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首页> 外文期刊>BMC Ophthalmology >Correction of irregular and induced regular corneal astigmatism with toric IOL after posterior segment surgery: a case series
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Correction of irregular and induced regular corneal astigmatism with toric IOL after posterior segment surgery: a case series

机译：后路手术后复曲面人工晶状体矫正不规则和诱发性规则角膜散光：一个病例系列

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Background Toric intraocular lens (IOL) implantation can be an effective method for correcting corneal astigmatism in patients with vitreoretinal diseases and cataract. Our purpose is to report the outcome of toric IOL implantation in two cases - a patient with scleral-buckle-induced regular corneal astigmatism and a patient with keratoconus following pars plana vitrectomy. As far as we are aware, there are no reported cases of toric IOL implantation in a vitrectomized eye with keratoconus nor of toric IOL implantation in patients with scleral-buckle-induced regular corneal astigmatism. Case presentation Two patients with myopia and high corneal astigmatism underwent cataract operation with toric IOL implantation after posterior segment surgery. Myopia and high astigmatism (>2.5 diopter) were caused by previous scleral buckling in one case and by keratoconus in the other case. Pre- and postoperative examinations during the follow-up of included uncorrected and spectacle corrected distance visual acuity (UCDVA/CDVA), automated kerato-refractometry (Topcon), Pentacam HR, IOL Master (Zeiss) axial length measurements and fundus optical coherence tomography (Zeiss). One year postoperatively, the UCDVA and CDVA were 20/25 and 20/20 in both cases, respectively. The absolute residual refractive astigmatism was 1.0 and 0.75 Diopters, respectively. The IOL rotation was within 3° in both eyes, therefore IOL repositioning was not necessary. Complications were not observed in our cases. Conclusion These cases demonstrate that toric IOL implantation is a predictable and safe method for the correction of high corneal astigmatism in complicated cases with different origins. Irregular corneal astigmatism in keratoconus or scleral-buckle-induced regular astigmatisms can be equally well corrected with the use of toric IOL during cataract surgery. Previous scleral buckling or pars plana vitrectomy seem to have no impact on the success of the toric IOL implantation, even in keratoconus. IOL rotational stability and refractive predictability in patients with a previous vitreoretinal surgery can be as good as in uncomplicated cases.
机译：背景复曲面人工晶状体（IOL）植入术可能是纠正玻璃体视网膜疾病和白内障患者角膜散光的有效方法。我们的目的是报告两种情况下复曲面人工晶状体植入的结果-巩膜扣引起的常规角膜散光患者和平面玻璃体切除术后圆锥角膜患者。据我们所知，尚无报道圆锥角膜玻璃体切除术的眼睛植入复曲面IOL以及巩膜扣引起的规则性角膜散光的复曲面IOL的病例。病例介绍两名近视眼和高度角膜散光的患者在后段手术后接受了白内障手术，并植入了复曲面人工晶体。近视和高度散光（> 2.5屈光度）是由先前的巩膜屈曲引起的，另一例是圆锥角膜引起的。随访期间的术前和术后检查包括未矫正和眼镜矫正的远视力（UCDVA / CDVA），自动角膜屈光计（Topcon），Pentacam HR，IOL Master（Zeiss）轴向长度测量和眼底光学相干断层扫描（蔡司）。术后一年，两种情况的UCDVA和CDVA分别为20/25和20/20。绝对残余屈光散光分别为1.0和0.75屈光度。两只眼睛的IOL旋转均在3°以内，因此无需重新定位IOL。在我们的病例中未观察到并发症。结论这些病例表明，在不同来源的复杂病例中，复曲面人工晶状体植入术是矫正高度角膜散光的一种可预测且安全的方法。在白内障手术期间使用复曲面IOL可以同样很好地矫正圆锥形圆锥角膜或角膜巩膜扣引起的规则性散光。既往在圆锥角膜上，先前的巩膜屈曲术或平面pars玻璃体切除术似乎对复曲面IOL植入的成功没有影响。先前进行过玻璃体视网膜手术的患者的IOL旋转稳定性和屈光可预测性与未发生并发症的患者一样好。

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