Al-Mohtaseb Zaina, Steigleman W Allan, Pantanelli Seth M, Lin Charles C, Hatch Kathryn M, Rose-Nussbaumer Jennifer R, Santhiago Marcony R, Olsen Timothy W, Kim Stephen J, Schallhorn Julie M
Whitsett Vision Group, Baylor College of Medicine, Houston, Texas.
University of Florida College of Medicine, Gainesville, Florida.
Ophthalmology. 2024 Mar;131(3):383-392. doi: 10.1016/j.ophtha.2023.10.010. Epub 2023 Dec 25.
To review the published literature evaluating the visual and refractive outcomes and rotational stability of eyes implanted with toric monofocal intraocular lenses (IOLs) for the correction of keratometric astigmatism during cataract surgery and to compare those outcomes with outcomes of eyes implanted with nontoric monofocal IOLs and other astigmatism management methods performed during cataract surgery. This assessment was restricted to the toric IOLs available in the United States.
A literature search of English-language publications in the PubMed database was last conducted in July 2022. The search identified 906 potentially relevant citations, and after review of the abstracts, 63 were selected for full-text review. Twenty-one studies ultimately were determined to be relevant to the assessment criteria and were selected for inclusion. The panel methodologist assigned each a level of evidence rating; 12 studies were rated level I and 9 studies were rated level II.
Eyes implanted with toric IOLs showed excellent postoperative uncorrected distance visual acuity (UCDVA), reduction of postoperative refractive astigmatism, and good rotational stability. Uncorrected distance visual acuity was better and postoperative cylinder was lower with toric IOLs, regardless of manufacturer, when compared with nontoric monofocal IOLs. Correcting pre-existing astigmatism with toric IOLs was more effective and predictable than using corneal relaxing incisions (CRIs), especially in the presence of higher magnitudes of astigmatism.
Toric monofocal IOLs are effective in neutralizing pre-existing corneal astigmatism at the time of cataract surgery and result in better UCDVA and significant reductions in postoperative refractive astigmatism compared with nontoric monofocal IOLs. Toric IOLs result in better astigmatic correction than CRIs, particularly at high magnitudes of astigmatism.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
回顾已发表的文献，评估在白内障手术中植入散光单焦点人工晶状体（IOL）以矫正角膜散光的眼睛的视觉和屈光结果以及旋转稳定性，并将这些结果与植入非散光单焦点IOL的眼睛以及白内障手术中使用的其他散光管理方法的结果进行比较。本评估仅限于美国可用的散光IOL。
2022年7月最后一次在PubMed数据库中检索英文出版物。检索到906条潜在相关引文，在对摘要进行审查后，选择63篇进行全文审查。最终确定21项研究与评估标准相关并被选入。小组方法学家为每项研究指定了证据等级；12项研究被评为I级，9项研究被评为II级。
植入散光IOL的眼睛术后裸眼远视力（UCDVA）良好，术后屈光性散光减少，旋转稳定性良好。与非散光单焦点IOL相比，无论制造商如何，散光IOL的裸眼远视力更好，术后柱镜度数更低。用散光IOL矫正术前存在的散光比使用角膜松解切口（CRI）更有效且可预测，尤其是在散光度数较高的情况下。
散光单焦点IOL在白内障手术时有效中和术前存在的角膜散光，与非散光单焦点IOL相比，可带来更好的UCDVA，并显著降低术后屈光性散光。散光IOL比CRI能更好地矫正散光，尤其是在高散光度数时。
在本文末尾的脚注和披露中可能会发现专有或商业披露。
