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[摘要]
目的:评价同轴微切口超声乳化术联合复曲面人工晶状体(Toric intraocular lenses,Toric IOL)植入治疗白内障合并角膜散光的临床效果,及其有效性和安全性。
方法:本研究为临床病例系列研究。年龄相关性白内障合并角膜散光(≥0.75D)患者58例69眼行同轴微切口超声乳化手术联合Acrysof Toric人工晶状体植入治疗,记录术前视力、角膜散光及理论残留散光等,观察术后第1d; 1,3mo; 1a的裸眼视力(uncorrected visual acuity,UCVA)、最佳矫正视力(best corrected visual acuity,BCVA)、术后残留散光、IOL轴位等。
结果:术后1a,平均裸眼视力为0.70±0.11,最佳矫正视力为0.73±0.20,均显著高于术前最佳矫正视力0.21±0.01,差异有统计学意义(χ2=86.67,χ2=82.23,P<0.05),术前角膜平均散光为2.25±0.73D,术前预计残留平均散光为0.34±0.09D,术后1a残留散光为0.51±0.21D,术前、术后散光比较差异有统计学意义(t=12.48,P<0.05)。预计残留散光与术后1a实际散光比较差异无统计学意义(t=1.69,P>0.05)。术后1a,IOL定位和预测轴位差值为3.79°±1.21°,96%旋转<5.00°。未发现1例手术并发症。各个时间段最佳矫正视力、残留散光及IOL轴位旋转无明显差异(P>0.05)。
结论:对术前合并角膜散光的白内障患者,行同轴微切口超声乳化联合Toric人工晶状体植入治疗能有效地提高视力、矫正术前角膜散光,而且稳定性较好。
[Key word]
[Abstract]
AIM: To assess the clinical outcomes and safety of toric intraocular lenses(Toric IOL)for the correction of preexisting corneal astigmatism in cataract patients having micro-incision phacoemulsification.
METHODS:Fifty-eight patients(69 eyes)with age-related cataract and corneal astigmatism were included in this clinical case series study and had micro-incision phacoemulsification combined with of Acrysof Toric IOL implantation. Preoperative corneal astigmatism was more than 0.75 diopter(D)for all eyes. The postoperative data of visual acuity, corneal astigmatism,and anticipated residual astigmatism were recorded. Uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), postoperative residual astigmatism and toric lens axis were observed. The postoperative data was collected on the day 1, month 1, 3 and year 1 after operation.
RESULTS: At 1 year following surgery, the UCVA rise up to 0.70±0.11 from 0.15±0.06(χ2=86.67, P<0.05)on average, and BCVA from 0.21±0.01 to 0.73±0.20(χ2=82.23, P<0.05)indicating a statistical difference. Mean preoperative figure of corneal astigmatism and anticipated residual astigmatism was 2.25±0.73D and 0.34±0.09D, and corneal astigmatism was 0.51±0.21D one year after operation, indicating a statistical difference between preoperative and postoperative astigmatism(t=12.48, P<0.05). There was no statistical difference among postoperative corneal astigmatism and anticipated residual astigmatism(t=1.69, P>0.05). The D-value of IOL positioning and predict axis was 3.79°±1.21° one year postoperatively. Ninety-six percent of patients had less than 5.00° of rotation, and no operative complication was found. There was no statistical difference in various time quantum in terms of BCVA, residual astigmatism, IOL axial view rotation(P>0.05).
CONCLUSION:For cataract patients, micro-incision phacoemulsification combined with Toric IOL can effectively improve visual acuity, rectify preoperative corneal astigmatism with fair stability.
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