散光人工晶狀體矯正白內障合併角膜散光的療效

目的：觀察白內障患者植入散光人工晶狀體（Toric intraocular lens, Toric IOL）後角膜散光及殘餘散光的變化以及術後視力情況，評估Acrysof IQ Toric IOL的效果和穩定性。方法：選取白內障合併角膜散光（≥1.5D）的連續患者，實驗組共59人（72眼）行白內障超聲乳化吸出聯合Acrysof IQ Toric IOL植入術，對照組共29人（36眼）行白內障超聲乳化吸出聯合單焦IOL植入術，術後平均隨訪時間6個月。主要觀察指標：患者的一般資料、術前角膜散光的大小及軸位、術後裸眼視力及最佳矯正視力、術後角膜散光及殘餘散光的大小及軸位。結果：實驗組與對照組患者術前平均角膜散光分別為2.18 ± 0.82D和2.01 ± 0.73D；術後平均殘餘散光分別為0.89 ± 0.54D和2.25 ± 0.72D，兩組術後平均殘餘散光的差別有統計學意義（P=0.006）。實驗組術後平均裸眼視力約0.8，對照組術後平均裸眼視力約0.4。結論：Acrysof IQ Toric IOL能有效矯正白內障患者合併角膜散光，可提高術後裸眼視力，且術後平均殘餘散光越少，裸眼視力越好。

關鍵字

白內障；角膜散光；散光人工晶狀體；視力

並列摘要

Objective: To observe the changes of corneal astigmatism and residual astigmatism after implantation of a toric intraocular lens (Toric IOL) in patients with cataract and corneal astigmatism and evaluate the effectiveness and stability of the Acrysof IQ Toric IOL. Methods: Consecutive patients with cataracts and corneal astigmatism (≥1.5D) were selected. A total of 72 eyes of 59 patients who underwent phacoemulsification with Acrysof IQ Toric IOL implantation were included in the treatment group, and 36 eyes of 29 patients who underwent phacoemulsification with Acrysof IQ single focus IOL implantation were included in the contrast group. All were performed with an average follow-up time of 6 months. The data included the demographic characteristics of patients, preoperative corneal astigmatism and axial, postoperative uncorrected and best-corrected visual acuity, postoperative corneal astigmatism, postoperative residual astigmatism and axial. Results: The mean of preoperative corneal astigmatism in the treatment group and control group were 2.18±0.82D and 2.01±0.73 D, respectively. The mean of postoperative residual astigmatism in the treatment group and contract group were 0.89±0.54D and 2.25±0.72D, respectively. There was a statistically significant difference in postoperative residual astigmatism in both groups (P =0.006). The mean of postoperative uncorrected visual acuity in the treatment group and control group was 0.8 and 0.4. Conclusion: Acrysof IQ Toric IOL can improve the postoperative vision of cataract patients with high corneal astigmatism. Implantation of Toric IOL effectively corrected the corneal astigmatism of the patients. The lower the postoperative residual astigmatism is, the better-uncorrected vision the patients gain.

並列關鍵字

Cataract ； corneal astigmatism ； toric intraocular lens ； vision

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