植入可调节人工晶状体和多焦点人工晶状体后视功能的对比研究

The clinical efficacy of accommodative intraocular lens and multifocal intraocular lens in pseudophakic after phacoemulsification

目的比较超声乳化白内障吸除术后植入可调节人工晶状体和多焦点人工晶状体的视功能。方法32例年龄相关性白内障患者根据自愿原则，采用非随机对照方式分成两组，试验组13例患者（24只眼）植入1CU可调节人工晶状体，对照组19例患者（30只眼）植入Array多焦点人工晶状体。术后3个月使用标准对数视力表检测患者最佳矫正视力及在最佳矫正视力基础上获得的近视力、近点及调节幅度、立体视觉。检查结果以年龄作为协变量，进行成组设计定量资料一元协方差分析。结果随诊期间所有患者均无明显的术后并发症。术后3个月试验组最佳矫正视力为4．96±0．15，对照组为5．02±0．08，两组比较差异无统计学意义（P=0．085）。试验组术后最佳矫正视力基础上获得的近视力为4．65±0．15，对照组为4．60±0．10，两组比较差异无统计学意义（P=0．398）。试验组术后主观近点为（56±9）cm，对照组为（61±11）cm，两组比较差异无统计学意义（P=0．80）。试验组术后调节幅度为（1．30±0．40）D，对照组为（1．20±0．36）D，两组比较差异无统计学意义（P=0．093）。试验组术后立体视觉为43．24”±18．25”，对照组为60．00”±23．09”，两组比较差异无统计学意义（P=0．543）。结论植入1CU可调节人工晶状体的患者术后可在保持最佳远视力的同时获得一定的近视力。两种人工晶状体在矫正远视力、远矫下近视力、主观近点、术后调节幅度及近距矫正基础上的立体视觉检查方面均无统计学意义。

Objective To compare the clinical efficacy of accommodative intraocular lens and multifocal intraocular lens in pseudophakic after phacoemulsification. Methods A total of 54 eyes from 32 patients undergoing phacoemulsification received intraccular lens based on the principle of voluntary. Twenty-four eyes from 13 patients [ 16 eyes from 8 male participants and 8 eyes from S female participants, mean age （60. 5 ± 6.3 ） years ] who had implantation of 1CU accommodative intraocular lens were randomized into experimental group. Thirty eyes from 19 patients [18 eyes from 11 male participants and 12 eyes from 8 female participants, mean age （61 ± 6） years] who had implantation of Array multifocal intraocular lens were randomized into control group. All participants were age related cataract patients. Main outcome measures include best corrected distance visual acuity, distance corrected near vision, near point, the accommodation amplitude and stereosis. All the clinical data were obtained at 3 months postoperatively and analyzed of covariance after controlling the factor of age. Results （ 1 ） At 3 months postoperatively, all 1CU lens maintained good centricity. No patients with 1CU had undergone fibrosis, conglutination and remarkable posterior capsule opacification （PCO）. Patients who received Array multifocal intraocular lens had not undergone other complications. （2） At 3 months postoperatively, best-corrected distance visual acuity were similar between the 1CU group and Array group （4.96 ±0. 15 versus 5.02 ±0. 08, P =0. 085）. （3） Distance corrected near vision were similar between the two groups （4. 65 ±0. 15 versus 4.60 ±0. 10, P =0. 398）. （4） Subjective near point were similar between the two groups [ （56 ± 9 ）cm versus （61 ± 11 ） cm, F = 0.065, P = 0. 80 ]. （5） The accommodation amplitude were similar between the two groups [ （ 1.30 ± 0. 40） D versus （ 1.20 ± 0. 36 ） D, P = 0. 093 ]. （ 6 ） Patients with a accommodative intraocular lens achieved significantly better stereosis than patients with muhifocal Intraocular lens （ 43.24＂ ± 18. 25＂ versus 60. 00＂ ± 23.09, P = 0. 543 ）. Conclusions Patients who received 1CU accommodative Intraocular lens demonstrated partial near vision when kept best distance vision. Our research found no significant difference between two groups in corrected distance vision acuity, distance corrected near vision, subjective near point, accommodation amplitude and near vision corrected stereosis.