Toric人工晶状体植入术患者远期临床效果观察  

Long term clinical outcome of cataract patients with Toric intraocular lens implantation

作　　者：孙琦[1,2,3] 赵江月[1,2,3] 彭程[1,2,3] 陆博[1,2,3] 马立威[1,2,3] 张劲松[1,2,3] 

机构地区：[1]中国医科大学附属第四医院眼科,沈阳110005 [2]中国医科大学眼科医院,沈阳110005 [3]辽宁省晶状体重点实验室,沈阳110005

出　　处：《中华实验眼科杂志》2013年第4期372-376,共5页Chinese Journal Of Experimental Ophthalmology

基　　金：辽宁省高等学校优秀人才支持计划项目（2009R53）

摘　　要：背景流行病学调查发现，15％～29％的白内障患者术前存在≥1．5D的角膜散光，角膜散光矫正已成为白内障屈光手术的重要部分。Toric人工晶状体（IOL）植入术是矫正角膜散光的一种新方法。Acry Sof Toric IOL矫正具有角膜散光的白内障患者的早期临床研究显示了其良好的稳定性，但是其远期临床疗效评价文献较少见。目的观察术前合并角膜散光的白内障患者植入Toric IOL术后的长期效果。方法采用前瞻性系列病例观察临床试验设计。选择行超声乳化白内障摘出联合IOL植入的患者78例120眼，术前角膜规则散光度为≥1．0 D°植入Toric IOL Acry Sof SN60TT，术后随访2年。评价术后1d，1、3、6个月，1年、2年的裸眼视力和最佳矫正远视力（BCDVA）、残余散光度、散光矢量、散光矫正准确性及散光IOL旋转度。结果共67例患者101眼完成2年的随访，患者19例19眼术后1个月因合并其他疾病行动不便而失访。患者植入Acry Sof Toric IOL术后2年裸眼视力（10gMAR）为0．16（0．20），BCDVA为0（0．1），残余散光-0．75（0．5）D，IOL轴位旋转2．87°±1．78°，眼内散光矫正的矢量大小为（1．2±0．6）D，散光矫正指数（cI）为0．90±0．41，术后2年术眼的实际矫正矢量（SIA）和目标矫正矢量（TIA）呈正相关（r=0．740，P=0．000）。与术后1、3、6个月，1年的检查结果比较，术后2年时患者的视力、残余散光和IOL的旋转度有轻度增大的趋势，cI减小，但差异均无统计学意义（P〉0．05）。结论Acry Sof Toric IOL植入术后2年仍具有良好的旋转稳定性，这种IOL通过眼内散光弥补了角膜的散光，具有良好的矫正准确性，患者获得较好的裸眼远视力。AcrySof Toric IOL植入术具有长期的准确性和稳定性。Background Epidemiologieal investigation showed that 15%-29% of patients with cataract have preexisting astigmatism of 〉 1.50 D. So to control astigmatism is very important to the improvement of visual function after cataract surgery. The implantation of Torie intraoeular lens （IOL） is a new option for the correction of preexisting astigmatism during cataract surgery, now. Short-term clinical studies of cataract patients with AcrySof Toric IOL implantation have revealed a good stability. However, the evaluation of long-term clinical result is seldom. Objective This study was to evaluate the long-term clinical results of Toric intraocular lens （IOL） implantation. Methods A serial case-observational study was designed. One hundred and twenty eyes of 78 cataract patients were included in this study. Phacoemulsification combined with AcrySof Toric IOL implantation was performed and the patients received a 2-year follow-up. Uncorrected distance visual acuity （UCDVA） , best corrected distance visual acuity（BCDVA） ,residual cylinder, IOL rotation, vector analysis and accuracy of astigmatic correction were clinically evaluated in 1 day, 1 month,3 months,6 months, 1 year and 2 years, respectively. Comparison of these results of different follow-up periods were made. Results Sixty-seven patients （101 eyes）finished the follow-up and 19 patients（19 eyes）lost visit due to other diseases affected. At 2 years visit after AcrySof SN60TT implantation, UCDVA,BCDVA, residual cylinder, absolute value of IOL rotation degree, vector magnitude of surgically induced astigmatism （ SIA ） was 0. 16 （ 0.20 ） , 0 （ 0. 1 ） , 0.75 （ 0. 5 ） D, （ 2.9 ± 1.8 ） °, （ 1. 2 ± 0.6 ） D, and the correction index （CI） was 0.90＋0.41. A positive correlation was found between SIA and TIA （ r = 0.74, P = 0. 000 ）. Compared to 1 month,3,6 months and 1 year,there was a mild tendency of decrease in accuracy of astigmatism correction and CI. Residual cylinder and degree of IOL rotation at 2 years afte

关 键 词：晶状体 人工 散光 视觉质量 白内障 矢量分析 

分 类 号：R779.6[医药卫生—眼科]