方法：采用随机数字表法将本院眼科中心收治的64例84眼老年性白内障合并散光患者分为散光型IOL组33例42眼和球面IOL组31例42眼，散光IOL组采用超声乳化白内障摘除术联合散光型人工晶状体植入术治疗，球面IOL组采用常规颞侧透明角膜切口超声乳化白内障摘除球面人工晶状体植入联合陡峭轴位上一对角膜缘松解切口治疗。观察两组手术前、术后3mo的视力分布、角膜散光度、球镜及柱镜指标(曲率、轴向、小瞳验光球镜、小瞳验光柱镜、散光轴向)的变化情况。

结果：散光型IOL组和球面IOL组在术后第3mo复查裸眼视力，与同组术前比较视力均提高(P<0.05)，术后散光型IOL组和球面IOL组裸眼视力比较，散光型IOL组裸眼视力分布优于球面IOL组(Z=-2.172，P=0.030<0.05)。术后3mo散光型IOL组、球面IOL组患者的角膜散光度与同组患者术前比较减小，差异具有统计学意义(P<0.05)。散光型IOL组和球面IOL组的小瞳验光球镜、小瞳验光柱镜较术前均减小(P<0.05)，散光轴向较术前变化无统计学差异(P>0.05)； 术后3mo散光型IOL组的小瞳验光球镜、小瞳验光柱镜值显著低于球面IOL组(P<0.05)。

结论：老年性白内障合并散光患者采用超声乳化白内障摘除术联合散光型人工晶状体植入具有较好的临床效果。

METHODS:Using the random number table method were enrolled 64 cases(84 eyes)with senile cataract at Eye Center of our hospital, which were divided into the astigmatism IOL group(42 eyes of 33 cases)and the spherical IOL group(42 eyes of 31 cases). The astigmatism IOL group was treated with phacoemulsification with intraocular lens implantation, and the spherical IOL group was treated with conventional temporal clarity cornea incision phacoemulsification and spherical intraocular lens implantation combined with limbal relaxing incisions on steep axial position. Distribution of vision at 3mo pre- and post-operation, astigmatism, the changes of spherical and cylindrical lens indicators(curvature, axial, non-mydriatic refraction spherical, non-mydriatic refraction cylindrical, astigmatism axial)were observed between two groups.

RESULTS:Uncorrected visual acuity of the astigmatism IOL group and the spherical IOL group were follow up to 3mo post-operation, the visual acuity was significantly improved(P<0.05)than that in pre-operation groups. Compared with the spherical IOL group of uncorrected visual acuity after operation, distribution of vision in the astigmatism IOL group was superior than that in the spherical IOL group(Z=-2.172,P=0.030<0.05). Compared with pre-operation groups, the corneal astigmatism was decreased in the astigmatism IOL group and the spherical IOL group at 3mo post-opearation, with statistically significant differences(P<0.05). Non-mydriatic refraction spherical and non-mydriatic refraction cylindrical were decreased after operation(P<0.05), astigmatism axial had no statistically significant differences compared with pre-operation(P>0.05). Non-mydriatic refraction spherical and non-mydriatic refraction cylindrical of the astigmatism IOL group were significant lower than than in the spherical IOL group at 3mo post-operation(P<0.05).

CONCLUSION:Phacoemulsification combined with intraocular lens implantation for senile cataract with corneal astigmatism have a good clinical effect.