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有术前散光的白内障病例中行散光人工晶状体植入术的长期临床结局

Long-term clinical outcomes of toric intraocular lens implantation in cataract cases with preexisting astigmatism.

作者信息

Miyake Toshiyuki, Kamiya Kazutaka, Amano Rie, Iida Yoshihiko, Tsunehiro Shuntaro, Shimizu Kimiya

机构信息

From the Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.

From the Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.

出版信息

J Cataract Refract Surg. 2014 Oct;40(10):1654-60. doi: 10.1016/j.jcrs.2014.01.044. Epub 2014 Aug 20.

Abstract

PURPOSE

To evaluate the long-term clinical outcomes and rotational stability of toric intraocular lenses (IOLs) to correct preexisting astigmatism in cataract patients.

SETTING

Kitasato University Hospital, Kanagawa, Japan.

DESIGN

Prospective observational study.

METHODS

Phacoemulsification with implantation of a toric IOL (Acrysof IQ toric SN6AT) was performed in cataract patients with corneal astigmatism. The postoperative follow-up was up to 2 years.

RESULTS

This study enrolled 378 eyes of 302 patients with a mean age of 63.4 years ± 16.9 (SD). The corrected distance visual acuity 3 months postoperatively was 20/25 or better in 94.7% of eyes. The mean refractive cylinder was -1.92 ± 1.45 diopters (D) preoperatively, -0.59 ± 0.62 D 3 months postoperatively (322 eyes), and -0.67 ± 0.90 D at 2 years (73 eyes). There were statistically significant differences between the preoperative and 3-month postoperative measurements (P<.001, Wilcoxon signed-rank test). The mean IOL misalignment was 4.1 ± 3.0 degrees 2 years postoperatively. The mean IOL rotation was 4.5 ± 4.9 degrees within 1 day postoperatively. The rotation was more than 20 degrees in 6 eyes, all of which had an axial length (AL) of more than 25.0 mm. All rotations occurred within 10 days postoperatively.

CONCLUSIONS

Toric IOLs were effective in reducing preexisting corneal astigmatism and had overall good rotational stability. A large degree of IOL rotation might occur in eyes with a relatively long AL, especially during the early postoperative period. The 6 rotated IOLs were implanted to correct with-the-rule astigmatism.

FINANCIAL DISCLOSURE

No author has a financial or proprietary interest in any material or method mentioned.

摘要

目的

评估矫正白内障患者术前散光的复曲面人工晶状体(IOL)的长期临床疗效和旋转稳定性。

设置

日本神奈川县北里大学医院。

设计

前瞻性观察研究。

方法

对有角膜散光的白内障患者进行超声乳化联合植入复曲面IOL(Acrysof IQ复曲面SN6AT)。术后随访长达2年。

结果

本研究纳入了302例患者的378只眼,平均年龄为63.4岁±16.9(标准差)。术后3个月时,94.7%的眼矫正远视力达到20/25或更好。术前平均屈光柱镜为-1.92±1.45屈光度(D),术后3个月为-0.59±0.62 D(322只眼),2年时为-0.67±0.90 D(73只眼)。术前与术后3个月测量结果之间存在统计学显著差异(P<0.001,Wilcoxon符号秩检验)。术后2年时IOL平均偏心为4.1±3.0度。术后1天内IOL平均旋转为4.5±4.9度。6只眼的旋转超过20度,所有这些眼的眼轴长度(AL)均超过25.0 mm。所有旋转均发生在术后10天内。

结论

复曲面IOL在减少术前角膜散光方面有效,且总体旋转稳定性良好。在眼轴相对较长的眼中可能会发生较大程度的IOL旋转,尤其是在术后早期。6只旋转的IOL植入用于矫正顺规散光。

财务披露

没有作者对文中提及的任何材料或方法拥有财务或专利权益。

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