白内障术中植入AcrySof Toric人工晶状体矫正角膜散光观察

目的 评价白内障手术中植入AcrySof(R) Toric散光型人工晶状体矫正角膜散光的效果及在囊袋内的稳定性.方法 对43例(48只眼)伴有角膜规则散光的白内障患者,采用颞侧透明角膜切口超声乳化术,植入AcrySof(R) Toric折叠式散光型人工晶状体.观察术前、术后裸眼视力及最佳矫正视力;术前预计残余散光、术后残余散光;术前及术后主观验光散光值;术前及术后角膜散光;术后人工晶状体在囊袋的旋转度,并进行统计分析.结果 术后裸眼视力及最佳矫正视力较术前均明显提高.主观验光散光值术前为(2.25±0.79)D、术后为(0.21±0.24)D,两者差异有统计学意义;术前预计残余散光(0.19±0.22)D;术后残余散光(0.20±0.21)D,差异无统计学意义;术前角膜散光(2.15±0.76)D、术后角膜散光(1.98±0.67)D,两者统计学无显著性差异;术后 6个月内最大偏差,除一例偏差＞15°达25°,进行了二次手术轴位调整;另有3只眼(6.3 %)旋转＞ 10°外,其余 41只眼(85.4%)旋转＜ 5° .结论 在白内障手术中植入AcrySof(R) Toric散光人工晶状体可使患者获得更好的裸眼远视力,减少了患者的残余散光,并且该晶体具有良好的旋转稳定性,是一种有效的、预测性强的矫正角膜规则散光的治疗方法,具有一定的推广前景.

Clinical study of AcrySof(R) Toric intraocular lens implantation on corneal astigmatism

Objective To observe the clinical outcome of implanting the AcrySof(R) Toric intraocular lens to correct the corneal astigmatism in cataract surgery, and to evaluate the result and rotational stability of AcrySof(R) Toric after cataract surgery. Methods A retrospective study of 48 eyes in 43 patients. All patients underwent similar uncomplicated phacoemulsification cataract surgery. The preoperative corneal astigmatism was more than 1.00 diopter (D) in all eyes. The uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), preoperative corneal astigmatism, anticipated residual astigmatism, postoperative residual astigmatism and toric lens axis were detected and measured. The postoperative IOL position was assessed at 1 day, 1 week, 1 month and 3 months using a specially designed angle measuring eyepiece under the slit lamp. Results At 3 months following surgery, the BCVA was 0.8 or better in 87% of eyes and 0.6 or better in 94%. All eyes achieved 0.5 or better UCVA. 67% of eyes showed the 0.8 or better in UCVA. The mean preoperative corneal astigmatism was (2.15±0.76) D and the postoperative refractive cylinder was (0.20±0.21) D, indicating a significant decrease in refractive cylinder after surgery (t =18.765, P = 0.000). The maxim rotation degrees were within 5 degrees in 85.4% of eyes 6 months after operation. Only one eye occurred more than 15 degrees of rotation after operation. Conclusions AcrySof Toric lens make cataract patients enjoy the better UCVA, including good rotational stability and predictability in the correct of corneal astigmatism. The AcrySof(R) Toric implantation is an effective option for the correct of preexisting corneal astigmatism in cataract surgery.