Toric人工晶状体植入治疗角膜散光的稳定性初步研究

目的 探讨白内障合并角膜散光患者植入Toric人工晶状体（AcrysofSN60TF）术后的稳定性及散光度变化,评价Toric人工晶状体治疗角膜散光的临床疗效.设计回顾性病例系列. 研究对象白内障合并中高度角膜散光患者3例.方法 于2008年2月至5月就诊的白内障患者3例,术前测量所需植入人工晶状体的球镜度数和角膜本身散光度数,并通过ALCON软件计算所需植入晶状体型号,术中将人工晶状体散光轴标记线和角膜屈光力最强的子午线重合,术后定期测量患者视力、散光度数、晶状体轴位变化.3例患者术前角膜散光度数分别为1.5 D、2.5 D、5.5 D,均行白内障超声乳化联合Torie人工晶状体植入术.术前应用IOLMaster（德国Carl Zeiss公司）仪器,SRK/T公式计算出人工晶状体球镜度数.应用角膜地形图仪测量患者的角膜散光轴,并将最大屈光度、最小屈光度及所在轴、所需球镜度数、手术导致的散光度、手术切口位置输入Alcon计算公式内,计算所需晶状体型号及晶状体散光轴向位置.散光度1.5 D患者植入AcrysofSN60T3 IOL,2.5 D患者植入AcrysofSN60T4.5.5 D患者植入AcrysofSN60T4.术后随访1年以上.主要指标术后视力、人工晶状体位置、散光度数及轴位.结果 术后随访1年,3例患者晶状体位置均无明显偏心,轴位偏移均小于5度.裸眼远方视力分别为0.6、1.0、1.0.较术前均显著提高,无明显后发性白内障发生.结论 Toric人工晶状体为治疗中高度角膜散光提供了一种安全、有效、稳定的治疗方法.

Observation on the stability of Toric IOL implantation for the cataract with corneal astigmatism

Objective To evaluate the effects of Toric OL （Acrysof SN60TY） for corneal astigmatism according to the stability of Toric IOL and the corneal cylinder power after Toric IOL implantation. Design Retrospective case series. Participants Three cataract patients （throe eyes） with middle or high degree of corneal astigmatism. Methods Toric IOL＇s spherical equivalent and corneal astig- matism were measured preoperatively. Different types of Toric IOL were implanted according to the ALCON software＇s calculation re- sults. During the operation, the axis of the toric lens was aligned to the steepest axis of the corneal astigmatism. Preoperative corneal astigmatism were 1.5 D, 2.5 D, 5.5 D respectively. Cataract phacoemulsification and Toric intraocular lens implantation were taken by the same doctor. AcrysofSN60 T3, AcrysotSN60 T4 and AcrysotSN60 T4 IOL were implanted. ntraocular lens spherical degree was calculat- ed with IOLMaster （Carl Zeiss, Germany） and SRIGT formula. Corneal astigmatism axis was measured by corneal topography, lens type and position were calculated by Alcon formula, inputting the axis of maximum diopter and minimun diopter, surgically induced astigma- tism, incision location. Patients were followed up at least more than 1 year. Main Outcome Measures The postoperative visual acuity, position of the lens, cylinder power. Results No postoperative complications were found. A significant improvement in visual acuity was 0.6, 1.0, 1.0. There was no significant rotation of the lens. The remaining corneal astigmatism was stable after the operation. Conclusion Toric IOL for corneal astigmatism is an effective and stable refractive corrective tool.