Anterior Segment Surgery Department, Asociación para Evitar la Ceguera, Mexico City, Mexico.
Research Department, Asociación para Evitar la Ceguera, Mexico City, Mexico.
Eur J Ophthalmol. 2021 Jul;31(4):1532-1539. doi: 10.1177/1120672120960585. Epub 2020 Oct 2.
To determine the refractive stability of patients with keratoconus and cataracts after the implantation of a toric intraocular lens.
This is a cross-sectional, retrospectivestudy. Clinical records from patients with non-progressive keratoconus and cataracts that underwent non-complicated phacoemulsification with toric IOL implantation were reviewed. Mean keratometry (Km), refractive cylinder (RC), spherical equivalent (SE), steeper keratometry (K), and axis were evaluated at the 1-month, 6-month, 12-month, and 24-month follow-up visits.
Fifty-four eyes from 41 patients were included. Thirty-seven (68.5%) female and 17 (31.5%) male patients, with a mean age of 67.52 ± 8.22. Refractive cylinder at postoperative 30 days was -1.61 ± 1.23, 6-month -1.22 ± 0.80, 12-month -1.10 ± 0.83 and 24-month visit after surgery was -1.37 ± 0.77( = 0.290). SE at the 30-day visit was -0.82 ± 1.90, 6-month -0.64 ± 1.23, 12-month -0.78 ± 1.91 and at 24-month postoperative visit -1.02 ± 1.87 ( = 0.210). Km value at the 1-month visit was 47.23 ± 1.95, 6-month 47.87 ± 1.61, 12-month 46.39 ± 2.52 and 24-month postoperative visit 46.92 ± 1.26 ( = 0.877). The steeper K axis in the 30-day control was 78.53 ± 30.12, 6-month 77.29± 37.68, 1-year 93.13 ± 62.42, 24-month 67.31 ± 38.49 ( = 0.632).
Our findings suggest a low variation in the refractive outcome for patients with mild and moderate keratoconus and cataracts, without evident progression signals, a demonstrated keratoconus clinical stability. No statistically significant postoperative changes in the refractive cylinder, SE, mean K, and steeper K axis were observed, which suggests good predictability for toric IOL implant.
评估角膜散光眼患者白内障术后植入散光型人工晶状体的屈光稳定性。
这是一项回顾性、横断面研究。回顾分析了 41 例非进展性圆锥角膜合并白内障患者行超声乳化白内障吸除联合散光型人工晶状体植入术的临床资料。术后 1 个月、6 个月、12 个月和 24 个月分别测量平均角膜曲率（Km）、等效球镜（SE）、角膜散光（RC）、陡峭角膜曲率（K）和散光轴位。
共纳入 54 只眼（41 例患者），其中女性 37 例（68.5%），男性 17 例（31.5%），平均年龄为 67.52±8.22 岁。术后 30 天、6 个月、12 个月和 24 个月的角膜散光分别为-1.61±1.23、-1.22±0.80、-1.10±0.83 和-1.37±0.77（ = 0.290）；等效球镜分别为-0.82±1.90、-0.64±1.23、-0.78±1.91 和-1.02±1.87（ = 0.210）。术后 1 个月、6 个月、12 个月和 24 个月的 Km 值分别为 47.23±1.95、47.87±1.61、46.39±2.52 和 46.92±1.26（ = 0.877）。术后 30 天、6 个月、1 年和 2 年陡峭 K 轴位分别为 78.53±30.12、77.29±37.68、93.13±62.42 和 67.31±38.49（ = 0.632）。
对于合并白内障的轻、中度圆锥角膜患者，术后随访 2 年发现其角膜散光、等效球镜、平均角膜曲率和陡峭角膜曲率轴位变化小，无明显进展趋势，提示该术式具有良好的预测性。
