Mendicute Javier, Irigoyen Cristina, Ruiz Miguel, Illarramendi Igor, Ferrer-Blasco Teresa, Montés-Micó Robert
Ophthalmology Service, Donostia Hospital, San Sebastián, Spain.
J Cataract Refract Surg. 2009 Mar;35(3):451-8. doi: 10.1016/j.jcrs.2008.11.043.
To compare toric intraocular lens (IOL) implantation with paired opposite clear corneal incisions (OCCIs) for astigmatism correction in patients having cataract surgery.
Ophthalmology Service, Donostia Hospital, San Sebastián, Spain.
This randomized prospective clinical study comprised eyes with more than 1.00 diopter (D) of preexisting corneal astigmatism. One group had AcrySof toric IOL implantation and the other, paired 2.75 mm/3.20 mm OCCIs in the steep axis with spherical IOL implantation. Uncorrected (UCVA) and best corrected (BCVA) visual acuity, refraction, corneal and total higher-order aberrations (HOAs), photopic and mesopic contrast sensitivity, and toric IOL axis were measured 3 months postoperatively.
Forty eyes (40 patients) were evaluated. In the toric group, 95% of eyes achieved 20/40 or better UCVA and 70%, 20/25 or better. In the OCCI group, 80% of eyes achieved 20/40 or better UCVA and 50%, 20/25 or better. All eyes achieved 20/25 or better BCVA. Mean refractive cylinder decreased significantly from preoperatively to postoperatively (-1.75 +/- 0.71 to -0.62 +/- 0.46 D, toric group; -1.61 +/- 0.67 to -0.97 +/- 0.51 D, OCCI group) (P<.01). In the toric group, 95% and 100% of eyes were within +/-0.50 D for J(0) and J(45), respectively. In the OCCI group, the percentages were 70% and 100%, respectively. No significant differences in HOA were found between groups (P>.1). Contrast sensitivity was similar except at the highest spatial frequency, being better in the toric group (P<.01).
Toric IOL implantation achieved a slight enhanced effect over OCCIs in treating preexisting astigmatism.
比较在白内障手术患者中使用带散光矫正的人工晶状体(IOL)植入联合相对的透明角膜切口(OCCI)与单纯IOL植入治疗散光的效果。
西班牙圣塞瓦斯蒂安多诺斯蒂亚医院眼科。
这项随机前瞻性临床研究纳入了术前角膜散光超过1.00屈光度(D)的患者。一组接受AcrySof带散光矫正的人工晶状体植入,另一组在陡峭轴向上进行配对的2.75mm/3.20mm透明角膜切口并植入球面人工晶状体。术后3个月测量未矫正视力(UCVA)、最佳矫正视力(BCVA)、屈光、角膜和总高阶像差(HOA)、明视觉和暗视觉对比敏感度以及带散光矫正的人工晶状体轴位。
评估了40只眼(40例患者)。在带散光矫正的人工晶状体组中,95%的眼睛UCVA达到20/40或更好,70%达到20/25或更好。在透明角膜切口组中,80%的眼睛UCVA达到20/40或更好,50%达到20/25或更好。所有眼睛的BCVA均达到20/25或更好。平均屈光柱镜度从术前到术后显著降低(带散光矫正的人工晶状体组:从-1.75±0.71D降至-0.62±0.46D;透明角膜切口组:从-1.61±0.67D降至-0.97±0.51D)(P<0.01)。在带散光矫正的人工晶状体组中,95%和100%的眼睛J(0)和J(45)分别在±0.50D范围内。在透明角膜切口组中,这两个百分比分别为70%和100%。两组之间高阶像差无显著差异(P>0.1)。除了最高空间频率外,对比敏感度相似,带散光矫正的人工晶状体组更好(P<0.01)。
在治疗术前散光方面,带散光矫正的人工晶状体植入比透明角膜切口有轻微增强效果。