Toric人工晶状体植入术与球面人工晶状体植入联合周边角膜缘松解术矫正散光的对比研究  

Comparison of Toric IOL implantation and spherical IOL with peripheral corneal limbus relaxing incision for astigmatism

作　　者：徐冰[1] 董宁[1] 肖林[1] 徐景美[1] 褚利群[1] 马骁[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院眼科,北京市100038

出　　处：《眼科新进展》2013年第1期56-59,共4页Recent Advances in Ophthalmology

摘　　要：目的对比Toric人工晶状体(intraocular lens,IOL)植入术与球面IOL植入联合周边角膜缘松解术(peripheral corneal relaxing incisions,PCRI)矫正散光的临床效果。方法本研究共纳入55例(55眼)白内障患者,术前散光1.00～3.00D,随机分为ToricIOL植入组(ToricIOL组,26例26眼)和球面IOL植入联合PCRI组(PCRI组,29例29眼)。术中ToricIOL组植入AcrySof Toric IOL,PCRI组在角膜最陡散光轴处做成对的角膜缘松解切口,植入AcrySof Nature(SN60AT)IOL。术后3个月进行裸眼视力、最佳矫正视力检查以及IOL-Master测量角膜散光轴向及度数、角膜地形图进行角膜散光测定,同时进行对比敏感度测定。结果 ToricIOL组和PCRI组术后裸眼视力较术前均有明显的改善。术后3个月,ToricIOL组18眼(69.2%)裸眼视力≥20/25,PCRI组16眼(55.2%)裸眼视力裸眼视力≥20/25;且ToricIOL组和PCRI组的散光度数都较术前减少,其中ToricIOL组平均下降1.19D,PCRI组平均下降1.00D,两组间残余散光相比,差异有统计学意义(P<0.05)。术后3个月,1.5c·d-1、3.0c·d-1、6.0c·d-1、12.0c·d-1空间频率时,ToricIOL组和PCRI组患者对比敏感度相比,差异均无统计学意义(均为P>0.05);18.0c·d-1空间频率时,两组对比敏感度(15.21±5.77和10.97±3.26)相比,差异有统计学意义(P=0.010)。结论 ToricIOL植入术与球面IOL植入联合PCRI对低、中度散光矫正都有明确的效果,但ToricIOL植入术具有更加安全、有效、稳定和可预测性好的特点,能使患者获得更加出色的视功能。Objective To compare the clinical effects of Toric intraocular lens （IOL） implantation and spherical IOL implantation with peripheral corneal relaxing inci- sion to correct astigmatism. Methods A total of 55 patients （55 eyes）, preoperative astigmatism from 1.0 D to 3.0 D, were randomly divided into Toric IOL implantation group （Toric IOL group,26 cases,26 eyes） and spherical IOL implantation with periph- eral corneal relaxing incision group （PCRI group, 29 cases, 29 eyes）. Patients of Toric IOL group were implanted with the AcrySof of Toric IOL, and PCRI group were implan- ted with the AcrySof Nature （SN60AT） and made peripheral corneal relaxing incision in the steepest corneal astigmatism axis. The uncorrected visual acuity and best corrected visual acuity at postoperative 3 months were examined, the corneal astigmatism axis anddegree were measured by IOL-Master, corneal astigmatism was detected by corneal topography, and the contrast sensitivity was also detected. Results In both groups, the postoperative uncorrected visual acuity was significantly improved; At postoperative 3 months,18 eyes （69.2%） in Toric IOL group and 16 eyes （55.2%） in PCRI group were more than 20/25. Meanwhile,the mean preexisting astigmatism of all patients significantly reduced, in which the astigmatism in Toric IOL group reduced 1.19 D ,PCRI group reduced 1.00 D ,there was statistical difference in residual astigmatism （P 〈0.05 ）. There was no statistical difference in contrast sensitivity under 1.5 c ^-1d c ^-1,3.0 c c ^-1 d c ^-1 ,6.0 c c ^-1 d c ^-1 ,12.0 c c ^-1 d- c ^-1spatial frequency between two groups （ all P 〉 0.05 ） ; but there was statistical difference under 18.0 c/d spatial frequency （ 15.21± 5.77, 10. 97± 3.26 ,P = 0.010）. Conelusion Toric IOL implantation and spherical IOL implantation with PCRI have the identi- fied effects on low and moderate astigmatism,but Toric IOL implantation is more safe, effective,stable and predictable,re- sulting in better visual function.

关 键 词：白内障超声乳化术 TORIC人工晶状体 周边角膜缘松解术 散光 

分 类 号：R776.1[医药卫生—眼科]