Objective To compare the Acrysof toric intraocular lens (IOL) with the Acrysof SA60AT spherical IOL for patients with cataracts and preexisting corneal astigmatism and to investigate the rotational stability of the Acrysof toric IOL.Methods This prospective case-control study was comprised of 104 eyes with more than 1.0 D of preexisting corneal astigmatism.One group of 56 eyes were implanted with Acrysof toric IOL (toric group) and the other 48 eyes were implanted with Acysof SA60AT IOL(control group). Uncorrected (UCVA) and best corrected visual acuity (BCVA), residual refractive cylinder,spectacle independence,total lower order (LOA) and higher order aberrations (HOA),modulation transfer function (MTF) under 5, 10, 15,20,25, 30 cpd,and toric IOL axis were recorded 3 months postoperatively. Data were analyzed using a paired samples t test and an independent samples t test.Results Postoperatively, UCVA (logMAR) was 0.22 ±0.12 in toric group,versus 0.36 ±0.20 in control group (t=4.526,P＜0.01).BCVA was 0.05±0.07in toric group,versus 0.06 ±0.08 in control group (t=0.894,P=0.37).Mean residual refractive cylinder was 0.36 D in toric group versus 1.19 D in control group (t=4.275,P＜0.01).Three-month distance vision spectacle independence was 59％ (toric IOL) versus 32％ (control IOL).LOA in the toric group was significantly lower than that in the control group (t=11.146, P＜0.01), but no significant differences were found in higher order abberration between the two groups.MTF values in the toric group were higher than values in the control group at all spatial frequencies with a 3 mm pupil size (t=8.894,5.750,4.573,4.475,2.968,4.756,P＜0.01).Mean rotation was 5.84°±4.12° (range 0°～18°)for the toric IOL.Conclusion The favorable visual acuity,distance vision spectacle independence,visual quality, predictability, and rotational stability support the use of the Acrysof toric IOL for cataractous patients with corneal astigmatism.%目的 比较术前存在角膜散光的白内障患者植入Acrysof toric (Acrysof SN60TT)人工晶状体(IOL)和Acrysof SA60AT球面IOL后的视觉效果.方法 前瞻性病例对照研究.收集术前角膜散光大于1.0 D的白内障患者96例(104眼),其中56眼植入Acrysof toric IOL(Toric组),48眼植入Acysof SA60AT球面IOL(对照组).术后3个月观察裸眼视力、最佳矫正视力、残余散光度、脱镜率、全眼总低阶和高阶像差、调制传递函数(5、10、15、20、25、30 cpd)以及Toric IOL轴位.采用配对设计t检验、独立样本t检验对数据进行分析.结果 术后Toric组裸眼视力(logMAR)0.22±0.12、最佳矫正视力0.05±0.07、残余散光度为0.36 D；对照组裸眼视力0.36±0.20、最佳矫正视力0.06±0.08、残余散光度为1.19 D;两组比较,裸眼视力和残余散光度差异均有统计学意义(t=4.526、4.275,P＜0.01),最佳矫正视力差异无统计学意义.术后3个月,视远脱镜率Toric组为59％,对照组为32％.3 mm瞳孔直径下,Toric组术后低阶像差低于对照组,差异有统计学意义(t=11.146,P＜0.01),但两组术后高阶像差差异无统计学意义,且术后Toric组MTF值于各空间频率均高于对照组,差异均有统计学意义(t=8.894、5.750、4.573、4.475、2.968、4.756,P＜0.01).Toric组术后散光轴平均偏移5.84°±4.12°(0°～l8°).结论 AcrySof toric IOL植入后可获得令人满意的术后裸眼视力、脱镜率、视觉质量,可预测性强,且具有良好的旋转稳定性.
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