陡峭轴向与非陡峭轴向透明角膜切口植入Toric人工晶状体的临床结果比较研究
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摘要
目的研究陡峭轴向与非陡峭轴向透明角膜切口植入Toric人工晶状体(IOL)的临床结果并进行比较分析。方法本文选取2016年至2018年在我院眼科就诊的白内障超声乳化吸除植入Toric IOL的白内障患者86例(86只眼),随机分为陡峭轴向组和非陡峭轴向组,两组患者分别采用陡峭轴向切口和非陡峭轴向切口,进行植入Toric IOL。观察两组患者术后1周、1个月、3个月的裸眼视力、角膜散光值、Toric IOL旋转度数、轴位差以及对比敏感度。结果陡峭轴向组和非陡峭轴向组两组患者术前裸眼视力值低于术后,陡峭轴向组术后1周、1个月、3个月显著高于非陡峭轴向。陡峭轴向组和非陡峭轴向组两组患者术前角膜散光值高于术后,陡峭轴向组术后1周、1个月、3个月的角膜散光值显著低于非陡峭轴向。陡峭轴向组和非陡峭轴向组两组患者术前晶状体旋转度低于术后1周、1个月、3个月的晶状体旋转度,陡峭轴向组术后1周、1个月、3个月的角膜散光值显著高于于非陡峭轴向。陡峭轴向组患者术后1个月、3个月轴位偏差显著小于非陡峭轴向组;非陡峭轴向组患者术后3个月不同空间频率对比敏感度均低于正常值,陡峭轴向组患者术后3个月不同空间频率对比敏感度均接近于正常值,陡峭轴向组患者3个月不同空间频率对比敏感度均高于于非陡峭轴向组,有统计学意义(P<0.05)。结论陡峭轴向透明角膜切口植入Toric IOL的临床效果优于非陡峭轴向透明角膜切口,可以矫正患者的视力和角膜散光,对于患者术后视觉质量的良好恢复意义重大。
Objective To compare the clinical results of Toric intraocular lens implantation via steep axial and non-steep axial clear corneal incision.Methods 86 eyes of 86 cataract patients who received phacoemulsification and implantation of Toric intraocular lens in our hospital from year 2016 to 2018 were selected, and randomly divided into steep axial incision group and non-steep axial incision group. The uncorrected visual acuity(UCVA), corneal astigmatism, Toric IOL lens rotation degree, axial difference and contrast sensitivity of the two groups were measured at 1 week, 1 month and 3 months after the surgery. Results The post-operative UCVA was better than pre-operative UCVA in both groups, and the post-operative UCVA in the steep axial group was significantly better than the non-steep axial group at all follow-ups. The post-operative corneal astigmatism was lower than pre-operative measurement in both groups, and the post-operative corneal astigmatism in the steep axial group was lower than the non-steep axial group at all follow-ups. The post-operative lens rotation degree was larger than pre-operative measurement in both groups, and the post-operative lens rotation degree in the steep axial group was larger than the non-steep axial group at all follow-ups. The post-operative axial difference at 1 month and 3 months was smaller in the steep axial group as compared with the non-steep axial group. The contrast sensitivity under different spatial frequency at 3 months post-operatively was lower than the normal value in the non-steep axis group, while similar to the normal value in the steep axis group. The contrast sensitivity under different spatial frequency at 3 months post-operatively were significantly higher in the steep axis group than the non-steep axis group(P<0.05). Conclusions The clinical effect of Toric intraocular lens implantation via the steep axial clear corneal incision is better than the non-steep axial clear corneal incision, with the former able to correct the patient's vision and corneal astigmatism, and is of great significance for the good recovery of patient's post-operative visual quality.
Objective To compare the clinical results of Toric intraocular lens implantation via steep axial and non-steep axial clear corneal incision.Methods 86 eyes of 86 cataract patients who received phacoemulsification and implantation of Toric intraocular lens in our hospital from year 2016 to 2018 were selected, and randomly divided into steep axial incision group and non-steep axial incision group. The uncorrected visual acuity(UCVA), corneal astigmatism, Toric IOL lens rotation degree, axial difference and contrast sensitivity of the two groups were measured at 1 week, 1 month and 3 months after the surgery. Results The post-operative UCVA was better than pre-operative UCVA in both groups, and the post-operative UCVA in the steep axial group was significantly better than the non-steep axial group at all follow-ups. The post-operative corneal astigmatism was lower than pre-operative measurement in both groups, and the post-operative corneal astigmatism in the steep axial group was lower than the non-steep axial group at all follow-ups. The post-operative lens rotation degree was larger than pre-operative measurement in both groups, and the post-operative lens rotation degree in the steep axial group was larger than the non-steep axial group at all follow-ups. The post-operative axial difference at 1 month and 3 months was smaller in the steep axial group as compared with the non-steep axial group. The contrast sensitivity under different spatial frequency at 3 months post-operatively was lower than the normal value in the non-steep axis group, while similar to the normal value in the steep axis group. The contrast sensitivity under different spatial frequency at 3 months post-operatively were significantly higher in the steep axis group than the non-steep axis group(P<0.05). Conclusions The clinical effect of Toric intraocular lens implantation via the steep axial clear corneal incision is better than the non-steep axial clear corneal incision, with the former able to correct the patient's vision and corneal astigmatism, and is of great significance for the good recovery of patient's post-operative visual quality.
引文
[1] 刘晓静,郭淑玲,栗庆霞,等.超声乳化人工晶状体植入联合房角分离术治疗年龄相关性白内障合并PACG[J].国际眼科杂志,2017,17(10):1883-1885.
[2] 陈祥菲,陆燕,段娴艺,等.AcrySof IQ Restor Toric人工晶状体植入术后对视觉质量的影响[J].眼科新进展,2014,34(4):337-340,344.
[3] 陈潇,苟甫伟,陈茂盛.Acrysof IQ Restor多焦点Toric人工晶状体植入术后临床效果观察[J].眼科学报(英文版),2016,31(2):98-102.
[4] Rastogi A,Khanam S,Goel Y,et al.Comparative evaluation of rotational stability and visual outcome of toric intraocular lenses with and without a capsular tension ring[J].Indian J Ophthalmol,2018,66(3):411-415.
[5] 秦艳,秦伟.白内障手术同时矫正散光的研究进展[J].局解手术学杂志,2017,26(12):909-913.
[6] 吴剑伟,夏林.小切口白内障摘除治疗急性闭角型青光眼合并白内障临床研究[J].中国基层医药,2017,24(15):2285-2288.
[7] 郭立涛,张铁民,谭小波,等.角膜地形图引导下白内障手术切口的改变对中度角膜散光的影响[J].河北医学,2017,23(5):745-747.
[8] 戴红梅,李兰,吴柄成,等.不同位置切口对非超声乳化白内障手术角膜散光控制的研究[J].中国实用眼科杂志,2015,33(11):1235-1239.
[9] 陈星,于建春.白内障手术同时矫正散光的方法研究进展[J].国际眼科杂志,2015,15(6):993-996.
[10] 谢南明,吕旭菁.不同术式白内障术后屈光状态变化规律及稳定性研究[J].国际眼科杂志,2016,16(10):1865-1868.
[2] 陈祥菲,陆燕,段娴艺,等.AcrySof IQ Restor Toric人工晶状体植入术后对视觉质量的影响[J].眼科新进展,2014,34(4):337-340,344.
[3] 陈潇,苟甫伟,陈茂盛.Acrysof IQ Restor多焦点Toric人工晶状体植入术后临床效果观察[J].眼科学报(英文版),2016,31(2):98-102.
[4] Rastogi A,Khanam S,Goel Y,et al.Comparative evaluation of rotational stability and visual outcome of toric intraocular lenses with and without a capsular tension ring[J].Indian J Ophthalmol,2018,66(3):411-415.
[5] 秦艳,秦伟.白内障手术同时矫正散光的研究进展[J].局解手术学杂志,2017,26(12):909-913.
[6] 吴剑伟,夏林.小切口白内障摘除治疗急性闭角型青光眼合并白内障临床研究[J].中国基层医药,2017,24(15):2285-2288.
[7] 郭立涛,张铁民,谭小波,等.角膜地形图引导下白内障手术切口的改变对中度角膜散光的影响[J].河北医学,2017,23(5):745-747.
[8] 戴红梅,李兰,吴柄成,等.不同位置切口对非超声乳化白内障手术角膜散光控制的研究[J].中国实用眼科杂志,2015,33(11):1235-1239.
[9] 陈星,于建春.白内障手术同时矫正散光的方法研究进展[J].国际眼科杂志,2015,15(6):993-996.
[10] 谢南明,吕旭菁.不同术式白内障术后屈光状态变化规律及稳定性研究[J].国际眼科杂志,2016,16(10):1865-1868.