囊袋张力环联合Toric人工晶状体植入治疗高度近视合并角膜散光的白内障  

Toric Intraocular Lens Combined with Capsular Tension Ring Implantation in Treatment of Cataract in Combination with High Myopia and Corneal Astigmatism

作　　者：罗艳[1] 杨慧[1] 肖泽锋 Luo Yan;Yang Hui;Xiao Zefeng(Department of Ophthalmology,Wuhan No.1 Hospital,Wuhan 430015,China)

机构地区：[1]武汉市第一医院眼科,武汉430015

出　　处：《华中科技大学学报（医学版）》2024年第2期233-238,共6页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：武汉市卫生计生委员会科研基金资助项目(No.WX15B18,No.WX16C35)。

摘　　要：目的研究伴有角膜散光的高度近视白内障患者进行超声乳化+环曲面人工晶状体(Toric intraocular lens,Toric IOL)及囊袋张力环(capsular tension ring,CTR)植入术的临床效果及稳定性。方法通过回顾性研究,分析在武汉市第一医院行白内障超声乳化吸除术的高度近视伴有角膜散光的患眼54例(76眼),其中31例(38眼)联合植入Toric IOL及CTR(联合组),23例(38眼)单纯植入Toric IOL(对照组)。术后随访6个月,比较两组患者术前及术后视力、角膜内皮细胞密度、人工晶状体旋转度、残余散光度,以及并发症发生情况。结果术后6月,两组患者裸眼远视力(uncorrected distance visual acuity,UCVA)、最佳矫正视力(best corrected visual acuity,BCVA)均显著高于术前,联合组术后UCVA(LogMAR)优于对照组,差异有统计学意义[(0.34±0.15)vs.(0.46±0.25),P<0.05]。术后1周、1月、3月及6月,联合组散光分别为(0.38±0.31)、(0.45±0.25)、(0.47±0.23)、(0.56±0.26),均明显低于对照组各时间点(均P<0.01)。术后6月联合组IOL平均旋转(2.63±0.94)°,显著低于对照组的(4.00±1.43)°(P<0.01)。两组间各时间点角膜内皮细胞密度比较,差异无统计学意义(均P>0.05)。联合组术后并发症总发生率低于对照组(P<0.05)。结论对于高度近视伴角膜散光的白内障患者,术中植入Toric IOL的同时联合应用CTR,安全性好,能够改善Toric IOL旋转稳定性,提高视觉质量,并且减少并发症。Objective To examine the clinical outcome and stability of Toric intraocular lens(IOL)combined with capsular tension ring(CTR)implantation in the treatment of cataract in combination with high myopia and corneal astigmatism.MethodsBy using a historical study,clinical data from 54 patients(76 eyes)with high myopia and regular corneal astigmatism who underwent cataract phacoemulsification in Wuhan First Hospital were analyzed.Among these patients,31 patients(38 eyes)received co-implantation with Toric IOL and CTR(combined group),and 23 patients(38 eyes)were simply implanted with Toric IOL(control group).Preoperative and postoperative visual acuity,corneal endothelial cell count,IOL rotation,residual astigmatism,and complications were compared between the two groups 6 months after surgery.Results After 6 months of follow-up,postoperative uncorrected distance visual acuity(UCVA)and best corrected visual acuity(BCVA)were significantly improved in both groups when compared with those before operation(P<0.05).The postoperative UCVA(LogMAR)was significantly better in combined group than that in control group[(0.34±0.15)vs.(0.46±0.25),P<0.05].At 1-week,1-month,3-month and 6-month,astigmatism indicators in combined group were(0.38±0.31),(0.45±0.25),(0.47±0.23)and(0.56±0.26),respectively,which were significantly lower than those in control group(all P<0.05).The mean rotation of the IOL at the end of 6 months of follow-up in combined group was significantly lower than that in control group[(2.63±0.94)°vs.(4.00±1.43)°,P<0.05].No significant differences in corneal endothelial cell counts between the two groups was observed at each time point(all P>0.05).The overall incidence of postoperative complications in combined group was lower than that in control group.Conclusion In cataract patients with high myopia and corneal astigmatism,combined therapy of Toric IOL and CTR achieves better rotation stability,improves visual quality,and reduces the occurrence of complications.

关 键 词：囊袋张力环 人工晶状体 高度近视 白内障 散光 

分 类 号：R776.1[医药卫生—眼科]