应用AcrySofToric人工晶状体矫正角膜散光

Clinical observation of the AcrySof Toric intraocular lens correcting corneal astigmatism

目的观察AcrySofToric人工晶状体（IOL）植入的临床效果和旋转稳定性；探讨如何减少术后散光轴位的偏差。方法白内障合并角膜规则散光120例（120眼），随机分A、B两组各60例（60眼），分别植入AcrySofToricIOL（A组）、单焦点人工晶状体AcrySofSA60AT（B组）。观察术后3个月和6个月时未校正视力（UCVA）及总散光度，对两组术后视觉效果进行分析和比较，比较A组60眼术后3个月和6个月时IOL散光轴位的旋转度，评价其在囊袋的稳定性，探讨如何减少术后散光轴位的偏差。结果术后120眼视力均有不同程度提高。术后3个月时A组60眼的UCVA为（O．78±0．15），B组60眼的UCVA为（O．53±0．11），两者差异有统计学意义（P〈0．05），A组视力提高优于B组。6个月时A组的总散光度从术前的2．07D降至0．67D，下降了约68％，B组的总散光与术前相比无明显改善。A组术后3个月IOL的旋转度平均值是（3．66±2．81）度，术后6个月IOI．的旋转度平均值是（3．65±2．74）度。术后6个月IOL的旋转度与术后3个月IOL的旋转度相比，差异无统计学意义（P〉0．05）。结论AcrySofToricIOL能显著减少术后散光，使白内障合并角膜规则散光的患者术后获得良好的视觉效果；具有良好的旋转稳定性；术后散光轴位出现偏差的原因与术者操作密切相关。

Objective To observe the efficacy and rotational stability of AcrySof Toric lens （IOL） implantation; To explore ways to reduce postoperative astigmatism axis deviation. Methods This prospec- tive observational study included 120 eyes from 120 consecutive patients, who were randomly divided into two groups. 60 cases in group A were implanted with the AcrySof Toric IOL , another 60 cases （ group B） were implanted with the monofocal classic IOL, the AcrySof SA6OAT . Outcomes of uncorrected visual acuity （UCVA）, total astigmatism and IOL rotation after 3 months and 6 months follow-up were evaluated respec- tively. Visual acuity of patients in the two groups were analyzed and compared. The lens stability in the cap- sular bag and ways to reduce postoperative astigmatism axis deviation were assessed. Results All the pa- tients had improved visual acuity after surgery. The UCVA after 3 months follow-up was 0.78±0.15 in group A,and 0.53 ±0.11 in group B. The UCVA after 6 months follow-up was 0. 73±0.16 in group A,and 0.51 ± 0. 12 in group B. There were significant differences between the two groups among the follow-up times （P 〈 0.05）. The visual acuity of group A patients improved was better than that of group B. The total astigma- tism of group A reduced from 2.07D to 0.67D after 6 months follow-up. There was no significant improve- ment compared with preoperative in group B. The mean rotation of IOL in group A was （3.66±2.81 ）°after 3 months follow-up ,and （3.65± 2.74）° after 6 months follow-up. There was no significant difference be- tween the two follow-up times （ P 〉 0.05 ）. Conclusion The AcrySof of Toric IOL can significantly reduce postoperative astigmatism. It can make cataract patients with corneal regular astigmatism get a good visualeffects. It has good rotational stability. The reasons for axial astigmatism deviation were closely related to the manipulation of the surgeon.