Acrysof Toric人工晶状体植入矫正白内障术前角膜散光的短期观察  

Shoft-term observation of Acrysof Toric intraocular lens for correction of preoperative astigmatism in patients having cataract surgery

作　　者：李瑾[1] 赵云娥[1] 李军花[1] 黄芳[1] 黄和和[1] 郑景伟[1] 

机构地区：[1]温州医学院附属眼视光医院,325027

出　　处：《中华眼科杂志》2010年第6期513-517,共5页Chinese Journal of Ophthalmology

摘　　要：目的 评价超声乳化白内障吸除术中Acrysof Tofic人工晶状体（IOL）植入矫正白内障伴术前角膜散光的早期临床效果,及其有效性、安全性和预测性.方法 前瞻性病例系列研究.植入Acrysof Toric IOL的年龄相关性白内障患者60例（71只眼）,观察其术前、术后的IogMAR裸眼视力、最佳矫正视力、术前角膜散光、术后残留散光、术后残留球镜、IOL轴位等.术后残留散光根据柱镜轴向分为散光全矫,残留斜轴散光（45°/135°±30°）,残留顺规散光（90°±15°）,残留逆规散光（180°±15°）,并收集各类散光组中散光为0.50～0.75 D者的裸眼远近视力.随访3个月.采用非参数检验秩和检验和Friedman检验等对数据进行统计学分析.结果 裸眼远视力中位数：术前为0.80;术后3个月为0.20.散光中位数：术前为2.02 D,术前预计残留散光为0.34 D,术后3个月为0.67 D.IOL术后1 d定位和预计轴位差值为1.58°±2.30°.3个月时旋转1.63°±1.83°,96%旋转小于5.00°.未发现一例手术并发症.裸眼近视力中位数：散光全矫组0.50,残留顺规散光组0.50,残留逆规散光组0.21,残留斜轴散光组0.30;裸眼远视力中位数：散光全矫组0.10;残留顺规散光组0.26;残留逆规散光组0.15.残留斜轴散光组0.20;非参数统计分析结果提示：裸眼远视力,残留逆规散光组与顺规散光组比较,差异具有统计学意义（t=4.00,P=0.000）,而与斜轴散光组,散光全矫组之间的差异无统计学意义（t=0.49,P=0.623;t=2.00,P=0.061）;裸眼近视力,逆规散光组最佳,而且与顺规散光组,斜轴散光组,散光全矫组的差异均具有统计学意义（t分别为6.95,2.60,6.52,P分别为0.000,0.011,0.000）.结论 超声乳化白内障吸除术中Acrysof Toric IOL植入是一种有效、安全,可预测的矫正年龄相关性白内障伴术前角膜散光的方法.术后残留少量的逆规近视性散光可以在不明显影响裸眼远视力基础上获得较好的裸眼近�Objective To evaluate the results of Toric intraocular lens （IOL） for correction of preoperative astigmatism in patients having cataract phacoemulsification.Methods It Was a prospective case series study. Seventy-one eyes （60 patients） had implantation of Acrysof Toric IOL logMAR uncorrected visual acuity（UCVA）,best corrected visual acuity（BCVA）,preexisting corneal astigmatism,residual refractive sphere and cylinder.and toric IOL axis were measured.Four residual astigmatism models were compared according to their axis postoperatively：neutral,against-the-rule （ATR,180±15 degrees）,with-the-rule（WTR,90 ± 15 degrees）and oblique（OB,45/135±30 degrees）.Rank sum test and Friedman test was used to analyze these data.Results Three months postoperatively.the median dislant UCVA increased significandy from 0.80 to 0.20,residual refractive astigmatism decreased significantly from 2.02 D to 0.67 D.The mean Toric IOL axis rotation was 1.63±1.83 degrees.with rotation less than 5.00 degrees in 96% of eyes.For uncorrected near visual acuity.group ATR fared the best results and the difference between group ATR and groups WTR,neural and OB was statistically significant.For UCVA,there Was no statistically significant difference between group ATR and groups neutral and OB.Conclusions Acrysof Toric IOL implantation is a predictable.safe and effective method to correct preexisting corneal astigmatism in patients having cataract phacoemulsification. A pseudophakic eye after Acrysof Toric IOL implantation with low residual ATR myopic astigmatism is beneficial for obtaining a better uncorrected near and distant visual acuities.

关 键 词：散光 晶体 人工 超声乳化白内障吸除术 

分 类 号：R779.66[医药卫生—眼科]