Operacje wszczepiania torycznych soczewek wewnątrzgałkowych – wyniki badań u pacjentów im poddanych i czynniki wpływające na ostateczny wynik
Intraocular Toric Lens Implantation Surgeries – Results and Factors Influencing Final Outcomes
Ludmiła Popowska1, Yurij Takhtajev2
1Lumed, Ośrodek Mikrochirurgii Okoluxklinik w Opocznie
2 Północno-Wschodni Medyczny Uniwersytet im. I. I. Mecznikova, Sankt Petersburg, Federacja Rosyjska
Kierownik oddziału okulistyki: prof. dr hab. n. med. Jurij Takchtajev
Summary: Purpose: Presentation of visual acuity results before and after the phacoemulsification surgery with implantation of aspheric toric intraocular lens Tecnis ZCT in eyes with low to high corneal astigmatism, in different age groups, monocularly or binocularly and factors influencing final results
Patients and Methods: The surgeries (17 surgeries) were performed from August 2013 till November 2014 in 15 patients (7 male, 8 female), aged 26 to 85 years with low to high grade astigmatism.
During preoperative patient preparation, meridian 0–180 degrees was marked at the slit lamp in sitting position with the insulin needle and topical anaesthesia (0.5% Alcaine).
Prior to anterior chamber opening, the surgeon marks intraocular lens axis according to calculation using sterile set of markers (Asico). Phacoemulsification was performed using Geuder Megatron S4 system with topical anaesthesia. Anterior capsulorhexis of 5.0 to 5.5 mm diameter was performed.
After cataract lens removal, Healon 1% was administered, an intraocular lens was implanted to the capsular bag and rotated to marked position clockwise.
In some patients binocular phacoemulsification was performed with aspherical toric intraocular lens implantation.
Visual acuity for far and near was measured with Snellen’s table before and after the surgery. Then the follow-up visits were scheduled to first day, a week, a month, 3 months and 6 months after the surgery. Presented results are those from last visits.
Visual acuity pre-op was up to 0.6 with correction.
Corneal keratometry, refractometry, optical biometry (IOL Master), corneal topography and fundus and cornea evaluation were performed.
Results: Prior to surgery visual acuity was 0.1 to 0.4 without correction. Higher satisfaction was reported by patients after binocular implantation. Decrease in cylinder value (D) in refractometry by 0.5 D on average was observed, only one patient had 1.75 D. lens rotation below 2 degrees. Corneal keratometry did not show significant changes pre- and post-operatively. After the surgery visual acuity for far vision varied from 0.4 to 0.6 without correction and up to 1.0 with correction.
Conclusions: Tecnis Toric (AMO) intraocular lenses are well tolerated and with proper power and axis calculation provide significant improvement in visual acuity after the surgery. Side effects related to toric lenses were minimal and limited to residual astigmatism in one of the patient due to lack of high cylinder power lens at the time of surgery. Toric intraocular lens implantation improves spatial vision and is a good alternative for glasses and contact lenses. Biggest improvement in visual acuity and in patient satisfaction was observed for patients in age group from 42 to 60 years old.
Słowa kluczowe: zaćma, soczewka Tecnis Toric ZCT AMO, korekcja astygmatyzmu, ostrość wzroku, resztkowy astygmatyzm.
Keywords: cataract, intraocular lens Tecnis Toric ZCT AMO, astigmatism correction, visual acuity, residual astigmatism.