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目的观察术前伴有较大角膜散光的白内障患者植入Toric人工晶状体(Acrys of SN60TT)后的屈光效果及囊袋内旋转稳定性。设计前瞻性病例系列。研究对象25例(30眼)角膜散光均大于1D的老年性及发育性白内障患者。方法术前通过生物测量及软件计算确定人工晶状体型号及放置轴位,并进行手术切口及目标人工晶状体轴位两步标记,行超声乳化白内障吸除手术,术中将人工晶状体准确放置于目标位置。术后随访3个月。主要指标裸眼视力、最佳矫正视力、总合散光、角膜散光、人工晶状体柱镜轴位。结果术后裸眼视力1个月为0.73±0.18,3个月为0.79±0.17。最佳矫正视力1个月为0.93±0.13,3个月为0.98±0.09。总合散光术后1个月为(0.68±0.53)D,3个月为(0.47±0.39)D。术后3个月角膜散光为(1.58±0.84)D,与术前(2.02±0.90)D相比明显下降(P=0.00)。手术源性散光为(0.62±0.32)D。术后3个月人工晶状体矫正散光(1.27±0.69)D,与预计人工晶状体矫正散光(1.36±0.44)D相比,差异无统计学意义(P=0.31)。术后3个月人工晶状体旋转(4.0±3.2)°,旋转5°以内占76.7%。结论Toric人工晶状体在本文短期随访期间能有效地矫正散光,在囊袋内稳定,具有良好的旋转稳定性。
Objective To observe the refractive effect and rotational stability of capsular bag after implanting Acrys of SN60TT in cataract patients with preoperative anterior corneal astigmatism. Design prospective case series. Participants 25 patients (30 eyes) corneal astigmatism were greater than 1D of senile and developmental cataract patients. Methods Preoperative biomechanical measurements and software calculations were performed to determine the type of intraocular lens and axial placement, and surgical incision and axial incision of the target intraocular lens were performed. Phacoemulsification and phacoemulsification were performed. The intraocular lens was accurately placed in the target position . Follow-up 3 months after operation. The main indicators of uncorrected visual acuity, best corrected visual acuity, total astigmatism, corneal astigmatism, intraocular lens axis. Results The uncorrected visual acuity was 0.73 ± 0.18 in 1 month and 0.79 ± 0.17 in 3 months. The best corrected visual acuity was 0.93 ± 0.13 for 1 month and 0.98 ± 0.09 for 3 months. One month after combined total astigmatism was (0.68 ± 0.53) D, and three months was (0.47 ± 0.39) D. Corneal astigmatism was (1.58 ± 0.84) D at 3 months after operation, which was significantly lower than that before operation (2.02 ± 0.90) D (P = 0.00). The source of astigmatism was (0.62 ± 0.32) D. The correction of astigmatism (1.27 ± 0.69) D at 3 months after surgery was not statistically significant (P = 0.31) compared with the expected correction of IOL (1.36 ± 0.44) D. The intraocular lens was rotated (4.0 ± 3.2) ° 3 months after operation and 76.7% within 5 ° of rotation. Conclusion The Toric intraocular lens (IOL) can effectively correct astigmatism during the short-term follow-up and is stable in the capsular bag with good rotational stability.