TICL治疗近视散光术后散光和人工晶体轴的稳定性

Study on the stability of astigmatism and aix after Toric-ICL implantation for moderate to high myopic astigmatism

目的评价后房型有晶体眼散光性人工晶体(toric Visian Implantable Collamer Lens,TICL)植入治疗中高度近视散光术后散光和人工晶体轴的稳定性及术后视觉功能调查分析。方法 33眼(21例)行后房型有晶体眼散光性人工晶体植入治疗中高度近视散光。手术前后检查患者屈光、裸眼视力、最佳矫正视力、眼压、角膜内皮细胞。术后随访6个月以上,在随访1周和6个月散瞳检查TICL轴向;并由同一医师在术后6个月完成对患者的视觉功能调查表填写。结果术后6个月,所有患者术眼裸眼视力(Uncorrected visual acuity,UCVA)达到0.5或以上;最佳矫正视力(best corrected visual acuity,BCVA)达0.6或以上,27眼(81.8%)较术前提高1行或以上,没有患者术后最佳矫正视力低于术前;有效性指数和安全性指数分别是1.09±0.20和1.25±0.23。散光从术前-2.48±0.91D降到术后1周-0.54±0.25D和术后6个月-0.50±0.19D,从术后1周到术后6个月散光平均变化0.03±0.17D。从术后1周到术后半年轴位平均偏离2.48±1.25°,范围在0°～6°,其中0°～3°有27眼(81.8%)。术后视觉功能调查显示除14.3%的患者诉中距离视力电脑屏幕阅读困难外,其他视觉功能满意度均达满意或很满意。结论术后6个月,散光及TICL轴保持良好的稳定性;而且术后患者视觉功能满意度高。TICL治疗中高度近视散光是安全、有效的。

Objective To assess the stability of astigmatism and aix after toric Visian Implantable Collamer Lens implantation （TICL） for moderate to high myopic astigmatism. Methods Thirty -three eyes of 21 consecutive patients with TICL implantation for the correction of moderate to high myopic astigmatism were collected and a minimum follow -up of 6 months was performed. The refraction, visual acuity, intraocular pressure （IOP） and endothelial cell density were detected. The axis deviation of TICL was measured from 1 week to 6 months postoperatively. The visual functions evaluation was done by the same clinician 6 months after surgery. Results Six months after surgery, the uncorrected visual acuity （UCVA） was 0.5 or more and the best corrected visual acuity （BCVA） was 0.6 or more. Twenty - seven eyes （81.8%） got the improvement of 1 line or more and no eyes lost 1 line or more. The effica- cy and safety indexes were 1.09±0.20 and 1.25±0.23, respectively. The mean refractive value was decreased from -2.48±0.91D preoperatively to -0.54±0.25D 1 week and -0.50±0. 19D 6 months after surgery. The mean change of astigmatism from 1 week to 6 months after surgery was 0.03±0.17D. The mean axis deviation of TICL from 1 week to 6 months postoperatively was 2.48±1.25° （normal range of 0° - 6°）. Except 14.3% patients had difficulty in reading computer screen, the re- maining patients were satisfied with the visual functions. Conclusion TICL implantation shows to be an effective and safe method for correction of moderate to high myopic. The astigmatism and axis of TICL appear to have better stability 6 months after surgery with patient higher satisfaction and TICL implantation might possess a promising therapy for moderate to high myopic astigmatism.