Royal Eye Infirmary, University Hospitals Plymouth NHS Trust, Plymouth, UK.
School of Health Professions, Plymouth University, Plymouth, UK.
Eye (Lond). 2020 Jun;34(6):1142-1148. doi: 10.1038/s41433-019-0744-0. Epub 2019 Dec 16.
To determine the efficacy of toric intraocular lens (TIOL) implantation in cataract surgery patients with high levels of pre-operative corneal astigmatism and ocular co-morbidities in a state funded, National Health Service (NHS) hospital.
Retrospective cohort study involving consecutive cases of TIOL implantation in cataract surgery with over 3.00DC of pre-operative corneal astigmatism. Subjects were implanted with the Tecnis TIOL (Abbot Medical Optics) with capsular tension ring stabilisation using the Callisto system (Carl Zeiss Meditec). Visual acuity and refraction were assessed at 4-6 weeks post-operatively. Vector analysis was used to calculate the intended refractive correction, surgically induced refractive correction (SIRC), correction ratio (CR), error of magnitude (EM) and error vector (EV).
Sixty-six eyes of forty-seven subjects aged 73.8 ± 11.9 were included. Eyes with ocular co-morbidities included dry age-related macular degeneration (n = 13), amblyopia (n = 7), high myopia (n = 7), glaucoma (n = 6), previous corneal transplantation (n = 2), nanophthalmos (n = 2) and corneal scarring (n = 1). Pre-operative corneal astigmatism was 4.25 ± 1.69DC (range 3.00-12.00), post-operative refractive astigmatism was 1.31 ± 1.05DC (range 0.00-6.50DC) and post-operative unaided visual acuity was 0.25 ± 0.19 LogMAR. Vector analysis demonstrated an SIRC of 4.08 ± 1.39DC, CR = 1.1 ± 0.3, EM -0.4 ± 1.0 and EV of 1.23 ± 0.72.
The results demonstrate the efficacy of TIOL implantation in patients with high corneal astigmatism and provide strong evidence advocating their use in cataract surgery within a state funded hospital eye service. Refractive astigmatism was significantly lower than the pre-operative corneal astigmatism and a low error vector was achieved relative to the magnitude of correction.
在一家国家资助的国民保健服务（NHS）医院中，确定在术前角膜散光较高且存在眼部合并症的白内障手术患者中，进行 toric 人工晶状体（TIOL）植入的疗效。
回顾性队列研究，纳入了术前角膜散光超过 3.00DC 的白内障手术中 TIOL 植入的连续病例。使用 Callisto 系统（卡尔蔡司）对 Tecnis TIOL（雅培医疗光学）进行囊袋张力环稳定。术后 4-6 周评估视力和屈光。使用向量分析计算预期的屈光矫正、手术诱导的屈光矫正（SIRC）、矫正比（CR）、幅度误差（EM）和误差向量（EV）。
纳入了 47 名 73.8±11.9 岁患者的 66 只眼。存在眼部合并症的眼睛包括干性年龄相关性黄斑变性（n=13）、弱视（n=7）、高度近视（n=7）、青光眼（n=6）、既往角膜移植（n=2）、先天性小眼球（n=2）和角膜瘢痕（n=1）。术前角膜散光为 4.25±1.69DC（范围 3.00-12.00），术后屈光性散光为 1.31±1.05DC（范围 0.00-6.50DC），术后未矫正视力为 0.25±0.19 LogMAR。向量分析显示 SIRC 为 4.08±1.39DC，CR=1.1±0.3，EM=-0.4±1.0，EV 为 1.23±0.72。
结果表明 TIOL 植入在高角膜散光患者中的疗效，为在国家资助的医院眼科服务中开展白内障手术提供了有力证据。屈光性散光明显低于术前角膜散光，且相对于矫正幅度，实现了低误差向量。
