山东大学耳鼻喉眼学报 ›› 2025, Vol. 39 ›› Issue (6): 108-112.doi: 10.6040/j.issn.1673-3770.0.2024.040

• 论著 • 上一篇    

陡峭轴透明角膜切口植入Toric人工晶状体的长期旋转稳定性和视觉质量观察

郝文娜1,2,孟微1,2,邵震2,3,刘冬梅2,3   

  1. 1.山东中医药大学, 山东 济南 250014;
    2.山东省眼视光与青少年视力低下防控临床医学研究中心, 山东 济南 250002;
    3.山东中医药大学附属眼科医院, 山东 济南 250002
  • 发布日期:2025-11-19
  • 通讯作者: 刘冬梅. E-mail:13854191223@163.com

Long-term rotation stability and visual quality of Toric intraocular lens implantation with steep-axis clear corneal incision

HAO Wenna1,2, MENG Wei1,2, SHAO Zhen2,3, LIU Dongmei2,3   

  1. 1. Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong, China2. Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Jinan 250002, Shandong, China3. Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Shandong Academy of Eye disease Prevention and Therapy, Jinan 250002, Shandong, China
  • Published:2025-11-19

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摘要： 目的 探讨在陡峭轴做透明角膜切口植入散光矫正型人工晶状体(toric intraocular lens, Toric IOL)的长期旋转稳定性及视觉质量。 方法 回顾分析2018年1月1日至2022年3月21日在山东中医药大学附属眼科医院进行白内障手术患者111例(111眼),所有患者均行在角膜陡峭轴方位做透明角膜切口,白内障超声乳化吸除联合Toric IOL植入手术。通过术前视力、近期随访视力、术后综合验光及OPD-Scan Ⅲ等检查评估患者视觉质量,比较顺规、逆规和斜轴方向陡峭轴向透明角膜切口植入组以及术后12~24个月、24~36个月、36~48个月的Toric IOL的轴向变化。采用单因素方差分析与配对样本t检验方法进行数据分析。 结果 本研究111只眼中,平均裸眼视力(uncorrected visual acuity, UCVA)术后(0.13±0.21)LogMAR较术前(0.90±0.71 )LogMAR提高(P<0.001);平均最佳矫正视力(best corrected visual acuity, BCVA)术后(0.06±0.14)LogMAR较术前(0.70±0.70)LogMAR提高(P<0.001);术后点扩散函数(point spread function, PSF)中的斯特列尔比值(Strehl ratio,SR值)0.06±0.04较术前0.01±0.01增加(P<0.001);术后人眼调制传递函数(modulation transfer function, MTF)曲线中4 mm面积比(Area ratio, AR)0.31±0.11较术前0.15±0.06增加(P<0.001);Toric IOL平均旋转角度为(2.78±2.50)°;对术后顺规、逆规和斜轴方向陡峭轴透明角膜切口植入组以及术后不同时间段的Toric IOL的旋转角度进行分析,顺规散光组为(2.90±2.43)°,逆规散光组为(2.69±2.66)°,斜轴散光组为(2.83±2.23)°,三组差异无统计学意义(P=0.932);术后12~24个月为(2.72±2.11)°,术后24~36个月为(2.81±2.54)°,术后36~48个月为2.81±2.78,三组差异无统计学意义(P=0.985)。 结论 Acrysof IQ Toric植入术后囊袋内旋转稳定性良好,其旋转角度与通过顺规、逆规还是斜轴方向的陡峭轴向透明角膜切口植入无关,与术后不同长度时间段随访也无关,并可有效矫正患者角膜散光,提供良好的视觉质量。

关键词: Toric人工晶状体, 旋转稳定性, 陡峭轴向透明角膜切口

Abstract: Objective To investigate the long-term rotation stability and visual quality of Toric intraocular lens implantation with steep-axis clear corneal incision. Methods A retrospective analysis was conducted on 111 cases(111 eyes)of cataract surgery performed at the affiliated Ophthalmology Hospital of Shandong University of Traditional Chinese Medicine, spanning from January 1, 2018, to March 21, 2022. All patients underwent transparent corneal incision in the steep axis position, along with phacoemulsification of cataracts and implantation of Toric IOL. The visual quality of the patients was evaluated through preoperative visual acuity, recent follow-up visual acuity, postoperative comprehensive refraction, and OPD-Scan III examinations. The study aimed to compare the axial changes of Toric IOL in the conforming, non-conforming, and oblique axis directions of steep-axis transparent corneal incision implantation groups at 12-24 months, 24-36 months, and 36-48 months postoperatively. Data analysis was performed using one-way analysis of variance and paired sample t-test methods. Results In 11 eyes, the mean uncorrected visual acuity(UCVA)after surgery(0.13±0.21)LogMAR was significantly higher than before(0.90±0.71)LogMAR(P<0.001). The mean best corrected visual acuity(BCVA)after surgery(0.06±0.14)LogMAR was significantly higher than before(0.70±0.70 LogMAR)(P<0.001). The Strehl ratio(SR value)of the Point spread function(PSF)after surgery(0.06±0.04)was higher than before(0.01±0.01)(P<0.001). In the modulation transfer function(MTF)curve, the Area ratio(AR)of 4mm increased after surgery(0.31±0.11)compared with that before surgery(0.15±0.06)(P<0.001). The average rotation Angle of Toric IOL was(2.78±2.50)°. The rotation angles of Toric IOL implanted with steep axis clear corneal incision in the with the rule, against the rule and oblique direction after surgery and at different time points after surgery were analyzed. The WTR astigmatism was(2.90±2.43)°, the ATR astigmatism was(2.69±2.66)°, and the oblique astigmatism was(2.83±2.23)°. There was no significant difference among the three groups(P=0.932). The postoperative rotation angles were(2.72±2.11)° at 12-24 months,(2.81±2.54)° at 24-36 months, and(2.81±2.78)° at 36-48 months. There was no significant difference among the three groups(P=0.985). Conclusion Acrysof IQ Toric implantation has a good rotation stability in the capsule. The rotation angle of Acrysof IQ Toric implantation is not related to implantation through steep-axial clear corneal incision in the direction of with the rule, against the rule or oblique axis, and has no relationship with different follow-up periods. Acrysof IQ Toric implantation can effectively correct corneal astigmatism and provide good visual quality.

Key words: Toric IOL, rotational stability, steep-axial clear corneal incision

中图分类号: 

  • R776.1
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