天津医药

天津医药 ›› 2026, Vol. 54 ›› Issue (8): 858-864.doi: 10.11958/20253708

• 临床研究 • 上一篇    下一篇

CASIA 2测量的晶状体等效直径评估白内障囊袋张力环植入后Toric人工晶状体旋转稳定性

许衍辉1(), 孟克青1, 刘晓静2, 张鑫2, 翟欣然2, 甄宇涵2, 陈志敏1,△()   

  1. 1 河北省眼科医院白内障科， 河北省眼科学重点实验室， 河北省眼部疾病临床医学研究中心（邮编054001）
    2 河北医科大学眼科学教研室
  • 收稿日期:2025-12-24 修回日期:2026-02-24 出版日期:2026-08-15 发布日期:2026-08-07
  • 通讯作者: △E-mail：ykyyczm@126.com
  • 作者简介:许衍辉（1981），女，副主任医师，主要从事白内障及晶状体疾病方面研究。E-mail：XuYH11525@163.com
  • 基金资助:
    邢台市重点研发计划自筹项目(2024ZC132)

Evaluation of the rotational stability of the Toric intraocular lens after cataract capsular tension ring implantation based on the equivalent diameter of the lens measured by CASIA 2

XU Yanhui1(), MENG Keqing1, LIU Xiaojing2, ZHANG Xin2, ZHAI Xinran2, ZHEN Yuhan2, CHEN Zhimin1,△()   

  1. 1 Department of Cataract, Hebei Eye Hospital, Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Clinical Research Center for Eye Diseases, Xingtai 054001, China
    2 Department of Ophthalmology Teaching and Researching, Hebei Medical University
  • Received:2025-12-24 Revised:2026-02-24 Published:2026-08-15 Online:2026-08-07
  • Contact: △E-mail: ykyyczm@126.com

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摘要：

目的 应用眼前节扫频光学相干断层扫描仪CASIA 2测量晶状体等效直径（LE-Dia），并探讨其与高度近视白内障患者囊袋张力环（CTR）植入术后Toric人工晶状体（IOL）旋转稳定性的关系。方法 本研究为一项前瞻性随机对照研究，纳入2023年1月—2024年3月于河北省眼科医院就诊的40例双眼高度近视合并白内障患者（80眼）。采用配对设计，将同一患者的双眼随机分为CTR组与对照组，每组40眼。使用分段线性回归确定LE-Dia影响旋转稳定性的阈值。比较2组术前及术后1周、1个月、3个月、6个月的裸眼视力（UCVA）、最佳矫正视力（BCVA）、晶状体后囊膜与IOL后表面的附着率及IOL旋转度，并分析LE-Dia与术后6个月IOL旋转度的相关性。结果 术后6个月，2组UCVA、BCVA均较术前显著提高（均P<0.05）。CTR组IOL旋转<5°的比例与对照组差异无统计学意义（100% vs. 87.5%，P>0.05），晶状体后囊膜与IOL后表面附着率优于对照组（97.2% vs. 77.8%，P<0.05）。相关性及分段回归分析显示，LE-Dia与IOL旋转度的相关性存在阈值效应：当LE-Dia ≤ 11.0 mm时，无显著相关性（r=0.073，P=0.682，β=1.103，R2=0.005）；当LE-Dia为11.1~11.34 mm时，呈中度正相关（r=0.579，P=0.030，β=15.041，R2=0.335）；当LE-Dia >11.34 mm时，呈强正相关（r=0.712，P<0.001，β=8.903，R2=0.507）。结论 在高度近视白内障眼中，LE-Dia是影响Toric IOL旋转稳定性的关键因素，常规CTR在LE-Dia ≤ 11.0 mm时效果显著，但对LE-Dia>11.34 mm者效果有限，提示需根据LE-Dia测量值选择个体化的囊袋支撑方案。

关键词: 近视, 散光, 体层摄影术, 光学相干, 多焦点人工晶状体, 旋转稳定性

Abstract:

Objective To measure the lens equivalent diameter (LE-Dia) using the anterior segment swept-source optical coherence tomography CASIA 2 and investigate its relationship with the rotational stability of toric intraocular lens (IOL) after capsular tension ring (CTR) implantation in highly myopic cataract patients. Methods This prospective randomized controlled study enrolled 40 bilateral highly myopic cataract patients (80 eyes) who visited Hebei Eye Hospital from January 2023 to March 2024. Using a paired design, both eyes of each patient were randomly assigned to the CTR group and the control group, with 40 eyes in each group. Piecewise linear regression was used to determine the threshold of LE-Dia affecting rotational stability. Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), the attachment rate of the posterior lens capsule to the posterior surface of the IOL and IOL rotation were compared between the two groups before operation and at 1 week, 1 month, 3 months and 6 months postoperatively. The correlation between LE-Dia and IOL rotation at 6 months postoperatively was also analyzed. Results At 6 months after operation, UCVA and BCVA were significantly improved in both groups compared with preoperative values (all P<0.05). There was no significant difference in the proportion of IOL rotation <5° between the CTR group and the control group (100% vs. 87.5%, P>0.05). The attachment rate of the posterior lens capsule to the posterior surface of the IOL in the CTR group was superior to that in the control group (97.2% vs. 77.8%， P<0.05). The correlation analysis and piecewise regression analysis showed a threshold effect in the correlation between LE-Dia and IOL rotation: when LE-Dia ≤11.0 mm, no significant correlation was observed (r=0.073, P=0.682, β=1.103, R2=0.005); when LE-Dia was 11.1-11.34 mm, a moderate positive correlation was found (r=0.579, P=0.030, β=15.041, R2=0.335); when LE-Dia >11.34 mm, a strong positive correlation was observed (r=0.712, P<0.001, β=8.903, R2=0.507). Conclusion In highly myopic cataractous eyes, LE-Dia is a critical factor affecting toric IOL rotational stability. Conventional CTR is effective when LE-Dia ≤11.0 mm, but has limited efficacy when LE-Dia >11.34 mm, suggesting that individualized capsular support strategies should be selected based on LE-Dia measurements.

Key words: myopia, astigmatism, tomography, optical coherence, multifocal intraocular lenses, rotational stability

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