上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (8): 1073-.doi: 10.3969/j.issn.1674-8115.2011.08.005

• 专题报道（眼科视觉科学） • 上一篇    下一篇

衍射型多焦点人工晶体与单焦点人工晶体植入术后的临床观察

计 菁, 罗 敏, 范先群, 陆剑峰   

  1. 上海交通大学 医学院附属第九人民医院眼科, 上海 200011
  • 出版日期:2011-08-28 发布日期:2011-08-29
  • 通讯作者: 罗 敏, 电子信箱: qiangson@sh163.net。
  • 作者简介:计 菁（1978—）, 女, 主治医师, 硕士生；电子信箱: flowerrainday@sina.com。
  • 基金资助:

    上海市重点学科建设项目（S30205）

Clinical observations of monofocal intraocular lens and multifocal intraocular lens implantation in cataract surgery

JI Jing, LUO Min, FAN Xian-qun, LU Jian-feng   

  1. Department of Ophthalmology, the Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
  • Online:2011-08-28 Published:2011-08-29
  • Supported by:

    Shanghai Academic Leading Discipline Project, S30205

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摘要：

目的 对比研究ReSTOR折叠式衍射型多焦点人工晶体和AcrySof Natural折叠式球面单焦点人工晶体在老年性白内障手术后的视觉质量。方法 选取年龄相关性白内障患者51例（64眼），分别植入ReSTOR折叠式衍射型多焦点人工晶体（观察组，30眼/24例）和AcrySof Natural折叠式球面单焦点人工晶体（对照组，34眼/27例）。术后1周、1个月和3个月随访，观察术后两组患者的最佳矫正远视力、裸眼近视力、拟调节力、波前像差和对比敏感度。结果 术后3个月观察组最佳矫正视力≥4.7者占93.3%，裸眼近视力≥4.5者占86.6%；对照组最佳矫正远视力≥4.7者占73%，术后裸眼近视力≥4.5者占11.1%；两组间最佳矫正远视力比较，差异无统计学意义（P>0.05）；两组间裸眼近视力比较，差异具有统计学意义（P＜0.05）；术后3个月，观察组拟调节力为（-3.14±0.91）D，对照组为（-1.03±0.33）D，两组间比较，差异具有统计学意义（P＜0.01）；术后1周、1个月和3个月两组间对比敏感度在各空间频率上比较，差异具有统计学意义（P＜0.05）。两组波前像差检查显示：小瞳孔时两组均方根值和Z04比较，差异有统计学意义（P＜0.05），但Z-13、Z13的差异无统计学意义（P>0.05）；而大瞳孔时两组均方根值和Z-13比较，差异有统计学意义（P＜0.05）。结论 ReSTOR折叠式衍射型多焦点人工晶体植入后能够提供良好的远、近视力，与AcrySof Natural折叠式球面单焦点人工晶体比较能有效提高拟调节力，但植入后引起眼的高阶像差增加和对比敏感度降低，尤其在暗视下更加明显。

关键词: 白内障, 对比敏感度, 波前像差, 多焦点人工晶体, 拟调节力

Abstract:

Objective To compare the vision performance of foldable monofocal intraocular lens (IOLs) (AcrySof Natural) with foldable multifocal IOLs (ReSTOR) implantation in cataract surgery in the elderly. Methods Fifty-one patients (64 eyes) with age-related cataract were selected, and were implanted with foldable multifocal IOLs (ReSTOR) (observation group, 24 patients, 30 eyes) or foldable monofocal IOLs (AcrySof Natural)(control group, 27 patients, 34 eyes). The best corrected distant vision acuity, uncorrected near vision acuity, amplitude of pseudoaccommodation, contrast sensitivity and wavefront aberration were measured 1 week, 1 month and 3 month after surgery. Results Three months after surgery, there was no significant difference in the percent of patients with best corrected distant vision acuity ≥4.7 between observation group and control group (93.3% vs 73%, P＞0.05), there were significant differences in the percent of patients with uncorrected near vision acuity ≥4.5 between observation group and control group (86.6% vs 11.1%, P<0.05), and there were significant differences in the amplitude of pseudoaccommodation between observation group and control group [(-3.14±0.91) D vs (-1.03±0.33) D, P＜0.01]. One week, 1 month and 3 months after surgery, there were significant differences in contrast sensitivity between two groups for all spatial frequencies (P<0.05). The wavefront aberration examinations revealed that there were significant differences in root mean square value and Z04(P＜0.05) and there was no significant difference in Z-13 and Z13 between two groups at small pupils (P＞0.05), and there were significant differences in root mean square value and Z-13 between two groups at big pupils (P＜0.05).  Conclusion Foldable multifocal IOLs (ReSTOR) implantation may lead to favorable distant and near vision acuity, and may effectively increase the amplitude of psedoaccommodation compared with foldable monofocal IOLs (AcrySof Natural). However, foldable multifocal IOLs (ReSTOR) implantation may lead to increased high-order aberration and decreased contrast sensitivity.

Key words: cataract, contrast sensitivity, wavefront aberration, multifocal intraocular lens, pseudoaccommodation