Hayashi Eye Hospital, 4-7-13 Hakataekimae, Hakata-Ku, Fukuoka, 812-0011, Japan.
Department of Ophthalmology, National Hospital Organization of Saitama Hospital, Wako, Japan.
Graefes Arch Clin Exp Ophthalmol. 2022 Feb;260(2):509-519. doi: 10.1007/s00417-021-05406-7. Epub 2021 Sep 8.
To examine the long-term changes in the astigmatism-correcting effect of a toric intraocular lens (IOL) after stabilization of surgically induced astigmatic changes due to cataract surgery.
Unilateral eyes of 120 patients that received a toric IOL for against-the-rule (ATR) or with-the-rule (WTR) astigmatism were enrolled. Manifest refractive and anterior corneal astigmatism, and ocular residual astigmatism which is mainly derived from internal optics were examined preoperatively, at approximately 2 months postoperatively (baseline) and at 5 ~ 10 years postbaseline. The astigmatism was decomposed to vertical/horizontal (Rx) and oblique components (Ry), which was compared between baseline and 5 ~ 10 years postbaseline.
In the eyes having ATR astigmatism, the mean Rx and Ry of the manifest refractive and corneal astigmatism significantly changed toward ATR astigmatism between the baseline and 5 ~ 10 years postbaseline (p ≤ 0.0304), but those of ocular residual astigmatism did not change significantly between the 2 time points. In the eyes having WTR astigmatism, the Rx and Ry of refractive, corneal, and ocular residual astigmatism did not change significantly between the 2 time points. Double-angle plots revealed an ATR shift in refractive and corneal astigmatism and no marked change in the ocular residual astigmatism in the eyes with ATR astigmatism, and there is no change in this astigmatism in the eyes with WTR astigmatism.
The long-term changes with age in the effect of a toric IOL significantly deteriorated due to an ATR shift of corneal astigmatism in the eyes having ATR astigmatism, while it was maintained in eyes having WTR astigmatism, suggesting that ATR astigmatism should be overcorrected.
研究白内障术后因手术引起的散光稳定后，散光矫正型人工晶状体（IOL）的长期散光矫正效果变化。
本研究纳入了 120 例因逆规（ATR）或规则性（WTR）散光而接受散光 IOL 治疗的单眼患者。术前、术后约 2 个月（基线）和术后 510 年（随访）检查了患者的客观屈光和角膜散光及主要来源于眼内光学部分的残余散光。将散光分解为垂直/水平（Rx）和斜向（Ry）分量，比较基线和随访 510 年时的差异。
ATR 散光眼的客观屈光和角膜散光的平均 Rx 和 Ry 在基线和随访 5~10 年之间明显向 ATR 散光转变（p≤0.0304），而残余散光无明显变化。WTR 散光眼的 Rx 和 Ry 在这两个时间点之间无显著变化。双角度图显示，ATR 散光眼的屈光和角膜散光发生 ATR 移位，而残余散光无明显变化，WTR 散光眼的这种散光无明显变化。
ATR 散光眼的角膜散光发生 ATR 移位，导致散光矫正型 IOL 的长期效果随年龄增长而显著恶化，而 WTR 散光眼的效果保持稳定，这表明 ATR 散光应进行过矫正。
