Toric人工晶状体(IOL)的应用为合并散光的白内障患者提供了同时矫正散光的可能。为使术后效果最优、残余散光最小,Toric IOL的术前测量和计算至关重要,为实现其精准化,不同特性的散光测量设备相继应用于临床,了解设备原理及优缺点有助于根据患者情况个性化选择测量设备。手动角膜曲率计是测量角膜曲率的金标准,角膜地形图可用于评估角膜散光是否规则,许多设备所测角膜数据都可作为计算Toric IOL的参考数据,建议术前至少使用3种设备测量来提高预测精准度。角膜后表面散光对Toric IOL测量和计算均有影响,也越来越受到临床重视。Barrett Toric计算器准确性好,适用性强,在Toric IOL计算中推荐使用,同时其他各类Toric计算器及公式经过修正优化也可获得准确稳定的结果。本文从各类角膜曲率测量设备、角膜后表面散光以及Toric计算器3个方面对Toric IOL测量和计算的影响进行综述。
The application of Toric intraocular lens (IOL) provides an opportunity for patients who want to remove cataract and correct astigmatism at the same time.In order to optimize the postoperative result and minimize the residual astigmatism, the accurate preoperative measurement and calculation of Toric IOL are crucial.To improve the accuracy, different astigmatism measurement devices with various advantages have been introduced into clinical practice one after another.Knowing the principle, advantages and disadvantages of the devices contributes to personalized selection of devices according to the patient's condition.Manual keratometer is still the gold standard tool for measuring curvature, and corneal topography is used to assess whether the corneal astigmatism is regular.Most devices can provide reliable corneal data for Toric IOL calculation, and it is recommended that at least three different devices should be used to enhance the prediction accuracy preoperatively.The posterior corneal astigmatism, which has an effect on the measurement and calculation of Toric IOL, has been attracting more attention of ophthalmologists.With high accuracy and strong applicability, Barrett Toric Calculator is preferred in Toric IOL calculation.Moreover, various Toric calculators and formulas can give stable and accurate results after modification and optimization.In this article, the effects of various corneal curvature measurement devices, posterior corneal astigmatism and Toric calculator on Toric IOL measurement and calculation were reviewed.
高艺,李朝辉. Toric人工晶状体测量和计算研究进展[J]. 中华实验眼科杂志,2021,39(04):341-345.
DOI:10.3760/cma.j.cn115989-20191127-00541版权归中华医学会所有。
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