重视Toric人工晶状体应用误差来源分析和控制

Paying attention to the analysis and control of errors of Toric intraocular lens application

Toric人工晶状体（IOL）是一种双曲面屈光性IOL，可将白内障患眼散光度与球镜度数相结合，用于白内障患者角膜散光的矫治。与其他矫正白内障患者角膜散光的方法相比较，白内障摘出后植入Toric IOL术后不发生屈光回退，对角膜和眼表环境影响小，术后患眼视觉质量好。然而，临床经验和既往研究的结果发现，相当一部分白内障患者植入Toric IOL后仍残留一定程度的散光，提示存在Toric IOL植入误差，是造成术后散光残留和患者屈光状态不满意的主要原因。根据Toric IOL应用过程中的误差来源不同可分为角膜散光测量误差、术源性散光（SIA）引起的误差、IOL计算引起的误差以及术后IOL偏心、倾斜、旋转等位置改变引起的误差。临床眼科医生应针对相关患者对Toric IOL误差来源进行分析和控制，减少Toric IOL植入误差，提高患者对Toirc

Toric intraocular lens （IOL） is a kind of hyperboloidal IOL and is used for the correction and treatment of cataract with corneal astigmatism by combining the astigmatism and spherical power.Topic IOL implantation has better stability and less impact on the ocular surface and provides better visual quality in comparison with other approaches for the patients with cataract and corneal astigmatism after surgery.However, based on the clinical experiences and the results of previous studies, a considerable number of eyes remain a certain amount of residual astigmatism following Toric IOL implantation, indicating some errors in Toric IOL implantation.Studies showed that Toric IOL implantation errors are the main causes of residual astigmatism and postoperative unsatisfactory refractive outcomes, including preoperative measurement error, the evaluation error for surgery-induced astigmatism （SIA）, the imprecision of calculators for IOL power, and the refractive changes caused by IOL decentration, tilt and rotation after surgery.Ophthalmologists should fully understand, analyze and control the causes of these errors to improve the satisfaction of patients to Toirc IOL implantation.