Tian Qingfen, Zhang Xueyan, Wang Ximing, Wu Xuelian, Li Bin
Department of Ophthalmology, Jinan Second People's Hospital, Jinan, 250001, China.
Int Ophthalmol. 2025 Sep 26;45(1):387. doi: 10.1007/s10792-025-03755-4.
To investigate long-term effects of bifocal intraocular lenses (IOLs) implantation combined with opposite clear corneal incisions (OCCIs) and bifocal toric IOL implantation solely in cataract patients with low corneal astigmatism.
The study included 58 patients (60 eyes) with corneal astigmatism of 0.75 to 1.5 diopter (D) who underwent cataract surgery. 30 eyes received bifocal IOLs implantation through steep meridian incisions combined with OCCIs (OCCI group), and 30 eyes received bifocal toric IOLs implantation solely (control group). Uncorrected distance visual acuity (UCDVA), uncorrected near visual acuity (UCNVA), corneal astigmatism, rotational stability of bifocal toric IOLs, corneal higher-order aberrations (HOAs) and spectacle independence were collected postoperatively.
No significant difference in UCDVA and UCNVA between the two groups (all P > .05) at 1 week, 1 month, 3, 6 and 12 months postoperatively. Compared with preoperative data, corneal astigmatism in the OCCI group was significantly decreased at 1 month, 3 and 12 months postoperatively (all P < .001), but in the control group, no statistically decreased was detected at 1 month, 3 and 12 months (all P > .05). No obvious rotation of IOLs in the control group postoperatively. No significant difference in corneal HOAs in either group postoperatively compared with preoperative values (all P > .05) or between the two groups (P > .05). The rates of spectacle independence were above 90% in both groups.
Both bifocal IOLs implantation through steep meridian incisions combined with OCCIs and bifocal toric IOL implantation solely can significantly reduced corneal astigmatism in cataract patients with low corneal astigmatism, providing good visual quality and stable long-term effects. So bifocal IOLs implantation through steep meridian incisions combined with OCCIs can serve as an alternative to bifocal toric IOL implantation solely.
探讨双焦点人工晶状体（IOL）植入联合对侧透明角膜切口（OCCI）及单纯双焦点散光型IOL植入对低角膜散光白内障患者的长期影响。
该研究纳入58例（60只眼）角膜散光为0.75至1.5屈光度（D）的白内障手术患者。30只眼通过陡峭子午线切口联合OCCI植入双焦点IOL（OCCI组），30只眼单纯植入双焦点散光型IOL（对照组）。术后收集未矫正远视力（UCDVA）、未矫正近视力（UCNVA）、角膜散光、双焦点散光型IOL的旋转稳定性、角膜高阶像差（HOA）及脱镜率。
术后1周、1个月、3个月、6个月和12个月时，两组间UCDVA和UCNVA均无显著差异（均P＞0.05）。与术前数据相比，OCCI组术后1个月、3个月和12个月时角膜散光显著降低（均P＜0.001），但对照组在术后1个月、3个月和12个月时未检测到统计学上的降低（均P＞0.05）。对照组术后IOL无明显旋转。两组术后角膜HOA与术前值相比均无显著差异（均P＞0.05），两组间也无显著差异（P＞0.05）。两组脱镜率均高于90%。
通过陡峭子午线切口联合OCCI植入双焦点IOL及单纯植入双焦点散光型IOL均可显著降低低角膜散光白内障患者的角膜散光，提供良好的视觉质量和稳定的长期效果。因此，通过陡峭子午线切口联合OCCI植入双焦点IOL可作为单纯植入双焦点散光型IOL的替代方法。
