人工晶体单眼视设计在白内障手术中的应用

The application of pseudophakic monovision in cataract surgery

目的评估白内障复明术中应用人工晶体单眼视(MV)设计患者术后效果和满意度。方法在白内障复明活动中有32例白内障患者选择人工晶状体MV设计,按照传统MV设计,主导眼最终屈光设计为-0.5～0D,非主导眼设计为-1.5～-1.0D。另外选取154例术后双眼裸眼视力均在0.6D以上的患者作为对照,对比两组患者术后屈光状况,双眼裸眼远视力和近视力以及患者满意度和不满意之处。结果 28例患者获得成功的MV设计,双眼裸眼远视力为(0.80±0.16)D(0.6～1.2D),对照组为(0.87±0.19)D(0.6～1.5D),两组间没有统计学差异(P>0.05)。MV设计组双眼裸眼近视力为(0.57±0.17)D(0.3～1.0D),而对照组为(0.38±0.25)D(0.1～0.6D),两组间有统计学差异(P<0.05),人工晶体MV设计组双眼裸眼近视力好于对照组。28例行人工晶体MV设计患者中21例对结果满意,7例患者对结果不满意,而对照组154例患者中138例对结果满意,16例对结果不满意,两组间有统计学差异(P<0.05),人工晶状体MV设计组患者满意度低于对照组。但不满意的原因两组间没有统计学差异(P>0.05)。结论人工晶体MV设计能在不影响双眼裸眼远视力的前提下提高裸眼近视力且给患者提供很多方便,但在白内障复明术中比较难得到较好理解。

Objective To evaluate the visual outcome and patient satisfaction with pseudophakic monovision in sight rehabilitation program of cataract.Methods 32 cataract patients were selected to undergo pseudophakic monovision in cataract surgery of sight rehabilitation program of cataract.The refractive error of the biometry calculation was programmed for -0.5 to 0 D in the dominant eye and -1.5 D to -1.0 D in the nondominant eye as traditional monovision.154 patients underwent binocular cataract surgery during the same period with postoperative uncorrected distant visual acuity more than 0.6 D in each eye were collected as control.Postoperative evaluation included refractive errors,binocular uncorrected distant and near visual acuity as well as patients′satisfaction and complaints.Results 28 patients got desired pseudophakic monovision.Binocular uncorrected near visual acuity of pseudophakic monovision group were(0.57±0.17)D(0.3 to 1.0 D),while the number was(0.38±0.25)D(0.1 to 0.6 D)in contrast group.There was statistics difference between the two groups(P<0.05),and pseudophakic monovision group had better binocular uncorrected near visual acuity than the control group.21 out of 28 were satisfied and 7 had complaints with the results in pseudophakic monovision group,while in control group,138 of 154 patients were satisfied and 16 had complaints.There was statistics difference between the two groups(P<0.05),and pseudophakic monovision group had more dissatisfaction than control group.Conclusions Pseudophakic monovision provides more convenience to cataract patients after surgery in sight rehabilitation program with enhanced uncorrected near vision,but it is hard to do better getting more patients understood in sight rehabilitation program.