眼轴长度和IOL在囊袋内的对齐方式对Toric IOL旋转稳定性的影响

Influence of axial length and alignment in the capsular bag on rotational stability of a Toric intraocular lens

目的:使用特定软件(Adobe Photoshop)评估人工晶状体(intraocular lens,IOL)的旋转稳定性,确定眼轴长度和IOL在囊袋内的对齐方式对ToricIOL旋转稳定性的影响。方法:研究对象眼植入AcrySof Toric IOL。使用光学相干或浸润式A型超声生物测量仪测量眼轴(axial length,AL)。手动角膜曲率计和角膜地形图测定角膜散光。IOL的对齐方式包括垂直、水平和倾斜。使用特定软件测定IOL的旋转程度并获得平均绝对差。观察术后6mo眼轴长度和IOL在囊袋内的对齐方式对旋转稳定性的影响。结果:该研究评估了168例168眼。AL为19.33～29.04(平均24.12±1.62)mm。平均IOL旋转在术后1wk为0.4°,1wk～1mo为1.1°,1～3mo为0.3°,3～6mo为0.2°。最大旋转发生在1wk～1mo。术后6moAL和晶状体的旋转有很强的相关性(r=0.92,P<0.01),而三种对齐方式(垂直、水平、斜向)对旋转的影响没有显著差异(P=0.102)。结论:眼轴越长ToricIOL的旋转程度越大。IOL在囊袋内的对齐方式对旋转程度没有影响。

· AIM： To evaluate the rotational stability of a Toric intraocular lens （IOL） using purpose-designed software and to determine the influence of axial length （AL） and in- the-bag IOL alignment on IOL rotation.· METHODS： This study enrolled eyes that had AcrySof toric IOL implantation. The AL was measured using optical coherence biometry or immersion A-scan biometry. Corneal astigmatism was determined by manual keratometry and topography. The IOL alignment was vertical, horizontal, or oblique. Rotational stability was measured using the purpose-designed software, and the mean absolute difference was determined. The effect of AL and IOL alignment on rotational stability was determined 6 months postoperatively. · RESULTS. The study evaluated 168 eyes （168 patients）.The mean AL was 24.12±1.62 （ range 19.33 to 29.04） mm. The median IOL rotation was 0.4 degree from baseline to 1 week, 1.1 degree from 1 week to 1 month, O. 3 degree from 1 to 3 months, and 0.2 degree from 3 to 6 months.The maximum rotation occurred between 1 week and 1 month. There was a strong correlation between AL and IOLrotation at 6 months （r = 0.92, P〈0.01）. The mean absolute difference at 6 months was not significantly different between the 3 axis placement categories when correlated with the rotation （ P= O. 102, analysis of variance）.· CONCLUSION ： Toric IOL rotation is greater in eyes with a longer AL. Alignment of the IOL in the capsular bag have no influence on rotation.