Toric人工晶状体矫正角膜散光的效果评价

目的评价Toric人工晶状体（IOL）矫正角膜散光的效果及在囊袋内的稳定性。方法收集确诊为年龄相关性白内障并伴有角膜规则散光的患者32例（35眼）,采用白内障超声乳化法植入ToricIOL。观察术前、术后裸眼视力（UCVA）及最佳矫正视力（BCVA）、术前角膜散光、预计残余散光、术后残余散光、IOL旋转度,并进行分析。结果术后3个月92%患眼UCVA≥0.5,78%患眼UCVA≥0.8,BCVA≥0.8者达96%。术前角膜散光平均为（1.500±0.405）D,术后3个月残余散光为（0.200±0.179）D。3个月时与术后第1d轴位相比较,IOL旋转平均为（2.132±1.853）°。结论ToricIOL可使患者获得更好的裸眼远视力,减少了患者的残余散光,预测性强,具有良好的旋转稳定性,是一种有效的矫正角膜规则散光的治疗方法。

Effect of implantation of toric intraocular lens on corneal astigmatism

Objective The clinical outcome of correct of corneal astigmatism following cataract surgery showed a limit effectiveness,and implantation of toric intraocular lens（IOL）has become a new option.This study was to evaluate the result and rotational stablility of toric IOL after cataract surgery.MethodsThirty-five eyes of 32 subjects were enrolled from Tianjin Medical University Eye Center.The preoperative corneal astigmatism was more than 1.00 diopter（D）for all the eyes.All patients underwent similar phacoemulsification combined with toric IOLs implantation.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.ResultsAt 3 months following surgery,92% of eyes showed the 0.5 or better in UCVA;78% of eyes was 0.8 or better in UCVA and 96% of eyes achieved 0.8 or better in BCVA.The mean preoperative corneal astigmatism was（1.500±0.405）D and the postoperative refractive cylinder was（0.200±0.179）D,indicating a significant decrease in refractive cylinder after surgery（t=18.817,P〈0.05）.The mean rotation of toric IOLs was（2.132±1.853）degrees after postoperative 1 day,and that of 3 months after operation was within 5 degrees in 94.3% of eyes.Only one eye occurred more than 10 degrees of rotation after operation.ConclusionToric IOLs allow cataract patients the better UCVA,good rotational stability and predictability in the correct of corneal astigmatism.The combination procedure of phacoemulsification and posterior chamber toric IOL implantation is an effective option for the correct of preexisting corneal astigmatism in cataract surgery.