角膜后表面散光对散光型人工晶状体柱镜计算影响的临床研究  

Clinical study on the effects of posterior corneal astigmatism(PA)on Toric intraocular lens(IOLs)cylinder calculation

作　　者：金恬如 李晶晶 于兰 周衍文 Jin Tianru;Li Jingjing;Yu Lan;Zhou Yanwen(Liao Ning Aier Eye Hospital,Shenyang110000,China)

机构地区：[1]辽宁爱尔眼科医院,沈阳110000

出　　处：《眼科》2023年第5期397-402,共6页Ophthalmology in China

基　　金：爱尔眼科医院集团自由探索计划科研基金(AF2002D6)。

摘　　要：目的探讨在高角膜后表面散光(PA)的年龄相关性白内障患者中,选择模拟角膜曲率计散光(KA)和总角膜散光(TCA)对散光型人工晶状体(Toric IOL)柱镜计算的影响。设计回顾性比较性病例系列。研究对象2017年6月至2021年12月沈阳爱尔眼视光医院PA>0.5 D的逆规散光(ATR)年龄相关性白内障患者77例(77眼)。方法研究对象分为KA组和TCA组,采用Alcon公司在线计算器(https://www.myalcon-toriccalc.com/)进行Toric IOL柱镜度数计算,KA组选择Barrett公式进行计算,输入KA的K1、K2及其对应的轴位;TCA组选择Holladay公式进行计算,输入TCA的K1、K2及其对应的轴位。主要指标术后2个月时的裸眼视力(UCVA)、最佳矫正视力(BCVA)、主觉验光、误差幅度(ME)、矫正指数(CI)及散光预测误差的质心值。结果KA组和TCA组术后的UCVA分别为0.14±0.80 logMAR和0.15±0.72 logMAR(t=0.79,P=0.718)。KA组术后主觉验光散光度(-0.27±0.92 D)与TCA组(-0.40±0.64 D)相似(t=-0.55,P=0.582)。KA组的ME值为0.33±0.33 D提示术后散光欠矫,TCA组为-0.22±0.52 D提示术后散光过矫,两组ME值的绝对值差异无统计学意义(t=-0.46,P=0.542)。双倍角分析法提示,KA组和TCA组术后散光预测误差的质心值分别为0.28±0.56@175°和0.13±0.71@10°,KA组的散光预测误差量小于0.5 D者占48%,TCA组为43%。结论在高度角膜后表面散光眼中,选择KA进行Toric IOL计算会导致散光欠矫,选择TCA则会出现散光过矫,两者矫正量的误差幅度相近。(眼科,2023,32:397-402)Objective To assess the effects of selecting keratometer astigmatism(KA)or total corneal astigmatism(TCA)as a reference on toric IOL calculation among subjects with age-related cataract and high posterior corneal astigmatism(PA).Design A retrospective comparative case series.Participants The present study included 77 eyes with against the role astigmatism(ATR)from age-related cataract patients and measured PA of more than 0.5 D in Aier Eye Hospital(Shenyang)from June 2017 to December 2021.Method The subjects were randomly divided into the KA and TCA groups and each group selected KA and TCA for toric IOL cylinder power calculations with Alcon Acrysoft Toric online calculator(https://www.acrysoftoriccalculator.com/).Holladay formula was choose to calculate the IOL cylinder power by using TCA and Barrett formula was choose to calculate the IOL cylinder power by using KA.Main Outcome Measures The uncorrected visual acuity(UCVA),best-corrected visual acuity(BCVA),subjective refraction,magnitude of error(ME)and correction index(CI)and the centroid error in predicted residual astigmatism in two groups.Results The postoperative UCVA in the KA and TCA groups were 0.14±0.80 logMAR and 0.15±0.72 logMAR,respectively,whereas the difference between the two groups was not statistically significant(t=0.79,P=0.718).The subjective refraction stigmatism value in the KA group was similar to that noted in the TCA group(KA group:-0.27±0.92 D,TCA group:-0.40±0.64 D,t=-0.55,P=0.582).The ME value was 0.33±0.33 D in the KA group and-0.22±0.52 D in the TCA group,suggesting postoperative undercorrection in KA group and overcorrection in TCA group.The absolute ME values of the two groups were not statistically significant(t=-0.46,P=0.542).According to the double-angle plot,the postoperative refractive prediction errors were 0.49±0.56 at 175°and 0.13±0.71 at 10°.The postoperative refractive astigmatism prediction error in KA group(48%)was similar with TCA group(43%)in<0.5 D.Conclusions In the eyes of high PA,the choice of TCA for T

关 键 词：白内障 角膜后表面散光 散光型人工晶状体 

分 类 号：R776.1[医药卫生—眼科]