Application of Toric Intraocular Lens in 25G Vitrectomy Combined with Phacoemulsification
Objective To observe the clinical effect and stability of implanting Toric intraocular lens(Toric IOL)during 25G vitrectomy combined with ultrasonic emulsification and aspiration of cataract.Methods A historical cohort study was conducted to analyze 58 patients(58 eyes)who underwent ultrasonic emulsification and aspiration of cataract+Toric IOL implantation in Wuhan No.1 Hospital.Among them,group A consisted of 20 cases(20 eyes)who underwent 25G vitrectomy combined with ul-trasonic emulsification and aspiration of cataract+primary Toric IOL implantation.group B included 18 cases(18 eyes)who un-derwent 25G vitrectomy followed by ultrasonic emulsification and aspiration of cataract+secondary Toric IOL implanta-tion.group C comprised 20 cases(20 eyes)who underwent ultrasonic emulsification and aspiration of cataract+Toric IOL im-plantation alone.Postoperative follow-up was conducted for 6 months to observe preoperative and postoperative visual acuity,re-sidual astigmatism,postoperative Toric IOL rotation,eccentricity,and aberrations.Results Six months after operation,the un-corrected distance visual acuity(UCVA)and best corrected visual acuity(BCVA)in all three groups were significantly higher than preoperative values(all P＜0.05).At 1 week,1 month,3 months,and 6 months after operation,astigmatism results in group A were(0.95±0.34)D,(1.01±0.34)D,(1.23±0.35)D,(1.21±0.32)D,respectively.The results in group B were(0.92±0.31)D,(1.14±0.33)D,(1.21±0.31)D,(1.22±0.33)D,respectively,which were all significantly higher than those in group C at corresponding time points[(0.65±0.29)D,(0.73±0.24)D,(0.91±0.34)D,(0.96±0.37)D],with statistically significant differences(all P＜0.05).At 6 months postoperatively,the mean IOL rotation was significantly higher in group A(4.85±1.23)° and group B(4.78±1.56)° compared to group C(3.80±1.20)°(both P＜0.05).There was no statistically sig-nificant difference in rotation between group A and group B.The differences in total whole-eye aberrations,total whole-eye low-order aberrations(excluding defocus),and total whole-eye high-order aberrations were not statistically significant between group A and group B,but were all higher than those in group C(all P＜0.05).The mean eccentricity of group A,group B,and group C were(0.284±0.060)mm,(0.278±0.069)mm,and(0.265±0.047)mm,respectively,with no statistically significant differ-ences(P＞0.05).Conclusion For cataract patients with corneal astigmatism and vitreous disease,implanting Toric IOLs can a-chieve better rotational stability and lower eccentricity,resulting in improved visual quality.There was no significant difference in the stability of Toric IOL between primary IOL implantation combined with vitrectomy and secondary IOL implantation.
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