摘要
目的评估微切口白内障屈光手术中植入Toric人工晶状体(IOL)的远期疗效。方法前瞻性病例对照研究。入选术前角膜规则散光≥0.75 D的白内障患者87例(96只眼),其中42例(46只眼)植入Alcon Acrysof Toric IOL(试验组),45例(50只眼)植入Hoya YA-60BB IOL(对照组)。比较两组术后1 d、1周、1个月、3个月、6个月、2年的视力、残余散光、角膜内皮计数(EDC)、IOL旋转度和旋转稳定性及脱镜率等。采用χ^2检验、独立样本t检验进行统计学分析。结果共84例患者完成2年随访。与术前相比,试验组患者和对照组患者术后各时间点的未矫正视力(UCVA)和最佳矫正视力(BCVA)差异均有统计学意义(P值分别为<0.01和<0.05)。试验组患者术后各时间点UCVA与对照组相比,术后1周至2年差异均有统计学意义(P值均<0.01)。两组术后1 d的EDC较术前有明显降低,差异有统计学意义(P<0.01)。两组术后平均残余散光度数比较,差异有统计学意义(P<0.01)。术后1 d至2年的Toric IOL轴位旋转度<3°的病例≥70%,轴位旋转度<5°的病例≥81.8%。术后2年,两组视远脱镜率差异有统计学意义(χ^2=9.70,P<0.01)。结论微切口白内障屈光手术中远期植入Toric IOL能够安全、有效地改善轻中度角膜散光,减少对眼镜的依赖,提高患者术后视觉质量,并具有良好的旋转稳定性。
Objective To assess the long-time clinical outcomes after implantation of a Toric intraocular lens(IOL)during micro-incision cataract surgery.Methods This study was a prospective case-control study,and 87 cataract patients(96 eyes)with regular corneal astigmatism≥0.75 D were included.Phacoemulsification was performed in all patients with 42 patients(46 eyes)implanted with Alcon Acrysof Toric IOL(case group)and 45 patients(50 eyes)with Hoya YA-60 BB IOL.Patients were examined at 1 day,1 week,1 month,3 months,6 months and 2 years postoperatively,and uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),residual astigmatism,corneal endothelial density(EDC),the cylinder axis of the Toric IOL and the postoperative distance spectacle-independence rate were measured.Statistical analysis was performed usingχ^2 test and independent sample t test.Results A total of 84 patients finished the 2 year follow-up,including 40 patients(44 eyes)in the case group and 44 patients(49 eyes)in the control group.The postoperative UCVA and BCVA were significantly better compared to that before the surgery in both groups(P<0.01 and P<0.05,respectively).The UCVA in the case group were significantly better than the control group at each follow up(all with P<0.01),while the better BCVA in the case group were not statistically significant(P>0.05).The mean EDC decreased significantly at 1 day postoperatively in both groups(P<0.05),and the mean residual astigmatism was significantly different between the case and control group(P<0.01).The percentage of patients with absolute IOL misalignment from the intended axis of less than 3 degrees was more than 70%,and the percentage of less than 5 degrees was more than 81.8%.The distance spectacle-independence rate at 2 years postoperatively was 72.5%in the case group and 38.6%in the control group,with statistically significant difference(χ^2=9.70,P<0.01).Conclusions Application of Toric IOL is effective and safe in correcting mild and moderate astigmatism after micro-incision cataract re
作者
管宇
王惠芬
吴坚
管怀进
周婧
Guan Yu;Wang Huifen;Wu Jian;Guan Huaijin;Zhou Jing(Department of Ophthalmology,Affiliated Hospital of Nantong University,Nantong,Jiangsu 226001,China)
出处
《临床眼科杂志》
2020年第1期30-34,共5页
Journal of Clinical Ophthalmology
基金
国家自然科学基金面上项目(81470616)
江苏省科学技术厅社会发展重大项目-重点病种规范化诊疗项目(BE2016699)
