年龄因素对植入可调节人工晶状体临床疗效的影响

To observe dinical effect of accommodative IOL on different age patients

目的探讨不同年龄阶段白内障患者使用可调节人工晶状体的临床疗效。方法为回顾性系列病例研究。分别对54例（54只眼）使用可调节人工晶状体的白内障患者按照年龄分为3组，即〈60岁、60～75岁、〉75岁组，各组患者均为18例，术后3个月进行检查，项目包括：远近视力、可调节度数、制作视远及视近的视标、使用超声活体显微镜（UBM）检查患者的前房情况并测量前房深度。结果3组术后平均远视力的差异无统计学意义（P〉0．05），〉75岁组患者的平均近视力低于其他两组（P〈0．05）；UBM检查结果显示，3组术后平均视远时前房深度差异无统计学意义（P〉0．05），〉75岁组患者视近时前房深度的变化明显低于其他两组（P〈0．05）；〉75岁组患者手术眼人工晶状体平均调节力低于其他两组（P〈0．05）。结论白内障患者可以通过可调节人工晶状体的植入获得良好的远、近视力和二者之间的过渡视力。但是对于年龄〉75岁的患者，使用可调节人工晶状体所获得的调节力明显低于75岁以下的患者。（中华眼科杂志，2008，44：30-32）

Objective To observe clinical effect of accommodative IOL on different age patients. Methods Retrospective case series of fifty-four patients implanted with accommodative IOL were divided into three groups according to their age： 39-60, 60-75 and older than 75 years. Three months after the cataract surgery, distant visual acuity, near visual acuity and defocusing with minus glasses （D） were examined and depth of anterior chamber was measured by ultrasound biomicroscope. Result There were no statistically significant differences in distant visual acuity among these three groups. Near visual acuity in older than 75 group was significantly lower than the other two groups. There were no statistically significant differences in the depth of anterior chamber among these three groups. When patients watched the target moving from 5 meters away to near, the change of depth of anterior chamber in older than 75 group was significantly less than that in the other two groups. Accommodation power in older than 75 group was significantly lower than that in the other two groups as measured by defocusing with minus glass （D）. Conclusion Patients implanted with accommodative IOL can get good distant and near visual acuities. Younger patients may obtain more benefit from accommodative IOL such as obtaining higher accommodative power. （Chin J Ophthalraol , 2008,44：30-32 ）