Objective To evaluate the safety,efficacy,and stability of AcrySof Toric intraocular lens (IOL) implanting in correcting residual astigmatism in patients who have cataract surgery.Methods This was a prospective case control study.Sixty-nine eyes of 59 consecutive cataract patients during a 12-month period who had more than 0.75 diopters (D) of pre-existing astigmatism of the cornea were included.After phacoemulsification,33 patients (37 eyes) were implanted with AcrySof Toric IOL (test group) and 26 patients (32 eyes) with AcrySof SN60AT IOL (control group).One day,1 week,1 month,and 3 months after IOL implantation,uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),residual refractive sphere and cylinder,corneal keratometry,and the AcrySof Toric IOL axis were measured.Visual acuity and residual refractive cylinder distribution were analyzed by Fisher's exact probability and refractions were analyzed by independent samples t tests.Results UCVA:three months after implantation,1 eye (3％) in the test group and 10 eyes (31％) in the control group presented with 0.1-0.3; 22 eyes (60％) in the test group and 15 eyes (47％) in the control group presented with 0.4-0.6; 5 eyes (14％) in the test group and 6 eyes (19％)in the control group presented with 0.7-0.9; and 9 eyes (24％) in the test group and 1 eye (3％) in the control group presented with 1.0 or better.There were statistically significant differences between the two groups (Fisher's exact=0.000,P＜0.05).Residual refractive cylinder:68％ of the test group eyes and 12％ of the control group eyes had 0-0.75 D; 32％ of test group eyes and 59％ of the control group eyes had 1-1.75 D; and 0％ of the test group eyes and 28％ of the control group eyes had more than 2 D.There were statistically significant differences between the two groups (Fisher's exact=0.000,P＜0.05).Rotational stability:3 months after implantation,all AcrySof Toric IOL had rotated less than 20 degrees:IOL in 21 eyes (57％) had rotated less than 5 degrees,IOL in 7 eyes (19％) had rotated 6°-10°,and IOL in 9 eyes (24％) had rotated 11°-15°.The mean AcrySof Toric IOL axis rotation was 5.8°±5.0° (0°-15°).Surgically induced astigmatism (SIA):the mean SIA was (0.66±0.17)D in the test group and (0.62±0.24)D in the control group.There was no statistically significant differences between the two groups.Conclusion The results show that phacoemuisification and AcrySof Toric IOL implantation are safe and effective to correct residual astigmatism 3 months after cataract surgery.%目的 研究AcrySof Toric人工晶状体(IOL)矫正白内障患者术后残留散光的有效性、安全性和稳定性.方法 前瞻性病例对照研究.2008年5月至2009年4月期间在南通大学附属医院眼科住院的白内障患者59例(69眼),术前角膜散光≥0.75 D,根据患者意愿分为实验组33例(37眼)和对照组26例(32眼).两组患者行超声乳化白内障吸除术后,实验组植入AcrySof Toric IOL,对照组植入AcrySof SN60AT IOL.术后1d、1周、1个月、3个月检查记录两组患者的裸眼视力(UCVA)、最佳矫正视力(BCVA)、屈光状态、角膜曲率、AcrySof Toric IOL的轴位.采用Fisher精确概率法、独立样本t检验对数据进行分析.结果 术后3个月,实验组和对照组中UCVA为0.1～0.3的分别有1眼(3％)和10眼(31％)；0.4～0.6分别有22眼(60％)和15眼(47％)；0.7～0.9分别有5眼(14％)和6眼(19％)；≥1.0分别有9眼(24％)和1眼(3％),两组比较差异有统计学意义( Fisher's exact=0.000,P＜0.05).实验组和对照组中残留散光为0～0.75 D的分别有25眼(68％)和4眼(12％);1～1.75 D的分别有12眼(32％)和19眼(59％)；≥2 D的分别有0眼(0％)和9眼(28％),两组差异有统计学意义( Fisher's exact =0.000,P＜0.05).术后3个月,实验组37眼中有32眼发生旋转,IOL旋转均＜20°,其中≤5°有16眼(57％),6°～10°有7眼(19％),11°～15°有9眼(24％),平均值为5.8°±5.0°(0°～15°).术后3个月,实验组和对照组术源性散光分别为(0.66±0.17)D和(0.62±0.24)D,两组差异无统计学意义.结论 白内障手术中植入AcrySof Toric IOL在短期内可安全有效地矫正白内障患者部分术后散光,提高患者术后的裸眼视力.
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