植入TICL对高眼内散光的矫正效果  

Correction efficacy of Toric implantable collamer lens implantation for high ocular residual astigmatism

作　　者：熊瑛 姚沁楠 万修华 Xiong Ying;Yao Qinnan;Wan Xiuhua(Beijing Institute of Ophthalmology,Beijing Tongren Eye Center,Beijing Key Laboratory of Ophthalmology and Visual Sciences,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科研究所眼科学与视觉科学北京市重点实验室,100730

出　　处：《眼科》2022年第3期213-218,共6页Ophthalmology in China

基　　金：北京市医院管理中心临床医学发展专项经费资助(XMLX202133)。

摘　　要：目的比较植入散光型有晶状体眼后房型人工晶状体(Toric implantable collamer lens,TICL)对高眼内散光(high ocular residual astigmatism,HORA)与低眼内散光(low ocular residual astigmatism,LORA)患者的散光矫正效果。设计回顾性病例系列。研究对象2020年7月至12月于北京同仁眼科中心接受V4c型TICL植入术的患者100例(200眼)。方法眼内散光(ocular residual astigmatism,ORA)是总散光与角膜散光的差值。术前通过主觉验光获得总散光,通过角膜地形图(iTrace视觉功能分析仪)获得角膜散光,利用Alpins提出的矢量分析法计算出总散光与角膜散光的差值获得ORA。再根据ORA大小将术眼分为HORA组(ORA≥1.30 D,94眼)和LORA组(ORA<1.30 D,106眼)。再使用“美国国家标准化组织(American National Standards Institute,ANSI)”推荐使用的标准矢量分析法计算预期矫正散光(intended refractive correction,IRC)、手术矫正散光(surgically induced refractive correction,SIRC),SIRC与IRC的比值即为矫正率(CR),CR等于1即代表最理想矫正,CR>1表示散光过矫,CR<1则表示散光欠矫。SIRC与IRC之间的差值为误差矢量(EV),EV与IRC之间的比值为误差率(ER),ER为0时代表最理想矫正,ER为1时代表完全未获得矫正。比较两组间上述参数的差异。主要指标IRC、SIRC、CR、EV、ER。结果HORA组术后1周时IRC、SIRC、CR、EV、ER分别为1.52(0.88~2.60)D、1.47(0.83~2.53)D、0.91(0.75~1.16)、0.67(0.39~1.04)D、0.43(0.24~0.90);术后6个月时分别为1.52(0.88~2.60)D、1.37(0.68~2.43)D、0.92(0.69~1.15)、0.7(0.43~1.14)D、0.49(0.28~1.02)。LORA组术后1周时IRC、SIRC、CR、EV、ER分别为1.18(0.53~1.70)D、1.1(0.59~1.91)D、1.03(0.66~1.49)、0.57(0.29~1.00)D、0.62(0.31~1.02);术后6个月时分别为1.12(0.53~1.68)D、0.93(0.50~1.67)D、0.91(0.61~1.24)、0.54(0.28~1.07)D、0.61(0.32~1.13)。比较HORA组与LORA组,术后1周时IRC、SIRC有显著差异(P<0.01、0.01),CR、EV、ER均无统计学差异;术后6个月时,IRC、SIRC和Objective To compare the correction efficacy of Toric implantable collamer lens(TICL)implantation for high ocular residual astigmatism(HORA)with that for low ocular residual astigmatism(LORA).Design Retrospective case series.Participants A total of 200 eyes of 100 patients underwent TICL implantation from July to December 2020 at Beijing Tongren Eye Center.Methods Total astigmatism was obtained by subjective refraction using corneal topography(iTrace visual function analyzer)before surgery.The difference between total astigmatism and corneal astigmatism was calculated by the vector analysis method to obtain intraocular astigmatism(ocular residual astigmatism,ORA).According to the magnitude of ORA,the surgical eyes were divided into HORA group(ORA≥1.30 D,94 eyes)and LORA group(ORA<1.30 D,106 eyes).Then,the standard vector analysis method recommended by the American National Standards Institute(ANSI)was used to calculate the intended refractive correction(IRC)and surgically induced refractive correction(SIRC)in both groups.The ratio of SIRC to IRC is the correction ratio(CR).CR equal to 1 represents the most ideal correction,CR>1 indicates overcorrection of astigmatism,and CR<1 indicates undercorrection of astigmatism.The difference between SIRC and IRC is the error vector(EV),and the ratio between EV and IRC is the error rate(ER).When ER is 0,it represents the most ideal correction,and when ER is 1,it represents no correction at all.The differences of the above parameters between the two groups were compared.Main Outcome Measures IRC,SIRC,CR,EV,ER.Results In the HORA group,the IRC,SIRC,CR,EV,ER was 1.52(0.88~2.60)D,1.47(0.83~2.53)D,0.91(0.75~1.16),0.67(0.39~1.04)D and 0.43(0.24~0.90)respectively at 1 week after operation;was 1.52(0.88~2.60)D,1.37(0.68~2.43)D,0.92(0.69~1.15),0.7(0.43~1.14)D and 0.49(0.28~1.02)respectively at 6 months after surgery.In the LORA group,the IRC,SIRC,CR,EV,ER was 1.18(0.53~1.70)D,1.1(0.59~1.91)D,1.03(0.66~1.49),0.57(0.29~1.00)D and 0.62(0.31~1.02)respectively at 1 week after operation;

关 键 词：散光型有晶状体眼后房型人工晶状体 眼内散光 

分 类 号：R779.6[医药卫生—眼科]