双眼混合植入多焦点和单焦点人工晶状体的可行性研究

Visual function of pseudophakia patients with implant of multifocal and monofocal intraocular lenses in two eyes

目的探讨已行一眼单焦点人工晶状体(IOL)植入的白内障患者,在另眼植入多焦点IOL的可行性及其临床意义。方法选取非术眼已植入单焦点IOL待术者共55例,根据患者意愿分为单焦组27例和多焦组28例。单焦组术眼植入单焦点IOL,多焦组术眼植入多焦点IOL,行白内障超声乳化加IOL植入手术。术后6个月进行裸眼远、近视力,近立体视锐度及不等像检查,以及脱镜率及视功能评估的测定。结果两组患者术后远视力比较无统计学差异。术后裸眼近视力相比,单焦组为0.7000(0.220,1.000),多焦组为0.3000(0.100,0.520),差异有统计学意义(P<0.05)。两组患者立体视数据予以等级赋值后,多焦组术后近立体视结果等级高于单焦组(Z=-5.828,P<0.05)。多焦组不等像数值高于单焦组,两组差异有统计学意义(Z=6.201,P<0.05)。单焦组脱镜率为19.23%,多焦组脱镜率为78.57%(x^2=18.989,P<0.05)。单焦组VF-12-CN量表得分19(15,28)分,多焦组为9(6,23)分。多焦组患者术后生活质量较单焦组更好(Z=-5.659,P<0.05)。结论对于已行一眼单焦点IOL植入并有脱镜意愿的白内障患者,在另眼植入多焦点IOL可提高近距离视功能及生活质量,但需经过充分的沟通。

Objective To evaluate the feasibility and efficacy of implantation of multifocal intraocular lenses monofocal intraocular lens(IOL)in two eyes.Methods Fifty five pseudophakia patients who had monofocal IOL implanted were randomly assigned into two groups:in monofocal group(n=27)the monofocal IOLs were implanted in the second eyes,while in multifocal group(n=28)the multifocal IOLs were implanted in the second eyes.After follow-up for 6 months,the UCDVA(uncorrected distance visual acuity),UCNVA(uncorrected near visual acuity),near stereopsis,aniseikonia,as well as the rates of spectacle freedom and visual function index were measured.Results There was no significant difference in UCDVA between the two groups.The UCNVA in monofocal group was 0.7000(0.220,1.000),while that was 0.3000(0.100,0.520)in multifocal group(P<0.05).The stereopsis of multifocal group was superior to that of monofocal group(Z=-5.828,P<0.05).The aniseikonia in multifocal group was significantly higher than that in monofocal group(Z=6.201,P<0.05).The rate of spectacle free in multifocal group was significantly higher than that of monofocal group(78.57%vs 19.23%,x^2=18.989,P<0.05).The scores of VF-12-CN scale in two groups were 19(15,28)and 9(6,23),respectively(Z=-5.659,P<0.05).Conclusion For pseudophakia patients implanted with a monofocal IOL,the multifocal IOL implantation in second eye can improve near vision function and quality of life.