多焦点与单眼视单焦点人工晶状体双眼白内障植入的比较

Effects of multifocal and monovision single-focus intraocular lenses implantation on visual function recovery for bilateral cataract patients

目的比较多焦点与单眼视单焦点人工晶状体植入对双眼白内障患者术后视功能恢复的情况。方法采用前瞻性研究方法，从2013年6月至2014年12月本院双眼白内障55例（110只眼），随机分为多焦点人工晶状体组（MIOL组）25例（50只眼）和单眼视单焦点人工晶状体组（SI—OL组）30例（60只眼）。分别在双眼中均植入多焦点人工晶状体，以及植入单眼视设计双眼植入不同屈光度的单焦点人工晶状体。其中，SIOL组采用单眼视设计，即术后优势眼形成正视，而非优势眼形成近视。于术后90d比较两组双眼裸眼视力、立体视、对比敏感度和满意度。结果术后90d，MI—OL组与SIOL组的对比敏感度、63cm和5m的视力以及满意度，差异均无统计学意义（P〉0．05）；而SIOL组30Cm（近距离）的视力优于MIOL组（P〈0．05）。与MIOL组相比，SIOL组患者的立体视受损，MIOL组（P〈0．05）。与MIOL组相比，SIOL未对患者的主观疗效评价造成显著影响（P〉0．05）。结论患者双眼白内障多焦点人工晶状体植入和单眼视单焦点人工晶状体植入的效果均较理想，患者术后均可获得全程视力。但是与MIOL相比，SIOL的费用成本较低。在临床上适用证范围内者，似以采用SIOL为宜。

Objective To compare the visual function recovery of bilateral cataract patients with bilateral muhifocal intraocular lens implantation and monovision single-focus intraocular lens implantation. Methods The study was conducted using the prospective method. One hundred and ten eyes of 55 cases of bilateral cataract were enrolled. The patients were divided into two groups： monocular vision single-focus intraocular lens mplantation group （SIOL, 60 eyes of 30 cases） and multifocal intraocular lens implantation group （MIOL, 50 eyes of 25 cases）. Patients in SIOL group adopted the monovision design the dominant eye was treated with emmetropization while the other was treated with hypometropia. Parameters were measured 90 days postoperatively which consisted of visual acuities, stereo scopic vision, contrast sensitivity, and patient＇ s satisfaction. Results The contrast sensitivity, 63 cm intermediate visual function, 5 m distance visual acuities, and patient＇ s satisfaction had no significant differences between two groups （P 〉 0.05 ）. The 30 cm near visual acuities in SIOL group were significantly better than that in MIOL group （P 〈 0.05）. Compared with MIOL, SIOL affected the function of stereo scopic vision, but it did not affect the subjective feeling of patient （P 〉 0. 05 ）. Conclusion Both SIOL and MIOL achieved distance vision and acceptable recovery of visual function for cataract patients. Compared with MIOL, SIOL had lower costs, there for it was visual recovery plan recommended for a clinical practice.