国际眼科纵览 ›› 2025, Vol. 49 ›› Issue (4): 253-258.doi: 10. 3760/cma.j.cn115500-20241114-25403

• 综述 • 上一篇    下一篇

现代白内障手术中个性化散光管理的研究

王梓柏 张凤妍   

  1. 郑州大学第一附属医院眼科,郑州 450052
  • 收稿日期:2024-11-14 出版日期:2025-08-22 发布日期:2025-08-12
  • 通讯作者: 张凤妍,Email:Zhangfengyanx@aliyun.com E-mail:Zhangfengyanx@aliyun.com
  • 基金资助:
    2021年度中原英才计划(育才系列)-中原名医(11679)

Research on personalized astigmatism management in modern cataract surgery

Wang Zibo, Zhang Fengyan   

  1. Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
  • Received:2024-11-14 Online:2025-08-22 Published:2025-08-12
  • Contact: Zhang Fengyan, Email: Zhangfengyanx@aliyun.com E-mail:Zhangfengyanx@aliyun.com
  • Supported by:
    2021 Central Plains Talent Program (Talent Cultivation Series) -Central Plains Famous Doctors (11679)

摘要: 约有40%的白内障患者术前合并有超过1.00 D的角膜散光。白内障手术中角膜散光的矫正方法有角膜切口矫正和散光矫正型人工晶状体植入(Toric intraocular lens,Toric IOL)。角膜切口矫正散光,包括透明角膜切口、角膜缘松解切口及角膜松解切开术,这几种方法对于低中度散光均有较好的矫正效果,操作方便、性价比高,但由于散光随年龄变化、术源性散光、散光回退等因素的影响,切口计算困难且长期稳定性较低,需要更精确的计算方法以及个性化设计切口;Toric IOL对各种类型及大小的散光矫正效果明确,但存在轴位旋转的风险。新型的光可调节人工晶状体对于术前眼球生物测量误差较大的患者,如高度近视、圆锥角膜者可以优先考虑。

关键词: 白内障, 角膜散光, 散光矫正

Abstract: Approximately 40% of cataract patients have preoperative corneal astigmatism exceeding 1 diopter(D). For correcting corneal astigmatism during cataract surgery, the methods include corneal incision correction and implantation of Toric intraocular lenses. Corneal incisional methods, such as clear corneal incisions, limbal relaxing incisions, and corneal relaxing incisions, which is effective for low to moderate astigmatism, offering advantages in ease of operation and cost-effectiveness. However, their long-term stability is somewhat limited due to factors such as age-related astigmatic changes, surgically induced astigmatism, and regression of the astigmatic correction. This makes precise calculation and personalized incision design essential for optimal outcomes. In contrast, Toric IOL provide reliable correction for various types and magnitudes of astigmatism but carry the risk of postoperative axis rotation. For patients with significant preoperative biometric errors (e.g. high myopia or keratoconus), the newer generation of light-adjustable intraocular lenses may be a preferable option.

Key words: Cataract, Corneal astigmatism, Astigmatism correcting