单焦点人工晶状体单眼视设计术后视功能观察

Postoperative visual function observation in monofocal IOL monovision design

目的探讨双眼植入单焦点人工晶状体单眼视设计术后的视功能及立体视功能。方法临床病例对照研究。选择2011年3月至2012年3月在丹阳市人民医院眼科诊断为双眼白内障患者40例，双眼先后行白内障超声乳化摘除联合单焦点人工晶状体植入术，1只眼按术后为正视眼，另1只眼按术后为-2．50D近视植入相应度数人工晶状体，记录术后3个月时患者双眼裸眼以及矫正远、近、中距离视力、屈光度、对比敏感度、立体视。术后6个月，视功能及满意度调查问卷评价患者主观的视觉功能和脱镜率。对计量资料中数据进行正态性检验分析，满足正态分布的行t检验，对计数资料行χ2检验。结果术后患者两眼裸眼矫正后远视力（t=2．001，P=0．052），中距离视力（t=1．304，P=0．199），近视力（t=1．642，P=0．108）差异无统计学意义，各空间频率对比敏感度差异无统计学意义（P〉0．05），术后脱镜率为92．5％。结论按照单眼视设计的双侧人工晶状体眼，能同时获得良好的裸眼远、近视力，而双眼裸眼状态下的近立体视功能受到一定影响。

Objective To study visual function and stereopsis in monovision pseudophakia. Methods This study was based on 40 patients who had bilateral cataract phacomulsification and intraocular lens （IOL） implantation. The implantation of an IOL calculated to achieve emmetropia was performed in one eye then an IOL calculated to yield a spherical equivalent of-2.50 D was implant- ed into the other eye. Parameters analyzed 3 months postoperatively included binocular uncorrected distance, intermediate, and near visual acuities; near stereo vision; photopic and mesopic contrast sensitivity function without glare. Parameters analyzed 6 months postoperatively included spectacle independence; subjective visual symptoms; and patient satisfaction. The independent-samples t test was used to compare the measure data which met normal distribution. The chi-square test was applied to compare categorical variables. Results There were no significant differences between bilateral uncorrected and corrected distance vision （t =2.001, P =0.052）, intermediate （t =1.304, P =0.199） and near vision （t =1.642, P =0.108）. Percentage of patients wearing spectacle for distance vision were less than 7.5%. Conclusions Monovision pseudophakia can obtain good distance and near visual acuity without correction.