正确认识多焦点人工晶状体植入术后的神经适应

The importance of neuroadaptation after multifocal intraocular lens implantation

多焦点人工晶状体(MIOL)可以重建人眼全程视力、恢复双眼立体视觉、提升拟调节力并在一定范围校正角膜规则散光,完美地契合了当代人白内障摘除手术后的视觉需求。然而,MIOL亦有缺点,即使在严格控制适应证的条件下,也会出现对比敏感度下降、夜间眩光和光晕等视觉异常感受,部分视觉异常感受能够自发缓解,在此过程中神经适应发挥着重要的作用。本文将阐述神经适应的概念、机制、中枢定位、神经适应的训练、MIOL植入的术前评估和术后视觉异常的相关处理,主要阐述神经适应在MIOL植入术后的重要作用,为正确认识MIOL植入术后并发症提供一定的理论依据。

Multifocal intraocular lens(MIOL)can help cataract patients get a full range of vision,restore binocular stereopsis,improve pseudo-accommodation power,and correct regular corneal astigmatism with limits.However,MIOL also have shortcomings,including decreased contrast sensitivity,night glare,halos and other negative dysphotopsias,despite strictly controlled indications.Sometimes dysphotopsia can be relieved spontaneously after surgery in a period of time.During this process neuroadaptation plays an important role.This article explains the concept and mechanism of neuroadaptation,the location of neuroadaptation in the central nervous system,cognitive training,the preoperative evaluation of MIOL implantation,and the treatment for postoperative dissatisfaction.Correct understanding of the important role of neuroadaptation will provide theoretic foundation for cataract specialists and facilitate the handling of complications after MIOL implantation.