阶梯渐进衍射型多焦点人工晶状体植入术后的临床观察

Clinical evaluation of multifocal intraocular lens implantation

目的观察阶梯渐进衍射型多焦点人工晶状体(ReSTOR MIOL)植入的临床效果。方法收集在我院行晶状体超声乳化白内障摘出联合ReSTOR MIOL植入术连续病例12例(15眼)作为实验组,随机选择同期20例(24眼)植入单焦点人工晶状体(SA60AT)作为对照组。观察手术并发症、术后视力、伪调节幅度及对比敏感度。结果末次随访时的裸眼和矫正远视力后的近视力实验组依次为4.74±0.09,4.72±0.07;对照组依次为4.42±0.10,4.39±0.08,两组差异均有统计学意义(t=6.37,8.12;P=0.00)。实验组调节幅(3.95±0.33)D高于对照组(2.06±1.20)D,差异有统计学意义(t=3.23;P=0.00)。各空间频率对比敏感度组间差异无统计学意义(t=1.29,0.76,-0.14,-1.15,0.33,-0.57,P=0.21,0.47,0.88,0.25,0.71,0.59)。结论ReSTOR MIOL可以为患者提供良好的近视力,不会降低对比敏感度。但其远期效果还需要大样本及更长时间的研究。

Objective To evaluate the clinical efficacy after implantation of ReSTOR muhifocal intraocular lens（mIOL）. Methods 12 patients （15 eyes） who received phacoemulsification with ReSTOR mIOL implantation from 2005.8 to 2006.12 were included in case group. 20 patients （24 eyes） who operated with SA60AT IOL implantation in the same period were included in control group. The complications, contract sensitivity, pseudoaccommodative amplitude were measured. Results No complications occurred in both groups. There were no significant different of the uncorrected distance vision acuity（ UCDVA）, best corrected distance vision acuity（BCDVA） and best corrected near vision acuity （BCNVA） between case group and control group（ t = -0.96, -1.47, 0. 38, P =0.36,0. 16, 0.70）. The uncorrected near vision acuity（ UCNVA） and the distance - corrected near vision acuity（DCNVA） in case group were higher than these of the control group （t = 6. 37, 8. 12, P =0.00） . The mean pseudoaccommodative amplitude in case group were higher than these of the control group （t =3.23 ,P =0.00） . There were no significant different of contract sensitivity between case group and control group. （t = 1.29, 0. 76, - 0. 14, -1. 15,0. 33, -0. 57,P = -0. 21,0.47,0.88,0.25,0. 71, 0.59）. Conclusions ReSTOR mIOL can be implanted easily and safely, and it can increase uncorrected near vision acuity（UCNVA） and the distance -corrected near vision acuity（DCNVA） and improve pseudoaccommodative amplitude after implantation. It still has a longer period to study the far clinical efficacy.