国际眼科纵览 ›› 2026, Vol. 50 ›› Issue (3): 201-209.doi: 10.3760/cma.j.cn115500-20251209-26307

• 综述 • 上一篇    下一篇

散光型人工晶状体研究进展

文可依   万修华
  

  1. 首都医科大学附属北京同仁医院 北京同仁眼科中心 眼科学与视觉科学北京市重点实验室,北京 100730

  • 收稿日期:2025-12-09 出版日期:2026-06-22 发布日期:2026-06-22
  • 通讯作者: 万修华,Email: xiuhuawan@163.com

Advances in Toric intraocular lens

Wen Keyi, Wan Xiuhua   

  1. Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing 100730, China

  • Received:2025-12-09 Online:2026-06-22 Published:2026-06-22
  • Contact: Wan Xiuhua, Email: xiuhuawan@163.com

摘要: 散光型人工晶状体(Toric intraocular lens,Toric IOL)植入具有矫正散光范围广、精度高、无需角膜切口且术后效果长期稳定等优点,成为当今治疗白内障合并较大术前角膜散光的首选方式。近年来,Toric IOL的设计及临床应用方面进展显著。在形状设计方面,出现了改良C形襻、改良L形襻、方形磨砂襻、板环形襻以及双环形襻等;材料设计方面,丙烯酸酯类材料已基本取代聚甲基丙烯酸甲酯和硅胶,相关前沿研究着重关注对亲水性丙烯酸酯进行表面疏水化处理或引入具有生物活性的涂层;功能设计方面,非球面、多焦点、景深延长、光可调等新型功能设计层出不穷;临床应用方面,Toric IOL植入在合并中央规则成分的不规则散光、囊袋结构损伤、非进展期的圆锥角膜、穿透性角膜移植术后稳定状态、无角膜水肿的Fuchs角膜内皮营养不良等患者中取得令人满意的屈光矫正效果。随着对角膜后表面散光认识的加深,IOLMaster 700和Pentacam等可直接测量角膜后表面曲率及散光的仪器以及包括Barrett、EVO、Hoffer QST、Kane在内的多种计算公式相继问世,显著提高了Toric IOL度数计算的准确性。经巩膜缝线固定技术的改进使囊袋缺失患者通过植入Toric IOL获得散光矫正成为可能。术前轴位标记与术后轴位旋转测量技术由传统手动向数字化、大数据算法发展。


关键词: 散光型人工晶状体, 白内障, 散光

Abstract: Toric intraocular lens (Toric IOL) implantation offers advantages such as a wide range of astigmatism correction, high precision, no need for corneal incisions, and long-term stability of postoperative effect, making it the preferred option for treating cataracts with significant preoperative corneal astigmatism. Recent years have witnessed numerous advances in Toric IOL design and clinical application. In terms of haptic design, new configurations including modified C-loop, modified L-loop, square-frosted loop, plate-loop, and double-loop designs have emerged. Regarding materials, acrylic has largely replaced polymethylmethacrylate and silicone; cutting-edge research focuses on hydrophobic treatment of hydrophilic acrylic or introduction of bioactive coatings. For functional design, novel technologies such as aspheric, multifocal, extended depth of focus, and light-adjustable designs have been developed. Clinically, Toric IOL implantation has achieved satisfactory refractive outcomes in patients with irregular astigmatism featuring central regular components, capsular bag defects, non-progressive keratoconus, stable post-penetrating keratoplasty status, and Fuchs endothelial corneal dystrophy without corneal edema. Deeper understanding of posterior corneal astigmatism, along with instruments enabling direct measurement of posterior corneal curvature and astigmatism (e.g., IOLMaster 700, Pentacam) and newer formulas (e.g., Barrett, EVO, Hoffer QST, Kane), has significantly improved Toric IOL power calculation accuracy. Innovations in transscleral suture fixation have enabled astigmatic correction using Toric IOLs in patients lacking capsular support. Preoperative axis marking and postoperative rotational measurement techniques are transitioning from manual to digital and big data-driven approaches.

Key words: Toric intraocular lens, Cataract, Astigmatism