多焦点人工晶状体眼早期视觉质量的研究

Early postoperative visual function after multifocal imtraocular lens implantation

目的 :比较多焦点人工晶状体 (MIOL)与单焦点人工晶状体 (SIOL)植入术后早期患者的视觉质量改变 ,评价多焦点人工晶状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病例 4 4例 (6 0只眼 ) ,随机分为两组 ,每组 30只眼 ,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 1天查远、近视力 ,3个月对患者进行远、近视力、对比敏感度 (CS)、色觉、视野及拟调节力等视功能的检查 ,问卷调查视物情况及视觉症状。结果 :MIOL眼具有与SIOL眼一样良好的裸眼远视力 ,两组分别为 1 0 0± 0 2 7、0 89± 0 2 3(P >0 0 5 ) ,裸眼近视力MIOL眼明显优于SIOL眼 ,分别为 0 86± 0 2 7、0 4 5± 0 14 (P <0 0 5 ) ;两组患者的CS在低、中空间频段均位于正常范围内 ,高空间频段均有部分病例稍下降 ,异常率两组的差异无显著性意义 (P >0 0 5 ) ;两组患者的色觉无异常 ;自动视野计检查发现MIOL组 1例 (1只眼 )视野缺损 ,其余患者视野正常 ;MIOL眼焦深大于SIOL眼 ,分别为 +1 0D～ - 3 5D、+1 0D～ - 1 0D ;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 ) ;近用镜脱镜率MIOL组 5 7 14 % ,SIOL组无人能脱镜 ;两组患?

objective:comparing the early postoperative visual function of the eyes implanted with multifocal intraocular lens (miol) and those with monofocal intraocular lens (siol) in order to evaluate the effectiveness and safety of the miol.methods:44 senile cataract patients (60 eyes) were divided into two groups randomly:group miol and group siol.each group included 30 eyes.all the patients accepted phacoemulsification and miol/siol implantation.the miol was amo array sa40n while the siol was allergan si40nb.distance visual acuity (dva) and near visual acuity (nva) were observed at 1 day postoperatively.visual functions including dva,nva,contrast sensitivity (cs),color vision,visual field and pseudoaccommodation were measured at 3 month postoperatively.visual symptoms were obtained from questionnaire.results:miol eyes showed excellent dva as siol eyes (1.00±0.27 versus 0.89±0.23, p >0.05) and better nva than the latter (0.86±0.27 versus 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 cpd,the cs of some cases of the two groups lower than reference range.all the patients color vision were good and all the patients' visual fields were in normal range except for one case (1 eye) having defect in the nasal inferior quadrant because of retinal vascular disease.miol provided better pseudoaccommodation than siol,the depth of focus were +1.0d～-3.5d and +1.0d～-1.0d respectively.most patients were satisfied with the result of the operation but higher degree of satisfaction was found in miol group when near task was asked.conclusion:miol is safe and effective.cs of miol is not different from that of siol.it can provide good dva as the siol do,but better nva,less near glasses use and higher degree of satisfaction than the latter.