Clinical Study Of Toric Intraocular Lens In The Treatment Of Cataract With Corneal Astigmatism

Objective: To compare the residual astigmatism,corneal astigmatism,IOL degree and accuracy of implantation and postoperative visual quality after steep axial and non steep axial clear corneal incision implantation in Toric IOL.To evaluate the rotation stability and influencing factors of Toric IOL implantation one year after implantationMethods According to the incision position,Patients were divided into two groups: steep axial incision group and non steep axial incision group,30 cases(30 eyes).Visual acuity,astigmatism and corneal astigmatism in 1 groups were compared between two groups at 1 and 3 months after operation.The Toric IOL axis deviation,Toric IOL rotation degree and visual quality after 3 months were compared.Retrospective study.1 years after cataract phacoemulsification and Toric IOL implantation,305cases(392eyes)were excluded.After 1 years the uncorrected visual acuity of UCVA,BCVA,residual astigmatism,record Toric IOL and the degree of rotation of anterior capsule fibrosis fully after pupil dilation(anterior capsular opacification,ACO).SPSS22.0 software was used in statistical analysis,and the difference was statistically significant in P<0.05.Results: Two groups of postoperative uncorrected visual acuity(uncorrected visual,acuity,UCVA)and best corrected visual acuity(best-corrected visual,acuity,BCVA)were significantly increased(P<0.05),the two groups after 1 months and 3 months,there was statistical difference in residual astigmatism deviation(P<0.05).Corneal astigmatism in steep axial incision group decreased significantly(P<0.05)at 1 and 3 months after operation.In addition,more of the non steep axial groups changed into irregular corneal astigmatism,which was significantly increased compared with the steep axial incision group(P=0.004).PSF and MTF of steep axial incision group was significantly better than non steep axial incision group(P<0.05),and the root mean square of total HOAs,total ocular higher-order aberrations and ocular trefoil and Clover difference were significantly less than that of the latter(P<0.05).After 1 year,In T3 and T4 groups,the degree of rotation of Toric IOL was significantly correlated with the magnitude of residual astigmatism(Pearson correlation analysis: T3 group,r=0.552,P<0.001,T4 group,r=0.622,P=0.003).Further analysis of IOL rotation factors significantly correlated with axial length(Pearson analysis,r=0.335,P=0.003),grading was negatively correlated with ACO(Spearman correlation analysis,P=-0.541,P<0.001).Multiple linear regression analysis showed that the ocular axis and ACO classification were independent factors of IOL rotation(P=0.031 and P<0.001,R2=0.397).Conclusion Corneal steep axial incision is a good predictor of the effect of astigmatism correction,and it can partially ascertain corneal astigmatism,reduce Toric IOL column lens degree and barely cause irregular astigmatism.It can improve the accuracy of the Toric IOL implantation and the corneal optical quality and overall visual quality,and may be the ideal incision for the implantation of Toric IOL.Long axis is a rotation of the Toric IOL risk factors.Increasing the degree of ACO could reduce Toric IOL rotation,so reducing the anterior capsule polishing may help reduce the Toric IOL rotation,but it still need further prospective studies to verify.