白内障合并规则角膜散光患者在基层医院眼科行散光矫正型人工晶状体植入术的临床效果

Clinical effect of astigmatism correction intraocular lens implantation for patients with cataract and regular corneal astigmatism in the ophthalmology department of primary hospitals

目的探讨白内障合并规则角膜散光患者在基层医院眼科行散光矫正型人工晶状体(Toric IOL)植入术的临床效果。方法回顾性分析2019年1月至2019年12月在勉县红十字医院和宜川县人民医院住院行白内障超声乳化联合Toric IOL植入术的84例(108眼)患者的临床资料。术前采用自动角膜曲率测量仪测量角膜散光,范围1.00~3.00 D,平均(2.10±0.68)D;角膜地形图检查为规则角膜散光,A超测量眼轴,采用SRK/T公式计算人工晶状体度数,在线计算散光轴位,行白内障超声乳化摘除联合Toric IOL植入术。术后3个月,评估裸眼视力、最佳矫正视力、残余散光、IOL轴位旋转及主观视觉质量满意度。结果术后1 d、1个月、3个月,患者的裸眼视力、最佳矫正视力与术前比较均明显提高,差异具有统计学意义(P<0.05)。术后3个月,实际残余散光(0.48±0.25)D,与术前预期残留散光(0.40±0.38)D比较,差异无统计学意义(P>0.05);术后3个月,实际残余散光在±0.5 D的患眼比例为60.0%。术后3个月,Toric IOL植入术后轴位旋转(4.12°±6.35°),旋转在0°~5°的比例75.00%(81/108);85.19%(92/108)患者术后视远脱镜;87.96%(95/108)患者对术后患眼获得的视觉质量满意。结论白内障合并规则角膜散光患者在基层医院眼科行Toric IOL植入术的临床效果显著,可明显改善患者术后裸眼视力,提高脱镜率,增强散光矫正预测性,稳定性好,且患者主观视觉质量满意度高,值得临床进一步推广和应用。

Objective To investigate the clinical effect of astigmatism correction intraocular lens(Toric IOL)implantation for patients with cataract and regular corneal astigmatism in the ophthalmology department of primary hospitals.Methods The clinical data of 84 patients(108 eyes)who underwent phacoemulsification of cataract combined with Toric IOL implantation in Mian County red cross hospital and Yichuan people’s hospital from January 2019 to December 2019 were retrospectively analyzed.The automatic corneal curvature measuring instrument was used to measure corneal astigmatism before the operation,ranging from 1.00-3.00 D,with an average of(2.10±0.68)D;the corneal topography examination was regular corneal astigmatism,the A-ultrasound measured the axis of the eye,the SRK/T formula was used to calculate the power of the intraocular lens,the axis of astigmatism was calculated online,and the phacoemulsification of cataract combined with Toric IOL implantation was performed.Three months after operation,the uncorrected visual acuity,best corrected visual acuity,residual astigmatism,IOL axis rotation and subjective visual quality satisfaction were evaluated.Results At 1 d,1 month,and 3 months after operation,the patients’uncorrected visual acuity and best corrected visual acuity were significantly improved compared with those before operation,and the differences were statistically significant(P<0.05).Three months after operation,the actual residual astigmatism was(0.48±0.25)D,which compared with the expected residual astigmatism(0.40±0.38)D before operation,and the difference was not statistically significant(P>0.05);the proportion of eyes with actual residual astigmatism within±0.5 D at 3 months after surgery was60.0%.Three months after operation,the axial rotation was(4.12°±6.35°)after Toric IOL implantation,the ratio of rotation within 0°-5°was 75.00%(81/108);85.19%(92/108)patients had postoperative visual distance take off lens;87.96%(95/108)of the patients were satisfied with the visual quality obtained after the operation of the affected eyes.Conclusion Toric IOL implantation for patients with cataract and regular corneal astigmatism in the ophthalmology department of primary hospitals has a significant clinical effect,it can significantly improve the postoperative uncorrected visual acuity,increase the lens removal rate,enhance the predictability astigmatism correction and has good stability,and the subjective visual quality satisfaction of patients is high,which is worthy of further clinical promotion and application.