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目的:应用角膜曲率联合角膜地形图检查测量角膜曲率,采用个性化手术源性散光值,计算人工晶状体型号及轴位,在白内障手术中植入散光型人工晶状体来矫正角膜散光并观察疗效。 方法:收集白内障并伴有角膜规则散光的病例43眼,手术中采用白内障超声乳化术植入AcrySof Toric IOL,并放置IOL于目标轴位,观察术后屈光结果。 结果:术后随访3mo,33眼使用T5以下人工晶状体,85%患者裸眼视力>0.5,70%患者裸眼视力>0.8术后角膜散光由术前的1.64±0.53D降至0.63±0.32D,10眼应使用T6,T 7,但使用T5裸眼视力均>0.5,残余散光接近预测值。术后3mo观察,43眼术后第1d平均轴位偏离465°±4.21°,84% IOL轴位偏离<10°,3mo平均旋转116°±184°,100% IOL旋转<10°。 结论:应用角膜曲率联合角膜地形图检查测量角膜曲率,采用个性化手术源性散光值,计算人工晶状体型号及轴位,植入AcrySof Toric IOL能有效地矫正角膜散光,并具有良好的囊袋内稳定性。
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[Abstract]
AIM:To evaluate the clinical effect of corneal astigmatism correction with Toric intraocular lens(IOL) in cataract surgery.Corneal astigmatism was determined by auto-keratometry and topography.Surgical induced astigmatism was personal to calculate IOL models and axis. METHODS:This study involved 43 cataract cases (43 eyes)with astigmatism. AcrySof Toric IOL implantation was adopted in the operation and placed at the target axis to evaluate the clinical effect of postoperative corneal astigmatism correction. RESULTS:The patients were followed up for 3 months with postoperative refractive assessments performed.33 eyes used T3,T4,T5 IOL,with 85% naked vision>0.5 and 70% naked vision>0.8. Preoperative corneal astigmatism was(1.64±0.53)D while postoperative corneal astigmatism was(0.63±0.32)D.10 eyes should have used T6,T7 IOL,but used T5 IOL,with naked vision>0.5. Residual astigmatism was near to the estimated numbers.The average IOL axis deviation of 43 eyes was 4.65°±4.21°on the first day after the operation. 84% IOL axis deviation was<10°.The mean axis rotation was 1.16°±1.84°in postoperative 3 months and 100% IOL axis rotation was<10°. CONCLUSION:Corneal astigmatism is determined by auto-keratometry and topography.Surgical induced astigmatism is personal to calculate IOL models and axis.The clinical effect of corneal astigmatism correction with Toric intraocular lens in cataract surgery proves to be successful. The rotational stability of Toric intraocular lens is good.
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