University Eye Clinic, Maastricht University Medical Centre, Maastricht, The Netherlands.
Cornea. 2011 Jun;30(6):720-3. doi: 10.1097/ICO.0b013e31820009d4.
We report 2 cases in which cataract extraction with a foldable acrylic toric intraocular lens (IOL) implantation was used to correct (irregular) corneal astigmatism in patients with keratoconus and cataract.
Case 1 was a 78-year-old man with cataract and keratoconus in the left eye. He underwent phacoemulsification with a toric IOL [Acrysof SN60T9; cylinder power: 6.0 diopters (D)] implantation. Case 2 was a 64-year-old woman with bilateral cataract and keratoconus. She underwent phacoemulsification with toric IOL implantation in the right (Acrysof SN60T9; cylinder power: 6.0 D) and left eyes (Acrysof SN60T5; cylinder power: 3.0 D). Postoperative follow-up in both cases was 6 months.
In case 1, the uncorrected visual acuity increased from 20/400 to 20/50. The refractive cylinder decreased from -6.0 to -1.5 D, which is a reduction of 75%. In case 2, the uncorrected visual acuity increased from 20/400 to 20/130 in the right eye and from 20/400 to 20/30 in the left eye. Refractive astigmatism decreased by 70% in both eyes. No IOL misalignment or other complications occurred.
Cataract extraction with toric IOL implantation can be used to correct (irregular) astigmatism and to improve visual functioning in patients with mild to moderate amounts of stable keratoconus and cataract.
我们报告了 2 例使用折叠式丙烯酸散光人工晶状体（IOL）植入术矫正圆锥角膜合并白内障患者（不规则）角膜散光的病例。
病例 1 为 78 岁男性，左眼患有白内障和圆锥角膜。行超声乳化白内障吸除术联合散光 IOL[Acrysof SN60T9；柱镜度数：6.0 屈光度（D）]植入术。病例 2 为 64 岁女性，双眼均患有白内障和圆锥角膜。右眼（Acrysof SN60T9；柱镜度数：6.0 D）和左眼（Acrysof SN60T5；柱镜度数：3.0 D）行超声乳化白内障吸除术联合散光 IOL 植入术。术后随访均为 6 个月。
病例 1 中，未矫正视力从 20/400 提高至 20/50。屈光度从-6.0 降低至-1.5 D，降低了 75%。病例 2 中，右眼未矫正视力从 20/400 提高至 20/130，左眼从 20/400 提高至 20/30。双眼的屈光性散光均降低了 70%。未发生 IOL 偏位或其他并发症。
对于轻中度稳定的圆锥角膜合并白内障患者，白内障摘除联合散光 IOL 植入术可以矫正（不规则）散光，改善视力功能。
