Toric人工晶状体矫正外伤性白内障患者散光的观察

Study of a foldable Toric intraocular lens to correct astigmatism in traumatic cataract patients

目的评价Toric人工晶状体矫正外伤性白内障患者散光的效果。方法前瞻性病例研究,收集我科散光大于1.0D的外伤性白内障患者17例(17只眼),所有患者受伤后角膜缝线已拆除,屈光状态稳定3个月以上,施行白内障超声乳化联合Toric人工晶状体植入术。术后随访3～28个月,观察手术前后裸眼视力(uncorrected visual acuity,UCVA)、最佳矫正视力(best corrected visual acuity,BCVA)、散光(包括角膜源性散光及总合散光)、人工晶状体位置、术中及术后并发症等情况。结果术后UCVA及BCVA均较术前提高,差异有统计学意义(P<0.05),术后UCVA≥0.6者11例,所有患者BCVA≥0.6,BCVA≥1.0者8例;术后球镜度数及总合散光均较术前降低,差异有统计学意义(P<0.05);手术前后角膜源性散光变化无统计学意义。人工晶状体具有良好的居中性,随访末期,旋转度为(3.51±2.97)°,未见明显严重的术中及术后并发症。结论 Toric人工晶状体可矫正部分外伤性白内障患者的散光,把握合适的手术适应证,可为患者提供更好的预后视力。

Objective To evaluate the efficacy of a foldable Torie intraoeular lens on the correction of astigma- tism in traumatic cataract patients. Methods This prospective clinical study was based on 17 cases（ 17 eyes） with more than 1.00 diopter（D） of preexisting astigmatism in traumatic cataract patients. Three months after the sutures were removed and the refraction was stabilized, all the patients were performed phaeoemulsification to remove cataract and implantation of a foldable Toric intraocular lens. In the 3 - 28 months＇ following-up after surgery, uncorrected visual acuity （UCVA） and the best corrected visual acuity（BCVA）, refraction, astigmatism, Toric IOL axis and position, and the complications were measured. Results After surgery＇, both UCVA and BCVA were all increased, 11 eyes achieved 0.6 or better in UCVA,all eyes achieved 0.6 or better in BCVA, and 8 eyes achieved 1.0 or better in BCVA. There were sig- nificant differences in visual acuity, sphere diopter and sum astigmatism diopter before and after surgery, and no significant difference in corneal astigmatism. The stability of Toric IOL was satisfactory, and the mean Toric IOL axis rotation was （3.51± 2.97 ）°. No severe complications during and after surgery were observed. Conclusions Torie intraocular lens could correct astigmatism in some traumatic cataract patients, and suitable selection of patients could achieve better optical and visual quality.