Blau-Most Michal, Levy Adi, Assia Ehud I, Kleinmann Guy
Ein-Tal Eye Center, Tel Aviv, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Ophthalmol Ther. 2023 Jun;12(3):1747-1755. doi: 10.1007/s40123-023-00700-5. Epub 2023 Apr 13.
Implantation of toric intraocular lenses (IOLs) in patients with Fuchs endothelial corneal dystrophy (FECD) is still considered relatively contraindicated, without sufficient clinical evidence. Therefore, this study was designed to evaluate the results of toric IOL implantation in patients with FECD.
A retrospective case-control study of 28 eyes of FECD patients and 84 eyes of healthy control patients who received toric IOLs during routine cataract surgery was performed. The outcome measures were uncorrected and corrected distance visual acuity, spherical equivalent, and refractive residual astigmatism.
The mean postoperative uncorrected and corrected distance visual acuity in the FECD eyes compared to the control eyes were 0.15 ± 0.14 vs. 0.13 ± 0.17, respectively (P = 0.32), and 0.05 ± 0.08 vs. 0.06 ± 0.10, respectively (P = 0.95). The spherical equivalent in the FECD eyes compared to the control eyes was - 0.29 ± 0.43 vs. - 0.21 ± 0.50, respectively (P = 0.19). The preoperative corneal centroid astigmatism in the FECD eyes compared to the control eyes was 0.85 D@93° ± 2.42° vs. 0.23 D@68° ± 2.50°, respectively (P = 0.43), and the mean preoperative corneal astigmatism magnitude was 2.26 ± 1.1 D vs. 2.28 ± 1.03 D, respectively (P = 0.82). A trend toward higher postoperative refractive centroid astigmatism was found in the FECD eyes compared with the control eyes: 0.24 D@28° ± 0.57° vs. 0.03 D@127° ± 0.53°, respectively (P = 0.09). However, the mean refractive astigmatism magnitude was similar in FECD eyes and the healthy control eyes: 0.52 ± 0.31 D vs. 0.42 ± 0.31 D, respectively (P = 0.44) (D diopters).
The postoperative refractive astigmatism (both centroid astigmatism and mean magnitude astigmatism) was no higher than 0.52 D in both groups. Therefore, FECD patients without corneal edema can be considered for toric IOLs.
在没有充分临床证据的情况下，在患有富克斯内皮性角膜营养不良（FECD）的患者中植入散光型人工晶状体（IOL）仍被视为相对禁忌。因此，本研究旨在评估在FECD患者中植入散光型IOL的效果。
对28只FECD患者的眼睛和84只在常规白内障手术期间接受散光型IOL的健康对照患者的眼睛进行回顾性病例对照研究。观察指标为未矫正和矫正的远视力、等效球镜度和屈光残余散光。
与对照眼相比，FECD眼术后平均未矫正和矫正远视力分别为0.15±0.14和0.13±0.17（P = 0.32），以及0.05±0.08和0.06±0.10（P = 0.95）。与对照眼相比，FECD眼的等效球镜度分别为-0.29±0.43和-0.21±0.50（P = 0.19）。与对照眼相比，FECD眼术前角膜质心散光分别为0.85 D@93°±2.42°和0.23 D@68°±2.50°（P = 0.43），术前角膜散光平均度数分别为2.26±1.1 D和2.28±1.03 D（P = 0.82）。与对照眼相比，FECD眼术后屈光质心散光有升高趋势：分别为0.24 D@28°±0.57°和0.03 D@127°±0.53°（P = 0.09）。然而，FECD眼和健康对照眼的平均屈光散光度数相似：分别为0.52±0.31 D和0.42±0.31 D（P = 0.44）（D为屈光度）。
两组术后屈光散光（质心散光和平均散光度数）均不高于0.52 D。因此，没有角膜水肿的FECD患者可以考虑植入散光型IOL。
