Symfony人工晶体在LASIK术后白内障患者中的临床应用

Clinical Application of Symfony Intraocular Lens in Cataract Patients with Previous Myopic Laser in Situ Keratomileusis (LASIK)

目的 探讨LASIK术后白内障患者植入Symfony人工晶体的早期临床效果。方法 前瞻性临床研究。收集2019年1月-2020年1月于我院行白内障超声乳化联合Symfony新无级人工晶状体植入术的LASIK术后的白内障患者10例(12眼),分别于术前、术后1天、1周、1个月、2个月、3个月观察裸眼远距离视力(Uncorrected distance visual acuity,UCDVA)、裸眼中距离视力(Uncorrected intermediate visual acuity,UCIVA)、裸眼近距离视力(Uncorrected near visual acuity,UCNVA);最佳矫正远视力(Best corrected distance visual acuity,BCDVA)、最佳矫正远视力下中距离视力(Best corrected intermediate visual acuity,BCIVA)、最佳矫正远视力下近视力(Best corrected near visual acuity,BCNVA),视力均使用标准对数视力表(小数法)进行统计,进行客观视觉质量分析系统Ⅱ检查;术后进行离焦曲线测量并评定患者术后视觉效果(光学现象、脱镜率及术后满意度)。结果 所有患者术后1 天、1周、1个月、2个月、3个月时UCDVA、UCIVA、BCDVA、BCIVA均为0.6以上,均较术前显著提高,差异均有统计学意义(P<0.05),术后UCNVA、BCNVA均为0.5以上,较术前略提高,差异有统计学意义(P<0.05)。术后1天、1周、1个月、2个月、3个月时离焦曲线在+1.0^-3.0 D跨度的视力均可达0.5以上。患者术后1天、1周、1个月、2个月、3个月时视觉质量较术前好转,差异均有统计学意义(P<0.05)。结论 LASIK术后白内障患者植入Symfony人工晶状体后可获得良好的矫正和裸眼远、中视力,获得相对较好的矫正和裸眼近视力,视觉质量较术前明显好转;但是对于此类患者,由于角膜的改变,应在术前多次、多公式进行人工晶体度数计算检查一致性,并根据患者需求,个性化选择多功能人工晶体。

Objective:To investigate the early clinical effect of Symfony intraocular lens implantation in cataract patients with previous myopic LASIK surgery.Methods:Prospective clinical study.Ten patients (12 eyes) with previous myopic LASIK surgery who underwent cataract surgery and Symfony intraocular lens implantation from January 2019 to January 2020 in our hospital were collected.Uncorrected distance visual acuity(UCDVA)、Uncorrected intermediate visual acuity(UCIVA)、Uncorrected near visual acuity (UCNVA)、Best corrected distance visual acuity(BCDVA)、Best corrected intermediate visual acuity(BCIVA)、Best corrected near visual acuity(BCNVA)were observed before surgery and 1 day,1 week,1 month,2 months and 3 months after cataract surgery,and Optical Quality Analysis System Ⅱ examination were performed;defocus curve measurement and postoperative visual effects (photic phenomena spectacle independence rate and satisfaction outcomes) were evaluated after surgery.Results:UCDVA、UCIVA、BCDVA、BCIVA were all above 0.6 at follow-up days of 1 week、1 month、2 months and 3 months,which were significantly higher than those before surgery (P < 0.05);UCNVA and BCNVA after surgery were more than 0.5,slightly higher than those before surgery (P < 0.05).The visual acuity was more than 0.5 between + 1.0D and-3.0 in the defocus curve at 1 day,1 week,1 month,2 months and 3 months after surgery.The visual quality of the patients improved at 1 day,1 week,1 month,2 months and 3 months after surgery,and the differences were statistically significant (P < 0.05).Conclusion:These patients in our study with previous myopic LASIK surgery who underwent cataract surgery and Symfony intraocular lens implantation can obtain good correction and uncorrected distant、intermediate vision,and relatively good corrected and uncorrected near visual acuity;the visual quality is significantly improved compared with that before operation.However,for such patients,due to the changes of cornea,the intraocular lens power calculation should be carried out multiple times with multiple formulas before cataract surgery,and the consistency should be checked according to the needs of patients and select multifunctional intraocular lens personalized.