多焦点折叠式人工晶状体植入术的临床观察

Clinical observation on foldable multifocal intraocular lens

目的探讨ReSTOR多焦点折叠式人工晶状体的临床应用价值。方法将102例(176眼)年龄相关性白内障患者分为多焦点组46例(86眼)植入ReSTOR多焦点折叠式人工晶状体(Multifocal intraocular lens,MIOL)和单焦点组56例(90眼)植入SN60AT单焦折叠式人工晶状体(Singleintraocularlens,SIOL)行超声乳化白内障吸除人工晶状体植入术。检查患者术后的远、近视力、观察配镜情况、人工晶状体及视近调节力,角膜散光。随访时间3至9个月。结果术后3个月,MIOL组裸眼远视力≥0.6占97.67%(84/86),≥1.0占24.42%(21/86),与SIOL组比较差异无显著意义(P>0.05);MIOL组裸眼近视力≥0.6占84.88%(73/86),≥1.0占20.93%(18/86),MIOL明显优于SIOL组(P<0.01)。裸眼远视力≥0.6,同时裸眼近视力≥0.6者,MIOL组39眼,占45.35%;SIOL组3眼占3.33%,两者之间存在显著性差异。MIOL组双眼手术者中13.33%阅读时戴镜,SIOL组88.24%阅读时戴镜。手术源性角膜散光度数为0.32D。两组术后视觉异常症状均不明显;术后晶状体后囊膜混浊,MIOL组5只眼,SIOL组8只眼。结论多焦点人工晶状体植入术可使患者恢复良好的裸眼远近视力。

OBJECTIVE To evaluate the clinical effect of foldable multifocal intraocular lens（MIOL）. METHODS One hundred and two patients（ 176 eyes）with age - related cataract were divided into two groups. Group Ⅰ was the multifocal group：46 cases（86 eyes）,and ReSTOR SA60D3 MIOL was implanted after phacoemulsification; Group Ⅱ was the monofocal group：56 cases（90 eyes） ,and Natural SN60AT monofocal intraocular lens（SIOL）was implanted after phacoemulsification. Postoperative examination included distant and near, uncorrected and bestcorrected visual acuity, pseudoaccommodation and measurement of corneal curvature. Follow- up period ranged from three months to nine months. RESULTS Three months after surgery,97.67 % eyes（84/86）in test group with ReSTOR MIOL had a distance visual acuity ≥ 0.6, and 24.41% （21/86） ≥ 1.0. It was not statistically different from the monofocal group（ P 〉 0.05）. Seventy - two eyes（83.72 % ） in test group had an uncorrected near acuity ≥ 0.5 and 19.77 % （17/86） ≥ 1.0. It was statistically better in the multifocal group compared with the monofocal group（ P 〈 0.01）. In MIOL, the eyes with beth the uncor- rected distance vision ≥ 0.8 and the uncorrected near vision ≥0.5 were in 45.35 %, but in SIOL were only in 3.33 %. The multifocal group was better. （P 〈 0.01）. The rate of wearing spectacles was 13.33 % in test group and 88.24 % in case control group. The surgery - induced astigmatism in test group was 0.31 D, and no visual impairment appeared in beth groups. Posterior capsule opacification was seen in 5 eyes in test group and 8 in case control group. CONCLUSIONS The implantation of multifocal IOL has a good distance uncorrected visual acuity and better near visual acuity.