Piggyback技术在超高度近视合并白内障手术的应用
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Piggyback implantation using Toric intraocular lens in high myopia
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    摘要:

    目的:观察piggyback(背驮式)散光矫正型人工晶状体\〖Toric intraocular lens(IOL)\〗植入在超高度近视合并角膜散光的白内障术中的临床应用效果。

    方法:选取2010-01/2013-06因超高度近视合并年龄相关性白内障及角膜散光在我院行超声乳化白内障摘除联合IOL植入术的患者60例,按随机对照原则分为观察组和对照组,观察组30例行piggyback Toric IOL植入,背驮植入囊袋的两枚IOL分别为一枚正度数Acysoft IQ Toric IOL和一枚负度数折叠三片式IOL,对照组30例植入无散光矫正功能的普通折叠IOL。术后随访6mo,观察术后视力、IOL位置、术后残留散光及并发症等。

    结果:术后6mo, 观察组裸眼视力从术前的3.52±0.03提高到4.78±0.01,对照组从术前的3.51±0.03上升到4.30±0.13,观察组裸眼视力明显高于对照组,差异有统计学意义(t =3.612, P <0.05)。两组术前角膜散光均较高,观察组1.70~4.27(平均2.97±0.87)D,对照组1.50~4.90(平均2.92±0.97)D,术后6mo观察组残留散光明显降低到0.25~1.00(平均0.48±0.23)D,而对照组仍残留散光1.00~5.20(平均2.87±1.11)D,两组间比较差异有统计学意义(t=-11.995,P<0.05)。术中及术后未见并发症。

    结论:Piggyback Toric IOL植入术可帮助解决目前超高度近视合并角膜散光眼无匹配Toric IOL度数的难题,有效提高其白内障术后裸眼视力,降低散光。

    Abstract:

    AIM: To assess the postoperative outcomes of piggyback implantation using Acrysof Toric intraocular lens(IOL)in high myopia combined with corneal astigmatism.

    METHODS: Sixty patients who had phacoemulsification with IOL implantation due to high myopia,cataract and corneal astigmatism from January 2010 to June 2013 were randomly divided into observation group(piggyback Toric IOL implantation, both an Acrysoft IQ Toric IOL and a minus foldable acrylic three piece IOL were implanted in the capsular bag, n=30)and control group(foldable IOL implantation, n=30). Postoperative follow-up went on 6mo. Information collected included uncorrected visual acuity(UCVA), IOL position, residual astigmatism and complications.

    RESULTS: The UCVA increased from 3.52±0.03 preoperatively to 4.78±0.01 at 6mo postoperatively in the observation group, from 3.51±0.03 preoperatively to 4.30±0.13 at 6mo postoperatively in the control group. The observation group's postoperative UCVA was better than that of the control group. There was statistically significant difference(t=3.612, P<0.05). The preoperative corneal astigmatism was 2.97±0.87(1.70-4.27)D in the observation group and 2.92±0.97(1.50-4.90)D in the control group. The postoperative residual astigmatism was 0.48±0.23(0.25-1.00)D in the observation group and 2.87±1.11(1.00-5.20)D in the control group. There was statistically significant difference postoperatively(t=-11.995, P<0.05)between the two groups. No complications occurred.

    CONCLUSION: Piggyback implantation using Toric IOL can help to solve the problem of no matching Toric IOL power for the high myopia combined with corneal astigmatism at the current stage. It improves the UCVA and reduces the astigmatism after the cataract surgery.

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唐琼燕,彭满强,林丁. Piggyback技术在超高度近视合并白内障手术的应用.国际眼科杂志, 2014,14(9):1599-1601.

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  • 收稿日期:2014-06-03
  • 最后修改日期:2014-07-25
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  • 在线发布日期: 2014-08-19
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