目的：对比飞秒激光囊膜标记(FLACM)法与裂隙灯下手工标记(SAMM)法的Toric IOL轴位准确性和术后效果。

方法：将拟行白内障超声乳化联合Toric IOL植入术的患者分为两组，分别采用FLACM法(25例25眼，FLACM组)与SAMM法(25例25眼，SAMM组)对散光轴位进行标记。评估比较术后两组患者裸眼远视力(UCDVA)、最佳矫正远视力(BCDVA)、残余散光(RA)、IOL轴位偏离度、总调制传递函数(MTF Total)。

结果：术后1mo，FLACM组UCDVA(LogMAR)显著优于SAMM组(0.15±0.09 vs 0.22±0.11，P<0.05)； FLACM组术后RA和IOL轴位偏离度均显著低于SAMM组(0.30±0.18D vs 0.64±0.28D，P<0.05； 3.64°±1.68° vs 5.40°±3.44°，P<0.05)； 两组BCDVA和MTF Total均无差异(P>0.05)。术后UCDVA(LogMAR)与RA(r=0.350，P<0.05)、IOL轴位偏离度(r=0.369，P<0.05)呈正相关，与MTF Total值呈负相关(r=-0.290，P<0.05)； 术后RA与IOL旋转度呈正相关(r=0.431，P<0.05)。

结论：FLACM法标记的Toric IOL轴位比SAMM法更加精确，从而获得更好的散光矫正效果和术后视力。

METHODS: Totally 50 patients required cataract surgery and Toric IOL implantation were assigned to the FLACM group(25 eyes)or the SAMM group(25 eyes). The uncorrected distant visual acuity(UCDVA), best corrected distant visual acuity(BCDVA), residual astigmatism(RA), IOL rotation, MTF Total were measured 1mo after surgery.

RESULTS: The UCDVA(LogMAR)was significantly lower in the FLACM group than in the SAMM group 1mo postoperatively(0.15±0.09 vs 0.22±0.11, P<0.05). The RA and IOL rotation were significantly lower in the FLACM group than in the SAMM group(0.30±0.18D vs 0.64±0.28D, P<0.05; 3.64°±1.68° vs 5.40°±3.44°, P<0.05). There was no statistical difference between the two groups in the BCDVA and MTF total value(P>0.05). The UCDVA(LogMAR)was positive correlative to the RA(r=0.350, P<0.05)and IOL rotation(r=0.369, P<0.05), and was negative correlative to the MTF total value(r= -0.290, P<0.05); the RA was positive correlative to the IOL rotation(r=0.431, P<0.05).

CONCLUSION: The accuracy of the axis alignment was significantly higher in the FLACM group, which results in lower residual astigmatism and better visual outcome.