version 7) method. Patient satisfaction was evaluated using a satisfaction questionnaire at 3 months.Results
The mean residual refractive astigmatism was 0.57 D at the final follow-up of 3 months. Mean alignment error was 3.44 degrees (SD = 2.60) by slit lamp method and 3.88 degrees (SD = 2.86) by Photoshop method. Forty-six (71.9%) eyes showed misalignment of 5 degrees or less, and 60 (93.8%) eyes showed misalignment of 10 degrees or less. The mean log MAR UCVA at 1st post-op day was 0.172 (SD = 0.02), on 7th post-op day was 0.138 (SD = 0.11), and on 30th post-op day was 0.081 (SD = 0.11). The mean log MAR BCVA at three months was −0.04 (SD = 0.76).Conclusion
We believe that implantation of AcrySof® toric IOL is an effective, safe and predictable method to correct high amounts of corneal astigmatism during cataract surgery. 相似文献方法:选取2010-03/2013-02收治的老年性白内障患者93例124眼随机分为两组,42例59眼行小切口非超声乳化白内障摘除术(SICS组),51例65眼行超声乳化白内障吸除术(Phaco组),比较两组患者术后视力、角膜散光、手术源性散光及术中、术后并发症。
结果:术后1d; 1wk两组患者视力≥0.5分别为SICS组38眼(64.4%),41眼(69.5%),Phaco组29眼(44.6%),32眼(49.2%),SICS组的视力优于Phaco组(χ2=4.877,5.243,P<0.05)。术后1,3mo两组视力≥0.5眼数比较差异无统计学意义(χ2=0.005,0.085,P>0.05)。平均角膜散光采用重复测量设计方差分析:组内比较不同时间有统计学意义(F=25.624,P<0.05),且有随时间降低的趋势; 组间比较无统计学意义(F=0.986,P>0.05),两组患眼术后1wk平均角膜散光较术前增大,差异有统计学意义(t=2.906,2.427,P<0.05)。术后1wk; 1mo Phaco组手术源性散光SIA均低于SICS组(t=-4.628,2.770,P<0.05),术后3mo两组SIA对比差异无统计学意义(t=0.754,P>0.05), 组内比较和组间比较不同时间的SIA均有统计学意义(F=26.37,P<0.05,F=14.29,P<0.05)。两组患者术中后囊膜破裂、术后角膜水肿、前房色素膜反应对比差异无统计学意义。
结论:小切口非超声乳化白内障摘除术与超声乳化白内障吸除术对比,两种手术术后效果相近,对于白内障的治疗方案选择,白内障超声乳化手术并非唯一最佳手术方案,在缺少超乳设备的边远地区,选择小切口非超声乳化手术同样可以达到与超乳手术接近的术后视觉效果。 相似文献