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根据术前散光类型评估白内障手术联合散光型人工晶状体植入的长期效果。

Long-term outcomes of cataract surgery with toric intraocular lens implantation by the type of preoperative astigmatism.

机构信息

Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.

Division of Ophthalmology, Ryugasaki Saiseikai Hospital, Ryugasaki, Ibaraki, Japan.

出版信息

Sci Rep. 2022 May 19;12(1):8457. doi: 10.1038/s41598-022-12426-8.

DOI:10.1038/s41598-022-12426-8
PMID:35589932
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9120159/
Abstract

Surgical outcomes of toric intraocular lens (IOL) implantation for 8 years after surgery were analyzed. Data were retrospectively collected in 176 eyes of 176 patients before and 1 month, 1, 3, 5, and 8 years after phacoemulsification and implantation of a toric IOL. Preoperative corneal and postoperative manifest astigmatism was analyzed by converting to power vector notations; horizontal/vertical (J) and oblique (J) astigmatism components. Toric IOL implantation significantly reduced pre-existing astigmatism by decreasing J in eyes with preoperative with-the-rule (WTR) astigmatism, increasing J in eyes with against-the-rule (ATR) astigmatism, and correcting J in eyes with oblique astigmatism. After surgery, the eyes with preoperative ATR astigmatism showed a significant ATR astigmatic shift, and J at 5 and 8 years was significantly smaller than that at 1 month postoperatively. Uncorrected distance visual acuity was also significantly worse at 5 and 8 years than at 1 month postoperatively. In eyes with WTR and oblique astigmatism, the effects of toric IOLs on astigmatism and visual acuity were sustained for 8 years. The long-term astigmatism-correcting effects did not differ among the models of toric IOL used in this study, SN6AT3-8 (Alcon Laboratories). In eyes with preoperative ATR astigmatism, astigmatism-correcting effects of toric IOLs decreased at 5 years and later postoperatively, indicating that overcorrection may be considered at the time of cataract surgery. In eyes with WTR and oblique astigmatism, the effects of toric IOLs were maintained throughout the 8-year follow-up period.

摘要

对术后 8 年的散光型人工晶状体（IOL）植入手术的手术效果进行了分析。回顾性收集了 176 例 176 只眼的资料，这些患者在白内障超声乳化联合散光型 IOL 植入术前、术后 1 个月、1 年、3 年、5 年和 8 年分别进行了角膜和术后显性散光分析，采用向量化分析方法分析水平/垂直（J）和斜（J）散光分量；对术前顺规散光（WTR）眼，降低 J 以减少术前散光；对术前逆规散光（ATR）眼，增加 J 以增加术前散光；对斜散光眼，矫正 J。术后，术前 ATR 散光眼表现出明显的 ATR 散光漂移，术后 5 年和 8 年的 J 值明显小于术后 1 个月；术后 5 年和 8 年的未矫正远视力也明显差于术后 1 个月。对于 WTR 和斜散光眼，IOL 对散光和视力的影响可维持 8 年。本研究中使用的三种散光型 IOL（Alcon Laboratories 的 SN6AT3-8）的长期散光矫正效果没有差异。对于术前 ATR 散光眼，术后 5 年以后 IOL 的散光矫正效果逐渐下降，提示在白内障手术时可考虑过矫。对于 WTR 和斜散光眼，IOL 的效果在 8 年的随访期内保持不变。

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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b756/9120159/6f5d8cb8917c/41598_2022_12426_Fig9_HTML.jpg
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Predicting Residual Astigmatism in Cataract Surgery.预测白内障手术中的残余散光
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