Toric人工晶状体治疗合并散光白内障的临床疗效

Toric intraocular lens on the treatment of cataract with astigmatism

目的观察术前伴有较大角膜散光的白内障患者植入Toric人工晶状体（Acrysof SN60TT）后的屈光效果及囊袋内旋转稳定性。方法选取在我院植入Toric人工晶状体的13例（20只眼）角膜散光均大于1 D的年龄相关性白内障患者作为研究对象,男女比例为9：4,平均年龄为（70.4±12.5）岁,术前最佳矫正视力为0.20±0.16,术前平均角膜散光为（1.84±0.66）D;术前通过IOL Master及软件测量计算确定人工晶状体型号及放置轴位,行超声乳化白内障吸除手术,术中将人工晶状体准确放置于目标位置。主要随访指标为患者的自觉症状、眼压、裸眼视力、最佳矫正视力、总合散光、角膜散光、人工晶状体柱镜轴位。结果所有病例术后复视及视疲劳症状较术前均有所改善,术后随访2-25个月,平均随访13.4个月,术后第1天裸眼视力为0.65±0.25,最佳矫正视力为0.69±0.22,末次随访时裸眼视力为0.73±0.29,最佳矫正视力为0.86±0.30,末次随访时总合散光为（0.64±0.81）D,与预计残余散光（0.19±0.13）D相比,差异无统计学意义（P〉0.05）,末次随访时人工晶状体旋转（8.4±7.4）°。结论 Toric人工晶状体能有效地矫正散光,在囊袋内具有良好的稳定性。

Objective To evaluate the refractive effects and rotational stability of Acrysof SN60 TT Toric intraocular lens（ IOL） in cataract patients with astigmatism. Methods This study involved 13 age-related cataract patients（20eyes） who hadcorneal astigmatism higher than 1. 0 diopter（D）. Male to female ratio was 9：4,and average age was 70. 4 ±12. 5 years. Best corrected visual acuity was 0. 20 ± 0. 16,and meanastigmatism was 1. 84 ± 0. 66 D. The type and axis of intraocular lens was determined by a keratometer（ IOL master,Carl Zeiss）. Patients were followed up for symptoms,intraocular pressure,uncorrected and best correctedvisual acuity,total and corneal astigmatism,and IOL cylinder axis. Results Patients were followed for 2 to 25 months,averaged at 13. 4 months. Diplopia and visual fatigue symptoms improved significantly after the surgery in all patients. On postoperative day one,uncorrected visual acuity（UCVA） was 0. 65 ± 0. 25 and best corrected visual acuity（BCVA） was 0. 69 ± 0. 22. At the end of follow-up,UCVA improved to 0. 73 ± 0. 29 and BCVA improved to 0. 86 ± 0. 30. Total astigmatism0. 64 ± 0. 81 Ddid not differ significantly estimated residual astigmatism（0.19 ±0.13 D,P 〉0.05）. AverageIOL rotation was 8.4 ±7.4 degrees. Conclusions Toric intraocular lens effectively correct astigmatism and long-term axial stability is satisfactory.