AcrySof ReStor临床应用多焦点人工晶状体的

Clinical application of AcrySof ReStor multifocal intraocular lens

目的比较AcrySof ReStor多焦点人工晶状体（MIOL）眼与AcrySof-片式单焦点人工晶状体（SIOL）眼的视功能状况，了解多焦点人工晶状体植入的有效性及安全性。方法本文是非随机、对照临床实验。在我院行超声乳化白内障吸除术的患者中，22例（30只眼）植入ReStor MIOL（观察组），20例（30只眼）植入AcrySof SIOL（对照组）。观察患者的术后远、近视力，角膜散光度数，手术并发症，问卷形式调查脱镜率、视觉不良症状和满意度，随访时间3～14个月。对计数资料采用X^2检验，计量资料采用t检验。结果术后3个月裸眼近视力／〉0．5者，观察组占86．7％（26／30），≥1．0者占66．7％（20／30），对照组分别占33．3％（10／30）和0％（0／30），两组比较差异有统计学意义（X^2=17．78，21.82；P〈0．05）；裸眼远视力、最佳矫正近视力和远视力两组比较，差异均无统计学意义（X^2=0．13，0．35，0．35；P〉0．05）。术前、术后1周、1个月、3个月两组角膜散光度数比较，差异均无统计学意义（t=-0．46，-0．47，-0．44，-0．48；P〉0．05）。脱镜率：观察组86．7％（26／30），对照组13．3％（4／30），差异有统计学意义（X^2=32．3；P〈0．05）。观察组近距离视物满意度86．7％（26／30），高于对照组13．3％（4／30），差异有统计学意义（）（2=32．3；P〈0．05）。观察组2例（2只眼）出现糖皮质激素性高眼压，对照组1例（1只眼）因后发性白内障行激光晶状体后囊膜切开术。结论MIOL可为患者提供良好的远、近视力，86．7％的患者可脱掉眼镜，提高了患者的生活质量。

Objective To study the results of using AcrySof ReStor multifocal intraocular lens （MIOL） after the cataract operation. Methods It was a non-random comparative clinical study. After the small incision phacoemulsification, AcrySof ReStor MIOL was inserted into the eye in 22 cases （30 eyes, observed group） ;single focal intraocular lens （SIOL） was inserted in 20 cases （30 eyes, control group）. Visual acuity, corneal astigmatism, operative complications, spectacles independence, patient satisfaction and untoward visual symptoms were observed. The follow up period was 3 - 14 months. Results Patients with uncorrected near visual acuity 0. 5 or better accounted for 86. 7% （26/30） in the observed group and 33.3% （10/30） in the control group, respectively. There was a significantly statistical difference between these two groups 3 months postoperatively （ X^2 = 17. 78, P 〈 0.05 ）. Patients with uncorrected near visual acuity 1.0 or better accounted for 66. 7 % （20/30） in the observed group and 0% （0/30） in the control group. There was a significantly statistical difference between these two groups 3 months postoperatively （X^2 =21.82,P 〈0. 05）. There was no statistically significant difference in the corrected near and distant visual acuities and uncorrected distant visual acuity between these two groups （X^2 = 0. 13,0. 35,0. 35 ;P 〉 0. 05）. There was no statistically significant difference in preoperative corneal stigmatism and corneal astigmatism 1 week, 1 month and 3 months after the operation between these two groups （ t = - 0. 46, - 0. 47, -0. 44, -0. 48 ;P 〉0. 05）. Spectacles were not necessary in 86. 7% （26/30） and 13. 3% （4/30） cases in observed and control groups, respectively. In the observed group, glucocorticoid-induced high ocular pressure occurred in two eyes. One eye required Nd： YAG laser posterior capsulotomy in the control group. Conclusions AcrySof ReStor MIOL implantation provides a better distant and near vision, spectacles are not required in 86. 7% cases and the life quality is improved.