CAJ | 학술논문

目的： Acrysof IQ Restor multifocal toric人工晶状体（ intraocular len ， IOL）是一种新型IOL，可在一次手术中实现老视和角膜散光的矫正。文章旨在评价白内障超声乳化联合Acrysof IQ Restor toric IOL植入术后患者的早期临床效果。方法对前来南京军区南京总医院行白内障超声乳化联合多焦点散光型IOL植入患者7例（9眼）进行分析，其术前散光均≥1．0 D。术后随访3个月，分别观察术前及术后1周、1个月、3个月裸眼远近视力、最佳矫正远近视力、等效球镜等效球镜、焦点深度、预计残余散光、术后残余散光及人工晶状体的稳定性、对比敏感度（contrast sensitivity， CS）及脱镜率等。结果术后3个月，裸眼远视力（logMAR）为0．07±0．10，最佳矫正远视力为0．02±0．11，裸眼近视力为0．12±0．06，最佳矫正近视力为0．08±0．07，等效球镜≤±0．5D者8眼（88．9％），焦点深度为（5．32±1．78）D。术后3个月全眼总散光（0．25±0．28）D，与术前（1．55±0．39）D相比，差异有统计学意义（P＜0．05）。术后全眼总散光与术前预计残留散光（0．13±0．09）D接近，其差异无统计学意义（P＞0．05）。术后3个月，IOL轴位平均偏离（3．11±1．61）°。术后3个月与术后1个月相比，眩光和无眩光时CS在中低频区（3、6、12 cpd）的提高差异无统计学意义（P＞0．05），而在高频区（18 cpd）提高差异有统计学意义（P＜0．05）。术后脱镜率为100％。结论 Acrysof IQ Restor toric多焦点散光型人工晶状体能为白内障患者提供满意的全程视力、视觉质量和脱镜率，可预测性好，并有良好的旋转稳定性。
목적： Acrysof IQ Restor multifocal toric인공정상체（ intraocular len ， IOL）시일충신형IOL，가재일차수술중실현로시화각막산광적교정。문장지재평개백내장초성유화연합Acrysof IQ Restor toric IOL식입술후환자적조기림상효과。방법대전래남경군구남경총의원행백내장초성유화연합다초점산광형IOL식입환자7례（9안）진행분석，기술전산광균≥1．0 D。술후수방3개월，분별관찰술전급술후1주、1개월、3개월라안원근시력、최가교정원근시력、등효구경등효구경、초점심도、예계잔여산광、술후잔여산광급인공정상체적은정성、대비민감도（contrast sensitivity， CS）급탈경솔등。결과술후3개월，라안원시력（logMAR）위0．07±0．10，최가교정원시력위0．02±0．11，라안근시력위0．12±0．06，최가교정근시력위0．08±0．07，등효구경≤±0．5D자8안（88．9％），초점심도위（5．32±1．78）D。술후3개월전안총산광（0．25±0．28）D，여술전（1．55±0．39）D상비，차이유통계학의의（P＜0．05）。술후전안총산광여술전예계잔류산광（0．13±0．09）D접근，기차이무통계학의의（P＞0．05）。술후3개월，IOL축위평균편리（3．11±1．61）°。술후3개월여술후1개월상비，현광화무현광시CS재중저빈구（3、6、12 cpd）적제고차이무통계학의의（P＞0．05），이재고빈구（18 cpd）제고차이유통계학의의（P＜0．05）。술후탈경솔위100％。결론 Acrysof IQ Restor toric다초점산광형인공정상체능위백내장환자제공만의적전정시력、시각질량화탈경솔，가예측성호，병유량호적선전은정성。
Objective Acrysof IQ Restor multifocal toric intraocular lens ( IOL) is a new product , which allows a single sur-gical procedure for presbyopia correction and corneal astigmatism management .This study was to evaluate the early clinical effects of phacoemulsification cataract surgery with implantation of a diffractive multifocal toric IOL . Methods We retrospectively analyzed 7 cases (9 eyes) of corneal astigmatism ≥1.0 diopter (D) treated by phacoemulsification with implantation of an Acrysof IQ Restor toric IOL.The patients were followed up for 3 months for observation of uncorrected distance visual acuity ( UDVA) , best corrected distance visual acuity ( CDVA) , uncorrected near visual acuity ( UNVA ) , best corrected near visual acuity ( CNVA ) , spherical equivalent (SE) refraction, focal depth, residual astigmatism, rotational stability of the IOL, contrast sensitivity (CS), and spectacle independ-ence preoperatively and at 1 week, 1 month, and 3 months after operation . Results At 3 months after surgery , the UDVA ( log-MAR), CDVA, UNVA, and CNVA were 0.07 ±0.10, 0.02 ±0.11, 0.12 ±0.06, and 0.08 ±0.07, respectively, with an SE re-fraction within ±0.50 D of the attempted spherical correction in 8 eyes (88.9%) and a focal depth of (5.32 ±1.78) D.The residual astigmatism at 3 months was significantly reduced as compared with the baseline ([0.25 ±0.28] vs [1.55 ±0.39] D, P<0.05), but showed no statistically significant differences from the preoperative an-ticipated residual astigmatism (P>0.05).At 3 months, the mean IOL axis rotation was (3.11 ±1.61)°and CS was remarkably im-proved ( P<0 .05 ) , while CS with or without glare was not significantly different from that at 1 month at all spatial frequencies ( P>0.05) except at 18.0 cpd (P<0.05). Conclusion Implantation of the Acrysof IQ Restor multifocal toric IOL provides excellent overall quality of vision, spectacle independence, visual quality, and rotational stability for patients with cataract and corneal astigmatism.