Implantation of a toric phakic intraocular lens to correct high corneal astigmatism in a patient with bilateral marginal corneal degeneration

We present a patient with marginal corneal degeneration and corneal astigmatism of more than 10.0 diopters (D). A toric phakic intraocular lens (IOL) of 7.0 D cylindrical power was implanted in both eyes to correct the high astigmatism. An uncorrected visual acuity of 20/40 was achieved in both eyes, and the best corrected visual acuity improved by 4 Snellen lines to 20/20 in both eyes. Refraction and visual acuity remained stable at 1.5 years postoperatively. Implantation of a toric phakic IOL can be an option to correct high corneal astigmatism even when the full corneal astigmatism cannot be treated.     

Cataract surgery with implantation of toric silicone lenses for severe astigmatism after keratoplasty

BACKGROUND: The treatment of high astigmatism after keratoplasty is often not possible with glasses or refractive corneal surgery, particularly in patients with anisometropia and contact lens incompatibility. METHODS: In 3 patients with cataract and high astigmatism after penetrating keratoplasty, phacoemulsification was performed via a 4 mm sclerocorneal tunnel incision. A toric silicone lens with Z-haptic was implanted in the bag (Type MS 6116 TU, Dr. Schmidt). All patients had high anisometropia and contact lens incompatibility. The follow-up was ten weeks, uncorrected and corrected visual acuity, corneal and total astigmatism were evaluated. RESULTS: A 68-year-old female presented with corneal astigmatism of 10 dpt. Keratoplasty was performed two years earlier. After implantation of a toric lens (+ 22.5 + 11.0 dpt.) uncorrected visual acuity increased from 1/50 to 20/40, corrected visual acuity increased from 20/30 to 20/25. A 78-year-old male presented with irregular corneal astigmatism of 6.5 dpt. Keratoplasty was performed 25 years previously. Due to high myopia (corneal radii 5.3/5.9 mm), implantation of a toric lens (- 3.0 + 7.0 dpt.) in the bag was combined with implantation of a spheric lens (- 6.0 dpt., Type MS 614, Dr. Schmidt) in the sulcus. Uncorrected visual acuity increased from light perception to 1/20, corrected visual acuity increased to 1/10. An 84-year-old female presented with irregular corneal astigmatism of 8.6 dpt. Keratoplasty was performed two years earlier. After implantation of a toric lens (+ 16.0 + 11.0 dpt.) uncorrected visual acuity increased to 20/50, corrected visual acuity increased from 20/100 to 20/25. During the follow-up all implanted lenses were well-centered and no significant IOL rotation was observed. CONCLUSION: Implantation of foldable toric silicone lenses during cataract surgery may improve considerably the uncorrected visual acuity by reducing the total astigmatism in patients with high astigmatism after keratoplasty. Preoperatively, a reliable keratometry is important.     

Toric intraocular lens to correct high astigmatism after penetrating keratoplasty in a pseudophakic eye - a case report]

BACKGROUND: After penetrating keratoplasty residual astigmatism can be treated with various options. Correction with spectacles or contact lenses, methods such as radial keratotomy, photorefractive keratectomy (PRK) or Laser-in-situ keratomileusis (LASIK) are limited only to mild and moderate astigmatism. In laser ablation a sufficient corneal thickness must be ensured. On the other hand surgical correction is performed on transplanted tissue which can increase the risk of allograft rejection. In pseudophakic eyes the implantation of an individually designed toric intraocular lens (IOL) according to keratometry and biometry with a cylindrical power up to 12 D provides an alternative method for correcting higher astigmatism. This individually designed IOL can be implanted additionally to the existing IOL. CASE: A 66-year-old patient presented after penetrating keratoplasty and implantation of an IOL 4 years ago with a visual acuity of 20/160 and residual astigmatism of - 10 D x 151(o). After biometry an individually manufactured toric PMMA-IOL of + 12 D cylindrical and - 9.5 D spherical power was implanted via a sclerocorneal tunnel incision additionally to the existing IOL into the ciliary sulcus. Postoperatively a well centered and stable positioned IOL was found. One year after implantation of the toric IOL the position was still unchanged and the graft had remained clear. Spherical equivalent refraction was + 1,5 D - 3,0 D x 141(o), with an uncorrected visual acuity of 20/60. CONCLUSION: Implantation of a toric intraocular lens in pseudophakic eyes allows the correction of high astigmatism after penetrating keratoplasty. The advantage of this method compared to the keratorefractive options lies in its minor manipulation on the allograft.     

Implantation of a custom intraocular lens with a 30-diopter torus for the correction of high astigmatism after penetrating keratoplasty

We present a 62-year-old woman who had implantation of an intraocular lens (IOL) with a torus of 30.0 diopters (D) in an eye after penetrating keratoplasty. The patient presented with cataract and a best corrected visual acuity of 20/400. Penetrating keratoplasty was performed in 1975 because of decompensated keratoconus. With a clear but inferiorly decentered corneal graft, visual acuity was limited because of keratoplasty-related high corneal astigmatism of 22.5@156 that could not be successfully treated with spectacles or contact lenses. A custom toric IOL with -30.0 D of cylindrical power was implanted in the capsular bag via a sclerocorneal tunnel incision. Additionally, a spherical IOL of -15.0 D sphere was implanted in the ciliary sulcus. Six months after implantation, the IOLs were still well centered and the uncorrected visual acuity was 20/60.     

Phakic toric intraocular lens implantation after flap decentration in laser in situ keratomileusis

We describe a patient with flap decentration after laser in situ keratomileusis (LASIK) and subsequent phakic toric intraocular lens (IOL) implantation. A 19-year-old man with mixed astigmatism had LASIK in the left eye complicated by flap decentration. Laser ablation was abandoned and implantation of a phakic toric IOL was done. Ten months after IOL implantation, the uncorrected visual acuity in the left eye was 20/25 and best corrected visual acuity was 20/20 with +0.25 -0.50 x 90. Simulated keratometry values were 44.30@150 and 42.00@60 before LASIK and 45.00@150 and 41.90@60 after IOL implantation. Phakic toric IOL implantation may be adequate treatment for flap decentration after LASIK in cases of mixed astigmatism.     

Piggyback silicone intraocular lenses of opposite power

A patient with high myopia and astigmatism had cataract extraction with implantation of 2 silicone intraocular lenses (IOLs) of opposite power (ie, 1 plus and 1 minus). A Staar AA4203TL toric IOL (+9.50 diopters [D]/3.50 D) and a Staar AQ5010V additive lens (-3.00 D) were used to correct both the astigmatism and the high myopia. The use of the 2 lenses was necessary because the toric IOL was not available in low dioptric powers. A crystalline interpseudophakos deposit developed after 1 week and resolved after 4 weeks. Three months postoperatively, the patient had an uncorrected visual acuity of 20/25.     

Evaluation of axis alignment and refractive results of toric phakic IOL using image-guided system

AIM: To evaluate accuracy of axis alignment and refractive results of toric phakic intraocular lens(IOL) implantation using a digital imaging system. METHODS: This retrospective study investigated toric implantable collamer lens(ICL) implantation in 30 eyes of 21 patients with myopic astigmatism more than 2.0 D guided with digital imaging system. Data were collected during the first week after phakic IOL implantation.RESULTS: Thirty eyes of 21 patients were included in our study. Patients includes 9 males and 12 females. The mean age of the patients was 26.5±7.1(range 21-44)y. The mean preoperative manifest astigmatism was 3.2±1.7(range from 2.25 to 4.75) D. The mean postoperative uncorrected distance visual acuity(UCDVA) were 0.07±0.07(range from 0.1 to 0.0) log MAR. The mean postoperative residual refractive cylinder was 0.25±0.29(range 0-0.75) D. Eyes with postoperative residual refractive cylinder of 0.5 D or less represented 80%(24 eyes). The mean postoperative toric IOL misalignment measured by the OPD scan III was 1.9°±1.45°(range from 0 to 5°). CONCLUSION: Image guided system allows accurate alignment of toric ICL. This is associated with good postoperative visual acuity and low residual refractive astigmatism which correlates with the precision of toric phakic IOL alignment.     

Postoperative astigmatism and rotational stability after artisan toric phakic intraocular lens implantation

PURPOSE: To evaluate deviations in the axis (intended versus achieved) and postoperative astigmatism after implantation of an Artisan toric phakic intraocular lens (IOL). SETTING: University Eye Hospital, Mainz, Germany. METHODS: This prospective study comprised 29 eyes with high ametropia and astigmatism. All eyes had uneventful implantation of a toric phakic IOL through a superior scleral tunnel incision at 12 o'clock. After a minimum of 6 months, the uncorrected visual acuity (UCVA), best correct visual acuity, refraction, and astigmatism were analyzed in all eyes. A multivariate analysis of postoperative astigmatism was performed. RESULTS: After a follow-up of at least 6 months, 95% of eyes were within +/-1.00 diopter (D) of emmetropia and 85% of eyes has a UCVA of 20/30 or better. The difference between the mean intended cylinder axis and achieved cylinder axis was 3.9 degrees (median 3 degrees; range to 13 degrees). The difference between the mean intended axis and the achieved axis between miosis and mydriasis was 1.8 degrees (median 1.5 degrees; range 0 to 5 degrees). The mean postoperative astigmatism after 6 months was 0.56 D with an axis of 31 degrees. Doubled-angle scatterplot analysis showed a tendency toward more flattening in the vertical meridian. CONCLUSIONS: During the 6-month follow-up, no significant rotation was observed after implantation of Artisan toric phakic IOLs to correct high ametropia. A sutureless sclerocorneal superior approach for phakic IOL insertion resulted in moderate to low astigmatism. Induced astigmatism should be taken into consideration during preoperative planning.     

Combined toric intraocular lens implantation and relaxing incisions to reduce high preexisting astigmatism

PURPOSE: To evaluate whether combining toric intraocular lens (IOL) implantation with astigmatic keratotomy (AK) can correct higher levels of astigmatism while minimizing undue effects on the optical qualities of the cornea. SETTING: St. Luke's Cataract and Laser Institute, Tarpon Springs, Florida, USA. METHODS: Thirteen eyes with corneal astigmatism greater than 2.50 diopters (D) (mean 5.54 D) had implantation of a Staar toric IOL combined with AK. RESULTS: All eyes had less than 1.00 D of refractive astigmatism postoperatively. Sixty-nine percent achieved an uncorrected visual acuity of 20/40 or better, and no patient lost best corrected visual acuity. CONCLUSIONS: Implanting a toric IOL in patients with high astigmatism reduced the amount of incisional surgery required. Combining techniques can correct all or most of even very high astigmatism (>5.00 D) while avoiding induced corneal irregularities.     

Foldable toric intraocular lens for astigmatism correction in cataract patients

PURPOSE: To evaluate the results of AcrySof toric intraocular lens (IOL) (Alcon) implantation to correct preexisting astigmatism in patients having cataract surgery. SETTING: Ophthalmology Service, Donostia Hospital, San Sebastián, Spain. METHODS: This prospective observational study included 30 eyes of 15 consecutive patients with more than 1.00 diopter (D) of preexisting corneal astigmatism having cataract surgery. Bilateral implantation of the AcrySof toric IOL was performed after phacoemulsification. The uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), residual refractive sphere, residual keratometric and refractive cylinders, and toric IOL axis were measured. RESULTS: The UCVA was 20/40 or better in 93.3% of eyes and 20/25 or better in 66.6%. All eyes achieved 20/25 or better BCVA. The mean refractive cylinder decreased significantly after surgery from -2.34 D +/- 1.28 (SD) to -0.72 +/- 0.43 D (P<.01). Vector analysis of attempted versus achieved correction showed that 100% of eyes were within +/-1.00 D and 80% and 93.9% were within +/-0.50 D for J(0) and J(45), respectively. The mean toric IOL axis rotation was 3.63 +/- 3.11 degrees, with rotation less than 10 degrees in 96.7% of eyes. CONCLUSIONS: The results indicate that phacoemulsification and posterior chamber AcrySof toric IOL implantation is an effective option to correct preexisting astigmatism in cataract surgery. The AcrySof toric IOL showed good rotational stability.     

Artisan iris-fixated toric phakic and aphakic intraocular lens implantation for the correction of astigmatic refractive error after radial keratotomy

We report 2 patients who had radial keratotomy (RK) to correct myopia. The first patient developed a postoperative hyperopic shift and cataract. Nine years post RK, she had intracapsular cataract extraction and implantation of an Artisan aphakic intraocular lens (IOL). Twenty years post RK, hyperopia and astigmatism progressed to +7.0 -5.75 x 100 with a best corrected visual acuity (BCVA) of 20/20. Due to contact lens intolerance, the Artisan aphakic IOL was exchanged for an Artisan toric aphakic IOL. Three months later, the BCVA was 20/20 with +1.0 -0.50 x 130. The second patient demonstrated residual myopic astigmatism 6 years after bilateral RK and had become contact-lens intolerant. An Artisan toric phakic IOL was implanted in both eyes. Four months later, the BCVA was 20/25 with a refraction of +0.25 -1.0 x 135 and 20/20 with a refraction of -1.0 x 40. Both patients were satisfied with the visual outcomes.     

Clear lens extraction with intraocular lens implantation for hyperopia.

PURPOSE: Current surgical options for the correction of moderate to severe hyperopia include hyperopic laser in situ keratomileusis (LASIK), phakic intraocular lens implantation and clear lens extraction with intraocular lens (IOL) implantation. We investigate the safety and efficacy of clear lens extraction with IOL implantation to correct hyperopia. METHODS: Phacoemulsification and IOL implantation was performed on 18 eyes of 10 patients. In 16 eyes, the Hoffer-Q formula was used for IOL power calculation and a single IOL was inserted; in the remaining 2 nanophthalmic eyes, the Holladay-II formula was used and two piggy-back IOLs were inserted. RESULTS: Mean preoperative spherical equivalent for distance was +6.17 D (range, +4.25 to +9.62 D). Patients were followed postoperatively for a mean of 10.5 months (range, 4 to 27 mo). Uncorrected visual acuity in all eyes was 20/50 or better with a median uncorrected visual acuity of 20/40 (range, 20/30 to 20/50). Two patients lost 2 lines of spectacle-corrected visual acuity; both of these patients achieved spectacle-corrected visual acuity of 20/30. CONCLUSIONS: Clear lens extraction with IOL implantation is a safe and effective procedure for the correction of moderate to severe hyperopia in the presbyopic age range.     

Toric人工晶状体矫正角膜散光的效果评价

目的评价Toric人工晶状体（IOL）矫正角膜散光的效果及在囊袋内的稳定性。方法收集确诊为年龄相关性白内障并伴有角膜规则散光的患者32例（35眼）,采用白内障超声乳化法植入ToricIOL。观察术前、术后裸眼视力（UCVA）及最佳矫正视力（BCVA）、术前角膜散光、预计残余散光、术后残余散光、IOL旋转度,并进行分析。结果术后3个月92%患眼UCVA≥0.5,78%患眼UCVA≥0.8,BCVA≥0.8者达96%。术前角膜散光平均为（1.500±0.405）D,术后3个月残余散光为（0.200±0.179）D。3个月时与术后第1d轴位相比较,IOL旋转平均为（2.132±1.853）°。结论ToricIOL可使患者获得更好的裸眼远视力,减少了患者的残余散光,预测性强,具有良好的旋转稳定性,是一种有效的矫正角膜规则散光的治疗方法。     

Toric intraocular lenses for correcting astigmatism in 130 eyes

OBJECTIVE: This study evaluated the results after implantation of toric intraocular lenses (IOLs) to correct preexisting corneal astigmatism in patients undergoing either cataract or clear lens extraction surgery. DESIGN: Retrospective, noncomparative case series. PARTICIPANTS: One hundred thirty eyes of 99 patients who underwent phacoemulsification and posterior chamber toric IOL implantation from January 1997 through February 1998 were included in the study. INTERVENTION: Implantation of a toric IOL was performed after cataract surgery (122 eyes) or clear lens extraction surgery (eight eyes). Both preoperative corneal cylinder and refractive cylinder powers were more than 1.50 diopters (D) for all the eyes included in this study. To provide a comparison, we also studied 51 eyes of 45 patients meeting the same preoperative criteria for degree of corneal and refractive cylinder who underwent implantation of a spherical (nontoric) IOL combined with limbal relaxing incisions. The data for both study and comparison groups were analyzed retrospectively. The selection for the two groups was arbitrary. MAIN OUTCOME MEASURES: Uncorrected visual acuity (UCVA), mean spherical equivalent, residual refractive cylinder, and toric IOL axis. RESULTS: In the toric IOL group, 84% of eyes achieved 20/40 or better UCVA. In the spherical IOL group, 76% achieved 20/40 or better UCVA. The mean postoperative refractive cylinder was -1.03 +/- 0.79 D in the toric IOL group and -1.49 +/- 0.75 D in the spherical IOL group. CONCLUSIONS: Our results indicate that phacoemulsification and posterior chamber toric IOL implantation is a largely predictable new surgical option to correct preexisting corneal astigmatism in cataract or clear lens extraction surgery.     

Distance vision after bilateral implantation of AcrySof toric intraocular lenses: a randomized, controlled, prospective trial

AIM: To evaluate the distance vision of Chinese patients with cataracts and corneal astigmatism after implantation of bilateral AcrySof toric intraocular lens (IOL) versus bilateral AcrySof spherical IOL. METHODS: This study randomized 60 patients into equal groups to receive toric IOL or spherical IOL. IOL powers targeting emmetropia were selected for 93% of toric IOL patients and for 90% of spherical IOL patients. Assessments included monocular and binocular distance vision, with and without best correction. Patients also completed surveys about their distance vision. RESULTS: Preoperatively, the two study groups were similar in age, in distance visual acuity, and in the magnitude of corneal astigmatism. At 6 months postoperative, binocular uncorrected distance vision was 0.06±0.14 logMAR in the AcrySof toric IOL group, significantly better than the 0.14±0.11 logMAR in the spherical IOL group (P<0.05). For eyes with emmetropia as a target, the equivalent of 20/20 uncorrected vision was more likely (P<0.001) in the toric IOL group (36% of eyes) than in the spherical IOL group (4% of eyes). No patients in the emmetropia/toric IOL group used distance glasses, as compared to 52% of patients in the emmetropia/spherical IOL group. All patients were satisfied or highly satisfied. Quality of distance vision was rated higher by toric IOL patients than by spherical IOL patients (P<0.05). CONCLUSION: Bilateral AcrySof toric IOL is superior to bilateral spherical IOL in providing uncorrected distance vision to cataract patients with corneal astigmatism.     

Artisan toric lens implantation for correction of postkeratoplasty astigmatism

PURPOSE: To determine the efficacy of Artisan toric iris-fixated lens implantation after penetrating keratoplasty to correct high ametropia and astigmatism. DESIGN: Prospective, noncomparative case series. PARTICIPANTS: Artisan toric lens implantation was performed in 16 eyes of 16 patients who were contact lens intolerant or were unable to wear glasses because of anisometropia, high astigmatism, or both. INTERVENTION: Sixteen eyes of 16 patients received Artisan toric lenses for postkeratoplasty astigmatism, anisometropia, or both. MAIN OUTCOME MEASURES: Manifest refraction, uncorrected and spectacle-corrected visual acuity, and corneal topography were performed before surgery and 1, 3, 6, 12, and 18 months after surgery. Efficacy, percent reduction of refractive astigmatism, topographical astigmatism, anisometropia of defocus, and the astigmatism correction index were determined. A patient satisfaction questionnaire and specular microscopy results were assessed. RESULTS: The mean +/- standard deviation of the preoperative refractive cylinder was -6.66+/-1.93 diopters (D; range, -4.0 to -10.0 D), which was reduced to -2.08+/-1.33 D, -2.14+/-1.76 D, -1.98+/-1.65 D, -1.84+/-0.77 D, and -1.42+/-0.78 D at 1 month, 3 months, 6 months, 12 months, and the final follow-up examination (8.4+/-4.9 months), respectively. Spherical equivalent was reduced from -4.90+/-5.50 D before surgery to -0.96+/-0.86 D at the final follow-up. The uncorrected and best-corrected visual acuities were >/=20/40 in 42% and 100% of eyes, respectively. There was no loss of best-corrected visual acuity and a gain of at least 2 lines in 50% of eyes. The percent reduction in refractive astigmatism, topographical astigmatism, and anisometropia of defocus were 78.0+/-11.5%, 20.3+/-34.9%, and 77.0+/-12.0%, respectively. The astigmatism correction index was 102.8+/-18.6%. Satisfaction increased from 3.2 to 8.3 after implantation. The endothelial cell loss was 7.6+/-18.9% at 3 months and 16.6+/-20.4% at the last follow-up. In 1 patient, a reversible graft rejection occurred. CONCLUSIONS: Artisan toric lens implantation after penetrating keratoplasty was effective for reduction of refractive astigmatism and ametropia. All patients were suitable for spectacle correction after implantation. A longer follow-up and a larger number of patients are needed to assess the safety and the effect of the lens on the corneal graft endothelium.     

Phacoemulsification and customized toric intraocular lens implantation in eyes with cataract and high astigmatism after penetrating keratoplasty

Phacoemulsification and implantation of a hydrophilic acrylic toric intraocular lens (IOL) (T-flex 623T) with customized cylindrical power was performed in 1 eye in 3 consecutive patients with cataract and high postkeratoplasty astigmatism (range 6.75 to 8.75 diopters [D]). Twelve months postoperatively, the uncorrected distance visual acuity improved from 20/200 to 20/30 in Case 1, from 20/400 to 20/40 in Case 2, and from 20/200 to 20/25 in Case 3 and the corrected distance visual acuity was 20/25 or better in all 3 eyes. The spheroequivalent was within ± 0.50 D of the intended value and the refractive astigmatism was less than 1.00 D. The corneal grafts were transparent, and the endothelial cell loss range was 6% to 12%. Rotation of the toric IOL was less than 5 degrees. The toric IOL with customized cylindrical power provided good postoperative rotational stability and very satisfactory postoperative visual recovery. This type of toric IOL is appropriate to correct high postkeratoplasty astigmatism in eyes operated on for cataract. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.     

Impact of the line of sight on toric phakic intraocular lenses for hyperopia

We present a hyperopic patient with a decentered line of sight in whom the residual refractive error after toric phakic intraocular lens (TP IOL) implantation was improved by displacement and individualized treatment. A 35-year-old woman presented with asthenopic complaints 2 months after bilateral TP IOL implantation and IOL rotation 4 weeks later. Examination revealed the line of sight to be nasally and inferiorly decentered in relation to the center of the pupil. A more nasal reenclavation of the TP IOL decreased the coma, and the uncorrected visual acuity was 20/20. We conclude that line of sight should be measured before TP IOL implantation, especially in hyperopic eyes.     

Implantation of a toric poly(methyl methacrylate) intraocular lens to correct high astigmatism

A 57-year-old man experienced a decrease in visual function because of cataract formation. Corneal astigmatism was 13.4 diopters (D) because he had had a penetrating keratoplasty 27 years before. Cataract surgery was planned, and biometric data for toric intraocular lens (IOL) implantation were collected for the manufacture of a custom IOL. After phacoemulsification, a toric poly(methyl methacrylate) (PMMA) IOL of +19.0 D spherical and +12.0 D cylindrical power was implanted via a sclerocorneal tunnel incision. Three months postoperatively, corneal astigmatism was 14.3 D and best corrected visual acuity (BCVA), 20/25. Postoperative refraction (+1.5 -3.0 x 90) and BCVA remained stable for 7 months. No significant IOL rotation was observed. Implantation of a toric PMMA IOL corrected high corneal astigmatism. Toric IOL technology with high cylindrical power allows enhancement of IOL surgery.     

Acrysof Toric人工晶状体植入矫正白内障术前角膜散光的短期观察

目的 评价超声乳化白内障吸除术中Acrysof Tofic人工晶状体(IOL)植入矫正白内障伴术前角膜散光的早期临床效果,及其有效性、安全性和预测性.方法 前瞻性病例系列研究.植入Acrysof Toric IOL的年龄相关性白内障患者60例(71只眼),观察其术前、术后的IogMAR裸眼视力、最佳矫正视力、术前角膜散光、术后残留散光、术后残留球镜、IOL轴位等.术后残留散光根据柱镜轴向分为散光全矫,残留斜轴散光(45°/135°±30°),残留顺规散光(90°±15°),残留逆规散光(180°±15°),并收集各类散光组中散光为0.50～0.75 D者的裸眼远近视力.随访3个月.采用非参数检验秩和检验和Friedman检验等对数据进行统计学分析.结果 裸眼远视力中位数:术前为0.80;术后3个月为0.20.散光中位数:术前为2.02 D,术前预计残留散光为0.34 D,术后3个月为0.67 D.IOL术后1 d定位和预计轴位差值为1.58°±2.30°.3个月时旋转1.63°±1.83°,96%旋转小于5.00°.未发现一例手术并发症.裸眼近视力中位数:散光全矫组0.50,残留顺规散光组0.50,残留逆规散光组0.21,残留斜轴散光组0.30;裸眼远视力中位数:散光全矫组0.10;残留顺规散光组0.26;残留逆规散光组0.15.残留斜轴散光组0.20;非参数统计分析结果提示:裸眼远视力,残留逆规散光组与顺规散光组比较,差异具有统计学意义(t=4.00,P=0.000),而与斜轴散光组,散光全矫组之间的差异无统计学意义(t=0.49,P=0.623;t=2.00,P=0.061);裸眼近视力,逆规散光组最佳,而且与顺规散光组,斜轴散光组,散光全矫组的差异均具有统计学意义(t分别为6.95,2.60,6.52,P分别为0.000,0.011,0.000).结论 超声乳化白内障吸除术中Acrysof Toric IOL植入是一种有效、安全,可预测的矫正年龄相关性白内障伴术前角膜散光的方法.术后残留少量的逆规近视性散光可以在不明显影响裸眼远视力基础上获得较好的裸眼近视力.