Khan Muhammad Azaan, McCall Dominic, Samarawickrama Chameen
Translational Ocular Research and Immunology Consortium (TORIC), Westmead Institute of Medical Research, Westmead, Australia.
University of Sydney, Sydney, Australia.
BMC Ophthalmol. 2025 Mar 3;25(1):102. doi: 10.1186/s12886-025-03907-1.
To determine if a standardised Toric Allocation Pathway (TAP) improved visual and refractive outcomes for patients undergoing cataract surgery at a tertiary referral teaching hospital.
Demographic, visual, and refractive data from all patients who underwent cataract surgery and toric intraocular lens (IOL) insertion with an emmetropic target between January 2015 and December 2019 were retrospectively collected and separated into pre-TAP and TAP groups. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), postoperative spherical equivalent refraction (SER) and postoperative cylinder were compared using multivariate regression analysis and Mann-Whitney U testing.
A total of 118 eyes were divided into pre-TAP (n = 59, 50%) and TAP (n = 59, 50%) groups. Case-mix and surgeon rank was comparable between the two groups (all variables p > 0.05). The TAP group outperformed the pre-TAP group in postoperative mean UDVA (6/7.5 ± 0.13 LogMAR vs. 6/9 ± 0.19 LogMAR, p = 0.049, respectively) and residual cylinder (0.47 ± 0.54D vs. 0.87 ± 0.78D, p < 0.001). As well, the TAP group was more consistent, with significantly smaller standard deviations for all outcomes. Consequently, a higher proportion of patients achieved a SER of ≤ 0.5D from emmetropia in the TAP group (78% vs. 58%, p < 0.001).
The TAP improved the visual and refractive outcomes for patients with regular astigmatism while minimising inappropriate implantation of toric IOLs. It is ideal for large teaching hospitals and provides a framework for developing surgeons in correctly selecting patients who would most benefit from toric IOLs.
确定标准化的散光人工晶状体分配路径（TAP）是否能改善在三级转诊教学医院接受白内障手术患者的视力和屈光效果。
回顾性收集2015年1月至2019年12月期间所有接受白内障手术并植入散光人工晶状体（IOL）且目标屈光状态为正视的患者的人口统计学、视力和屈光数据，并将其分为TAP实施前组和TAP组。使用多因素回归分析和曼-惠特尼U检验比较未矫正远视力（UDVA）、矫正远视力（CDVA）、术后等效球镜度（SER）和术后柱镜度。
共118只眼被分为TAP实施前组（n = 59，50%）和TAP组（n = 59，50%）。两组间病例组合和手术医生级别具有可比性（所有变量p > 0.05）。TAP组在术后平均UDVA（分别为6/7.5 ± 0.13 LogMAR与6/9 ± 0.19 LogMAR，p = 0.049）和残余柱镜度（0.47 ± 0.54D与0.87 ± 0.78D，p < 0.001）方面优于TAP实施前组。此外，TAP组更具一致性，所有结果的标准差均显著更小。因此，TAP组中从正视达到SER≤0.5D的患者比例更高（78%对58%，p < 0.001）。
TAP改善了规则散光患者的视力和屈光效果，同时最大限度地减少了散光IOL的不适当植入。它适用于大型教学医院，并为培养外科医生正确选择最能从散光IOL中获益的患者提供了一个框架。
