| Background The cataract surgery has entered the stage of refractive surgery,of which the aim is to recover the vision,correct the lower-order aberrations such as corneal astigmatism and can reduce or even eliminate the higher-order aberrations,and at the same time hope the patients to recover the full-distanced vision.Corneal astigmatism is a common type of ametropia to cataract patients[1].Cataract patients with no corneal astigmatism were only about 4.2%[2].Corneal astigmatism can affect the postoperative vision and decrease the visual quality after cataract surgery.So scholars at home and abroad pay more and more attention to correcting corneal astigmatism of cataract patients safely and effectively.China epidemiological data indicate that 32.5% to 36.4% of cataract patients suffer 0.50 D to 1.00 D corneal astigmatism,21.3% to 22.4% of cataract patients suffer 1.00 D to 1.50 D corneal astigmatism,10.6% to12.4% of cataract ones suffer 1.50 D to 2.00 D corneal astigmatism,8.2%to 13.0% suffer more than 2.00 D corneal astigmatism[3].With the improvement of cataract surgery and intraocular lens,the implantation ofastigmatism treatment of intraocular lens(Toric IOL)has become the treatment of cataract with regular corneal astigmatism of the main method,while Toric IOL applications are also expanding.The correction of different degrees of corneal astigmatism by Toric IOL is important to consider whether to choose Toric IOL.Objective Compare the preoperative and postoperative refractive status of cataract patients who get the phacoemulsification and IOL implantation to explore the clinical effect of Toric IOL correction of corneal regular astigmatism.Methods Collected 35 patients(40 eyes)with regular corneal astigmatism(>0.5D)and cataract were treated in our hospital from January 2016 to December 2016.Surgery is done by the same doctor.Acrysof SN60 WF IOL were implanted into 25 cases(25 eyes)in group I(IQ group).Toric IOL were implanted into 10 cases(15 eyes)in group Ⅱ(Toric group).According to the degree of Toric IOL,5 cases(7 eyes)in group ⅡA used T3 and T4,and 5 cases(8 eyes)in group ⅡB used T5 to T9.Patients were observed for 3 months.Preoperative and postoperative observation indicators included the corneal astigmatism,uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),postoperative residual cylinders,TIA and the postoperative complaints.Then we recorded thedependence on the glasses at 3 months after the surgeon and analyzed the patient information and related data by SPSS 22.0.Results1.35 cases(40 eyes)were included in the standard.The astigmatism of the cornea was 0.55 ~ 4.1D,with an average of 1.75 D ± 0.89 D.Age ranged from 54 to 81,and the average age was 68.1 ± 7.8 years.Toric group cornea astigmatism ranged from 0.63 to 4.0D,with an average of1.92 ± 1.0D.Age ranged from 54 to 81 years,with an average age of 67.6± 7.9 years.There was no statistically significant difference between the two groups(P> 0.05).All patients had no complication during and after surgery.2.There was no significant difference between the IQ group and the Toric group(P> 0.05).There was no significant difference in BCVA between the time points(1m,3m)(P> 0.05),but the difference between the two groups in UCVA was statistically significant(P <0.05),Toric group was superior to IQ group.3.Comparing the correction index of group ⅡA and group ⅡB,the CI of ⅡA >1 and the CI of ⅡB<1.4.There was no significant difference in residual cylinders between1 month and 3 months after operation in the Toric group(P> 0.05).5.Recorded in the Toric group of patients’ adverse complaints,only1 eye implantation T9 complained after 1 day of the surgeon,and 1 weekafter the surgeon reduced.Then the symptoms disappeared in 1 month after surgery.At 3 months after the surgeon,the dependence of the glasses was significantly better in the Toric group than in the IQ group.Conclusion1.Phacoemulsification and the Toric IOL implantation can treat regular corneal astigmatism effectively.2.The implantation of Toric IOL correction can be used in different degrees of regular corneal astigmatism in patients with cataract,which has the advantages of strong predictability and good stability.3.Toric IOL used in high degree of corneal astigmatism will result in slight undercorrection,and used in low degree of corneal astigmatism will result in slight overcorrection.4.Degree of corneal astigmatism implanted Toric IOL may appear dizziness,but the symptoms will improve.Then we should pay attention to the patients with high degree corneal astigmatism,and strengthen the preoperative communication.Through long-term follow-up,Toric IOL can low dependence on glasses,and patients will be highly satisfied. |
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