CAJ | 학술논문

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±0.21 D，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。
목적：평개동축미절구초성유화술연합복곡면인공정상체（ Toric intraocular lenses ，Toric IOL）식입치료백내장합병각막산광적림상효과，급기유효성화안전성。방법：본연구위림상병례계렬연구。년령상관성백내장합병각막산광（≥0．75D）환자58례69안행동축미절구초성유화수술연합Acrysof Toric인공정상체식입치료，기록술전시력、각막산광급이론잔류산광등，관찰술후제1d；1，3mo；1a 적라안시력（ uncorrected visual acuity ， UCVA）、최가교정시력（ best corrected visual acuity ， BCVA）、술후잔류산광、IOL축위등。결과：술후1a，평균라안시력위0．70±0．11，최가교정시력위0．73±0．20，균현저고우술전최가교정시력0．21±0.01，차이유통계학의의（χ2＝86．67，χ2＝82．23， P＜0.05），술전각막평균산광위2．25±0．73D，술전예계잔류평균산광위0．34±0．09D，술후1a 잔류산광위0．51±0.21 D，술전、술후산광비교차이유통계학의의（ t＝12.48，P＜0．05）。예계잔류산광여술후1a실제산광비교차이무통계학의의（t＝1.69，P＞0．05）。술후1a，IOL정위화예측축위차치위3.79°±1．21°，96％선전＜5．00°。미발현1례수술병발증。각개시간단최가교정시력、잔류산광급IOL축위선전무명현차이（ P＞0．05）。결론：대술전합병각막산광적백내장환자，행동축미절구초성유화연합Toric인공정상체식입치료능유효지제고시력、교정술전각막산광，이차은정성교호。
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.