后发性白内障及Nd：YAG激光后囊膜切开对1CU可调节人工晶状体调节功能的影响

Effect of posterior capsular opacification and Nd：YAG laser capsulotomy on the accommodative function of the ICU accommodative intraocular lenses

目的探讨后发性白内障及Nd：YAG激光后囊膜切开术对1CU可调节人工晶状体调节功能的影响。方法回顾性病例研究。收集20例（24眼）白内障超声乳化联合1CU可调节人工晶状体植入术后发生后发性白内障的患者，分别于人工晶状体植入术后3个月、Nd：YAG激光后囊膜切开术前1d、Nd：YAG激光后囊膜切开术后3个月随访，检测裸眼远视力、最佳矫正远视力（5m），以及远视力矫正下的中（50cm）、近距离视力（33cm），并分别用主觉近点法、离焦法检测术眼调节幅度。各时期的检测数据用重复测量资料的方差分析进行检验。结果1CU可调节人工晶状体植入术后3个月、行Nd：YAG激光后囊膜切开术前1d、切开术后3个月，术眼裸眼远视力（F=108．87，P〈0．01）、最佳矫正远视力（F=116．97，P〈0．01）、远视力矫正下的中距离视力（F=79．89，P〈0．01）、远视力矫正下的近视力（F=118．84，P〈0．01），以及近点法和离焦法检测的调节幅度（F=81．78，P〈0．01）差异均有统计学意义。行Nd：YAG激光后囊膜切开术前1d均较植入术后3个月时降低，Nd：YAG激光后囊膜切开术后3个月，远、中、近距离视力及调节幅度明显改善，其差异均有统计学意义。2种调节幅度检查方法测量值之间的差异无统计学意义（F=0．272。P〉0．05）。结论后发性白内障的发生使1CU可调节人工晶状体植入术后术眼调节功能明显下降．Nd：YAG激光后囊膜切开术后术眼调节功能恢复。

Objective To evaluate the effect of posterior capsular opacification and Nd：YAG laser capsulotomy on the accommodative function of the 1CU accommodative intraocular lens （1CU AIOL）. Methods This was a retrospective study. Twenty patients （24 eyes） with posterior capsular opacification after phacoemulsification and implantation of an 1CU AIOL were included in the study. Uncorrected distance visual acuity, best corrected distance visual acuity （5 m）, distance corrected intermediate visual acuity （50 cm）, distance corrected near visual acuity （33 cm）, and amplitude of accommodation with subjective techniques of near point and defocusing were measured at 3 months after ICU AIOL surgery, 1 day before Nd：YAG laser capsulotomy and 3 months after Nd：YAG laser capsulotomy. All data were statistically analyzed with repeated measure analysis of variance （ANOVA）. Results Compared to 3 months after ICU AIOL surgery, uncorrected distance visual acuity （F=108.87, P〈0.01）, best corrected distance visual acuity （5 m） （F=116.97, P〈0.01）, distance corrected intermediate visual acuity （50 cm） （F=79.89, P〈0.01）, distance corrected near visual acuity （33 cm） （F=118.84, P〈0.01）, and amplitude of accommodation （F=81.78, P〈0.01） with subjective techniques of near point and defocusing had all decreased at 1 day before Nd：YAG laser eapsulotomy, and had increased by 3 months after Nd：YAG laser capsulotomy. The differences were statistically significant. There was no statistically significant difference between the two methods for measuring amplitudes of accommodation （F=0.272, P〉0.05）. Conclusion Conclusion The accommodative function of the 1CU AIOL had obviously decreased because of the presence of posterior capsular opacification and recovered after Nd：YAG laser capsulotomy 3 months after surgery.