单眼植入多焦点人工晶状体矫正老视的临床效果

The clinical effect of unilateral implantation of multifocal intraocular lens

目的:评价单眼植入Array多焦点人工晶状体(MIOL)后矫正老视阅读的效果。方法:32例(32眼)单眼白内障超声乳化手术患者被植入Array多焦点折叠式人工晶状体。手术后通过眼前段检查、远近视力检查、近距离立体视觉和阅读情况及质量的检查、满意度和接受性调查等观察Array多焦点人工晶状体的临床效果。结果:远视力≥4.7的有30例(占93.75％);最佳矫正视力为4.8～5.0,平均矫正视力为4.9,非矫正近视力为4.5～4.85(Jaeger 7～Jaeger 2),平均为4.65;21例(65.63％)有良好的双眼立体视觉,24例(75.00％)未借助眼镜基本能阅读;其中20例双眼未戴眼镜阅读是良好和满意的,4例满意度一般;6例由于对侧眼视力较差(远视力4.0～4.3,近视力4.0)只能勉强阅读和需要借助凸镜阅读,但不能持久;近距离立体视觉100″～400″的21例中有20例(95.23％)能良好阅读。结论:单眼植入MIOL后患者有较好的远和近视力,阅读能力普遍提高,阅读的质量与对侧眼的视功能状况有较大关系。术后双眼视功能的重建能够提高阅读的质量。双眼装配MIOL对保证良好的双眼阅读和最大发挥MIOL的近焦点作用有较大的帮助。

Objective: To observe and discuss the effects of Array SA40N zonal progressive multifocal intraocular lens(IOL) after unilateral implantation . Methods: Array SA40N multifocal IOLs were implanted after phacoemul-sification in one eye of 32 patients. Far and near visual acuity, stereoacuity and reading ability were tested and analyzed. Satisfaction and level of acceptance were also evaluated and the physiological status of the anterior segment of the eye was assessed regularly. Results: The uncorrected far visual acuity for the 30 patients was ≥4.7. The best-corrected far visual acuity was 4.8 to 5.0, with a mean value of 4.9. The uncorrected near visual acuity was 4.5 to 4.85, with a mean value of 4.65. 21 patients(65. 63%) had improved binocular function after the operation. 24 patients were easily able to read with both eyes without spectacle correction and twenty of these patients expressed good satisfaction but four did not. Reading was constrained for 6 patients and they needed spectacles to complete the reading in time. This was due to poor vision in the fellow eye(far visual acuity was 4.0- 4.3,near visual acuity was 4.0). 21 patients achieved good binocular function, and 20 patients(95.23%) were able to read with ease. Conclusion: Unilateral implantation of the multifocal intraocular lens provides good far and near visual acuity and good reading ability. The high quality of reading was related to the visual function of the fellow eye. Regaining binocular function after the operation can help to enhance the quality of reading. Bilateral implantation may guarantee good reading and make the best use of multifocal IOLs.