飞秒激光辅助下白内障手术联合ToricIOL植入在不同眼轴长白内障患者中的应用观察  

To observe the application of femtosecond laser-assisted cataract surgery combined with Toric intraocular lens implantation in patients with cataracts with different axial lengths

作　　者：袁媛 蔡小军 张珲璠 Yuan Yuan;Cai Xiaojun;Zhang Huifan(Wuhan Eyedood Ophthalmic Hospital,Wuhan 430019,China)

机构地区：[1]武汉艾格眼科医院,武汉430019

出　　处：《临床眼科杂志》2024年第4期289-293,共5页Journal of Clinical Ophthalmology

基　　金：湖北省卫生健康委科研项目(WJ2023F058)。

摘　　要：目的观察飞秒激光辅助下白内障手术联合复曲面人工晶状体(Toric IOL)植入在不同眼轴长白内障患者中的应用。方法回顾性临床研究。分析36例(36只眼)在我院进行飞秒激光辅助下白内障手术联合植入Toric IOL患眼资料,按患眼眼轴长度划分为正常眼轴组(22 mm≤眼轴<24 mm)和长眼轴组(24 mm≤眼轴),研究数据包括术后最佳矫正视力(BCVA)、术前角膜散光、术后残余散光、术后角膜指数及眼高阶相差与眼视觉质量相关性分析等。结果术后3个月,BCVA正常眼轴组(0.06±0.07)logMAR,长眼轴组(0.09±0.09)logMAR,均较术前显著提高,差异有统计学意义。术后3个月总残余散光,正常眼轴组为(0.83±0.53)D,长眼轴组为(0.50±0.50)D,均较术前明显减少,差异均有统计学意义。术后3个月斯特列尔比(Strchl)值,正常眼轴组为0.17±0.12,长眼轴组为0.18±0.14,均较术前明显增高,差异有统计学意义。术后3个月,两组间BCVA、术后总残余散光及Strchl值比较差异均无统计学意义(Z=0.99,1.78,0.08;P=0.32,0.08,0.94)。应用OPDSCANⅢ视觉质量分析仪检测:两组患眼各角膜指数与Strchl值均无相关性;术后3个月,正常眼轴组患眼Strchl值与角膜Total及眼内Total相差呈负相关(r=-0.82,-0.88,P=0.01,0.00);长眼轴组患眼Strchl值与全眼Tilt、High、s4+s6+s8等相差均呈负相关。应用TOPCON KR1W视觉质量分析仪检测:术后3个月,正常眼轴组患者Strchl值与全眼4 mm瞳孔直径下4s3、4s4及4Total均呈负相关,长眼轴组患眼Strchl值与全眼4 mm瞳孔直径下4s3、4s4、4Total均呈负相关,6 mm瞳孔直径下Strchl值与6s5呈负相关。结论飞秒激光辅助白内障手术联合Toric IOL植入是安全有效的治疗规则角膜散光白内障的方法,而且不仅在正常眼轴患者中效果稳定,在长眼轴患者中应用也同样有效。减少术源性损伤,保持Toric IOL囊袋居中性及晶状体光学面不倾斜是保证术后高视觉质量的前提。Objective To observe the application of femtosecond laser-assisted cataract surgery combined with toric intraocular lens(Toric IOL)implantation in patients with cataracts with different axial lengths.Methods A retrospective analysis of 36 eyes of our hospital with femtosecond laser-assisted cataract surgery combined with Toric IOL implantation was divided into normal axial length group(22 mm≤axial length<24 mm)and long axial group(24 mm≤ocular axis length),the research data includes postoperative best corrected visual acuity(BCVA),preoperative corneal astigmatism,postoperative residual astigmatism,postoperative corneal index and correlation analysis of ocular high-order phase difference and ocular visual quality.Results The logMAR of the BCVA normal axis group(0.06±0.07)and the long axis group(0.09±0.09).logMAR were significantly higher than those before the operation at three months after the operation,and the difference was statistically significant.The total residual astigmatism at 3 months after the operation was(0.83±0.53)D in the normal axial group and(0.50±0.50)D in the long axial group,both of which were significantly reduced compared with preoperatively,and the difference was statistically significant.The Strchl value at 3 months after the operation was 0.17±0.12 in the normal axial group and 0.18±0.14 in the long axial group,both of which were significantly higher than those before the operation,and the difference was statistically significant.At three months after the operation,there was no significant difference in BCVA,postoperative total residual astigmatism and Strchl values between the two groups(Z=0.99,1.78,0.08;P=0.32,0.08,0.94).Visual quality analysis.The OPD-ScanⅢvisual quality analyzer was used to detect:there was no correlation between the corneal index and the Strchl value of the two groups of eyes.At 3 months after the operation,the Strchl value of the normal axis group was negatively correlated with the difference between the corneal total and the intraocular total(r=-0.82,-0.

关 键 词：飞秒激光 白内障 复曲面人工晶状体 视觉质量 

分 类 号：R779.66[医药卫生—眼科]