高度角膜散光白内障患者植入Toric IOL的临床观察

目的:评估高度角膜散光患者植入高度数环曲面人工晶状体（AcrySof Toric intraocular lens,Toric IOL）术后的视力和屈光结果。 方法:对21例24眼高度角膜散光的白内障患者行回顾性系列研究,术前角膜散光≥2.5D，植入AcrySof Toric IOL(T6,T7,T8或者T9)。研究数据包括术前和术后3mo的裸眼远视力（uncorrected distance visual acuities,UCDVA）、最佳矫正远视力（best-corrected distance visual acuities，BCDVA）、术前角膜散光、术后残留散光和散光轴向的偏离情况。 结果:术后3mo的UCDVA中75%（18/24）患眼视力＞05,显著高于术前BCDVA，两组差异有统计学意义（χ2=50.12，P<0.05）。术前角膜散光是3.45±0.63D。术后3mo残留的散光是0.72±0.23D。两者差异具有统计学意义（t=0.128，P＜0.01）。术后67%（16/24）的眼残留散光＜0.75D，83%（20/24）的眼＜1.00D。术前预计矫正散光312±0.54D，术后实际矫正散光3.05±0.66D,两者差异无统计学意义（t=1.659，P＞0.05）。人工晶状体术后3mo和1wk之间的旋转度数是3.2°±2.1°。 结论:植入高度数Toric IOL是一种安全的、有效的和可预测的治疗白内障合并高度角膜散光的方法。

Clinical effect of cataract surgery with higher power toric intraocular lens implantation in patients with high corneal astigmatism

AIM:To evaluate the visual and refractive outcomes after higher power toric intraocular lens(IOL) implantation in patients with high amounts of corneal astigmatism.METHODS:This study comprised 21 cases 24 eyes with cataract and more than 2.5 diopters(D) of corneal astigmatism who had toric AcrySof SN60T6,SN60T7,SN60T8 or SN60T9 IOL implantation.The preoperative and postoperative 3 months uncorrected distance visual acuity(UCDVA) and best-corrected distance visual acuity(BCDVA),preoperative corneal astigmatism,residual refractive cylinder and IOL axis and position in postoperative 1 week and 3 months were evaluated.RESULTS:Three months postoperatively,75% of eyes showed the 0.5 or better in UCDVA.The preoperative corneal astigmatism was 3.45±0.63D.The postoperative 3 months residual refractive cylinder was 0.72±0.23D(P<0.01).The anticipated correction was 3.12±0.54D.The achieved correction was 3.05±0.66D(P>0.05).The mean Toric IOL misalignment was 3.2°±2.1°.CONCLUSION:Implantation of higher power toric IOL during cataract surgery is a safe,effective and predictable method in correcting high amounts of corneal astigmatism.