超声乳化白内障吸除联合散光型人工晶状体植入临床观察

The study ofToric intraocular lens for corneal astigmatism correction in cataract patients

目的 研究AcrySofToric人工晶状体（IOL）矫正白内障患者角膜散光的有效性、安全性、稳定性.方法 选取2008年5月至2009年4月期间南通大学附属医院眼科连续性住院病例.白内障患者39例46只眼,术前角膜散光≥0.75D,行超声乳化白内障吸除术（PEA）后,植入AcrySofToricIOL.术后1d、1周、1个月、3个月检查记录裸眼视力（UCVA）、屈光状态、角膜曲率、AcrySofToricIOL的轴位.结果 （1）UCVA：术前：＜0.1为21只眼,0.1～0.3为24只眼,0.4～0.6为1只眼;术后：0.1～0.3为4只眼,0.4～0.6为27只眼,0.7～0.9为6只眼,≥1.0为9只眼.术前术后比较差异有统计学意义（P＜0.05）.（2）残留散光：术后3个月,0～0.75D者为46只眼中30只眼（65.22%）,1D～1.75D者为46只眼中16只眼（34.78%）,≥2.0D者为46只眼中0只眼（0.00%）.（3）角膜散光：术前角膜散光度（1.84±0.53）D（0.75～3D）,术后角膜散光度（1.73±0.59）D（0.75～3D）,手术前后比较差异无统计学意义（P＞0.05）,术源性散光（SIA）术后3个月为（0.67±0.53）D.4.IOL旋转稳定性：术后3个月,所有46只眼的IOL旋转均＜20°,其中≤5°为21只眼（45.66%）,6°～10°为11只眼（23.91%）,11°～15°为13只眼（28.26%）,16°～20°为1只眼（2.17%）,平均值是7.23°±5.04°（0°～17°）.结论 白内障手术中植入AcrySofToric IOL可安全有效的矫正部分角膜散光提高患者术后的裸眼视力,并且未增加并发症的发生.

Objective To evaluate the safety, efficacy, stability of AcrySof Toric IOL implantation to correct corneal astigmatism in patients having cataract surgery. Methods This prospective study included 46 eyes of 39 consecutive cataract patients with more than 0.75 diopter （D） of preexisting corneal astigmatism during a period of 12 months. ARer PEA, 46 eyes were implanted with AcrySof Toric IOL, 1 day, 1 week, 1 month, 3 months after IOL implantation, the uncorrected visual acuity （UCVA）, residual refractive sphere and cylinders, corneal keratometric, the toric IOL axis were measured. Results 1. UCVA： before operation, 21 out of 46 eyes （45.65%） presented 〈0.1, 24 （52.17%） 0.1-0.3, 1 （2.18%） 0.4-0.6; 3 months after implantation, 4 out of 46 eyes （8.70%） presented 0.1-0.3, 27 （58.70%） 0.4-0.6, 6 （13.04%） 0.7-0.9, 9 （19.56%） 1.0 or better.There was statistically significant differences between before and after operation （P〈0.05）. 2. Residual refractive cylinders： 65.22% eyes had 0-0.75D, 34.78% 1.0-1.75D. 3. Corneal astigmatism： before operation, the corneal astigmatism was 1.84± 0.53D, after operation, was 1.73± 0.59D. There was no statistically significant differences between before and after operation （P〉0.05）. The mean SIA was 0.67± 0.53D. 4. Rotational stability： 3 months after implantation, all ActySofToric IOL rotated less than 20 degrees, IOL of 21 eyes （45.66%）less than 5 degrees, 11 eyes （23.91%）rotated 6° -10° , 13 eyes （28.26%） 11° -15° , 1 eye （2.17%） 16°-20° . The mean AcrySof Toric IOL axis rotation was 7.23±5.04 degrees （0-17degrees）. Conclusions The results show that phacoemulsification and AcrySof Toric IOL implantation is a safe and effective option to correct preexisting astigmatism in cataract surgery.