白内障手术中矫正中度角膜散光：散光型人工晶状体与周边角膜松解切口。
Correction of moderate corneal astigmatism during cataract surgery: toric intraocular lens versus peripheral corneal relaxing incisions.
机构信息
From Moorfields Eye Hospital NHS Foundation Trust (Hirnschall, Gangwani, Crnej, Koshy, Maurino, Findl), London, United Kingdom; the Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute (Hirnschall, Findl), Hanusch Hospital, Department of Ophthalmology, Vienna, Austria.
From Moorfields Eye Hospital NHS Foundation Trust (Hirnschall, Gangwani, Crnej, Koshy, Maurino, Findl), London, United Kingdom; the Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute (Hirnschall, Findl), Hanusch Hospital, Department of Ophthalmology, Vienna, Austria.
出版信息
J Cataract Refract Surg. 2014 Mar;40(3):354-61. doi: 10.1016/j.jcrs.2013.08.049. Epub 2014 Jan 17.
PURPOSE
To compare the astigmatism-reducing effect of a toric intraocular lens (IOL) and peripheral corneal relaxing incisions (PCRIs).
SETTING
Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.
DESIGN
Prospective masked bilateral randomized study.
METHODS
Cataract patients with a preoperative corneal astigmatism of 1.0 to 2.5 diopters (D) were included. All patients received a toric IOL in 1 eye and a nontoric IOL plus a PCRI in the other eye. Postoperative follow-up was at 1 hour, 1 month, and 6 months. The uncorrected distance visual acuity, corrected distance visual acuity, autorefraction (Topcon RM-8800), and subjective refraction were recorded. The IOL axis was assessed using retroillumination photographs.
RESULTS
The study enrolled 60 eyes of 30 patients. The mean astigmatism vector reduction was 1.74 D ± 0.64 (SD) in the toric IOL group and 1.27 ± 0.76 D in the PCRI group; the difference was statistically significant (P=.042). The mean absolute rotation of the toric IOL was 2.5 ± 1.8 degrees (maximum 6.3 degrees) in the first 6 postoperative months. Astigmatism increased in the PCRI group between the 1-month and 6-month follow-up (mean 0.38 ± 0.27 D; maximum 1.00 D) (P<.001).
CONCLUSION
Toric IOLs and PCRIs both reduced astigmatism; however, toric IOLs reduced astigmatism to a higher extent and they were more predictable.
目的
比较散光矫正型人工晶状体（IOL）和周边角膜松解切口（PCRIs）的散光矫正效果。
地点
英国伦敦 Moorfields 眼科医院 NHS 基金会信托基金。
设计
前瞻性、双盲、随机研究。
方法
纳入术前角膜散光 1.0 至 2.5 屈光度（D）的白内障患者。所有患者的 1 只眼接受散光矫正型 IOL 治疗，另 1 只眼接受非散光矫正型 IOL 联合 PCRIs 治疗。术后随访时间为 1 小时、1 个月和 6 个月。记录未矫正远视力、矫正远视力、自动验光（Topcon RM-8800）和主观验光。使用背面照明照片评估 IOL 轴位。
结果
该研究纳入 30 例患者的 60 只眼。散光矫正型 IOL 组的平均散光向量减少为 1.74 ± 0.64 D（标准差），PCRIs 组为 1.27 ± 0.76 D；差异具有统计学意义（P=.042）。在术后 6 个月内，散光矫正型 IOL 的平均绝对旋转为 2.5 ± 1.8 度（最大 6.3 度）。PCRIs 组在 1 个月至 6 个月的随访期间散光增加（平均 0.38 ± 0.27 D；最大 1.00 D）（P<.001）。
结论
散光矫正型 IOL 和 PCRIs 均可减少散光；然而，散光矫正型 IOL 可更大程度地降低散光，且更具预测性。
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