多焦点人工晶体眼视功能的研究

A study on vision function of multifocal intraocular lens

目的 比较多焦点人工晶体 (MIOL)眼与单焦点人工晶体 (SIOL)眼的视功能状况 ,评价多焦点人工晶体植入的有效性及安全性。方法 从我院住院的老年性白内障患者中选择合适的病例 4 4例 (6 0只眼 ) ,随机分为两组 ,每组 30眼 ,行超声乳化白内障吸出术 ,MIOL组植入AMOArraySA4 0N ,SIOL组植入AllerganSI4 0NB。术后 1d查远、近视力 ,3m对患者进行远、近视力、对比敏感度 (CS)、色觉、立体视锐度、视野等视功能的检查 ,问卷调查视物情况及视觉症状。结果 MIOL眼具有与SIOL眼一样良好的非矫正远视力 (分别为 1 0 0± 0 2 7、 0 89± 0 2 3,P >0 0 5 ) ,非矫正近视力明显优于SIOL眼 (分别为 0 86± 0 2 7、 0 4 5± 0 14 ,P <0 0 5 ) ;两组病人CS在低、中空间频段均位于正常范围内 ,高空间频段则有部分病例稍下降 ,异常率差异无显著性 (P >0 0 5 ) ;双眼植入MIOL近立体视觉优于双眼植入SIOL ;两组病人色觉无异常 ;视野检查均正常 ;多数患者对手术效果满意 ,MIOL组近距离作业满意度高于SIOL组 (85 71%、 34 78% ,P <0 0 5 ) ;脱镜率MIOL组 5 7 14 % ,SIOL组无人能脱镜 ;两组病人视觉症状均较少 (10 0 0 %、 3 33% ,P >0 0 5 )。结论 MIOL植入安全而有效 ,可以提供与SIOL一样良好的远视力 。

Objective Comparing the vision function o f the multifocal intraocular lens(MIOL)eye with monofocal intraocular lens(SIOL)ey e in order to evaluate the effectiveness and safety of the MIOL. Methods In this study,44 senile catar act patients(60 eyes)were devided into two groups randomly:Group MIOL and Gro up SIOL.Each group included 30 eyes.All the patients accepted phacoemulsificat ion and MIOL/SIOL implantation.The MIOL we used is AMO Array SA40N while the SI OL is Allergan SI40NB.Distance visual acuity(DVA)and near visual acuity(NVA) were observed in 1d postoperatively.Vision function including DVA and NVA,con trast sensitivity(CS),color vision,visual field and stereopsis acuity were m easured in 3m postoperatively.Visual symptoms were observed by questionnaire. Results MIOL eye showed excellent DVA as SIOL eye(100± 027 versus 089±023,P>005)and better NVA than the later(086±0 27、045±014,P<005).The CS of both groups were within the reference range and were identical at 15,3 and 6 cpd spatial frequencies.At 12 and 18 cp d,the CS of some cases of the two groups lower than reference range.Patients wit h biltateral MIOL implantaion have better stereoscopic visions than the one with biltateral SIOL implantaion.All the patients′ color vision are good and all th e patients′ visual field are in normal range.Most patients were satisfied with the result of the operation but higher satisfaction was found in MIOL group when near task was asked. Conclusions MIOL is safe and effective.It can provide goo d DVA as the SIOL does,but better NVA and stereoscopic vision,less glasses use a nd higher satisfaction than the latter.