维吾尔族白内障患者植入Toric人工晶状体治疗角膜散光的稳定性研究

Clinical studies on AcrySof Toric intraocular lens

目的评估AcrySof散光型人工晶状体矫正维吾尔族白内障患者术前角膜散光临床疗效和旋转稳定性。方法收集石河子人民医院眼科角膜散光〉1．0D的年龄相关性白内障患者38例49只眼，按族别将患者分为A、B两组，A组为维吾尔族（实验组）共（15例19只眼），B组为汉族（对照组），共（23例30只眼），两组患者均植入AcrySof Toric IOL，观察术后1周、1月、3月患者裸眼视力、最佳矫正视力、残余散光、人工晶状体的轴位旋转稳定性以及术后复诊患者的脱镜率。结果术后1周、1月、3月裸眼远视力／〉0．8者A组分别占73．7％（14／19）、84．2％（16／19）、89．5％（17／19），B组分别占76．7％（23／30）、86．7％（26／30）、93．3％（28／30），两组比较差异均无统计学意义（P〉0．05）；最佳矫正远视力≥0．8者，两组比较差异无统计学意义（P〉0．05）。A、B两组术前、术后3个月角膜散光比较，均无统计学意义（P〉0．05）。术后1周、1个月、3个月平均残余散光度数，A组分别为（0．29±0．12）D，（0．37±0．16）D，（0．37±＋0．18）D；B组分别为（0．27＋0．14）D，（0．36±0．19）D，（0．39±0．19）D，差异无统计学意义（P〉0．05）。术后3个月AcrySof ToricIOL平均离轴旋转度〈3度，远视脱镜率：A组为89．5％（17／19），B组为93．3％（28／30），两组术后无明显不良症状及并发症。结论AcrysofToric IOL具有良好的散光矫正效果并具有良好的旋转稳定性，可明显改善患者术后远视力，能有效提高术后脱镜率，无明显民族差异。

ObJective To evaluate the efficacy and rotational stability of AcrySof Toric intraocu- lar lens implantation to correct Uygur preexisting corneal astigmatism in cataract surgery. Methods Thirty-eight cataract patients （49 eyes） from Shihezi People＇s Hospital with corneal astigmatism greater than 1.0D were involved in this study and randomized into two groups. Group A （Experimental group） with 15 patients （19 eyes） and group B （Control group） with 23 patients （30 eyes） both re- ceived AcrySof Toric IOL implantation. Uncorrected distant visual acuity （UCDVA）, best corrected visual acuity （BCDVA）, residual astigmatism, rotational stability of intraocular lens and spectacles independence were observed. Results Patients with UCDVA 0.8 or better accounted for 73.7%（14/19）, 84.2%（16/19）, 89.5%（17/19） and 76.7%（23/30）, 86.7%（26/30）, 93.3%（28/30）, in group B, respectively. There were significant differences between two groups 1 week, 1 month and 3 months after opera- tion （P 〉0.05）. There was no statistically significant differences in BCDVA between the two groups （P 〉0.05）. There were no significant differences in preoperative corneal astigmatism and corneal astigmatism 3 months after operation in the two groups respectively （P 〉0.05）. There were significant dif- ferences in the mean residual astigmatisms between the two groups 1 week, 1 month and 3 months postoperatively （P 〉0.05）. The mean Toric IOL axis rotation was less than 5 degrees 3 months post- operatively. Spectacles were not necessary in 89.5%（17/19） and 93.3%（28/30）, cases in group A and B, respectively. No eye had intraoperative or postoperative complications. Conclusions AcrySof Toric IOL is effective in astigmatism correction which shows good rotational stability. And it is also effective option to correct preexisting corneal astigmatism in cataract surgery, No obvious racial difference.