|
|
白内障手术中矫正低度数角膜散光的研究进展
|
Abstract:
低度数的未矫正角膜散光是影响白内障患者术后屈光状态和视觉质量的重要因素之一，>0.75 D的散光便会引起视物模糊、重影、眩光等症状。随着白内障屈光手术领域的不断发展，针对白内障患者低度数角膜散光的矫正已经有多种手术技术可供选择。本文就目前白内障术中矫正低度数角膜散光的常见术式作一综述，以期帮助临床医生更好地为患者选择合适的散光矫正方法提供参考。
Uncorrected low corneal astigmatism is one of the important factors affecting the refractive outcomes and visual quality of cataract patients postoperatively. Astigmatism > 0.75 D can lead to symptoms such as blurred vision, double vision, and glare. With the continuous development in the field of cataract refractive surgery, there are multiple surgical techniques available for correcting low-degree corneal astigmatism in cataract patients. This article provides a comprehensive review of common surgical procedures for correcting low corneal astigmatism in cataract surgery, aiming to provide guidance to clinicians in selecting appropriate astigmatism correction methods for patients.
| [1] | Chen, W., Zuo, C., Chen, C., et al. (2013) Prevalence of Corneal Astigmatism before Cataract Surgery in Chinese Patients. J Cataract Refract Surg, 39, 188-192. https://doi.org/10.1016/j.jcrs.2012.08.060 |
| [2] | 邢茜, 管怀进, 吴坚. 超声乳化白内障吸除联合散光型人工晶状体植入临床观察[J]. 中国实用眼科杂志, 2010, 28(11): 1199-1202. |
| [3] | Watanabe, K., Negishi, K., Kawai, M., et al. (2013) Effect of Experimentally Induced Astigmatism on Functional, Conventional, and Low-Contrast Visual Acuity. Journal of Refractive Surgery, 29, 19-25. https://doi.org/10.3928/1081597X-20121211-01 |
| [4] | Datta, A., Richdale, K., Tomiyama, E.S., et al. (2021) Near Visual Function Measured with a Novel Tablet Application in Patients with Astigmatism. Clinical and Experimental Optometry, 104, 42-47. https://doi.org/10.1111/cxo.13138 |
| [5] | Hoffmann, P.C. and Hütz, W.W. (2010) Analysis of Biometry and Prevalence Data for Corneal Astigmatism in 23, 239 Eyes. Journal of Cataract & Refractive Surgery, 36, 1479-1485. https://doi.org/10.1016/j.jcrs.2010.02.025 |
| [6] | Day, A.C., Dhariwal, M., Keith, M.S., et al. (2019) Distribution of Preoperative and Postoperative Astigmatism in a Large Population of Patients Undergoing Cataract Surgery in the UK. British Journal of Ophthalmology, 103, 993-1000. https://doi.org/10.1136/bjophthalmol-2018-312025 |
| [7] | 中华医学会眼科学分会白内障与人工晶状体学组. 我国散光矫正型人工晶状体临床应用专家共识(2017年) [J]. 中华眼科杂志, 2017, 53(1): 7-10. |
| [8] | Yuan, X., Song, H., Peng, G., et al. (2014) Prevalence of Corneal Astigmatism in Patients before Cataract Surgery in Northern China. Journal of Ophthalmology, 2014, Article ID: 536412. https://doi.org/10.1155/2014/536412 |
| [9] | Liu, Y.C., Chou, P., Wojciechowski, R., et al. (2011) Power Vector Analysis of Refractive, Corneal, and Internal Astigmatism in an Elderly Chinese Population: The Shihpai Eye Study. Investigative Ophthalmology & Visual Science, 52, 9651-9657. https://doi.org/10.1167/iovs.11-7641 |
| [10] | Hayashi, K., Sato, T., Sasaki, H., et al. (2018) Sex-Related Differences in Corneal Astigmatism and Shape with Age. Journal of Cataract & Refractive Surgery, 44, 1130-1139. https://doi.org/10.1016/j.jcrs.2018.06.020 |
| [11] | Wilkins, M.R., Allan, B. and Rubin, G. (2009) Spectacle Use after Routine Cataract Surgery. British Journal of Ophthalmology, 93, 1307-1312. https://doi.org/10.1136/bjo.2008.151829 |
| [12] | Berdahl, J.P., Hardten, D.R., Kramer, B.A., et al. (2018) Effect of Astigmatism on Visual Acuity after Multifocal Versus Monofocal Intraocular Lens Implantation. Journal of Cataract & Refractive Surgery, 44, 1192-1197. https://doi.org/10.1016/j.jcrs.2018.06.048 |
| [13] | Mayer, W.J., Kreutzer, T., Dirisamer, M., et al. (2017) Comparison of Visual Outcomes, Alignment Accuracy, and Surgical Time between 2 Methods of Corneal Marking for Toric Intraocular Lens Implantation. Journal of Cataract & Refractive Surgery, 43, 1281-1286. https://doi.org/10.1016/j.jcrs.2017.07.030 |
| [14] | Schallhorn, S.C., Hettinger, K.A., Pelouskova, M., et al. (2021) Effect of Residual Astigmatism on Uncorrected Visual Acuity and Patient Satisfaction in Pseudophakic Patients. Journal of Cataract & Refractive Surgery, 47, 991-998. https://doi.org/10.1097/j.jcrs.0000000000000560 |
| [15] | Osher, R.H. (1989) Paired Transverse Relaxing Keratotomy: A Combined Technique for Reducing Astigmatism. Journal of Cataract & Refractive Surgery, 15, 32-37. https://doi.org/10.1016/S0886-3350(89)80137-3 |
| [16] | Bayramlar, H., Karadag, R., Cakici, O., et al. (2016) Arcuate Keratotomy on Post-Keratoplasty Astigmatism Is Unpredictable and Frequently Needs Repeat Procedures to Increase Its Success Rate. British Journal of Ophthalmology, 100, 757-761. https://doi.org/10.1136/bjophthalmol-2015-306738 |
| [17] | Wang, L., Xiao, X., Zhao, L., et al. (2017) Comparison of Efficacy between Coaxial Microincision and Standard-Incision Phacoemulsification in Patients with Age-Related Cataracts: A Meta-Analysis. BMC Ophthalmology, 17, Article No. 267. https://doi.org/10.1186/s12886-017-0661-6 |
| [18] | Hayashi, K., Yoshida, M., Hirata, A., et al. (2018) Changes in Shape and Astigmatism of Total, Anterior, and Posterior Cornea after Long versus Short Clear Corneal Incision Cataract Surgery. Journal of Cataract & Refractive Surgery, 44, 39-49. https://doi.org/10.1016/j.jcrs.2017.10.037 |
| [19] | 梁景黎, 邢秀丽, 杨晓彤, 等. 2.2Mm和3.0Mm透明角膜切口超声乳化白内障吸除术后全角膜及角膜前后表面术源性散光的比较分析[J]. 中华眼科杂志, 2019, 55(7): 495-501. |
| [20] | Guirao, A. (2005) Theoretical Elastic Response of the Cornea to Refractive Surgery: Risk Factors for Keratectasia. Journal of Refractive Surgery, 21, 176-185. https://doi.org/10.3928/1081-597X-20050301-14 |
| [21] | Baharozian, C.J., Song, C., Hatch, K.M., et al. (2017) A Novel Nomogram for the Treatment of Astigmatism with Femtosecond-Laser Arcuate Incisions at the Time of Cataract Surgery. Clinical Ophthalmology, 11, 1841-1848. https://doi.org/10.2147/OPTH.S141255 |
| [22] | Chen, M., Reinsbach, M., Wilbanks, N.D., et al. (2019) Utilizing Intraoperative Aberrometry and Digital Eye Tracking to Develop a Novel Nomogram for Manual Astigmatic Keratotomy to Effectively Decrease Mild Astigmatism during Cataract Surgery. Taiwan Journal of Ophthalmology, 9, 27-32. https://doi.org/10.4103/tjo.tjo_6_18 |
| [23] | 曹迎雪, 王军. 超声乳化白内障吸除联合导航下弧形角膜切开术后角膜散光变化的初期观察[J]. 中华眼科杂志, 2019, 55(7): 502-508. |
| [24] | Leung, D.Y., Yeung, E.F., Law, R.W., et al. (2004) In Vivo Confocal Microscopy of Epithelial Inclusions from Aberrant Wound Healing after Astigmatic Keratotomy. Cornea, 23, 299-301. https://doi.org/10.1097/00003226-200404000-00014 |
| [25] | 云睿, 边立娟, 刘敏, 等. 白内障术中矫正角膜散光的研究进展[J]. 中国眼耳鼻喉科杂志, 2021, 21(1): 55-59. |
| [26] | Abu-Ain, M.S., Al-Latayfeh, M.M. and Khan, M.I. (2022) Do Limbal Relaxing Incisions During Cataract Surgery Still Have a Role? BMC Ophthalmology, 22, Article No. 102. https://doi.org/10.1186/s12886-022-02327-9 |
| [27] | Ganekal, S., Dorairaj, S. and Jhanji, V. (2011) Limbal Relaxing Incisions during Phacoemulsification: 6-Month Results. Journal of Cataract & Refractive Surgery, 37, 2081-2082. https://doi.org/10.1016/j.jcrs.2011.09.002 |
| [28] | Liu, Z., Sha, X., Liang, X., et al. (2014) Toric Intraocular Lens vs. Peripheral Corneal Relaxing Incisions to Correct Astigmatism in Eyes Undergoing Cataract Surgery. Eye Science, 29, 198-203. |
| [29] | 王峥, 张琳, 郑帆, 等. 白内障术中采用不同方式矫正中低度角膜散光的疗效观察[J]. 福建医药杂志, 2016, 38(2): 15-18. |
| [30] | 王海燕, 孙朝晖, 冯艳霞, 等. 两种散光矫正方式治疗白内障合并中低度数角膜散光的临床对比研究[J]. 中国医学装备, 2020, 17(8): 113-117. |
| [31] | Lin, H.Y., Chen, S., Chuang, Y.J., et al. (2022) Effectiveness of Reducing Corneal Astigmatism after Combined High-Freq Uency LDV Z8 Femtosecond Laser-Assisted Phacoemulsification and Arcuat E Keratotomy. Frontiers in Cell and Developmental Biology, 10, Article 1036469. https://doi.org/10.3389/fcell.2022.1036469 |
| [32] | Roberts, H.W., Wagh, V.K., Sullivan, D.L., et al. (2018) Refractive Outcomes after Limbal Relaxing Incisions or Femtosecond Laser Arcuate Keratotomy to Manage Corneal Astigmatism at the Time of Cataract Surgery. Journal of Cataract & Refractive Surgery, 44, 955-963. https://doi.org/10.1016/j.jcrs.2018.05.027 |
| [33] | Visco, D.M., Bedi, R. and Packer, M. (2019) Femtosecond Laser-Assisted Arcuate Keratotomy at the Time of Cataract Surgery for The Management of Preexisting Astigmatism. Journal of Cataract & Refractive Surgery, 45, 1762-1769. https://doi.org/10.1016/j.jcrs.2019.08.002 |
| [34] | Rani, K., Grover, A.K., Singh, A.K., et al. (2020) Correction of Preexisting Astigmatism by Penetrating Arcuate Keratotomy in Femtosecond Laser-Assisted Cataract Surgery. Indian Journal of Ophthalmology, 68, 1569-1572. https://doi.org/10.4103/ijo.IJO_2060_19 |
| [35] | Wendelstein, J.A., Hoffmann, P.C., Mariacher, S., et al. (2021) Precision and Refractive Predictability of a New Nomogram for Femtosecond Laser-Assisted Corneal Arcuate Incisions. Acta Ophthalmologica, 99, e1297-e1306. https://doi.org/10.1111/aos.14837 |
| [36] | Diakonis, V.F., Yesilirmak, N., Cabot, F., et al. (2015) Comparison of Surgically Induced Astigmatism between Femtosecond Laser and Manual Clear Corneal Incisions for Cataract Surgery. Journal of Cataract & Refractive Surgery, 41, 2075-2080. https://doi.org/10.1016/j.jcrs.2015.11.004 |
| [37] | Vickers, L.A. and Gupta, P.K. (2016) Femtosecond Laser-Assisted Keratotomy. Current Opinion in Ophthalmology, 27, 277-284. https://doi.org/10.1097/ICU.0000000000000267 |
| [38] | González-Cruces, T., Cano-Ortiz, A., Sánchez-González, M.C., et al. (2022) Cataract Surgery Astigmatism Incisional Management. Manual Relaxing Incision versus Femtosecond Laser-Assisted Arcuate Keratotomy. A Systematic Review. Graefe’s Archive for Clinical and Experimental Ophthalmology, 260, 3437-3452. https://doi.org/10.1007/s00417-022-05728-0 |
| [39] | 李盼盼, 管怀进, 吴坚. 白内障术中联合矫正角膜散光的研究进展[J]. 中华实验眼科杂志, 2019, 37(4): 304-307. |
| [40] | Hayashi, K., Hayashi, H., Nakao, F., et al. (1995) The Correlation between Incision Size and Corneal Shape Changes in Sutureless Cataract Surgery. Ophthalmology, 102, 550-556. https://doi.org/10.1016/S0161-6420(95)30983-9 |
| [41] | 杨娜, 刘志英, 董竟. Toric人工晶体与角膜陡峭轴切口矫正白内障合并低度散光的临床研究[J]. 包头医学院学报, 2022, 38(11): 74-79. |
| [42] | 陈星, 于建春. 白内障手术同时矫正散光的方法研究进展[J]. 国际眼科杂志, 2015, 15(6): 993-996. |
| [43] | 杨丽红, 汤欣. 白内障手术同时矫正术前散光的研究进展[J]. 中华眼科杂志, 2011, 47(6): 573-576. |
| [44] | Ren, Y., Fang, X., Fang, A., et al. (2019) Phacoemulsification with 3.0 and 2.0 Mm Opposite Clear Corneal Incisions for Correction of Corneal Astigmatism. Cornea, 38, 1105-1110. https://doi.org/10.1097/ICO.0000000000001915 |
| [45] | Zhou, J., Wang, X., Wei, Y., et al. (2024) The Efficacy of Paired Opposite Clear Corneal Incisions Correcting Preexisting Low-to-Moderate Astigmatism in Implantable Collamer Lens Surgery. Journal of Refractive Surgery, 40, e20-e29. https://doi.org/10.3928/1081597X-20231212-02 |
| [46] | Chiam, P.J. (2015) Effect of Paired Opposite Clear Corneal Incisions on with-the-Rule versus against-the-Rule Astigmatism. Cornea, 34, 901-905. https://doi.org/10.1097/ICO.0000000000000441 |
| [47] | Endophthalmitis Study Group and Refractive, S. (2007) Prophylaxis of Postoperative Endophthalmitis Following Cataract Surgery: Results of the ESCRS Multicenter Study and Identification of Risk Factors. Journal of Cataract & Refractive Surgery, 33, 978-988. https://doi.org/10.1016/j.jcrs.2007.02.032 |
| [48] | Haripriya, A., Chang, D.F. and Ravindran, R.D. (2019) Endophthalmitis Reduction with Intracameral Moxifloxacin in Eyes with and without Surgical Complications: Results from 2 Million Consecutive Cataract Surgeries. Journal of Cataract & Refractive Surgery, 45, 1226-1233. https://doi.org/10.1016/j.jcrs.2019.04.018 |
| [49] | Bauer, N.J., De Vries, N.E., Webers, C.A., et al. (2008) Astigmatism Management in Cataract Surgery with the AcrySof Toric Intraocular Lens. Journal of Cataract & Refractive Surgery, 34, 1483-1488. https://doi.org/10.1016/j.jcrs.2008.05.031 |
| [50] | Visser, N., Ruíz-Mesa, R., Pastor, F., et al. (2011) Cataract Surgery with Toric Intraocular Lens Implantation in Patients with High Corneal Astigmatism. Journal of Cataract & Refractive Surgery, 37, 1403-1410. https://doi.org/10.1016/j.jcrs.2011.03.034 |
| [51] | Hienert, J., Ruiss, M., Hirnschall, N., et al. (2023) Assessing the Astigmatism-Reducing Effect of Toric Intraocular Lenses in Eyes with Low Astigmatism: Randomized Masked Bilateral Comparison. Journal of Cataract & Refractive Surgery, 49, 826-831. https://doi.org/10.1097/j.jcrs.0000000000001211 |
| [52] | 谭青青, 廖萱, 兰长骏, 等. Toric人工晶状体与角膜切口矫正白内障低中度角膜散光比较的Meta分析[J]. 中华眼科杂志, 2019, 55(7): 522-530. |
| [53] | Rocha-De-Lossada, C., Rodríguez-Vallejo, M., Rodríguez-Calvo-De-Mora, M., et al. (2023) Managing Low Corneal Astigmatism in Patients with Presbyopia Correcting Intraocular Lenses: A Narrative Review. BMC Ophthalmology, 23, Article No. 254. https://doi.org/10.1186/s12886-023-03003-2 |
