1CU可调节人工晶状体的临床应用研究

Clinical study of the 1CU accommodating intraocular lens

目的评价ICU可调节人工晶状体植入术的临床效果。设计回顾性病例系列。研究对象单纯老年性白内障患者65例(78眼),按照植入的人工晶状体类型分为可调节人工晶状体(ICU)组和单焦点人工晶状体(SA60AT)组。方法入选患者均行白内障超声乳化吸除术,分别植入ICU可调节人工晶状体(32例38眼)或单焦点人工晶状体(33例40眼)。所有患并术后1天、1周、1个月、3个月常规行裂隙灯、屈光、裸眼及矫正远视力和近视力检查。术后3个月检查调节幅度及2%毛果芸香碱滴眼前后的前房深度主要指标裸眼及矫正远视力和近视力,凋节幅度。结果术后两组均可获得良好的裸眼远视力及矫正远视力(视力均>0.7),ICU组裸眼近视力(0.3～0.6)明显好于传统单焦点组(0.1～0.3)。动态检影法ICU组的调节幅度为(2.10±0.45)D,单焦点组为(0.65±0.32)D,两者比较后异有统计学意义(P=0.000)滴2%毛果芸香碱后前房深度变浅,两组分别为(0.65±0.20) mm和(0.18±0.14)mm,两组比较差异有统计学意义(P=0.000)。结论植入ICU可调节人工晶状体安全有效,与传统单焦点组相比,ICU可调节人工晶状体可提供更好的近视力。(眼科,2008,17:98-100)

Objective To assess the clinical outcome after implantation of the 1CU accommodating intraocular lens （IOL）. Design Retrospective case series. Participants Consecutively 78 eyes selected from 65 senile cataract patients were divided into two groups by their type of IOL according to their desire： accommodating groups（1CU） or monofocal groups（SA60AT）. Methods 38 eyes of 32 cataract patients had phacoemulsifieation implantation of 1CU accommodating IOL. 40 eyes of 33 age-matched cataract patients had the same surgery but with a conventional monofocal IOL. Patients were examined at 1, 7, 30 and 90 postoperative days. All patients had assessments of slit lamp microscopy, refraction, uncorrected and best corrected distant and near visu.,d acuities. The amplitude of accommodation, anterior chamber depth （ACD） before and ＇after application of 2% pilocarpine were examined at 90 postoperative days. Main Outcome Measures Uncorrected and best corrected distant and near visual acuities, the amplitude of accommodation. Results Postoperatively, both groups had excellent uncorrected distant acuities, and best c, orrected distant acuities （〉0.7）. The mean uncorrected near visual acuity was significantly better in the ICU group （0.3-0.6, average 0.39）than in the conventional monofocal IOL group （0.1-0.3, average 0.16）. The retinoscopic accommodative range was （2.10±0.45） D in 1CU group and （0.65±0.32）D in monofocal IOL group （P= 0.000）. The mean ACD decrease （ram） was 0.65±0.20 and 0.18±0.14 after pilocarpine 2% eyedrops. The differences between the groups were statistically significant （P=0.000）. Conclusion The 1CU accommodating IOL is safe and effective. It can provide better useful near visual acuity than conventional monofocal IOL.