散光性后房型人工晶体植入矫治近视合并散光的临床研究

摘要

Objective To evaluate efficacy ,stability and safety after implantation of toric implantable collamer lens (TICL) to correct moderate to high myopic astigmatism .Methods This study evaluated 125 eyes of 71 patients with moderate to high myopic astigmatism who accepted TICL implantation .LogMAR uncorrected(UCVA) and best corrected(BCVA) visual acuity ,intraocular pressure ,cycloplegic refraction and manifest refraction examination were assessed preoperatively on 3 ,6 ,12 months postoperatively . The rotation of TICL axis were measured on 3 ,6 ,12 months postoperatively .Results 12 months postoperatively ,the logarithm of the minimum angle of resolution(LogMAR) UCVA were 0 .064 ± 0 .157 which were remarkably better than preoperative BCVA (P<0 .01) .119 eyes(95 .2% ) had postoperative UCVA better than or equal to preoperative BCVA .The manifest spherical refrac‐tion(absolute value) was (0 .36 ± 0 .41)D .105 (84 .0% ) eyes were within ± 0 .5 D .The mean manifest refractive cylinder was (-0 .63 ± 0 .61)D .109(87 .2% ) eyes had ≤ -1 .00 D .The mean rotation on 12 months postoperatively was (4 .76 ± 6 .14)° .The rotation of 101(80 .8% ) eyes were within 5 degrees .No vision threatening complications occurred during the observation period . Conclusion Implantation of TICL is safe and stable in the treatment of moderate to high myopic astigmatism .TICL is an ideal sur‐gical option to treat moderate to high myopic astigmatism .%目的：探讨散光性后房型人工晶体（TICL）植入矫治近视合并散光的有效性、稳定性。方法对该院就诊的71例中、高度近视合并散光患者共125眼植入TICL。术后随访1年以上，观察术后3、6、12个月的视力、屈光状态、人工晶体眼内旋转情况、眼压、角膜内皮细胞及拱高。结果LogMAR视力：术后12个月裸眼视力（UCVA）均值为0．064±0．157，较术前最佳矫正视力（BCVA）均值0．197±0．162有显著性提高（P＜0．01），其中，119眼UCVA（95．2％）达到或超过术前BCVA，仅6眼（4．8％）UCVA低于术前BCVA。屈光状态：术后3、6、12个月球镜及柱镜均值两两比较差异均无统计学意义（P＜0．01），术后12个月，球镜绝对值平均（0．36±0．41）D，共105眼（84．0％）在0～±0．50D内，柱镜平均（－0．63±0．61）D，共109眼（87．2％）在0～－1．00D内。人工晶体旋转情况：术后12个月人工晶体平均旋转（4．76±6．14）°，共101眼（80．8％）旋转度数低于5°。术后3、6、12个月眼压及角膜内皮细胞计数与术前比较，差异均无统计学意义（P＜0．01）。结论TICL植入矫治近视合并散光视力效果及术后稳定性较好，安全性高。