摘要
该文报道一例激光原位角膜磨镶(laser-assisted in situ keratectomy,LASIK)术后行白内障超声乳化摘除联合多焦点散光矫正型人工晶状体植入术的病例。该患者为42岁女性患者,20年前外院行双眼LASIK手术,现因右眼视物模糊1年就诊。术前IOLMaster检查患者右眼眼轴长度29.66 mm,前房深度3.18 mm,晶状体厚度4.75 mm,白到白距离11.6 mm,前表面及全角膜散光分别为1.01 D@67°及0.91 D@56°。Pentacam角膜地形图15°范围模拟角膜屈光力得到的角膜散光为1.2 D@58.1°,为规则领结型。患者眼底检查未见明显异常,因其脱镜意愿强烈,植入双焦点散光矫正型IOL(德国Zeiss公司AT LISA toric 909M)。根据Barrett True-K Toric公式测量的后表面散光计算结果进行手术规划,选择+17 D球镜1.5 D柱镜Zeiss 909M IOL,植入轴位55°。术后1个月患者裸眼远视力0.8,35 cm裸眼近视力1.0,最佳矫正远视力-0.25 DS/-0.5 DC×120°至1.0,患者满意。提示经过详细的术前评估及规划,并与患者充分沟通,多焦点散光矫正型人工晶状体可以在部分适合的LASIK术后患者中取得良好效果。
It is reported a case of cataract phacoemulsification combined with toric multifocal intraocular lens(IOL)implantation after LASIK surgery in this article.A 42 year-old female patient who underwent bilateral LASIK surgery in other hospital 20 years ago.She visited our hospital due to blurred vision in her right eye for one year.The preoperative IOL Master examination results showed an axial length of 29.66 mm,anterior chamber depth of 3.18 mm,lens thickness of 4.75 mm,white to white distance of 11.6 mm,and anterior surface and total corneal astigmatism of 1.01 D@67°and 0.91 D@56°,respectively in right eye.The corneal astigmatism measured by Pentacam using 15°range simulated keratometry is 1.2 D@58.1°,which is a regular bow tie shape.No obvious abnormalities was found in the patient's fundus examination.Due to her strong desire to get rid of the glassesa toric bifocal IOL(AT LISA Toric 909M,Zeiss,Germany)was implanted.Based onthe IOL power calculation results of Barrett True-K Toric formula with measured posterior corneal astigmatism,an IOL with Sph 17.0 D/Cyl1.5 D/A 55°was chosen.One month after surgery,the patient's uncorrected distance visual acuity was 20/25,35 cm uncorrected near visual acuity was 20/20,and the best corrected distance visual acuity was 20/20 with a prescription of–0.25 DS/–0.5 DC×120°.The patient was satisfied with the outcome.After detailed preoperative evaluation and design,and sufficient communication with patients,toric multifocal IOL implantation can achieve good results in some apropriated for the patients after LASIK surgery.
作者
何雯雯
康晴
郑凯文
竺向佳
HE Wenwen;KANG Ching;CHENG Kaiwen;ZHU Xiangjia(Department of Ophthalmology,Eye and Ear,Nose,and Throat Hospital of Fudan University,Shanghai 200031,China,Eye Institute,Eye and Ear,Nose,and Throat Hospital of Fudan University,Shanghai 200031,China,NHC Key Laboratory of Myopia(Fudan University),Key Laboratory of Myopia,Chinese Academy of Medical Sciences,Shanghai,200031,China,Shanghai Key Laboratory of Visual Impairment and Restoration,Shanghai 200031,China)
出处
《眼科学报》
CAS
2023年第12期867-873,共7页
Eye Science
基金
国家自然科学基金(81900838)。
