白内障超声乳化术后两种人工晶体植入效果比较

Comparative study of intraocular lenses in eyes after cataract phacoemulcification

目的比较蓝光滤过型AcrysofNatural(SN60AT)和一片式Acrysof(SA60AT)人工晶体植入的临床效果,探讨两者的区别。方法选取本院2004年10月至2005年2月住院白内障患者44例(44眼)随机分2组。Ⅰ组为24例(24眼),透明角膜切口,超声乳化后用推注器植入AcrysofNatural人工晶体;Ⅱ组为20例(20眼),同样手术方法植入一片式Acrysof人工晶体。其中1例左眼为AcrysofNatural人工晶体,右眼为一片式Acrysof人工晶体。术后1d、1周、1月、2月、3月、6月观察其中心视力,对比敏感度,色觉,稳定性,后囊混浊,后囊皱褶等。结果2组患者术后裸眼视力达0.8以上的分别为58.3%和55.0%。裸眼视力0.5%以上者分别为95.8%和93.5%,差异无显著性(P>0.05)。对比敏感度Ⅰ组较Ⅱ组在高频率点(12.0cpd),低频率点(1.5,3.0cpd)有提高,差异有显著性(P<0.05),色觉差异无显著性。术后无1例发生色素膜炎反应,后囊皱褶发生率为4.2%和5.0%,暂未发现明显后发障。结论两种人工晶体均有很好的光学特性及稳定性。AcrysofNatural没有因为加入一些新的成分而增加后发障的发生,添加的色素基团使整个植入过程更容易观察。

Objective To evaluate the postoperative outcomes between blue-light filtering Arcysof Natural （SN60AT） and conventional UV-absorbing single-piece Arcysof （SA60AT）. Methods Fifty-four eyes of 44 senile-cataract patients in Eye Center of Tianjin Medical University from October, 2004 to February, 2005 were randomly divided into two groups. Group Ⅰ included 24 eyes （24 patients） implanted with Arcysof Natural IOL after clear corneal incision phacoemulcification and group Ⅱ included 20 eyes （20 patients） implanted with Arcysof single-piece IOL in the same way. One of these patients received Arcysof Natural IOL in the left eye and Arcysof single-piece IOL in the right eye. Visual acuity, contrast sensitivity, color perception, eentration, stability, posterior capsular opacification （PCO） and pbsterior capsular winkle were investigated on days 1,7,30,60,90,180 after surgery respectively. Results 14 eyes （58.3%） attained uncorrected visual acuity （UCVA） of 0.8 or better in group Ⅰ and 11 eyes （55%） in group Ⅱ. 23 eyes （95.8%） attained UCVA of 0.5 or better in group Ⅰ and 19 eyes （93.5%） in group Ⅱ. There was no significant differences in visual acuity and color perception between the two groups, while there was a significant difference in contrast sensitivity between two groups. No case complicated uvitis. The incidence of posterior capsular winkle was 4.2 % and 5 % in two groups respectively. No PCO was found. Condusion Both lenses have high quality in optics, centration and stability. The new integration of Arcysof Natural dosen＇t increase the incidence of PCO and the added chromophore makes the lens easier to be seen during the implantation process.