Roberts Timothy V, Sharwood Phillipa, Hodge Christopher, Roberts Kiera, Sutton Gerard
From the *Vision Eye Institute, Chatswood; and †Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, University of Sydney; and ‡Medical School, University of New South Wales, Sydney, New South Wales, Australia.
Asia Pac J Ophthalmol (Phila). 2014 Jan-Feb;3(1):9-16. doi: 10.1097/APO.0b013e3182a0af21.
To compare toric intraocular lens (IOL) implantation with arcuate corneal relaxing incisions for moderate to high corneal astigmatism during cataract surgery.
A retrospective comparison study.
This 12-month single-surgeon study compared eyes with cataract and preexisting astigmatism of 1.75 diopters (D) or greater (range, 1.75-5.25 D) receiving corneal arcuate relaxing incisions or toric IOL implantation. Main outcome measures were visual acuity, refractive results, and IOL axis determination.
There were 45 and 20 eyes in the toric IOL and arcuate incision groups, respectively. Preoperative data were not significantly different between the 2 groups; the mean preoperative astigmatism was 2.16 ± 0.93 D in the toric IOL group and 2.41 ± 0.76 D in the incisional group. At 6 months postoperatively, the mean residual astigmatism was 0.75 and 1.33 D (P = 0.000), respectively; 82.2% and 44.4% of eyes were 1.00 D or less (P = 0.000), and 35.7% and 16.7% of eyes were 0.50 D or less (P = 0.000), respectively. Uncorrected distance visual acuity improved in both groups; eyes in the toric IOL group were more likely to be 20/30 or better (87% vs 29%, P = 0.008). Following surgery, all eyes had best corrected visual acuity of 20/40 or greater, and no eye lost a line of vision. The mean toric IOL rotation was 2.6 ± 1.7 degrees (range, 0-6 degrees).
Both toric IOLs and arcuate corneal incisions reduce moderate to high preexisting corneal astigmatism during cataract surgery; however, toric IOL implantation was more effective and predictable.
比较白内障手术中植入散光人工晶状体（IOL）与行角膜松解弧形切口治疗中度至高度角膜散光的效果。
一项回顾性对照研究。
这项为期12个月的单术者研究，比较了患有白内障且术前散光为1.75屈光度（D）或更高（范围为1.75 - 5.25 D）的患者，接受角膜松解弧形切口或散光IOL植入的情况。主要观察指标为视力、屈光结果和IOL轴位测定。
散光IOL组和弧形切口组分别有45只眼和20只眼。两组术前数据无显著差异；散光IOL组术前平均散光为2.16±0.93 D，切口组为2.41±0.76 D。术后6个月，平均残余散光分别为0.75 D和1.33 D（P = 0.000）；分别有82.2%和44.4%的眼残余散光为1.00 D或更低（P = 0.000），分别有35.7%和16.7%的眼残余散光为0.50 D或更低（P = 0.000）。两组的未矫正远视力均有改善；散光IOL组的眼更有可能达到20/30或更好（87%对29%，P = 0.008）。手术后，所有眼的最佳矫正视力均达到20/40或更好，且没有眼视力下降一行。散光IOL的平均旋转度数为2.6±1.7度（范围为0 - 6度）。
散光IOL和角膜弧形切口均可在白内障手术中降低术前存在的中度至高度角膜散光；然而，植入散光IOL更有效且可预测。
