散光型人工晶状体植入术联合超声乳化白内障摘除术治疗白内障合并角膜散光患者的临床研究

Clinical study of astigmatic intraocular lens implantation combined with phacoemulsification cataract extraction in treatment of cataract patients with corneal astigmatism

目的探究散光型人工晶状体植入术(IOL)+超声乳化白内障摘除术(Phaco)治疗白内障合并角膜散光(CA)患者的效果。方法选取2019年6—2022年1月商丘市中医院102例(102眼)白内障合并CA患者,按随机数字表法分成A组(n=51)、B组(n=51)。B组接受非球面IOL+Phaco治疗,A组接受散光型IOL+Phaco治疗。对比2组手术前后最佳矫正视力(BCVA)、裸眼视力(UCVA)、视觉质量、屈光状态(残余散光、CA)、小瞳验光柱镜、球镜及轴向、曲率、角膜内皮细胞(CEC)密度、变异系数及六角形细胞占比、并发症发生率。结果A组术后1个月、3个月BCVA、UCVA LogMAR值较B组低(P<0.05);A组术后3个月9%对比度视力、20%对比度视力、100%对比度视力及传递函数截止频率值均较B组高(P<0.05);A组术后1个月、3个月残余散光、CA较B组低(P<0.05);A组术后1个月、3个月小瞳验光柱镜、球镜值较B组低(P<0.05);A组术后1个月、3个月CEC密度、六角形细胞占比较B组高,CEC变异系数较B组低(P<0.05);2组术后均未发生并发症。结论散光型IOL+Phaco治疗白内障合并CA患者可有效提高UCVA、BCVA,提升视觉质量及功能,减轻屈光状态,且对CEC影响小,安全性高。

Objective To investigate the effect of astigmatic intraocular lens implantation(IOL)combined with phacoe⁃mulsification(Phaco)in the treatment of cataract patients with corneal astigmatism(CA).Methods A total of 102 ca⁃ses(102 eyes)of cataract patients with CA in our hospital from June 2019 to January 2022 were selected and divided in⁃to group A(n=51)and group B(n=51)according to the random number table method.Group B received aspheric IOL combined with Phaco therapy,and group A received astigmatic IOL+Phaco therapy.The best corrected visual acu⁃ity(BCVA),uncorrected visual acuity(UCVA),visual quality,refractive status(residual astigmatism,CA),small pupil refraction cylinder,spherical lens and axial direction,curvature,corneal endothelial cells(CEC)density,coeffi⁃cient of variation and proportion of hexagonal cells,complication rate were compared.Results The LogMAR values of BCVA and UCVA in group A were lower than those in group B at 1 month and 3 months after operation(P<0.05);9%contrast visual acuity,20%contrast visual acuity,100%contrast visual acuity and transfer function cutoff frequency in group A were higher than those in group B 3 months after operation(P<0.05);The residual astigmatism and CA in group A were lower than those in group B at 1 month and 3 months after operation(P<0.05);The values of small pupil refraction cylinder and spherical mirror in group A were lower than those in group B at 1 month and 3 months after opera⁃tion(P<0.05);The CEC density and hexagonal cell proportion in group A were higher than those in group B at 1 month and 3 months after operation,and the coefficient of variation of CEC was lower than that in group B(P<0.05).No postoperative complications occurred in both groups.Conclusion Astigmatism IOL+Phaco can effectively improve UCVA and BCVA,improve visual quality and function,reduce refractive status,and have little effect on CEC and high safety in the treatment of cataract patients with CA.