Toric IOL植入与角膜缘松解切开术矫正白内障低中度角膜散光的效果及安全性观察

目的 研究散光矫正型人工晶状体(toric intraocular lens,Toric IOL)植入和角膜缘松解切开术(limbal relaxingincision,LRI)矫正白内障低中度角膜散光的效果及安全性.方法 选取2016年1月—2020年1月我院行白内障超声乳化及散光矫正治疗的白内障低中度角膜散光90...

Effects and Safety of Toric IOL and Keratotomy in Correcting Low-to-moderate Corneal Astigmatism in Cataract

Objective To study the effects and safety of toric intraocular lens(Toric IOL)and keratotomy in correcting low-to-moderate corneal astigmatism in cataract.Methods A total of 90 patients(90 eyes)who underwent phacoemulsification and astigmatism correction in our hospital were selected from January 2016 to January 2020.According to the different surgical regimens,they were divided into IOL group(38 cases,38 eyes)and limbal relaxing incision(LRI)group(52 cases,52 eyes).The uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),corneal astigmatism-related indexes,surgically induced astigmatism(SIA),and intraocular pressure,anterior chamber volume and corneal thickness in the central area and incision area before and after mydriasis and coma aberration within 6 mm of the pupil(Coma),trefoil and total higher-order aberration(HOA)before surgery and at 3 months after surgery were compared between the two groups.The occurrence of intraoperative and postoperative complications were observed.Results The UCVA and BCVA in the two groups were significantly reduced compared with those before surgery,and the UCVA in IOL group was lower than that in LRI group(P<0.01).At 3 months after surgery,the corneal astigmatism,CJ0 and CJ45 in the two groups were significantly reduced compared with those before surgery,and the corneal astigmatism,CJ0 and CJ45 in IOL group were lower than those in LRI group(P<0.05 or P<0.01).The corneal thickness in the incision area before and after mydriasis in LRI group was significantly increased compared with that before surgery and was higher than that in IOL group(P<0.01).At 3 months after surgery,the Coma,trefoil and HOA in LRI group were significantly increased compared with those before surgery(P<0.01),and the Coma,trefoil and HOA in IOL group were lower than those in LRI group(P<0.05 or P<0.01).There was no significant difference in the incidence rate of complications between the two groups(χ^2=0.509,P=0.476).Conclusion Both Toric IOL and LRI have good effects and safety in the treatment of low-to-moderate corneal astigmatism in cataract.Toric IOL is beneficial to reduce the impact of incision on corneal thickness and high-order aberration,and its improvement effects on UCVA and corneal astigmatism are more advantageous than LRI.