单侧白内障患者多焦点人工晶状体植入术的视觉效果

Visual outcome of multifocal intraocular lenses implantation for unilateral cataract

目的 评价单侧白内障患者多焦点人工晶状体植入术的视觉效果并与双眼植入术进行比较.方法 前瞻性病例对照研究.年龄40～ 70岁的年龄相关性白内障62例,分成两组.单眼组30例（30只眼）,纳入对象为单侧白内障患者,另一眼为无明显白内障的健康眼或早期白内障尚不需手术者.双眼组32例（64只眼）,纳入对象为双侧白内障患者.两组患者分别单眼或双眼植入多焦点人工晶状体.术后随访3个月,观察指标包括术眼单眼及双眼的远、中、近视力,对比敏感度,近立体视,脱镜率及患者满意度.结果 单眼组远、中、近距离的裸眼单眼视力（log MAR）依次为0.10±0.14,0.29±0.16,0.28 ±0.24;双眼组依次为0.09 ±0.19,0.24±0.13,0.26±0.17.两组差异无统计学意义（t =0.32、0.54、0.78,P=0.75、0.59、0.44）.立体视单眼组逊于双眼组（x2=5.16,P=0.02）.脱镜率单眼组62.50％,双眼组71.88％,差异无统计学意义（x2=0.52,P=0.47）.两组患者术后的满意度差异无统计学意（x2=0.52,P=0.53）.结论 单侧白内障患者植入多焦点人工晶状体可以提高脱镜率和满意度.

Objective To evaluate the visual outcomes of multifocal intraocular lens （IOL）implantation for unilateral cataract and compare with binocular cataract multifocal IOL.Methods Age related cataract patients with age 40-70 years were collected and divided into two groups.Monocular group included 30 eyes of 30 patients with monocular cataract,and the other eyes were no significant cataract or early cataract needn＇t surgery.Bilateral group included 64 eyes of 32 patients with binocular cataract.Patients were implanted with multifocal IOLs unilaterally or bilaterally.Three months postoperatively,monocular and binocular uncorrected distance,intermediate and near visual acuity,contrast sensitivity,and near stereoacuity,the rate of spectacle glass independence and patient＇ s satisfaction were examined and assessed.Results The mean binocular uncorrected distance,intermediate,and near vision （logMAR） in the unilateral group were （0.10 ± 0.14）,（0.29 ± 0.16）,（0.28 ± 0.24） and in the bilateral group were （0.09 ± 0.19）,（0.24 ± 0.13）,（0.26 ± 0.17）.The difference was not significant between the two groups （t =0.32、0.54、0.78,P =0.75 、0.59、0.44）.Near stereoacuity was slighfly worse in the unilateral group than in the bilateral group（x2 =5.16,P =0.02）.The rate of spectacle glass independence was 62.50% in the unilateral group and 71.88% in the bilateral group.There was no significant difference among the two groups （x2 =0.52,P =0.47）.The differemce in patient satisfaction of the two groups was not statistically significant （x2 =0.52,P =0.53）.Conclusion Unilateral implantation of multifocal intraocular lens may increase the rate of spectacle glass independence and improve patient satisfaction.The treatment of implantation of multifocal intraocular lens for monocular cataract is worthy of recommendation.