Nag D, Hennig A, Foster A, Evans J R, Pradhan D, Johnson G J, Wormaid R P
London School of Hygiene and Tropical Medicine, London, UK.
Indian J Ophthalmol. 2001 Mar;49(1):31-5.
Postoperative astigmatism following intracapsular cataract extraction with or without anterior chamber intraocular lens implantation is reported as an outcome from a randomised controlled trial.
Five hundred and two of 1002 eyes randomised to intracapsular cataract extraction with anterior chamber intraocular lens (ICCE/AC IOL) and 417 of 998 eyes to intracapsular cataract extraction with aphakic spectacles (ICCE/AS) were seen for objective refraction one year after surgery. The prevalence and axis of astigmatism were evaluated using univariate analysis. Logistic regression was used to compare the postoperative astigmatism between the groups.
Acceptable astigmatism (-0.5 to 0.0 DCyl) in the AC IOL group was found in 60 (12.0%) patients (95% CI 9.1%-14.9%) and in the aphakic spectacles group (AS) in 69 (16.5%) patients (95% CI 12.9%-20.1%), moderate astigmatism (-1.0 to-1.5 DCyl) was found in 153 (30.4%) patients (95% CI 26.4-34.6%) in ACIOL group and in 288 (69.1%) patients (95% CI 64.6%-73.6%) in AS group; and large astigmatism (-2.0 to - 8.0 D Cyl) was found in 289 (57.6%) patients (95% CI 53.1%-61.6%) in ACIOL group and in 60 (14.4%) patients (95% CI 11.0% 17.8%) in AS group. Large astigmatism was approximately four times more common in the ICCE/AC IOL group compared to ICCE/AS group. In both groups, most patients had "against-the-rule" astigmatism, 446 (88.8%) (95%CI 86.0%-91.6%) in AC IOL group and 348 (83.5%) (95%CI 79.9%-87.1%) in AS group.
Astigmatism is common after intracapsular cataract extraction. Insertion of an anterior chamber IOL increases the risk of astigmatism.
报道一项随机对照试验中囊内白内障摘除术联合或不联合前房型人工晶状体植入术后的散光情况。
1002眼中有502眼被随机分配至囊内白内障摘除联合前房型人工晶状体植入术（ICCE/AC IOL）组，998眼中有417眼被随机分配至囊内白内障摘除联合无晶状体眼镜矫正术（ICCE/AS）组，术后一年对这些患者进行客观验光。采用单因素分析评估散光的患病率和轴位。运用逻辑回归比较两组术后散光情况。
前房型人工晶状体植入术组中60例（12.0%）患者（95%可信区间9.1%-14.9%）出现可接受的散光（-0.5至0.0柱镜），无晶状体眼镜矫正术组中69例（16.5%）患者（95%可信区间12.9%-20.1%）出现可接受的散光；前房型人工晶状体植入术组中153例（30.4%）患者（95%可信区间26.4%-34.6%）出现中度散光（-1.0至-1.5柱镜），无晶状体眼镜矫正术组中288例（69.1%）患者（95%可信区间64.6%-73.6%）出现中度散光；前房型人工晶状体植入术组中289例（57.6%）患者（95%可信区间53.1%-61.6%）出现高度散光（-2.0至-8.0柱镜），无晶状体眼镜矫正术组中60例（14.4%）患者（95%可信区间11.0%-17.8%）出现高度散光。与ICCE/AS组相比，ICCE/AC IOL组高度散光的发生率约为其四倍。两组中，大多数患者为“逆规性”散光，前房型人工晶状体植入术组446例（88.8%）（95%可信区间86.0%-91.6%），无晶状体眼镜矫正术组348例（83.5%）（95%可信区间79.9%-87.1%）。
囊内白内障摘除术后散光常见。植入前房型人工晶状体增加了散光风险。
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