Ruíz-Mesa Ramón, Carrasco-Sánchez Daniel, Díaz-Alvarez Sara B, Ruíz-Mateos M Angeles, Ferrer-Blasco Teresa, Montés-Micó Robert
Centro Integral Ocular, Jerez de la Frontera, Spain.
Am J Ophthalmol. 2009 Jun;147(6):990-6, 996.e1. doi: 10.1016/j.ajo.2009.01.004. Epub 2009 Mar 14.
To assess visual and refractive outcomes, and rotational stability after refractive lens exchange (RLE) with toric intraocular lens (IOL) implantation to correct ametropia and preexisting astigmatism.
Prospective, nonrandomized, observational case series (self-controlled).
This prospective, nonrandomized, and self-controlled study included 32 eyes of 19 consecutive patients with more than 1.00 diopter (D) of preexisting corneal astigmatism having RLE with AcrySof Toric IOL implantation (Alcon Laboratories Inc, Fort Worth, Texas, USA). Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), refractive sphere, and keratometric and refractive cylinder were recorded preoperatively and 6 months after surgery. Toric IOL axis shift was also measured. A patient satisfaction, visual phenomena, and spectacle dependency questionnaire was also carried out.
At 6 months postoperatively, UCVA was 20/32 or better in 100% of the eyes, with 84.3% achieving 20/25 or better. One hundred percent of eyes achieved 20/25 or better BCVA. No eye lost >or=2 lines, 1 eye lost 1 line, 16 eyes did not change, 4 eyes gained 1 line, and 11 eyes gained >or=2 lines of BCVA after the surgery. Mean refractive cylinder was reduced significantly after surgery from -2.46 +/- 0.99 D to -0.53 +/- 0.30 D (P < .001). Vector analysis to compare attempted vs achieved correction showed that 100% of eyes were within +/- 1.00 D for the spherical equivalent, and 100% of eyes were within +/-0.50 D for the astigmatic components (J(0) and J(45)). Mean toric IOL axis rotation was 0.90 +/- 1.76 degrees, being <or= 5 degrees in 96.8% of eyes evaluated. Patients were satisfied with their vision without reporting severe visual phenomena (from none to moderate).
RLE with toric IOL implantation showed good visual and refractive outcomes for correcting spherical and cylindrical refractive errors.
评估植入散光人工晶状体（IOL）的屈光性晶状体置换术（RLE）矫正屈光不正和既有散光后的视力、屈光结果及旋转稳定性。
前瞻性、非随机、观察性病例系列研究（自身对照）。
这项前瞻性、非随机且自身对照研究纳入了19例连续患者的32只眼，这些患者既有角膜散光超过1.00屈光度（D），接受了植入AcrySof Toric IOL（美国德克萨斯州沃思堡爱尔康实验室公司）的RLE手术。术前及术后6个月记录未矫正视力（UCVA）、最佳矫正视力（BCVA）、屈光球镜、角膜曲率及屈光柱镜。还测量了散光IOL轴位偏移。同时进行了患者满意度、视觉现象及眼镜依赖情况问卷调查。
术后6个月，100%的患眼UCVA达到20/32或更好，84.3%的患眼达到20/25或更好。100%的患眼BCVA达到20/25或更好。术后无患眼视力下降≥2行，1只眼下降1行，16只眼视力无变化，4只眼提高1行，11只眼提高≥2行。术后平均屈光柱镜显著降低，从-2.46±0.99 D降至-0.53±0.30 D（P <.001）。比较预期矫正与实际矫正的矢量分析显示，100%的患眼球镜等效值在±1.00 D以内，100%的患眼角膜散光分量（J(0)和J(45)）在±0.50 D以内。散光IOL平均轴位旋转为0.90±1.76度，96.8%接受评估的患眼旋转≤5度。患者对视力满意，未报告严重视觉现象（从无到中度）。
植入散光IOL的RLE在矫正球镜和柱镜屈光不正方面显示出良好的视力和屈光结果。
