Transcript PowerPoint

Comparison of Visual
Outcomes With Toric IOL and
With Limbal Relaxing Incisions
in Cataract Surgery
Eriko Fukuyama, MD
Fukuyama Eye Clinic
Fukuoka, Japan
The author has no financial interest in the subject matter of this e-poster.
Purpose
• To compare visual outcomes between a
toric intraocular lens (IOL) and limbal relaxing
incisions (LRIs) to correct preexisting
astigmatism in patients having cataract
surgery.
Methods
• This prospective study compared the
results of bilateral cataract surgery with
implantation of a AcrySof IQ Toric IOL in one
eye (group A) and with implantation of a
AcrySof IQ IOL with LRIs in a fellow eye
(group B). Outcome measures were
refraction and corneal astigmatism measured
using keratometory and topography,
uncorrected (UDVA) and corrected (CDVA)
distance visual acuities.
手術方法2
• LRIsの方法
– 切開の深さ:年齢や角膜中心厚に応じて450μm
もしくは500μm
– 切開の長さ:福山LRIノモグラムにより決定
[倒乱視]
[直乱視]
乱視矯正目標
(D)
切開長
乱視矯正目標
(D)
切開長
0.75
30°
0.75
60°
1.00
45°
1.00
70°
1.50
60°
1.50
80°
2.00
75°
2.00
90°
3.00
90°
3.00
120°
4.00
120°
4.00
120°、切開の深さ+50μm
Results(抄録提出時)
• The study comprised 16 patients (32 eyes). They
had astigmatism more over 1.00 dioptor in their both
eyes. The mean corneal astigmatism measured by
keratometer before the surgery was 1.76 dioptors in
group A and 1.87 dioptors in group B. After the
treatment, the mean corneal astigmatism was 1.86
dioptors in group A and 0.42 dioptors in group B, and
the mean refraction astigmatism was 0.63 dioptors in
group A and 0.38 dioptors in group B at three months
after the surgery.
• The UDVA and CDVA were similar in both groups.
The corneal shape measured by topography was
stabilized earlier in group A than in group B.
Results(改変用)
• The study comprised 20 patients (40 eyes). They
had astigmatism more over 1.00 dioptor in their both
eyes. The mean corneal astigmatism measured by
keratometer before the surgery was 1.89 dioptors in
group A and 1.73 dioptors in group B. After the
treatment, the mean corneal astigmatism was 1.89
dioptors in group A and 0.81 dioptors in group B, and
the mean refraction astigmatism was 0.73 dioptors in
group A and 0.51 dioptors in group B at six months
after the surgery.
• The UDVA and CDVA were similar in both groups.
The corneal shape measured by topography was
stabilized earlier in group A than in group B.
角膜乱視の経時変化 (ケラトメーター)
2.5DD
T-IOL
LRI s
**
2
**:
両群間に有意差有
ウィルコクソンの
順位和検定
P<0.02
1.5
1
術前は
両群間に有意差無
ウィルコクソンの
順位和検定
0.5
0
Pre
1M
3M
6M
術後
両群共
n=20
TMS™による術前-術後の乱視変化
角膜形状解析装置TMS™では2つのマップ間の角膜形状解析値の引き算ができる
これを用いると術前から術後へと変化した乱視度数を求めることができる
術前と術後6Mの乱視の比較
T-IOL
LRIs
(D)
(D)
4.0
自
覚
屈
折
乱
視
(
術
後
6
自
覚
屈
折
乱
視
(
術
後
6
M
)
3.5
3.0
2.5
2.0
M
1.5
)
1.0
0.5
(n=20)
(n=20)
0.0
(D)
角膜乱視(術前)
0.0
0.5
1.0
1.5
2.0
2.5
角膜乱視(術前)
3.0
3.5
4.0 (D)
LRIsとT- IOL
LRIs
T- IOL
裸眼視力の向上
○
○
角膜乱視の矯正
○
△
非対称性乱視の矯正
○
△
2D以上の乱視矯正
○
△
術後角膜形状の早期安定
△
○
合併症
△
○
Conclusion
• Both a toric IOL and LRIs are useful to
correct preexisting astigmatism in patients
having cataract surgery. A toric IOL excels
LRIs in the early stabilization of the corneal
shape.
KEYWORDS
• toric intraocular lens
• limbal relaxing incisions
• astigmatism management