Toric人工晶状体植入术后视觉质量的观察

Clinical observation of visual quality after implantation of toric intraocular lens

目的观察Acrysoftoric人工晶状体（IOL）植入矫正年龄相关性白内障合并角膜散光术后的视觉质量。方法前瞻性研究。收集2009年10月至2010年9月在青岛大学医学院附属医院眼科行超声乳化白内障吸除联合AcusoftoricIOL植入的患者60例（80只眼），依据晶状体型号分为乃，T4，T5a及T5b组，于术后3个月观察患者的裸眼视力，最佳矫正视力，术后残余散光，对比敏感度，波前像差及晶状体轴向。选取同期植入AcrysofNaturalIOL的患者45例（65只眼）作为对照组。两组间比较采用独立样本t检验，术前术后比较采用配对样本t检验，多组间比较采用方差分析及两两比较的q检验，两变量相关性分析采用pearson相关分析。结果T3，T4，T5组术后视力均较术前改善，T5b组视力低于其余3组；Toric组术后裸眼视力为（0．19±0．14），优于对照组（t=4．04，P〈0．05）。T5b组术后残余散光为（1．69±0．68）D，与T3，T4及TSa组比较差异均有统计学意义；Toric组术后残余散光为（0．51±0．78）D，明显低于对照组（t=2．54，P〈0．05）。T3，T4，T5组对比敏感度差异无统计学意义，TSb组低阶像差及彗差高于其余3组；Toric组各空间频率对比敏感度与对照组相比差异无统计学意义，Toric组低阶像差及彗差低于对照组。67只眼（83．75％）晶状体旋转≤5°，所有患者晶状体旋转≤10°。结论AcrysoftoricIOL矫正年龄相关性白内障合并角膜散光疗效准确、稳定，具有较好的术后视觉质量。

Objective To observe the visual quality after implantation of Acrysof toric intraocular lens （IOL） in cataract patients. Methods Eighty eyes （60 patients） had implantation of Acrysof toric IOL in our hospital between Oct. 2009 and Sep. 2010. The patients were divided into four groups according to the toric models （T3, T4 and T5 ）. The uncorrected visual acuity （UCVA）, best corrected visual acuity （BCVA）, residual cylinders, contrast sensitivity, high order aberration and IOL axis were evaluated preoperatively and 3 months postoperatively. Sixty-five eyes （45 patients ） had implantation of Acrysof Natural IOL. Results The UCVA improved in the toric groups three months postoperatively. The UCVA of group TSb was lower than that of the other three groups. The UCVA of toric group was （0. 19 ±0. 14） which was better than that of the control group （t = 4.04, P 〈 0. 05）. The residual cylinder was （ 1.69 ± 0. 68） D in group TSb, which was statistically different from the other three groups. The residual cylinder of the toric group was （0.51 ±0.78） D, which was much lower than the control group （t =2.54, P 〈0.05）. The difference of contrast sensitivity between the four toric groups was not statistically significant. The low-order aberration and coma of group TSb was higher than that of the other three groups. The difference of contrast sensitivity between the toric group and the control group was not statistically significant. The low-order aberration and coma of the toric group were lower than those of the control group. The !OLs in 67 eyes （83.75%） rotated less than 5 degrees and all IOLs rotated less than 10 degrees. Conclusion Implantation of the AcrySof toric IOL proves to be an effective, safe, and stable method of managing corneal astigmatism in cataract patients and provides good visual quality.