多焦点人工晶状体植入术后早期双眼视觉分析

Study of binocular function in early stage after implantation of multifocai intraocular lens

目的研究多焦点人工晶状体（MIOL）植入术后早期患者的双眼视觉恢复情况。方法31例（46只眼）白内障患者植入MIOL作为MIOL组，其中单眼手术16例，设为Ms组，双眼手术15例，设为Md组。32例（47只眼）白内障患者植入单焦点人工晶状体（SIOL）作为SIOL组，其中单眼手术17例，设为Ss组，双眼手术15例，设为Sd组。术后3周，观察患者的双眼视觉即同视功能、融合功能及远、近距离立体视功能及视力、视觉症状等。结果全部患者具有良好的同视功能及融合功能，两组比较差异均无统计学意义（P〉0．05）。具有远距离立体视功能者MIOL组占38．7％（12／31），SIOL组占40．6％（13／32），两组比较差异无统计学意义（P〉0．05）。具有近距离立体视功能者MIOL组占41．9％（13／31），SIOE组占15．6％（5／32），两组比较差异有统计学意义（P〉0．05）。Ms与Md、Ss与Sd比较远、近距离立体视功能差异均无统计学意义（P〉0．05）。仅2例（6．5％）单眼植入MIOL患者诉夜间出现眩光症状，其他患者均无明显不适，满意程度较高。MIOL组80．6％（25／31）、SIOL组56．2％（18／32）患者诉用餐夹菜、冲热水壶、上下楼梯等立体视觉明显改善，两组比较差异有统计学意义（P〉0．05）。结论MIOL植入术后早期患者立体视功能已达到老年人正常水平；且单眼与双眼植入立体视功能恢复相当。近距离立体视功能MIOL组较SIOL组恢复快。MIOL在为患者提供良好的全程视力及立体视功能方面具有明显优势。

Objective To evaluate binocular function in the early stage after implantation of multifocal intraocular lens. Methods Three weeks postoperatively, simultaneous perception, fusion, near and far-distance stereoacuity, visual acuity and visual symptoms were observed in 31 cases （46 eyes） with mulfifocal intraocular lens implantation （MIOL） [ MIOL group, in which 16 cases with unilateral implantation （Ms） and 15 cases with bilateral implantation （Md）] and 32 cases （47 eyes） with single- focal intraocular lens implantation（SIOL） [ SIOL group, in which 17 cases with unilateral implantation （Ss） and 15 cases with bilateral implantation （Sd） ]. Results All patients obtained simultaneous perception and fusion sense, there was no significantly statistical difference between these two group （ P 〉 0. 05 ）. Foveal far-distance stereoacuity was established in 38.7% cases among MIOL group（ 12/31 ）and 40.6% in SIOL group （13/32）, with no statistically significant difference between these two groups （P 〉 0. 05 ）. Foveal near-distance stereoacuity was established in 41.9% MIOL cases （ 13/31 ） and in 15.6% SIOL group （5/32） , the difference was statistically significant （ P 〈 0. 05 ）. Foveal near and far-distance stereoacuity of either Ms and Md or Ss and Sd revealed no significantly statistical difference （ P 〉 0. 05 ）. Two patients （6.5%） with MIOL in only one eye complained glare at night, others were satisfied. The stereopsis visual performance such as the quality of vision during eating, up-and-down stairs was improved in MIOL group [ 80. 6% （25/31） ] and in SIOL group [ 56. 2% （18/32） 1, the difference was statistically significant （P 〈 0. 05）. Conclusions There is a complete recovery of binocular vision in the early post-operative stage of MIOL implantation as compared with the normal value of aged people. Foveal near and far-distance stereoacuity after bilateral and unilateral implantation of either MIOL or SIOL revealed no statistically significant difference. Foveal near-distance stereopsis acuity of MIOL group was improved more quickly than that of SIOL group. MIOL has distinct advantage in providing whole-distance visual acuity and stereoacuity.