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[散光人工晶状体植入术有效性和安全性的多中心研究]

[A multicenter study of the effectiveness and safety of Toric intraocular lens implantation].

作者信息

Song X D, Hao Y S, Bao Y Z, Li Z H, Zhang H, Yu A Y, Zhao M S, Huang Y S, Fang J, Liu Y, Wang N L

机构信息

Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab., Beijing 100730, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2018 May 11;54(5):349-356. doi: 10.3760/cma.j.issn.0412-4081.2018.05.008.

Abstract

To evaluate the effectiveness and safety of Proming(®)Toric intraocular lens (IOL) in adults with cataract combined with corneal regular astigmatism. Multicentre, randomized, open and positive parallel controlled clinical study. A total of 121 patients (121 eyes) who had cataract combined with corneal regular astigmatism and met the inclusion criteria were enrolled in 9 hospitals from May 2014 to May 2016. There were 45 males and 76 females and the median age was 71 (42-88) years old. A total of 121 patients (121 eyes) were randomly assigned to the study group and the control group through the Central Randomization System. Sixty patients (60 eyes) of the study group were implanted with Proming(®)Toric IOL (Model: AT1BH-AT6BH) from Eyebright Medical Technology (Beijing) Co., Ltd., and 61 patients (61 eyes) of the control group were implanted with AcrySof (®)IQ Toric IOL (Model: SN6AT2-SN6AT7) from Alcon Laboratories, Inc. The visual acuity, IOL axial position, slit lamp examination, residual astigmatism and contrast sensitivity were recorded at 1 day, 1 week, 1 month, 3 months, 6 months and 1 year postoperatively. Statistical analysis was performed using χ(2) test, independent sample test, Mann-Whitney test, Friedman repeated measured ANOVA on ranks and non-parametric 2-factor variance analysis. A total of 118 patients completed 6 months of follow-up, including 59 from the study group and 59 from the control group. The difference between the two groups in terms of the percentage of best corrected distance visual acuity (BCDVA) reaching 20/40 was 1.69% [100% (59/59) . 98.31% (58/59) ], and the lower limit of the 95% (-1.60%) was greater than -10.00%. A total of 90 patients were followed up for 1 year, including 43 patients from study group and 47 patients from control group. At 1 year after operation, the percentages of the BCDVA up to 20/40 were 97.67%(42/43) in the study group and 97.87% (46/47) in the control group, and there was no significant difference between the two groups (χ(2)=0.00, 0.95);the percentages of the uncorrected distance visual acuity (UCDVA) up to 20/40 were 81.40%(35/43) in the study group and 82.98%(39/47) in the control group, and there was no significant difference between the two groups (χ(2)=0.04, 0.84). At 1 year follow-up, the difference of contrast sensitivity at 18.0 c/d under the bright light, dark light, bright glare and dark glare between the two groups was not statistically significant (468.50, 0.17;528.00, 0.28;465.50, 0.19;629.00, 0.39);the difference of residual astigmatism between the two groups was not statistically significant (798.50, 0.08);the difference of IOL rotation degree between the two groups was not statistically significant (869.00, 0.25). There were no severe inflammatory responses nor other complications associated with IOL in both groups at each follow-up point. The visual quality, astigmatism correction effect, rotation stability and safety of Proming(®)Toric IOL for the treatment of cataract combined with corneal regular astigmatism is equivalent to AcrySof(®) IQ Toric IOL. .

摘要

评估普诺明(®)散光型人工晶状体(IOL)在患有白内障合并角膜规则散光的成年人中的有效性和安全性。多中心、随机、开放、阳性平行对照临床研究。2014年5月至2016年5月,来自9家医院的121例患有白内障合并角膜规则散光且符合纳入标准的患者(121只眼)入组。其中男性45例,女性76例,年龄中位数为71(42 - 88)岁。通过中央随机系统将121例患者(121只眼)随机分为研究组和对照组。研究组60例患者(60只眼)植入了北京爱博诺德医疗科技有限公司的普诺明(®)散光型IOL(型号:AT1BH - AT6BH),对照组61例患者(61只眼)植入了爱尔康公司的AcrySof(®)IQ散光型IOL(型号:SN6AT2 - SN6AT7)。术后1天、1周、1个月、3个月、6个月和1年记录视力、IOL轴向位置、裂隙灯检查、残余散光和对比敏感度。采用χ²检验、独立样本t检验、Mann - Whitney U检验、Friedman重复测量秩方差分析和非参数双因素方差分析进行统计分析。共有118例患者完成了6个月的随访,其中研究组59例,对照组59例。两组间最佳矫正远视力(BCDVA)达到20/40的百分比差异为1.69%[100%(59/59). 98.31%(58/59)],95%可信区间下限(-1.60%)大于-10.00%。共有90例患者随访1年,其中研究组43例,对照组47例。术后1年,研究组BCDVA达到20/40的百分比为97.67%(42/43),对照组为97.87%(46/47),两组间差异无统计学意义(χ² = 0.00,P = 0.95);未矫正远视力(UCDVA)达到20/40的百分比研究组为81.40%(35/43),对照组为82.98%(39/47),两组间差异无统计学意义(χ² = 0.04,P = 0.84)。随访1年时,两组在明亮光线下、暗光下、明亮眩光下和黑暗眩光下18.0 c/d的对比敏感度差异无统计学意义(P = 0.17;P = 0.28;P = 0.19;P = 0.39);两组间残余散光差异无统计学意义(P = 0.08);两组间IOL旋转度数差异无统计学意义(P = 0.25)。在每个随访点,两组均未出现严重炎症反应及与IOL相关的其他并发症。普诺明(®)散光型IOL治疗白内障合并角膜规则散光的视觉质量、散光矫正效果、旋转稳定性和安全性等同于AcrySof(®)IQ散光型IOL。

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