视频监控联合标尺软件引导复曲面人工晶状体治疗白内障合并角膜散光  

Toric IOL implantation in treating corneal astigmatism-accompanied cataract led by the ruler software-combined realtime video surveillance system

作　　者：王勇[1] 叶应嘉[1] 鲍先议[1] 周龑丽[1] 许荣[1] 彭婷婷[1] 曾志富[1] 

机构地区：[1]武汉爱尔眼科医院,湖北省武汉市430063

出　　处：《眼科新进展》2013年第4期346-349,共4页Recent Advances in Ophthalmology

摘　　要：目的评估视频监控系统联合屏幕标尺软件实时定量引导复曲面(Toric)人工晶状体(intraocular lens,IOL)治疗白内障合并角膜散光的屈光效果。方法收集86例(116眼)角膜散光≥1.00D且行超声乳化白内障吸出术联合ToricIOL植入术患者的临床资料。通过手术显微镜连接视频监控系统,借助屏幕标尺软件MB-Ruler(精确到0.01°),实时定量手术切口与IOL轴向。术后随访3个月～1a,采用MB-Ruler标尺软件行术后IOL轴位分析,记录各组术前及术后视力、术前角膜散光、预计残留散光、术后实际散光、IOL旋转度数及并发症等。结果仰卧位与坐位比较,79.31%(92/116)的患眼眼球发生了旋转,眼球旋转度数为3.12°±1.76°。术后3个月,96.55%的患眼裸眼视力≥0.5,显著高于术前最佳矫正视力,差异有统计学意义(P<0.05)。患眼术前角膜散光度数为(1.67±0.68)D,预计残留散光(0.29±0.21)D,术后3个月残留散光为(0.34±0.25)D,术前、术后散光度数比较差异有统计学意义(P<0.05),预计残留散光与术后3个月实际散光度数比较差异无统计学意义(P>0.05)。术后1d,术眼散瞳后坐位行裂隙灯观察并照相,照片在电脑上通过MB-Ruler标尺软件分析后发现,IOL轴位与预期目标轴位差异为3.52°±1.87°,无差异≥5°者。术后3个月IOL旋转度数为4.89°±1.34°。所有患者在随访期间均未发生眼内感染、眼压升高、瞳孔变形、黄斑水肿、后发性白内障等并发症。结论采用视频监控系统,借助高精度的屏幕标尺软件实时定位手术切口轴位、ToricIOL植入轴位,有效避免了传统刻度盘定位精确度不高与按压眼球旋转导致的误差,且操作简单易行。Toric IOL能有效地矫正白内障患者的角膜散光,预测性强,且植入后具有良好的旋转稳定性,患者术后获得了更好的裸眼远视力。Objective To evaluate the Toric intraocular lens（IOL）implantation in treating corneal astigmatism-accompanied cataract led by the ruler software-combined realtime video surveillance system.Methods Clinical information of 86 patients（116 eyes）with corneal astigmatism higher than1.00 D and cataract who had Phacoemulsification-combined toric IOL implantation was collected.The surgical incision and IOL axial direction were positioned precisely using the the realtime video surveillance system linked by operating microscope and Mb-Ruler software（the minimum scale value was 0.01°）.Postoperative follow-ups lasted for 3 month to 1 year,during which postoperative IOL axial view was analyzed using Mb-Ruler software,preoperative and postoperative visual acuity,preoperative corneal astigmatism,anticipated residual astigmatism,postoperative real astigmatism,IOL rotation angle and complications were recorded.Results Compared with the seating position,the percent of eyeball rotation in supine position was 79.31%,the degree of eyeball rotation was 3.12°±1.76°.Three months after the operation,uncorrected visual acuity（UCVA）of 96.55% eyes were ≥0.5,which were significantly higher than preoperative best corrected visual acuity（BCVA,P0.05）.Preoperative corneal astigmatism were（1.67±0.68）D,expected residual astigmatism were（0.29±0.21）D.Postoperative corneal astigmatism three months after operation were（0.34±0.25）D.Difference between preoperative and postoperative corneal astigmatism was statistical significance（P0.05）,difference between anticipated residual corneal astigmatism and postoperative corneal astigmatism was no statistical significance（P0.05）.1 day after operation,slit lamp microscopy and photography were performed on postoperative eyes after mydriasis with the patient seated.Then the photograph were analyzed using Mb-Ruler software,the result showed that differences between postoperative and anticipated IOL axial view were 3.52°±1.87° and were all with 5°.Postoperative ro

关 键 词：角膜散光 人工晶状体 白内障 视频监控系统 

分 类 号：R779.66[医药卫生—眼科]