基于Sirius测量数据的Acrysof Toric人工晶状体临床应用研究

Clinical application of Acrysof Toric intraocular lens based on Sirius measurement data

目的评估基于Sirius测量的角膜曲率值对Acrysof Toric人工晶状体(IOL)植入准确性和散光矫正能力的影响。方法采取前瞻性研究,选择2015年9月至2016年10月在第三军医大学第一附属医院眼科白内障组就诊的年龄相关性白内障伴角膜散光患者23例(36眼),行白内障超声乳化吸除联合Acrysof Toric IOL植入术,术前应用Sirius测量的角膜曲率值作为的Acrysof Toric人工晶状体度数在线计算依据(19眼),术前应用手动角膜曲率计测量的角膜曲率值作为Acrysof Toric人工晶状体度数在线计算依据(17眼)。观察术后3个月的裸眼视力、最佳矫正视力、手术源性散光值、IOL轴位偏差及散光矫正指数。统计学方法采用t检验和Z检验。结果术后3个月视力比较,观察组平均裸眼视力(UCVA)为(0.8±0.11),对照组平均UCVA为(0.7±0.73),差异无统计学意义(Z=1.277,P=0.372);观察组平均最佳矫正视力(BCVA)为(0.8±0.21),对照组平均BCVA为(0.8±0.41),差异无统计学意义(Z=0.962,P=0.329)。IOL轴位偏差比较,观察组为(2.81±1.72)°,对照组为(3.12±1.56)°,2组比较差异无统计学意义(t=0.481,P=0.631)。手术矫正散光指数比较,观察组为(1.01±0.21),对照组为(1.03±0.32),2组比较差异无统计学意义(t=0.581,P=0.615)。结论与手动角膜曲率计相比,基于Sirius测量数据在线计算的Acrysof Toric IOL度数准确可靠,术后效果与手动角膜曲率值组相当。Sirius具有高分辨率、非接触性、无创性操作简便等明显优点。

Objective To evaluate the effect of corneal curvature based on Sirius measurement on the accuracy of implantation of Acry- sof Torie intraoeular lens （IOL） and astigmatism correction. Methods In this prospective study, 23 patients （36 eyes） with cataract and mild to moderate corneal astigmatism were recruited and underwent phaeoemulsification and Acrysof Torie IOL implantation. In the observation group ,the corneal curvature value of 19 eyes measured by Sirius was used as the basis for calculating Acrysof Toric intraocular lens power. In the control group ,the corneal curvature value of 17 eyes measured by manual corneal curvature was used as the basis for calculating Acrysof Toric intraoeular lens power. Main outcome measurements including uncorrected visual acuity（ UCVA）, best corrected visual acuity （BCVA）, surgically induced astigmatism（SIA） ,deviation of lens axis（LAD） ,index of corrected astigmatism（CAI） at 3 months postoperatively were observed. Results At 3 months postoperatively,the average UCVA of the observation group was （0.8± 0. 11 ） and the average UCVA of the control group was （0.7 ± 0.73 ） , there was no statistically significant differences （Z = 1. 277, P = 0.372 ）. The average BCVA of the observa- tion group was （0.8 ±0. 21 ） ,and the average BCVA of the control group was （0.8± 0.41 ） ,there was no statistically significant differences （Z = 0. 962,P = 0. 329）. The deviation of lens axis of the observation group was （2.81 ± 1.72）° and it was （ 3.12 ± 1.56）° in the control group, and there was no statistically significant differences（ t = 0. 481 ,P = 0. 631 ）. The index of corrected astigmatism of the observation group was （1.01 ± 0.21 ） and it was （1.03 ±0.32） in the control group,with no statistically significant differences （t = 0. 581,P = 0. 615 ）. Con- clusion Compared with the manual keratometer,Acrysof Toric IOL calculation based on Sirius measurement data is accurate and reliable. Meanwhile, Sirius has obvious advantages such as high resolution, non-contact, non-invasive and easy to operate.