1CU可调节人工晶状体植入术后调节功能的临床观察

Clinical investigation of the accommodating function after 1CU accommodative intraocular lens implantation

目的:观察分析1CU可调节人工晶状体植入术后近远期调节功能变化。方法:对2006/2008年在我院行白内障超声乳化联合1CU可调节人工晶状体植入术后的患者进行前瞻性随访研究2a,定期检测术眼裸眼远、近视力,最佳矫正远、近视力,分别用主觉近点法、离焦法检测术眼调节功能,并观察评价后囊膜混浊的发生。结果:1CU可调节人工晶状体植入术后1mo和6mo均可获得较好的裸眼远、近视力及最佳矫正远、近视力,其差异无统计学意义;术后1a远、近视力均下降,与6mo相比其差异有统计学意义(P<0.05)。近点法和离焦法检测的调节幅度在术后6mo和1a分别为(1.65±0.88)D,(1.78±0.67)D和(1.24±0.66)D,(1.15±0.62)D,其差异有统计学意义(P<0.05),术后2a为(0.92±0.44)D,(0.71±0.37)D,与术后1a相比差异有统计学意义(P<0.05)。发生后发性白内障的病例术后1a约占29%(10/34),术后2a约占47%(16/34)。结论:1CU可调节人工晶状体植入术后早期患者能够获得良好的远近视力及调节力,但随着后发性白内障的发生,术后1a以后远近视力及调节力均呈不同程度的下降,人工晶状体的特殊设计及晶状体材料可能与囊膜纤维化有较为密切的关系。

AIM：To evaluate the short-term and long-term accommodative efficacy of 1CU accommodating intraocular lens （AIOL）. METHODS：This prospective study comprised 26 cases （34 eyes） who underwent phacoemulsification and implantation of 1CU AIOL from 2006 to 2008, and all the cases were investigated for 2 years. The main outcome measures were uncorrected and best-corrected distance and near visual acuity, and amplitude of accommodation with subjective techniques of near point and defocusing. In addition, posterior capsule opacification were assessed.RESULTS： The results of uncorrected, best-corrected distance and near visual acuity, and amplitude of accommodation among 1 and 6 months were good in all cases, and the differences were not statistically significant （P〉0.05）. Distance and near visual performance worsened after 1-year contrast to 6 months （P〈0.05）. Amplitude of accommodation with subjective techniques of near point and defocusing were （1.65±0.88）D,（1.78±0.67）D at 6 months, （1.24±0.66）D, （1.15±0.62）D at one year, （0.92±0.44）D, （0.71±0.37）D at two years, respectively, and the difference were statistically significant （P〈0.05）. Posterior capsule opacifcation were present, respectively, in 29% （10/34） of patients at one year and in 47% （16/34） of patients at two years. CONCLUSION： Patients implanted with 1CU AIOL have good near and distance visual acuity, and amplitude of accommodation during the early term after surgery. But some of them lost their accommodation capacities with time because of the high incidence of posterior capsule opacification. The accommodative lens material and design may have played a role in capsulefibrosis