Analysis Of Clinical Efficacy Of Toric Intraocular Lens Guided By Corneal Topography

ObjectiveApplication of corneal topography of merger corneal astigmatism in cataract patients with preoperative astigmatism regularity screening,by comparing the changes of refractive state and visual quality before and after operation,explore the regularity Toric intraocular lens correction the clinical curative effect of corneal astigmatism and corneal topography in precise choice models and axis of the role of Toric intraocular lens.MethodsCollected 46 patients(53 eyes)with regular corneal astigmatism and cataract were treated in our hospital from January 2018 to December 2018.AL-SCAN and fully automatic corneal curvature test were used to check corneal astigmatism greater than 1.0D.Panoramic evaluation of corneal astigmatism guides the precise selection of the Toric IOL model.All surgeries were performed by the same doctor.Patients were observed for 3 months.Observe the UCVA,BCVA,corneal astigmatism,astigmatism axial position,target induced astigmatism,postoperative residual cylinders,IOL Axial rotation degree,and record the main complaints such as dysphotopsia,before and after surgery for 1 week,1month,and 3months.In addition,assessed visual quality and questionnaired the satisfaction at 3 months after the surgeon.Then we analyzed the related data by SPSS 24.0.Results1.46 patients(53 eyes)were included in the standard.The corneal astigmatism ranged from 1.04 to 3.75 D,with an average of 1.84 ± 0.68 D.All patients successfully inplanted the Toric IOL and without complications during and after surgery.2.Compared with the preoperative UCVA 0.01~0.60(0.20±0.15)and BCVA 0.01~0.60(0.25±0.16),there were significant improvements at all follow-up time points(1w,1m,3m)(P(27)0.05).3.Postoperative UCVA and BCVA were significantly improved compared with before surgery,and the difference was statistically significant(P< 0.05).4.Postoperative astigmatism in the whole eye improved significantly(P<0.01).The changes of corneal astigmatism before and after surgery were not statistically significant(P<0.05).Statistical analysis of postoperative residual astigmatism and target induced astigmatism showed no statistical significance(P>0.05).4.Postoperative rotation stability: There was no significant difference in comparison between 1 week(2.47±1.28)°,1 month,(2.82±1.51)° and 3 months(3.46±2.61)° after surgery(P<0.05).Three months after operation,the mean off-axis rotation degree of IOL ≤7°.In this group of patients,no significant correlation was found between postoperative residual astigmatism and postoperative axial deviation(r=-0.034,P= 0.736),and postoperative residual astigmatism and postoperative naked eye vision(r=0.093,P= 0.412).5.OPD results of postoperative patients: the residual astigmatism of the whole eye after operation is ≤0.5D,the spot area of the PSF point spread function is significantly reduced,and the MTF modulation transfer function curve is significantly increased.It is clear and the crystal axis is in the right position,which is basically consistent with the preoperative planning.6.Postoperative survey on the rate of hyperopia and visual quality satisfaction: Two patients with T7 implantation and one patient with T6 implantation reported mild dizziness one day after surgery.The symptoms were relieved in 1 week and disappeared completely in 1 month after the operation.Five patients complained of light halo at night,which was relieved 3 months after the operation and their daily life was not affected.Except for 2 cases of binocular high myopia with cataract,the other patients achieved see far away from glasses.Conclusions1.Corneal topography is more comprehensive and accurate in assessing corneal astigmatism before surgery for cataract patients,which will help guide the accurate selection of Toric IOL model and axis improve the expected effect after surgery.2.Analysis of regular astigmatism using corneal topography to select Toric IOL,which is highly predictable,can effectively reduce residual astigmatism and provide patients with satisfactory visual quality after surgery.3.AcrysofToric IOL has significant clinical effects on regular corneal astigmatism and UCVA,and has good rotational stability.4.Patients with high-number corneal astigmatism may experience dizziness in the short term after implantation of Toric IOL.Care should be taken to strengthen pre-operative communication with patients with high-number corneal astigmatism.