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31.
Toric人工晶状体矫正散光的短期临床疗效   总被引:1,自引:0,他引:1  
马剑欣  张恩魁  王军  王文莹 《眼科》2009,18(2):84-87
目的观察术前伴有较大角膜散光的白内障患者植入Toric人工晶状体(Acrysof SN60TT)后的屈光效果及囊袋内旋转稳定性。设计前瞻性病例系列。研究对象25例(30眼)角膜散光均大于1D的老年性及发育性白内障患者。方法术前通过生物测量及软件计算确定人工晶状体型号及放置轴位,并进行手术切口及目标人工晶状体轴位两步标记,行超声乳化白内障吸除手术,术中将人工晶状体准确放置于目标位置。术后随访3个月。主要指标裸眼视力、最佳矫正视力、总合散光、角膜散光、人工晶状体柱镜轴位。结果术后裸眼视力1个月为0.73±0.18,3个月为0.79±0.17。最佳矫正视力1个月为0.93±0.13,3个月为0.98±0.09。总合散光术后1个月为(0.68±0.53)D,3个月为(0.47±0.39)D。术后3个月角膜散光为(1.58±0.84)D,与术前(2.02±0.90)D相比明显下降(Jp=0.00)。手术源性散光为(O.62±0.32)D。术后3个月人工晶状体矫正散光(1.27+0.69)D,与预计人工晶状体矫正散光(1.36±0.44)D相比,差异无统计学意义(P=0.31)。术后3个月人工晶状体旋转(4.0±3.2)°,旋转5。以内占76.7%。结论Toric人工晶状体在本文短期随访期间能有效地矫正散光,在囊袋内稳定,具有良好的旋转稳定性。(眼科,2009,18:84-87)  相似文献   
32.
目的:研究T优化的后房型人工晶状体(toric implantable contactlens,TICL)矫正高度近视合并散光的效果。方法:本研究中高度近视合并散光患者7例13眼,术前屈光度-9.50~-24.00(平均-14.50±7.43)D,散光范围+1.0~+3.5(平均+2.59±0.38)D,眼轴长度26.20~32.85(平均29.38±3.01)mm。13眼均植入TICL。术后观察视力、屈光度、眼压、人工晶状体位置等。结果:所有病例均成功植入TICL,所有患者裸眼视力均有明显提高,术后1wk,所有术眼达到或超过术前最佳矫正视力,眼压正常,屈光度在术后6mo的随访中稳定。结论:TICL植入有晶状体眼治疗高度近视合并散光安全可靠,术后屈光度稳定,视觉质量提高。  相似文献   
33.
罗艳  程旭康  鲁铭  冯劼 《国际眼科杂志》2012,12(12):2296-2298
目的:回顾分析Toric(环曲面)人工晶状体植入治疗合并特殊角膜散光的白内障患者的临床治疗效果。

方法:对10例12眼合并特殊角膜散光的白内障患者行超声乳化白内障吸出及人工晶状体植入术治疗,进行回顾性分析。其中4眼为翼状胬肉切除术后,3眼为外伤后角膜散光,5眼为角膜云翳或斑翳患者。术后随访6mo,分析不同时间点裸眼视力、术后残余散光、并发症等,观察Toric人工晶状体植入后的疗效,旋转稳定性。

结果:术后随访观察6mo,术后裸眼视力平均0.62±0.31,最佳矫正视力0.70±0.35。裸眼视力≥0.8者2眼,占17%。裸眼视力≥0.5者9眼,占75%。术后残余散光0.51±0.36D。术后角膜源性散光未见明显改变,全眼总合散光得到明显改善,差异有统计学意义。术后全眼总合散光与术前预计残余散光值接近,无显著性差异。术后6mo旋转度为(3.80±1.46)°。末次随访时间点,植入Toric人工晶状体的12眼中,旋转度小于5°的11眼,占92%。仅1例术后旋转度为6°。

结论:对于某些特殊原因导致角膜散光的白内障患者,经过严格的手术前筛选,行白内障超声乳化吸出联合Toric人工晶状体植入,能够安全、有效的改善患者的散光,提高术后视觉质量,预测性好。  相似文献   

34.
目的 比较环曲面和球面角膜塑形镜停戴后角膜曲率的变化。方法 回顾性分析医院眼科2018年1月—2019年1月收治的近视患者70例,按照角膜塑形镜设计方式分组,环曲面与球面角膜塑形镜各35例,比较两组戴镜后裸眼视力、角膜点染发生率及停戴后角膜曲率变化。结果 戴镜后3个月环曲面组UCVA高于球面组,且两组均明显高于同组戴镜后1周,差异有统计学意义(P<0.05);两组戴镜后12个月角膜点染率发生率比较差异无统计学意义(P> 0.05,28.6%vs. 28.6%);停戴后两组均K与角膜散光均有变化,球面与环曲面对平坦K的影响相当,球面对陡峭K的影响多于环曲面。结论 环曲面和球面角膜塑形镜停戴后角膜平K与散光均有变化,且环曲面对角膜陡K的影响更小。  相似文献   
35.
Background:With about 87% of patients with cataracts having astigmatism, management of astigmatism in cataract surgery not only yields an improved unaided visual acuity and image quality but also higher patient satisfaction. The video will give a step-wise guide to cataract surgeons to manage astigmatism with cataracts.Purpose:To hit the bull’s eye as far as target refraction is concerned, it is necessary to understand the benefits and limitations of currently available cutting-edge technology and formulae and apply them to the cataract surgery practice. The purpose of the video is to make sure that we have no surprises in our Toric intraocular lens (IOL) planning.Synopsis:After a brief introduction to available modalities for the treatment of astigmatism, a step-wise approach to diagnostics is discussed, which will include the role of corneal topography and aberrometers and their application to planning Toric IOLs. Appropriate planning, implementation, and execution in form of preoperative and intraoperative pearls of using Toric IOLs are shown in the video. This will be followed by troubleshooting and case-based discussions and future perspectives including the possible role of corneal biomechanics.Highlights:What this video adds new is the importance of topography, interpretation of Belin‒Ambrosio display map and the equivalent keratometry reading (EKR) map, aberrometry, and higher order aberration (HOA) analysis and role of biomechanics in Toric IOL planning. Video also highlights the importance of posterior corneal astigmatism and accurate axis marking. With a case-based approach and relevant examples, we are trying to decipher the enigma of astigmatism by giving a step-wise approach for the same.Online Video Link: https://youtu.be/5VuEY_6NdQA  相似文献   
36.
37.
目的:比较Verion导航系统与手动标记对散光矫正型人工晶状体(Toric IOL)植入术矫正角膜散光效果的影响。方法:前瞻性随机对照研究。选取2015 年2 月至2017 年2 月在江苏省常州市第三人民医院就诊的白内障合并规则性角膜散光> 1.0 D的患者80例(80眼)。使用随机数字表法将患者随机分配到观察组(40例)和对照组(40例)。观察组使用Verion数字导航系统引导术中Toric IOL的植入,对照组术前在裂隙灯显微镜下手动标记用于指导Toric IOL的植入。2 组患者均行超声乳化白内障吸除联 合Toric IOL植入术,观察患者术前及术后3个月的裸眼远视力(UCDVA)( LogMAR)、最佳矫正远视力(BCDVA)( LogMAR)、角膜散光以及术后3个月的实际与预期残余散光、Toric IOL轴位。计量资料组间比较采用独立样本t检验,计数资料组间比较采用卡方检验。结果:对照组术后平均UCDVA为0.13±0.13,观察组术后平均UCDVA为0.11±0.11,2 组间差异无统计学意义(t=-0.96,P=0.34)。实际与预期残余散光的偏差绝对值对照组为(0.21±0.12)D,观察组为(0.12±0.11)D,2 组间差异有统计学意义(t=-3.71,P=0.001)。术后对照组裂隙灯显微镜下Toric IOL实际轴位与预期安放轴位偏差绝对值为4.6°±3.0°,观察组为2.2°±1.6°,2组间差异有统计学意义(t=-3.69,P=0.001)。结论:在Toric IOL植入术中应用Verion数字导航系统相较于传统手动标记技术可明显减小术后实际与预期散光的差值,减少术后Toric IOL轴位与预期轴位的偏离。  相似文献   
38.
AIM: To evaluate the efficacy of toric intraocular lens markers-assisted implantation of the scleral-fixated intraocular lens (SFIOL). METHODS: From October 2010 to December 2013, all patients who had undergone secondary SFIOL implantation were assigned to group 1 and 2, in group 1 SFIOL was performed with the assist of radial keratotomy (RK)-marker, and in group 2 SFIOL was performed with the assisted of toric intraocular lens markers (T-and axis markers). Patients’ demographic data and information on baseline preoperative visual acuity, indication for surgery and latest postoperative visual acuity were collected and analyzed. The haptic and optic positions were determined by ultrasound biomicroscopy. The optic tilt angle and decentration distance were measured. RESULTS: The study evaluated 43 eyes of 43 patients ranging in age from 3 to 66y. Group 1 comprised 24 eyes (24 patients) and group 2, 19 eyes (19 patients). Uncorrected reoperative acuity was improved on all the eyes postoperatively. The improved postoperative acuity was significantly more in group 2 than that in group 1 (1.11±0.38 vs 0.82±0.45 logMAR; F=4.85, P=0.03). Ultrasonic biomicrograph examination showed that the rate of haptic asymmetry was significantly higher in group 1 (42%, 10/24) than that in group 2 (11%; 2/19) (Chi square=3.68, P=0.04). The mean tilted degree in group 1 was significantly higher than that in group 2 (P=0.04). Mean decentration distance in group 1 was greater than that in group 2 (P=0.03). CONCLUSION: During SFIOL the toric markers help the surgeon identify the placement of fixation more precisely than that with the use of RK marker.  相似文献   
39.
AIM: To assess the relationship between axial length (AL) and intraocular lens (IOL) rotation among eyes receiving a toric IOL and subsequently entered into an online toric back-calculator database. METHODS: Retrospective analysis of data collected online via astigmatismfix.com, a freely available online toric back-calculator where surgeons enter pre- and post-operative information to help manage residual postoperative astigmatism. Included records were deemed valid with entry of AL and IOL orientation between January 2017 and March 2019. Rotation was determined by a difference of ≥5° between pre-operative intended IOL orientation and actual post-operative IOL orientation. Frequency and magnitude of rotation are presented with means and associated standard deviation (SD). Linear regression models of this association are presented. RESULTS: Records of 6752 eyes were included in the analysis, of which 74.8% were determined to have a rotated IOL. The magnitude of rotation increased with each millimeter (mm) increase in AL with a mean rotation of 13.3° (SD: 12.8°) for eyes with AL 20-20.9 mm and a maximum mean rotation of 30.6° (SD: 30.3°) among eyes with AL 29-29.9 mm. General linear modeling demonstrated a significant association (P<0.0001) with a parameter estimate of 1.19 (standard error: 0.159) and R2 of 0.0083. CONCLUSION: Analysis from an online database indicates that toric IOLs inserted into eyes with longer AL are more likely to rotate and to rotate more degrees from the target axis. The findings from this study are clinically relevant for surgeons implanting toric IOLs.  相似文献   
40.
Advances in small incision surgery have enabled cataract surgery to evolve from being concerned primarily with the safe removal of the opaque crystalline lens to a procedure refined to yield the best possible postoperative refractive result. As the outcomes of cataract surgery have improved, the use of lens surgery as a refractive modality in patients without cataracts (clear lens extraction) has increased in popularity. The removal of the crystalline lens for refractive purposes, or so-called refractive lens exchange (RLE), offers distinct advantages over corneal refractive surgery in selected cases. Nevertheless, in some middle-aged patients with high refractive errors, corneal refractive surgery can be a safe and effective treatment. In addition, the use of multifocal lenses offers an alternative for the correction of presbyopia. A further advantage of RLE is that it simultaneously eliminates the need for cataract surgery in the future. The keys for success in RLE are effectiveness and consistency in the refractive outcome, providing at the same time surgical and postoperative safety. To achieve these goals, adequate indications following strict risk/benefit criteria and refractive precision based on accurate preoperative protocols for IOL calculation and selection are mandatory, together with an appropriate choice of surgical procedure based on the surgeon's skills, minimizing complications.  相似文献   
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