Yang Juan-Juan, Qin Ya-Zhou, Qin Li, Li Jing-Ming
Department of Ophthalmology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.
Exp Ther Med. 2020 Nov;20(5):25. doi: 10.3892/etm.2020.9153. Epub 2020 Aug 28.
Corneal astigmatism significantly compromises uncorrected visual acuity (UCVA) after phacoemulsification with implantation of traditional spherical or non-spherical monofocal intraocular lens (IOL). Toric IOL provides an effective way to gain favorable postoperative UCVA for the patients with cataracts with corneal astigmatism. There are numerous types of toric IOLs; however AcrySof IQ toric IOL (Alcon Laboratories, Inc.) and TECNIS toric IOL (Johnson & Johnson Vision; Johnson & Johnson) are most frequently used in our clinical practice. The purpose of the current study was to compare the clinical efficacy of AcrySof IQ with TECNIS toric IOL implantation, and to provide a clinical basis on selecting an appropriate toric IOL before cataract surgery for patients with corneal astigmatism. A total of 30 patients with cataract (44 eyes) with corneal astigmatism [0.82-7.27 diopters (D)], who have undergone phacoemulsification with toric IOL implantation between October 2012 and December 2017, were included in the current retrospective cohort study. Patients were divided into two groups: One group (26 eyes) received the AcrySof IQ toric IOL (AcrySof group) and the other group (18 eyes) received the TECNIS toric IOL (Tecnis group). The indexes of curative effect, such as uncorrected and corrected distance visual acuity (UDVA and CDVA, respectively), refractive outcomes, contrast sensitivity (CS), IOL rotation, and satisfaction, were evaluated. Both toric IOLs significantly improved UDVA and CDVA. Postoperative mean residual astigmatism was similar in the AcrySof group and in the Tecnis group (0.75±0.50 and 0.78±0.90 D; P=0.896). There was no statistically significant between postoperative CS in the AcrySof and Tecnis groups. Rotations of >10˚ were considered to be significant and were identified in three eyes. The mean IOL rotation showed no statistically significant difference (AcrySof group, 0.24±5.54˚; Tecnis group, -0.19±6.28˚; P=0.416). The mean patient satisfaction score was 8.46±1.21 in the AcrySof group and 8.78±1.44 in the Tecnis group (P=0.260). The results of the current study indicated that patients with cataracts with corneal astigmatism undergoing phacoemulsification with AcrySof IQ and TECNIS toric IOL implantation achieved similar clinical efficacy in term of visual outcomes, refraction correction, CS, rotational stability and satisfaction.
角膜散光会显著降低白内障患者在植入传统球面或非球面单焦点人工晶状体（IOL）后进行超声乳化手术的裸眼视力（UCVA）。对于患有角膜散光的白内障患者，散光型IOL为术后获得良好的UCVA提供了一种有效方法。散光型IOL有多种类型；然而，AcrySof IQ散光型IOL（爱尔康实验室公司）和TECNIS散光型IOL（强生视力健公司；强生公司）是我们临床实践中最常用的。本研究的目的是比较AcrySof IQ与TECNIS散光型IOL植入的临床疗效，并为角膜散光患者在白内障手术前选择合适的散光型IOL提供临床依据。本回顾性队列研究纳入了2012年10月至2017年12月期间接受超声乳化联合散光型IOL植入手术的30例白内障合并角膜散光患者（44只眼），角膜散光度数为0.82 - 7.27屈光度（D）。患者分为两组：一组（26只眼）植入AcrySof IQ散光型IOL（AcrySof组），另一组（18只眼）植入TECNIS散光型IOL（Tecnis组）。评估了疗效指标，如裸眼和矫正远视力（分别为UDVA和CDVA）、屈光结果、对比敏感度（CS）、IOL旋转和满意度。两种散光型IOL均显著提高了UDVA和CDVA。AcrySof组和Tecnis组术后平均残余散光相似（分别为0.75±0.50和0.78±0.90 D；P = 0.896）。AcrySof组和Tecnis组术后CS之间无统计学显著差异。IOL旋转>10˚被认为是显著的，在三只眼中发现了这种情况。平均IOL旋转无统计学显著差异（AcrySof组，0.24±5.54˚；Tecnis组，-0.19±6.28˚；P = 0.416）。AcrySof组患者平均满意度评分为8.46±1.21，Tecnis组为8.78±1.44（P = 0.260）。本研究结果表明，对于患有角膜散光的白内障患者，植入AcrySof IQ和TECNIS散光型IOL进行超声乳化手术，在视力结果、屈光矫正、CS、旋转稳定性和满意度方面取得了相似的临床疗效。
