不同轴位和度数的残余散光对连续视程人工晶体植入后视觉质量的影响  

The effect of residual astigmatism with different minuscylinder axis and degrees on visual quality after Extended-Depth-of-Focus Intraocular Lens implantation

作　　者：杨起 陈佩卿[2] 秦健翔 杜嘉丽 YANG Qi;CHEN Peiqing;QIN Jianxiang;DU Jiali(People’s Hospital of Anji,Huzhou 313300,China;The Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310009,China)

机构地区：[1]安吉县人民医院,浙江安吉313300 [2]浙江大学医学院附属第二医院,浙江杭州310009

出　　处：《浙江实用医学》2023年第2期91-95,123,共6页Zhejiang Practical Medicine

摘　　要：目的评估连续视程人工晶状体术后不同轴位和度数的残余散光对视觉质量的影响。方法对2019年1月~2021年3月于浙江大学医学院附属第二医院已完成飞秒激光辅助微切口白内障超声乳化摘除联合SymfonyZXR00人工晶状体植入,并且术后矫正视力≥20/25的患者,通过人为干预散光度数和散光轴位,检测患者在诱发散光后的矫正远视力和矫正近视力的变化;询问患者的耐受情况并记录,并采用VF-14视觉功能评估量表进行问卷调查。结果在相同柱镜度数下,柱镜轴位在0°和90°比45°时能获得更好的矫正远视力;柱镜轴位在0°时比柱镜轴位在45°和90°时能获得更好的矫正近视力。在柱镜轴位相同的情况下,当柱镜度数从-1.0D逐渐增加到-1.5D,患者都具有良好的耐受性。结论患者在-1.0D至-1.5D的负柱镜散光下柱镜轴位在0°时仍有较好的耐受性及视力,临床上可以通过手术切口的位置减少术后散光,将散光控制在顺归散光将给患者带来更佳的术后效果。Objective To evaluate the effect of residual astigmatism at different minus-cylinder axis and degrees on visual quality after implanting Extended-Depth-of-Focus Intraocular Lens(EDOF IOLs).Methods admitted to the Second Affiliated Hospital of Zhejiang University from January 2019 to March 2021,Patients who had completed femtosecond laser-assisted microincision cataract phacoemulsification combined with SymfonyZXR00 intraocular lens implantation,and whose postoperative corrected visual acuity was greater than 20/25,were subjected to artificial intervention with astigmatism degree and astigmatism axis position.The changes of corrected distance vision acuity(CDVA)and corrected near vision acuity(CNVA)after induced astigmatism were measured.Major parameters were uncorrected distance vision acuity(UDVA),corrected near vision acuity,corrected distance vision acuity,subjective refraction and patients’subjective feeling.And conduct a questionnaire survey using theVF-14 Scale of Vision-Specific Functioning.Results The patient who was induced astigmatism at 0°and 90°could achieve better CDVA than at 45°,and there was no statistically significant difference between 0°and 90°.The axis of induced astigmatism at 0°could achieve better CNVA than at 45°and 90°,and there was no statistically significant difference between 45°and 90°.The induced residual astigmatism was-1.0 Diopter(D)to-1.5D,and almost all patients had good tolerance.Conclusion Patients with negative column astigmatism at-1.0D to-1.5D still have good tolerance and visual acuity when the column axis position is 0°.We can reduce residual astigmatism by adjusting the position of the surgical incision,and controlling astigmatism in the direction of regression will bring better postoperative results for patients.

关 键 词：连续视程人工晶体 残余散光轴位 视觉质量 飞秒激光 

分 类 号：R779.6[医药卫生—眼科]