摘要
目的:比较不同眼轴长度白内障患者应用改良襻设计散光矫正型人工晶状体(TIOL)植入后视力恢复、残余散光及TIOL旋转稳定性的差异并分析其相关影响因素。方法:前瞻性队列研究。选取郑州普瑞眼科医院2024年1至10月治疗的白内障伴规则性角膜散光61例(68眼)作为研究对象,根据眼轴长度将其分为A、B两组。A组35例(40眼)眼轴长度≤24 mm,B组26例(28眼)眼轴长度>24 mm,两组患者均接受白内障超声乳化改良襻设计TIOL植入手术。术后随访3个月,观察两组患者术后最佳矫正远视力(BCDVA,logMAR)、残余散光、TIOL轴位旋转及并发症发生率。结果:A组患者术后3个月BCDVA为0.10(0.00,0.10),残余散光为-0.50(-0.69,-0.25)D,B组患者BCVDA为0.10(0.00,0.10),残余散光为-0.50(-0.50,-0.25)D,两组之间的BCDVA及残余散光差异均无统计学意义(Z=-0.027、-0.233,P=0.979、0.816)。A组和B组术后BCDVA与术前相比均明显提高(Z=-5.539、-4.644,均P<0.001),术后残余散光与术前散光相比均明显降低(Z=-5.511、-4.623,均P<0.001)。术后3个月,A组TIOL旋转度为2.00°(0.25°,3.00°),B组TIOL旋转度为2.00°(0.00°,3.00°),两组之间的差异无统计学意义(Z=-0.754,P=0.456)。Spearman相关性分析显示,B组TIOL旋转度与眼轴长度呈弱相关(r=0.415,P=0.028),与角膜缘白到白距离及晶状体厚度之间无明显相关性(均P>0.05),A组TIOL旋转度与以上参数均无相关性(均P>0.05)。结论:不同眼轴长度白内障患者植入改良襻设计TIOL后,在术后视力恢复、残余散光及TIOL旋转稳定性方面无明显差异;TIOL旋转度与眼轴长度呈弱正相关,与角膜缘白到白距离及晶状体厚度之间无明显相关性。
Objective:To compare the differences in visual recovery,residual astigmatism,and rotational stability of a new Toric intraocular lens(TIOL)with frosted haptic design and influencing factors in cataract patients with different axial lengths.Methods:This was a prospective cohort study.The data of 61 patients(68 eyes)with age-related cataract and corneal astigmatism were collected from January 2024 to October 2024 in Zhengzhou Puri Eye Hospital.They were divided into groups A and B depending on the length of the eye axis.Group A included 35 cases(40 eyes)with an axial length of≤24 mm,while group B included 26 cases(28 eyes)with an axial length>24 mm.All cases received phacoemulsification combined with modified frosted haptics designed TIOL implantation.Patients were followed up for 3 months after operation to observe the differences in best corrected distance visual acuity(BCDVA,logMAR),residual astigmatism,rotation degree of TIOL,and incidence of complications between the two groups.Results:At 3 months postoperatively,BCDVA of group A was 0.10(0.00,0.10)and residual astigmatism was-0.50(-0.69,-0.25)D.While BCDVA of group B was 0.10(0.00,0.10)and residual astigmatism was-0.50(-0.50,-0.25)D.There were no statistically significant differences between the two groups in BCDVA and residual astigmatism(Z=-0.027,-0.233;P=0.979,0.816).Postoperative BCDVA significantly improved compared to the preoperative value(Z=-5.539,-4.644;all P<0.001),and residual astigmatism after surgery was significantly lower than the preoperative value(Z=-5.511,-4.623;all P<0.001).In terms of rotational stability,the rotation in group A was 2.00°(0.25°,3.00°),and 2.00°(0.00°,3.00°)in group B.There was no statistical significance in the difference between the two groups(Z=-0.754,P=0.456).The spearman correlation analysis showed that the rotation degree of TIOL in group B had a weak correlation with axial length(r=0.415,P=0.028),but no significant correlation with white-to-white distance of the corneal limbus or the lens thickness(all P>0.05).The rotation degree of TIOL in group A had no correlation with the above-mentioned parameters(all P>0.05).Conclusion:For patients with cataracts of different axial lengths who underwent modified frosted naptics designed TIOL implantation,there are no significant differences in postoperative visual recovery,residual astigmatism,or rotational stability of the TIOL.TIOL rotation degree is weakly positively correlated with the axial length of the eye relatively,and insignificantly correlated with the distance form the limbus to the cornea or the thickness of the lens.
作者
张楠
刘雪珂
郭莹
陈刚
Zhang Nan;Liu Xueke;Guo Ying;Chen Gang(Department of Ophthalmology,Zhengzhou Puri Eye Hospital,Zhengzhou 450000,China)
出处
《中华眼外伤职业眼病杂志(中英文)》
2025年第5期380-385,共6页
Chinese Journal of Ocular Trauma and Occupational Eye Disease
关键词
人工晶状体
散光型
长度
眼轴
白内障
散光
残余
旋转
Lens,intraocular,toric
Lengths,axial
Cataract
Astigmatism,residual
Rotation
