Toric人工晶状体植入矫正白内障合并中高度角膜散光的疗效观察

Clinical study of Toric intraocular lens implantation for correcting cataract patients with high astigmatism

目的回顾分析Toric人工晶状体植入治疗合并中高度角膜散光的白内障患者的临床治疗效果。方法对我院10例(11眼)合并中高度角膜散光的白内障患者行白内障超声乳化联合Toric人工晶状体植入术治疗,进行回顾性分析。术后随访6个月,分析不同时间点(术后1周、1个月、6个月)裸眼视力、最佳矫正视力及人工晶状体旋转稳定性,观察Toric人工晶状体植入后的疗效及有无并发症发生。术后随访观察6个月。结果术后6个月裸眼视力为0.58±0.29,最佳矫正视力0.65±0.30。裸眼视力≥0.5者6眼(54.5%),裸眼视力≥0.4者8眼(72.7%)。全眼总散光得到明显改善,从术前的(4.06±1.63)D降低到术后的(0.51±0.36)D,差异有统计学意义(P<0.01)。术后全眼总合散光与术前预计残余散光值(0.42±0.33)D接近,差异无统计学意义(P=0.360)。术后6个月,人工晶状体旋转度为(3.60±1.26)°。至末次随访时,植入Toric人工晶状体的11眼中旋转度均小于5°。所有患者均无术中及术后并发症发生。结论对于合并中高度角膜散光的白内障患者,经过严格的术前筛选,行白内障超声乳化吸出联合Toric人工晶状体植入,能够安全、有效地改善患者的散光,提高术后视觉质量,可预测性好,值得临床推广。

Objective To retrospective evaluate the clinical efficacy of the AcrySof toric intraocular lens（IOL）in correcting pre-operative corneal high astigmatism in cataract patients.Methods This retrospective observational study included 11 eyes from 10 cataract patients with high astigmatism who underwent implantation of an AcrySof toric IOL with cataract surgery.To analysis the outcomes of uncorrected visual acuity（UCVA）,the best corrected visual acuity（BCVA）,post-operation residual astigmatism,and IOL rotational stability after 1 week,1 month,and 6 months follow-up.Results The UCVA was 0.58±0.29 and BCVA was 0.65±0.30 at final follow-up（6 months）.The UCVA was 0.5 or better in 6 eyes（54.5%）,and was 0.4 or better in 8 eyes（72.7%）.The postoperation residual astigmatism was significant reduced to（0.51±0.36）D from（4.06±1.63）D before surgery（P0.01）.There were no statistically difference between the mean residual astigmatism at 6 months postoperative and the mean preoperative anticipated residual astigmatism（P0.05）.The mean rotation of the toric IOL was（3.60±1.25）° at 6 months follow-up.All eyes had IOL rotation of less than 5° at final follow-up.Conclusion The results of this review showed that implantation of the AcrySof toric IOL is an effective,safe,and predictable method for managing cataract patients with high astigmatism after strict screening,it provides a beneficial increase in UCVA with the use of toric IOL and can be widely implement.