摘要目的 评价白内障术中植入一片式散光型人工晶状体(IOL)矫正术前角膜散光的疗效和旋转稳定性.方法 白内障超声乳化吸除联合Acrysof toric IOL植入31只眼,其中T3(柱镜为1.50D)19只眼,T4(柱镜为2.25D)7只眼,T5(柱镜为3.00 D)5只眼.另外,对照组30只眼,手术方式相同,术中植入SA60AT型IOL.白内障超声乳化吸除联合IOL植入手术通过颞侧角膜切口进行.观察术后早期(1周)和远期(3月)术眼散光和角膜散光,晶状体的旋转度数,裸眼视力(UCVA),球镜矫正视力(SCVA)和最佳矫正视力(BCVA).结果 在最后随访时,观察组全部患眼的UCVA均LogMAR 0.3(20/40)以上,而对照组有86.7%的患眼达到LogMAR0.3(20/40)以上.平均眼散光观察组为(0.44±0.24)D,对照组为(1.44±0.34)D.观察组有21只眼(77%)的IOL轴旋转小于3°,所有患眼IOL旋转不超过9°.结论 术后早期和远期观察表明Acrysof toric IOL,植入可以有效和稳定地矫正白内障患者术前即存在的散光.

abstractsObjective To determine the efficacy and rotational stability of a posterior chamber single-piece toric intmocular lens(IOL)to correct preexisting corneal astigmatism in cataract patients.Methods Thirty one eyes of 25 patients who underwent phacoemulsification and foldable Aerysof toric IOL implantation from January 2008 to October 2008 were included in the study.The cylindrical IOL power was 1.5 diopters (D)(n=19),2.25 D(n=7),or 3.00 D(n=5).As a comparison,30 eyes of 21 patients meeting the same preoperative criteria for degree of corneal cylinder were enrolled to have a spherical(nontoric)IOL implanted.The data for both study and control groups were analyzed prospectively.Phacoemuisification was performed through a temporal clear corneal self-sealing incision.Outcomes of LogMAR visual acuity(without correct,with spherical correction and with best correction),refractive and keratometric astigmatism after early postoperative(one week)and long-term(3 months)follow-ups were evaluated.IOL axis rotation was also observed in the study group.Results At last follow-up,all patients achieved LogMAR 0.3(20/40)or better UCVA in the toric IOL group,while 86.7% achieved LogMAR 0.3(20/40)or better UCVA in the spherical IOL group.The mean postoperative refractive cylinder was 0.44±0.24 D in the toric IOL group and 1.44± 0.30D in the spherical(nontoric)IOL group.In 21 eyes(77%),the IOL axis was rotated less than 3 degrees.In all 27 eyes,the maxima rotation of the toric IOL axis was 9 degrees.Conclusions Early postoperative and long-term follow-ups results indicate that phacoemulsification and the Acrysoftoric IOL implantation is a largely predictable effective and stable surgical option to correcting preexisting astigmatism in cataract surgery.