Müftüoğlu İlkay Klç, Akova Yonca Aydn, Egrilmez Sait, Yilmaz Suzan Guven
Department of Ophthalmology (İ.K.M.), Istanbul Training and Research Hospital, Istanbul, Turkey; Department of Ophthalmology (Y.A.A.), Bayındır Kavaklidere Hospital, Ankara, Turkey; and Department of Ophthalmology (S.E., S.G.Y.), Ege University School of Medicine, Izmir, Turkey.
Eye Contact Lens. 2016 Mar;42(2):e8-e11. doi: 10.1097/ICL.0000000000000147.
To evaluate the results of toric intraocular lens (IOL) implantation in patients with cataract and postpenetrating keratoplasty astigmatism.
Seven eyes of 7 patients with cataract and more than 3.5 diopters (D) astigmatism following penetrating keratoplasty were included in this retrospective case series study. All of the eyes underwent phacoemulsification and Acrysof toric IOL (t5-t9) implantation at least 6 months later than the complete suture removal. Corrected visual acuity (CVA), manifest astigmatism, the keratometry measurements, and complications were assessed.
The mean preoperative CVA significantly increased (0.7±0.3 [range: 0.3-1.3] logMAR to 0.1±0.04 [range: 0.05-0.15] logMAR; P<0.05) at mean 8.71±4.11 months after the surgery. The mean preoperative corneal astigmatism and the average manifest refractive astigmatism at the last visit were 5.4±0.9 D (range: 4.25-7 D) and 1.6±0.6 D (range: 0.5-2.5 D), respectively. The mean attempted cylinder correction at spectacle plane was 4.3±0.9 D (range: 2.4-4.7 D) whereas the mean cylinder correction was 4.6±0.5 D (range: 3.9-5.9 D), showing a slightly tendency for overcorrection. All eyes (100%) were within 1 D of predicted residual astigmatism. No complication occurred during the follow-up.
Toric IOL implantation seems to be an effective, predictable, and safe procedure in patients with cataract formation and high astigmatism after penetrating keratoplasty.
评估散光人工晶状体（IOL）植入术治疗白内障合并穿透性角膜移植术后散光患者的效果。
本回顾性病例系列研究纳入了7例白内障患者的7只眼，这些患者在穿透性角膜移植术后散光度数超过3.5屈光度（D）。所有患眼均接受了白内障超声乳化吸除术，并在完全拆除缝线至少6个月后植入了Acrysof散光IOL（t5 - t9）。评估了矫正视力（CVA）、明显散光、角膜曲率测量值及并发症情况。
术后平均8.71±4.11个月时，平均术前CVA显著提高（从0.7±0.3[范围：0.3 - 1.3]logMAR提高至0.1±0.04[范围：0.05 - 0.15]logMAR；P<0.05）。末次随访时，术前平均角膜散光和平均明显屈光性散光分别为5.4±0.9 D（范围：4.25 - 7 D）和1.6±0.6 D（范围：0.5 - 2.5 D）。在眼镜平面上，平均尝试的柱镜矫正度数为4.3±0.9 D（范围：2.4 - 4.7 D），而平均柱镜矫正度数为4.6±0.5 D（范围：3.9 - 5.9 D），显示出轻微的过矫正倾向。所有患眼（100%）的残余散光均在预测值的1 D范围内。随访期间未发生并发症。
对于穿透性角膜移植术后出现白内障和高度散光的患者，散光IOL植入术似乎是一种有效、可预测且安全的手术方法。
