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Efficacy of toric intraocular lens implantation with high corneal astigmatism within the United Kingdom’s National Health Service
Eye ( IF 2.8 ) Pub Date : 2019-12-16 , DOI: 10.1038/s41433-019-0744-0 Andrew J Swampillai 1 , Ali Khanan Kaabneh 1 , Nabil E Habib 1 , Catriona Hamer 2 , Phillip J Buckhurst 2
Eye ( IF 2.8 ) Pub Date : 2019-12-16 , DOI: 10.1038/s41433-019-0744-0 Andrew J Swampillai 1 , Ali Khanan Kaabneh 1 , Nabil E Habib 1 , Catriona Hamer 2 , Phillip J Buckhurst 2
Affiliation
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Objectives To determine the efficacy of toric intraocular lens (TIOL) implantation in cataract surgery patients with high levels of pre-operative corneal astigmatism and ocular co-morbidities in a state funded, National Health Service (NHS) hospital. Methods Retrospective cohort study involving consecutive cases of TIOL implantation in cataract surgery with over 3.00DC of pre-operative corneal astigmatism. Subjects were implanted with the Tecnis TIOL (Abbot Medical Optics) with capsular tension ring stabilisation using the Callisto system (Carl Zeiss Meditec). Visual acuity and refraction were assessed at 4–6 weeks post-operatively. Vector analysis was used to calculate the intended refractive correction, surgically induced refractive correction (SIRC), correction ratio (CR), error of magnitude (EM) and error vector (EV). Results Sixty-six eyes of forty-seven subjects aged 73.8 ± 11.9 were included. Eyes with ocular co-morbidities included dry age-related macular degeneration ( n = 13), amblyopia ( n = 7), high myopia ( n = 7), glaucoma ( n = 6), previous corneal transplantation ( n = 2), nanophthalmos ( n = 2) and corneal scarring ( n = 1). Pre-operative corneal astigmatism was 4.25 ± 1.69DC (range 3.00–12.00), post-operative refractive astigmatism was 1.31 ± 1.05DC (range 0.00–6.50DC) and post-operative unaided visual acuity was 0.25 ± 0.19 LogMAR. Vector analysis demonstrated an SIRC of 4.08 ± 1.39DC, CR = 1.1 ± 0.3, EM −0.4 ± 1.0 and EV of 1.23 ± 0.72. Conclusions The results demonstrate the efficacy of TIOL implantation in patients with high corneal astigmatism and provide strong evidence advocating their use in cataract surgery within a state funded hospital eye service. Refractive astigmatism was significantly lower than the pre-operative corneal astigmatism and a low error vector was achieved relative to the magnitude of correction.
中文翻译：
英国国家卫生服务机构内高度角膜散光的环面人工晶状体植入术的疗效
目的 确定在国家资助的国家卫生服务 (NHS) 医院中，在白内障手术患者中植入环面人工晶状体 (TIOL) 的效果，这些患者术前角膜散光和眼部合并症的水平较高。方法 回顾性队列研究涉及连续 TIOL 植入白内障手术病例，术前角膜散光超过 3.00DC。使用 Callisto 系统 (Carl Zeiss Meditec) 为受试者植入具有包膜张力环稳定功能的 Tecnis TIOL（Abbot Medical Optics）。在术后 4-6 周评估视力和屈光度。矢量分析用于计算预期屈光矫正、手术诱导屈光矫正 (SIRC)、矫正比 (CR)、幅度误差 (EM) 和误差矢量 (EV)。结果 73.8±11.9岁的47名受试者共66只眼。患有眼部合并症的眼睛包括干性年龄相关性黄斑变性 (n = 13)、弱视 (n = 7)、高度近视 (n = 7)、青光眼 (n = 6)、既往角膜移植 (n = 2)、纳米眼球 (n = 2) 和角膜瘢痕 (n = 1)。术前角膜散光为 4.25±1.69DC（范围 3.00-12.00），术后屈光散光为 1.31±1.05DC（范围 0.00-6.50DC），术后裸眼视力为 0.25±0.19LogMAR。矢量分析表明 SIRC 为 4.08 ± 1.39DC，CR = 1.1 ± 0.3，EM -0.4 ± 1.0 和 EV 为 1.23 ± 0.72。结论 结果证明了 TIOL 植入术对高度角膜散光患者的疗效，并提供了强有力的证据，支持在国家资助的医院眼科服务机构内进行白内障手术。屈光散光明显低于术前角膜散光，并且相对于矫正量级实现了低误差向量。
更新日期：2019-12-16
中文翻译：
英国国家卫生服务机构内高度角膜散光的环面人工晶状体植入术的疗效
目的 确定在国家资助的国家卫生服务 (NHS) 医院中，在白内障手术患者中植入环面人工晶状体 (TIOL) 的效果，这些患者术前角膜散光和眼部合并症的水平较高。方法 回顾性队列研究涉及连续 TIOL 植入白内障手术病例，术前角膜散光超过 3.00DC。使用 Callisto 系统 (Carl Zeiss Meditec) 为受试者植入具有包膜张力环稳定功能的 Tecnis TIOL（Abbot Medical Optics）。在术后 4-6 周评估视力和屈光度。矢量分析用于计算预期屈光矫正、手术诱导屈光矫正 (SIRC)、矫正比 (CR)、幅度误差 (EM) 和误差矢量 (EV)。结果 73.8±11.9岁的47名受试者共66只眼。患有眼部合并症的眼睛包括干性年龄相关性黄斑变性 (n = 13)、弱视 (n = 7)、高度近视 (n = 7)、青光眼 (n = 6)、既往角膜移植 (n = 2)、纳米眼球 (n = 2) 和角膜瘢痕 (n = 1)。术前角膜散光为 4.25±1.69DC（范围 3.00-12.00），术后屈光散光为 1.31±1.05DC（范围 0.00-6.50DC），术后裸眼视力为 0.25±0.19LogMAR。矢量分析表明 SIRC 为 4.08 ± 1.39DC，CR = 1.1 ± 0.3，EM -0.4 ± 1.0 和 EV 为 1.23 ± 0.72。结论 结果证明了 TIOL 植入术对高度角膜散光患者的疗效，并提供了强有力的证据，支持在国家资助的医院眼科服务机构内进行白内障手术。屈光散光明显低于术前角膜散光，并且相对于矫正量级实现了低误差向量。
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