AcrySof Toric人工晶体治疗术前存在角膜散光的白内障短期临床疗效

目的观察术前存在角膜散光的白内障患者进行白内障超声乳化联合植入AcrySof Toric人工晶体（toric intraocular lens，IOL）后视力、矫正散光的有效性及稳定性的短期疗效。方法选择术前带有角膜散光（大于1．2D，小于3．0D），年龄61～75岁，平均（67．5土7．5）岁，晶状体混浊Ⅱ～Ⅳ级的的白内障患者20例（25只眼）为研究对象，进行白内障超声乳化联合植入AcrySof Toric IOL（T3-T5），术后第1d、1w、1m、及3m分别检查裸眼视力（UCVA），最佳矫正视力（BCVA），复查角膜曲率和角膜地形图，观察人工晶体轴向的位置，散瞳通过裂隙灯观察人工晶体标记线与角膜缘标记位置的方法确定人工晶体转动度数。结果术后第1d、1w、1m、3m裸眼视力为0．67±0．15、0．635=0．21、0．64±0．17、0．64土0．19，最佳校正视力分别为0．72±0．23、0．71±0．30、0．74±0．16、0．73±0．20，平均存在散光分别为（0．78±0．35）D、（0．82±0．37）D、（0．81±0．28）D、（0．77±0．33）D，散瞳查AcrySofToric IOL平均轴位偏转为（3．72±1．41）度、（3．63±1．61）度、（3．66±1．53）度、（3．75±1．45）度，各个时间段裸眼视力、最佳矫正视力、散光及轴位旋转无明显差异（P值均大于0．05）。结论对于术前存在角膜散光的白内障患者，植入AcrySof Toric IOL能有效的提高视力、矫正术前角膜散光，而且稳定性较好。

Short-term evaluation of AcrySof Toric intraocular lens implantation in cataract surgery with corneal astigmatism

Objective To evaluate the short-term efficacy and rotational stability of the AcrySof toric intraocular lens （IOL） in correcting preoperative corneal astigmatism in cataract elderly patients. Methods This prospective observational study included 25 eyes from 20 consecutive patients who underwent implantation of an AcrySof toric IOL with micro-coaxial cataract surgery. Outcomes of uncorrected visual （UCVA）, the best corrected visual （BCVA）, refractive and keratometric astigmatism, and IOL rotation after 1 day, 1 week, 1 month, and 3 months follow-up were evaluated, respectively. Results The UCVA was rised up to 0.64±0.19 from 0.15±0.06, and BCVA from 0.18±0.11 to 0.73±0.20. Mean refractive astigmatism was reduced to -0.77±0.33 diopter （D） from -2.25±0.73 D. The mean rotation of the toric IOL was 3.45 ±3.39 degrees at final follow-up. All eyes had IOL rotation of less than 5 degrees. There were no statistically difference among the follow-up times （P〉0.05）. Conclusions Early postoperative follow-up shows that implantation of the AcrySof toric IOL is an effective, safe, and predictable method for managing corneal astigmatism in cataract elderly patients.