白内障植入Toric IOL和单焦点非Toric IOL术后疗效观察

目的观察白内障手术中使用ToricIOL对视力和屈光结果的临床疗效.方法2012年7月至2015年7月在无锡市第九人民医院眼科手术治疗的白内障患者77例(108只眼).患者共分为3组.A组:角膜散光度≥2.0 D植入Toric单焦点晶状体22例患者(30只眼);B组:角膜散光度≥2.0 D植入单焦点非Toric晶状体25例患者38只眼;C组:角膜散光度≤1.5 D植入单焦点非Toric晶状体30例(40只眼).术后随访1周至2个月,观察其裸眼视力、最佳矫正视力、屈光度、角膜散光值,综合各指标评估Toric晶状体的有效及安全性.结果术后三组的裸眼视力LogMAR:A组0.25±0.21;B组0.52±0.22;C组0.16±0.25.最佳矫正视力LogMAR分别是:A组0.08±0.12;B组0.22±0.14;C组0.04±0.11.术前的角膜散光分别是A组(3.68±1.21)D;B组(3.42±1.47)D;C组(0.95±0.41)D.术后眼球散光度分别是A组(1.1±0.65)D;B组(3.15±1.35)D;C组(0.91±0.52)D.术后散光度A组和B组比较有显著的统计学意义(P≤0.001),而在A组和C组之间无明显的统计学意义(P=0.17).结论在白内障手术的同时,相对于角膜散光较大的患者,Toric晶状体植入可以矫正角膜散光,提高视力,是一种安全,有效的选择.

Outcomes of Toric IOL and monofocal non-Toric IOL implantation in cataract surgery

Objective To investigate visual outcomes of Toric intraocular lens implantation in cataract surgery. Methods 77 cataract patients (n = 108 eyes)underwent cataract surgery from July 2012 to July 2015 in Wuxi Ninth People's Hospital. Group A patients (n = 30 eyes)had more than 2. 0 diopters (D)of corneal astigmatism and received a Toric monofocal IOL. Group B patients (n = 38 eyes)also had more than 2. 0 D corneal astigmatism but received a monofocal non-toric IOL. Group C (n = 40 eyes)patients had less than 1. 5 D astigmatism and received a monofocal non-toric IOL. Patients were followed up for two months to observe their uncorrected visual acuity,best corrected visual acuity, refractive error,and corneal astigmatism. Results Postoperative uncorrected LogMAR visual acuity was 0. 25 ± 0. 21 in Group A,0. 52 ± 0. 22 in Group B and 0. 16 ± 0. 25 in Group C. The best corrected visual acuity was 0. 08 ± 0. 12 in Group A,0. 22 ± 0. 14 in Group B and 0. 04 ± 0. 11 in Group C. Preoperative keratometric cylinder was 3. 68 ± 1. 21 D in Group A,3. 42 ± 1. 47 D in Group B and 0. 95 ± 0. 41 D in Group C. These values changed to 1. 1 ± 0. 65 D,3. 15 ± 1. 35 D and 0. 91 ± 0. 52 D after surgery. Postoperative astigmatism was significantly different between group A and group B (P ≤0. 001)but not between group A and group C (P = 0. 17). Conclusions Toric IOL implantation is a safe and effective option to manage corneal astigmatism at the time of cataract surgery and to optimize visual outcomes for astigmatic patients.