Tetraflex可调节人工晶状体临床应用的初步观察

Clinical research of accommodating intraocular lens

目的观察白内障超声乳化联合囊袋内可调节人工晶状体植入术的效果。方法病例对照研究。全部患者行白内障超声乳化联合囊袋内人工晶状体植入术，根据植人人工晶状体的不同分为试验组：22例（30只眼）植入可调节人工晶状体，对照组：22例（29只眼）植入单焦点人工晶状体。观察并记录术后6个月和12个月时术眼远、近视力，主观调节幅度，应用OCULUS Pentacam三维前段分析仪测量2％毛果芸香碱眼液诱导前后的前房深度变化值。各观察指标数据以均数±标准差表示。使用SPSS13．0软件对数据进行分析。采用两组独立样本t检验比较两组各观察指标，以P〈0．05为差异有统计学意义。结果术后随访期间，试验组患者的裸眼近视力和最佳远视力矫正后的近视力与对照组患者相比，有统计学差异（P=0．000），两组患者的最佳矫正视力差异无统计学意义（P〉0．05）；术后6个月时，应用主观移近法测得的主观调节幅度，试验组为（1．60±0．57）D，对照组为（1．10±0．70）D。前房深度变化值试验组为（0．50±0．37）mm，对照组为（0．08±0．06）mm。术后12个月时，应用主观移近法测得的主观调节幅度，试验组为（1．38±0．52）D，对照组为（1．06±0．61）D。前房深度变化值试验组为（0．30±0．27）mm，对照组为（0．10±0．09）mm。结论与传统的单焦点人工晶状体相比，Tetraflex可调节人工晶状体可以为患者提供较好的近视力和主观调节幅度，但远期疗效有下降趋势。

Objective To assess the visual outcomes and accommodative amplitude of accommodating intraoeular lens （ AIOL）. Methods Case control study. Thirty eyes of 22 patients with cataracts had undergone phacoemulsification and implantation of AIOL. Twenty nine eyes of 22 age- and sex- matched patients with cataracts had the same surgery but foldable acrylic IOL were used as the controls. All patients were assessed for accommodation amplitude, visual acuity and for change of anterior chamber depth （ACD） at 6 and 12 months after surgery. Accommodation amplitude was measured using the pushing-up test. The change of ACD was measured with OCULUS Pentacam analysis system. Results During the follow-up time, the patients in the test group had better uncorrected near vision acuity （ UCNV ） and distance corrected near vision acuity （ DCNVA ） （ P = 0. 000）. The test group had the same corrected vision acuity as the control group. Six months after surgery, push-up test showed that the mean accommodative amplitude was （ 1.60 ±0. 57） D in the test group and （ 1.10 ±0. 70） D in the control group. The change of the ACD was （0. 50±0. 37） mm in the test group and （0. 08 ± 0. 06 ）mm in the control group. Twelve months after surgery, push-up test showed that the mean accommodative amplitude was （1.38 ± 0. 52 ） D in the test group and （1.06 ±0. 61 ） D in the control group. The change of the ACD was （0. 30 ±0. 27） mm in the test group and （0. 10 ±0. 09） mm in the control group. Conclusions In the present study, the Tetraflex AIOL showed greater accommodative amplitude and better near visual acuity than those of the control group with conventional IOL But 6 months later, all of these measurements in the test group were decreased.