To observe the application of femtosecond laser-assisted cataract surgery combined with Toric intraocular lens implantation in patients with cataracts with different axial lengths
Objective To observe the application of femtosecond laser-assisted cataract surgery combined with to-ric intraocular lens(Toric IOL)implantation in patients with cataracts with different axial lengths.Methods A retrospec-tive analysis of 36 eyes of our hospital with femtosecond laser-assisted cataract surgery combined with Toric IOL implanta-tion was divided into normal axial length group(22 mm≤axial length<24 mm)and long axial group(24 mm≤ocular axis length),the research data includes postoperative best corrected visual acuity(BCVA),preoperative corneal astigma-tism,postoperative residual astigmatism,postoperative corneal index and correlation analysis of ocular high-order phase difference and ocular visual quality.Results The logMAR of the BCVA normal axis group(0.06±0.07)and the long axis group(0.09±0.09).logMAR were significantly higher than those before the operation at three months after the operation,and the difference was statistically significant.The total residual astigmatism at 3 months after the operation was(0.83±0.53)D in the normal axial group and(0.50±0.50)D in the long axial group,both of which were significantly reduced com-pared with preoperatively,and the difference was statistically significant.The Strchl value at 3 months after the operation was 0.17±0.12 in the normal axial group and 0.18±0.14 in the long axial group,both of which were significantly higher than those before the operation,and the difference was statistically significant.At three months after the operation,there was no significant difference in BCVA,postoperative total residual astigmatism and Strchl values between the two groups(Z=0.99,1.78,0.08;P=0.32,0.08,0.94).Visual quality analysis.The OPD-ScanⅢ visual quality analyzer was used to de-tect:there was no correlation between the corneal index and the Strchl value of the two groups of eyes.At 3 months after the operation,the Strchl value of the normal axis group was negatively correlated with the difference between the corneal to-tal and the intraocular total(r=-0.82,-0.88,P=0.01,0.00).The Strchl value of the long axis group was negatively corre-lated with the difference of tilt,high,s4+s6+s8 of the whole eye.TOPCON KR-1W visual quality analyzer was used to de-tect:there was no statistically significant difference in the high-level phase difference of the whole eye between the two groups of patients after the surgery.At 3 months after the operation,the Strchl value of the normal axis group was nega-tively correlated with 4s3,4s4 and 4total under the 4mm pupil diameter of the whole eye,and the Strchl value of the long axis group was negatively correlated with 4s3,4s4,4total under the 4mm pupil diameter of the whole eye.Negative correla-tion,Strchl value at 6mm pupil diameter was negatively correlated with 6s5.Conclusions Femtosecond laser-assisted cataract surgery combined with Toric IOL implantation is a safe and effective method for the treatment of regular corneal astigmatism cataract,and it is not only stable in patients with normal axis,but also effective in patients with long axis.Re-ducing surgical damage,keeping the Toric IOL capsular bag centered and the lens optical surface not tilted are the prereq-uisites for ensuring high visual quality after surgery.
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