多焦折叠人工晶体的临床应用

The application of foldable multifocal intraocular lens

目的 :探讨多焦折叠人工晶体的临床应用价值。方法 :对 10 6眼单纯老年性白内障患者实施超声乳化及单焦折叠人工晶体 (SIOL)植入术 ,另 10 0眼植入多焦折叠人工晶体(MIOL) ,术前、术后第五天均查裸眼远近视力、矫正视力、角膜内皮计数、角膜地形图 ;于随访日复查远近视力、并进行主客观验光、视野计检查。结果 :植入MIOL患者术前后的散光状态无显著性差异 ,角膜内皮计数有显著性差异。MIOL组的裸眼远视力明显优于SIOL组(P <0 0 1) ,裸眼近视力、矫正远近视力两组间无显著差异 (P >0 0 5 ) ;裸眼远视力≥ 0 8同时裸眼近视力≥ 0 5者 ,MIOL组占 40 % ,SIOL组占 3 7% ,两组间有显著差异 (P <0 0 1)。MIOL的拟调节力在近距离视力明显优于SIOL组 (分别为 0 48±0 10和 0 3 4± 0 13、P <0 0 0 1) ,而远、中距离视力无差异。MIOL患者视野的对比敏感度明显下降。结论 :MIOL保证远距、近距以及中距视力范围内的视觉效果 ,生活质量高 ,使白内障患者术后可以不依赖眼镜 ,倍受医患的青睐。

Objective:To investigate the clinic application of foldable multifocal intraocular lens. Methods:106 senile cataract eyes were performed with phacoemulsificaton and implanted with single foldable intraocular lens (SIOL),and the other 100 eyes were implanted with foldable multifocal intraocular lens (MIOL).The uncorrected,corrected distance and near visions,corneal endothelium,Orbscan and visual field were examined before and after surgery in all the patients. Results:There was no significant difference on astigmatism for MIOL,but significant difference on corneal endothelium.The uncorrected distance vision of MIOL was better than that of SIOL,between the two IOLs,however,there was no difference on the items of uncorrected near vision,corrected distance and near vision (P>0 05).In MIOL,the eyes with both the uncorrected distance vision ≥0 8 and the uncorrected near vision ≥0 5 were in 40%,but in SIOL were only in 3 7% (P<0 01).For Pseudo-accommodation,significant difference existed on near acuity between MIOL and SIOL (0 48±0 10 and 0 34±0 13,respectively,P<0 001),but not existed on long and intermediate distance acuities.Lowering contrast was found in MIOL. Conclusions:MIOL can provide a high level of full vision,reduced spectacle dependency