国际眼科纵览 ›› 2025, Vol. 49 ›› Issue (5): 371-377.doi: 10.3760/cma.j.cn115500-20250102-25508

• 综述 • 上一篇    下一篇

白内障手术中的散光矫正

郑汇聪 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:2025-04-04 出版日期:2025-10-22 发布日期:2025-10-16
  • 通讯作者: 万修华,Email: xiuhuawan@163.com
  • 基金资助:
     国家自然科学基金(82171037,82471055);北京市科技新星交叉联合课题(20240484565)

Astigmatism correction in cataract surgery

Zheng Huicong, 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:2025-04-04 Online:2025-10-22 Published:2025-10-16
  • Contact: Wan Xiuhua, Email: xiuhuawan@163.com
  • Supported by:
    National Natural Science Foundation of China (82171037, 82471055); Beijing New-Star Plan Science and Technology Cross Cooperation Project (20240484565)

摘要: 术前散光是白内障手术后视觉体验重要影响因素。术前眼球的生物测量数据的精准采集与手术个性化设计是散光矫正的基础。对于特殊患者如干眼,则需要在稳定泪液后再予以测量以获得更精确结果。目前白内障术中散光矫正有四种常用手段:(1)在角膜陡峭子午线制作透明角膜切口,可以矫正小于1.00 D的角膜散光。(2)周边角膜松解切口可提供1.00~3.00 D角膜散光矫正。当无法使用散光矫正型人工晶状体时,周边角膜松解切口是合理选择。(3)散光矫正型人工晶状体植入术是最优选矫正方法,可矫正0.75~4.00 D的角膜散光。(4)飞秒激光辅助白内障手术通过飞秒激光弓形角膜切开术进行精准、可控的散光矫正。以上这些方法可以单独使用或联合使用。

关键词: 白内障手术, 散光, 透明角膜切口, 周边角膜松解切口, 散光矫正型人工晶状体, 飞秒激光辅助白内障手术

Abstract: Preoperative astigmatism is a key determinant of postoperative visual quality in cataract surgery. Accurate ocular biometry and individualized surgical planning are essential for effective astigmatism correction. For patients with conditions such as dry eye, tear film stabilization prior to measurement is necessary to ensure reliable data acquisition. Currently, four main approaches are commonly employed to correct astigmatism during cataract surgery: (1) Clear corneal incision at the steep meridian, suitable for astigmatism <1.00 D; (2) Peripheral corneal relaxing incision, which provides 1.00-3.00 D of correction and serves as a practical alternative when toric intraocular lens (IOL) is unavailable; (3) Toric IOL implantation, regarded as the most effective method, capable of correcting 0.75-4.00 D of astigmatism; and (4) Femtosecond laser-assisted arcuate keratotomy, offering precise and controllable correction of corneal astigmatism.These techniques may be applied individually or in combination to achieve optimal refractive outcomes.

Key words: Cataract surgery, Astigmatism, Clear corneal incision, Peripheral corneal relaxing incision, Toric intraocular lens, Femtosecond laser-assisted cataract surgery