双眼多焦点人工晶状体ReSTOR植入术后视功能观察

Objective To evaluate the effectiveness and security after implantation of multifocal intraocular lens in Chinese,by comparing the visual function of bilateral implantation of the new apodized diffractive AcrySof ReSTOR multifocal intraocular lens (MIOL) and Acrysof Natural, Monofocal intraocular lens (MoIOL) Methods Forty-three patients with age-related cataract were divided into two groups with random principia: bilateral Acrysof ResToR multifocal IOLs or the monofocal AcrySof Natural lols. The Acrysof ReSTOR group included 18 patients (36 eyes), and reference group-AcrysofNatural group (MoIOL) included 25 patients (50eyes). Measurements were taken after operation, including uncorrected distant vision acuity (UCDVA), uncorrected near vision acuity (UCNVA), best corrected distant vision acuity (BCDVA), best corrected near vision acuity (BCNVA), distant corrected near vision acuity (DCNVA), Intermediate Vision (40, 60,80 cm), contrast sensitivity (CS) and visual symptoms. Results UCNVA, DCNVA and Intermediate Vision (40, 60, 80cm)were significantly higher in the MIOL group (P＜0.05). No statistical difference was noted between 2 groups with the CS. The adverse symptoms of the MIOL group were slight. The dependence of glasses of the MIOL was 80%. The MIOL group provided better patient satisfaction. Conclusions Bilateral implantation in patients with the new apodized diffractive MIOL multifocal intraocular lens (IOL) appears a better outcome in near and intermediate vision, slight visual symptom, improve the quality of life after surgery.     

双眼植入多焦和单焦人工晶状体后视力及立体视比较研究

目的 比较双眼植入ReSTOR+3D非球面多焦点人工晶状体(MIOL)与传统球面单焦点人工晶状体(SIOL)后全程视力和立体视觉情况.方法 前瞻性临床研究.对2009年5月至2010年6月在上海公利医院眼科治疗的病人18例(36只眼)植入ReSTOR+3DMIOL(SN6ADI),20例(40只眼)植入传统球面SIOL(SNt0AT).以术后第二眼为标准随访3个月.测两组的远、中、近视力及近立体视锐度,进行相应统计学分析.结果 术后裸眼及最佳远、近矫正视力两组无明显差异(t值分别为1.14、1.74、0.99,P＞0.05),在25cm、30cm、33cm、40cm、50cm、60cm、70cm近中距离上,MIOL组远视力矫正下近视力均优于SIOL组(t值分别为14.02、20.28、24.52、32.74、21.91、11.66、9.76,P＜0.01).MIOL组裸眼近立体视锐度优于SIOL组(P＜0.05).双眼矫正近视力后,两组的立体视觉差异无统计学意义(X2=64.97 P＞0.05).结论 ReSTOR+3D多焦点IOL较单焦点IOL可提供更好的近、中视力和裸眼近立体锐度,实现了很高地脱镜率,良好地全程视力使其拥有广泛的应用价值.

Abstract：

Objective To compare visual acuity from far to near and stereoscopic vision in patients who underwent bilateral implantation of aspheric diffractive multifocal intraocular lens (IOLs)with monofocal IOLs. Methods This prospective study comprised patients having implantation of an aspheric diffractive multifocal ReSTOR SN6AD1 IOL with a C3.0 D add (SN6AD1) or a monofocal IOL (SN60AT). Visual acuity from far to near distances and stereoscopic vision were evaluated 3months postoperatively. Results Multifocal IOL group comprised 36 eyes of 18 patients. Monofocal IOL group comprised 40 eyes of 20 patients. The differences between groups of uncorrected and corrected distance visual acuity and corrected near visual acuity had not statistically significant (P＞0.05).The mean distance-corrected visual acuity at 25 cm, 30 cm, 33 cm, 40 cm, 50 cm, 60 cm, 70 cm were better in the multifocal group than in the monofocal group (P＜0.01). The near stereoscopic vision. in the multifocal group were better than in the monofocal group (P＜0.01). When near corrected,there were no significant difference between the stereoscopic vision for the multifocal and monofocal groups (P＞0.05). Conclusions The diffractive multifocal IOL with a low add power provides significantly better intermediate, near visual acuity than the monofocal IOL. When near uncorrected, the multifocal group has better stereoscopic vision. Spectacle independence is higher with the multifocal intraocular lens.     

可调节人工晶状体预留度数设计的临床观察

Objective To observe the vision circumstance and the change of accommodation after implantation of preserved degrees of accommodative intraocular lens. Methods Thirty cases (60 eyes) were implanted with accommodative intraocular lens, among which the SRKT for the research group, 15 cases (30 eyes), was theoretically over-corrected 0.5D in the major visual eyes and over 1.0D in the minor visual eyes; the SRKT for the control group, 15 cases (30 eyes) randomly chosen, was equal to the theoretical value for both the major and minor visual eyes. After the implantation, follow-up visits were above 3 months to observe the distant vision, near vision, optimal corrected distant and near visions, to determine the accommodation by objective and subjective methods and to test the combined distant and near visions of both eyes. Results In the research group, the diopter (D) of the major and minor visual eyes was 0.512±0.15 and 1.13± 0.12 respectively.The distant visions of the naked major visual eyes and the optimal corrected distant visions of the research and the control groups were 0.89± 0.11 and 0.91± 0.12, 0.97± 0.23 and 0.99± 0.14 respectively, exerting no significant difference. The 33 cm near visions of the major visual eyes and the optimal corrected near visions of the major visual eyes were 0.63± 0.16 and 0.48± 0.23, 0.97±0.25 and 0.86± 0.14, exerting significant difference. The optimal corrected near visions of the minor visual eyes are 0.99± 0.15 and 0.89± 0.14, having significant difference. For the accommodation (D) of two groups by the subjective method, it was 3.35± 0.71 and 3.27± 1.32 respectively without significant difference; while by the objective method, it was 0.38± 0.12 and 0.37±0.08 without significant difference. The distant vision of the combined eyes of two groups was 0.99±0.11 and 0.98± 0.21, exerting no significant difference. The near vision of the combined eyes of two groups was 0.91± 0.20 and 0.61± 0.17, exerting very significant difference. Conclusions There is no significant difference of implanting preserved degrees of accommodative intraocular lens on aspects of major visual eye's distant vision, optimal corrected vision, and distant vision of combined two eyes. As for 33 cm near vision and the optimal corrected near vision of the major and minor eyes, they both have significant difference. There is very significant difference on the near vision of the combined two eyes. To preserve some certain degrees of the accommodative intraocular lens on the basis of self-adjustment can obviously improve the visual function of the near vision.     

Acrysoft ReStOr多焦点人工晶状体的临床应用观察

Objective To evaluate the clinical effect of a multifocal IOL (Acrysoft ReSTOR). Methods Thirty-six patients with age-related cataract (46 eyes) were divided into two groups: MIOL group included 19 patients (23 eyes), SIOL group included 17 patients (23 eyes). All patients underwent phacoemulsification. MIOL group implanted ReSTOR SA60D3 and SIOL group implanted NaturalSN60AT. At 1 week, 3 months postoperatively, distant and near visual acuities, pseudoaccomodation, contrast sensitivity and patients's satisfaction with their vision were assessed. Results Uncorrected distance visual acuity (UCDVA), Best-corrected distance visual acuity (BCDVA), Best-corrected near visual (BCNV) in the multifocal were not statistically different from the sonofocal group (P ≥0.05), Uncorrected near visual acuity (UCNVA), Best corrected near visual acuity (BCNVA), pseudoaccomodation and the satisfaction of intermediate and near vision were better statistically in the multifocal group compared to the monofocal group (P ＜0.05). Conclusions Acrysoft ReSTOR can provide excellent outcomes in distance, intermediate and near vision, so as to improve the quality of life after surgery.     

Matrix Acrylic400型人工晶状体光致变色作用临床观察

目的 观察Matrix Acrylic 400型人工晶状体,植入人眼后,在自然光下其是否有光致变色作用.方法 42例年龄相关性白内障患者分为三组,分别植入Matrix Acrylic 400型人工晶状体,Acrysof Natural SN60AT人工状晶体及Matrix Acrylic 401型人工晶状体.术后1 d、1周、1个月、3个月观察三组视力、logMAR视力及在室外日照及室内条件下人工晶状体的颜色变化.结果 所有患者术后测定术眼裸眼远视力、最佳矫正远视力差异无统计学意义.三组患者在明视条件下三种对比度LogMAR视力差异无统计学意义,暗视条件下5%对比度时的logMAR视力黄色人工晶状体组低于另外两组,差异有统计学意义.照片拍摄显示在室内Matrix Acrylic 400型光致变色人工晶状体和Matrix Acrylic 401型人工晶状体呈无色透明,Acrysof Natural SN60AT人工晶状体呈黄色.在室外阳光下Matrix Acrylic 400型光致变色人工晶状体明显变为为黄色,Matrix Acrylic 401型人工晶状体仍无色透明,Acrysof Natural SN60AT人工晶状体呈黄色.结论 Matrix Acrylic 400型人工晶状体在人眼内可以在室外自然光条件下变为黄色,在室内黄色消退.在暗视5%对比度条件下LogMAR视力优于黄色人工晶体.

Abstract：

Objective To evaluate light accommodation effect of the intraocular photochromic blue light-filtering IOL (Matrix Acrylic 400 101) under the natural light. Methods Forty-two age related cataract patients (59 eyes) were divided into three groups in random. These three cataract groups were 'implanted Matrix Acrylic 400 IOLs, Acrysof Natural SN60AT IOLs and Matrix Acrylic 401 IOLs respectively. The visual acuity and logMAR vision of these cases were recorded at I day, 7 days, 1month, and 3 months afier operation, respectively. The photochromic changes of these IOLs were evaluated indoor and outdoor environment at the same time. Results There were no significant differences in the aspects of distance visual acuity, corrected distance visual acuity and logMAR vision of all patients in photopic condition. The logMAR vision of SN60AT IOLs group was lower than the other two groups in scotopic 5% contrast condition (P <0.05). The Matrix Acrylic 400 IOLs and the SN60AT IOLs were yellow, but the Matrix Acrylic 401 IOLs were transparent under the sunlight outdoor environment. The SN60AT IOLs were still yellow, but the Matrix Acrylic 400 IOLs and the Matrix Acrylic 401 IOLs was transparent at indoor environment. Conclusions Matrix Acrylic 400 IOL changes to yellow at outdoor and retums to transparent at indoor. Under scotopic condition of 5% contrast, the logMAR vision of the 400 IOL group is better than that of the blue light-filtering IOL group.     

衍射型多焦点人工晶状体眼对比敏感度和高阶像差研究

Objective To compare high-order aberration and contrast sensitivity in pseudophakic eye with a diffractive muitifocal intraocular lens(IOL)or a conventional monofoeal IOL.Methods In this comparative trial,the 72 patients(109 eyes)of multifocal group were implanted with apodized diffractive IOL (AcrySof ReSTOR)and the 88 patients(130 eyes)of control group were given with a monofocal IOL (AcrySof SA60AT),respectively.The distance visual acuity,near visual acuity,rate of spectacle freedom,contrast sensitivity and high-order aberration were measured.The follow-up time was from 6 to 24 months.Results Contrast sensitivity in monofocal group was better at all spatial frequencies under photopic,mesopic and mesopic with glare conditions.Contrast sensitivity was statistically different at median spatial frequencies under photopic conditions and at median and high spatial frequencies under mesopic with glare conditions (P＜0.05).The postoperative ocular root-mean-square(RMS)values were higher in multifocal group for 3rd-order coma aberrations,4th-order aberration and total higher-order aberrations(HOAs)for a 6.0 mm pupil,and there was no statistical difference between two groups(P＞0.05).Far visual acuity in two groups was similar.Without correction,101 eyes(91.8%)in multifocal group and 12 eyes(9.2%)in monofocal group achieved J3 or better for near vision,respectively.The patients who never need for spectacles were 89.9%(98 eyes)in multifolcal IOL group and 9.2%(12 eyes)in monofocal IOL group.Conclusions Although contrast sensitivity of patients with muitifocal IOL implantation was worse than with monofocal IOL at some spatial frequencies,higher-order aberrations were not higher and visual disturbances were slightly.Patients in multifocal IOL group can get good far and near uncorrected visual acuity and 89.9% of patients were freedom of spectacle.     

Visual performance with accommodating and multifocal intraocular lenses

AIM: To compare the visual functional outcomes with accommodating and multifocal intraocular lenses (IOLs). METHODS: Our retrospective comparative study included 51 patients (60 eyes) received implantation of an accommodating IOL (Tetraflex; 16 patients, 20 eyes), a refractive multifocal IOL (ReZoom; 18 patients, 20 eyes), or a diffractive multifocal IOL (ZMA00; 17 patients, 20 eyes). Subjective refraction, visual acuity, contrast sensitivity (CS), intraocular aberration, and subjective photic phenomena were detected at 3mo after surgery. RESULTS: The spherical equivalent in the three groups was -0.38±0.54 D, 0.14±0.56 D, and 0.35±0.41 D, respectively. No statistically significant differences were found in uncorrected and corrected distance visual acuity and uncorrected intermediate visual acuity among the groups (P=0.39). The ReZoom group had significantly better distance-corrected intermediate visual acuity than the ZMA00 group (P=0.003). The ZMA00 group had significantly better near visual acuity than the other groups (P＜0.05). Better contrast sensitivity values were observed in the Tetraflex group under most of the spatial frequencies conditions (P=0.025). The total aberration was lowest in the ZMA00 group (P=0.000), and the spherical aberration was highest in the Tetraflex group (P=0.000). The three groups had similar frequency of ghosting and glare, and the Tetraflex group had a low rate of halos (P=0.01). CONCLUSION: Both accommodating and multifocal IOLs can successfully restore distance and uncorrected intermediate visual acuities. Tetraflex accommodating IOLs perform better in CS and with less halos of photic phenomena. ReZoom refractive multifocal IOLs have better performance in distance-corrected intermediate visual acuity than ZMA00 diffractive multifocal IOLs, and the latter achieved better near visual acuity and efficiently decreased the optical aberration.     

A comparison of visual outcomes in three different types of monofocal intraocular lenses

AIM: To compare the visual outcomes (distance and near) in patients opting for three different types of monofocal intraocular lens (IOL) (Matrix Aurium, AcrySof single piece, and AcrySof IQ lens). METHODS: The present study is a cross-sectional analysis of secondary clinical data collected from 153 eyes (52 eyes in Matrix Aurium, 48 in AcrySof single piece, and 53 in AcrySof IQ group) undergoing cataract surgery (2011-2012). We compared near vision, distance vision, distance corrected near vision in these three types of lenses on day 15 (±3) post-surgery. RESULTS: About 69% of the eyes in the Matrix Aurium group had good uncorrected distance vision post-surgery; the proportion was 48% and 57% in the AcrySof single piece and AcrySof IQ group (P=0.09). The proportion of eyes with good distance corrected near vision were 38%, 33%, and 15% in the Matrix Aurium, AcrySof single piece, and AcrySof IQ groups respectively (P=0.02). Similarly, The proportion with good “both near and distance vision” were 38%, 33%, and 15% in the Matrix Aurium, AcrySof single piece, and AcrySof IQ groups respectively (P=0.02). It was only the Matrix Aurium group which had significantly better both “distance and near vision” compared with the AcrySof IQ group (odds ratio: 5.87, 95% confidence intervals: 1.68 to 20.56). CONCLUSION: Matrix Aurium monofocal lenses may be a good option for those patients who desire to have a good near as well as distance vision post-surgery.     

Comparison of Visual Function after Multifocal and Accommodative IOL Implantation

Purpose： To compare early visual function between patients undergoing phacoemulsification combined with multifocal and accommodative intraocular lens implantation.
Methods： A total of 112 patients with age-related cataract undergoing phacoemulsification in our hospital were recruited for this study and randomly assigned into multifocal （56 eyes; ZAM00 group） and accommodative （56 eyes; FLEX group） intraocular lens groups. Visual acuity and contrast sensitivity were statistically compared between the two groups.
Results： No significant difference was found in uncorrected distant visual acuity between the ZMA00 and FLEX groups at 1 week, or 1, 3, and 6 months after operation （all P〉0.05）. At postoperative 6 months, no statistical significance was noted in distant and intermediate best-corrected visual acuity or in contrast sensitivity between the two groups （all P〉0.05）. Patients in the ZMA00 group were superior to their counterparts in the FLEX group regarding near best corrected visual acuity, reading speed, and spectacle independence （all P〈0.05）.
Conclusion： ZMA00 and FLEX IOL implantation can provide excellent distant and intermediate visual acuity for patients with age-related cataract. ZMA00 IOL is superior to FLEX in terms of near visual acuity.     

Comparison on visual function after implantation of an apodized diffractive aspheric multifocal or monofocal intraocular lens

 Purpose: To evaluate visual outcomes after implantation of an aspheric multifocal/ intraocular lens (MIOL) or an aspheric monofocal intraocular lens (IOL). Methods: This was a prospective nonrandomized study. During 3-months of post-operative follow-up, the following outcomes for SN6AD1 MIOL (multifocal group) and SN60WF IOL (monofocal group) were compared: uncorrected (UDVA) and corrected (CDVA) distance visual acuity, uncorrected (UNVA) and distance-corrected (DCNVA) near visual acuity, Chinese character near visual acuity, uncorrected intermediate visual acuity (UIVA) under high (100% contrast) and low contrast (10% contrast), UIVA for different IOL powers, and a quality-of-life questionnaire. Results: UNVA, DCNVA, and UIVA under high contrast in the multifocal group were significantly better than those in the monofocal group (P＜0.05). UDVA, CDVA and UIVA under low contrast did not differ between groups at 63 cm and 100 cm (P＞0.05). In most of the cases, Chinese character near visual acuity was significantly better in the multifocal group (P＜0.05). UNVA and UIVA at 63cm were improved 3 months post-operatively. Better UIVA was found in emmetropic and mild myopic eyes as compared to hyperopic ones. The patients in the multifocal group had a higher degree of satisfaction and performed better on near and intermediate tasks, although with greater complaints of visual disturbance.    Conclusion: The SN6AD1 MIOL provides significantly better UNVA, DCNVA and UIVA under high contrast conditions, and better Chinese character near visual acuity. Patients receiving the SN6AD1 MIOL reported a better quality of vision in spite of more serious visual disturbances. Better UIVA was observed in emmetropic and mildly myopic eyes.     

植入可调节人工晶状体和多焦点人工晶状体后视功能的对比研究

目的比较超声乳化白内障吸除术后植入可调节人工晶状体和多焦点人工晶状体的视功能。方法32例年龄相关性白内障患者根据自愿原则,采用非随机对照方式分成两组,试验组13例患者（24只眼）植入1CU可调节人工晶状体,对照组19例患者（30只眼）植入Array多焦点人工晶状体。术后3个月使用标准对数视力表检测患者最佳矫正视力及在最佳矫正视力基础上获得的近视力、近点及调节幅度、立体视觉。检查结果以年龄作为协变量,进行成组设计定量资料一元协方差分析。结果随诊期间所有患者均无明显的术后并发症。术后3个月试验组最佳矫正视力为4．96±0．15,对照组为5．02±0．08,两组比较差异无统计学意义（P=0．085）。试验组术后最佳矫正视力基础上获得的近视力为4．65±0．15,对照组为4．60±0．10,两组比较差异无统计学意义（P=0．398）。试验组术后主观近点为（56±9）cm,对照组为（61±11）cm,两组比较差异无统计学意义（P=0．80）。试验组术后调节幅度为（1．30±0．40）D,对照组为（1．20±0．36）D,两组比较差异无统计学意义（P=0．093）。试验组术后立体视觉为43．24”±18．25”,对照组为60．00”±23．09”,两组比较差异无统计学意义（P=0．543）。结论植入1CU可调节人工晶状体的患者术后可在保持最佳远视力的同时获得一定的近视力。两种人工晶状体在矫正远视力、远矫下近视力、主观近点、术后调节幅度及近距矫正基础上的立体视觉检查方面均无统计学意义。     

三种单焦点人工晶状体植入术后拟调节力比较

目的：比较三种单焦点人工晶状体植入术后人工晶状体眼的拟调节力大小。 方法：白内障患者78例78眼根据自愿的原则,采用非随机方式分成三组,Ⅰ组23例23眼植入AcrySof Natural人工晶状体;Ⅱ组24例24眼植入Canon staa人工晶状体;Ⅲ组31例31眼植入聚甲基丙烯酸甲酯(PMMA)人工晶状体。术后3mo检测最佳矫正远视力及在最佳矫正远视力基础上获得的近视力,以及33cm处在最佳矫正近视力基础上获得的近附加值及拟调节力(PAC)。 结果：三组术后3mo最佳矫正远视力差异无统计学意义(F=0.317,P=0.729);最佳矫正远视力基础上获得的近视力差异有统计学意义(F=3.377,P=0.039);术后3mo,33cm处在最佳矫正近视力基础上获得的近附加值及拟调节力(PAC)比较差异均有统计学意义(F=10094,P=0.000;F=16.806,P=0.000)。 结论：白内障术后植入三种单焦点人工晶状体拟调节力比较,软性推注式折叠晶状体可获得更高的拟调节力及令人满意的近视力。     

拟调节人工晶状体在眼内位移与调节力研究

目的 探讨拟调节人工晶状体在眼内位移与调节力的关系.方法 采用病例对照研究方法,将白内障患者20例(20只眼)分成两组:10只眼植入Lestec公司生产的福来视拟调节人工晶状体(TetraflexIOL)(福来视组);另外10只眼植入其他无调节功能的人工晶状体(单焦点组).检测患者术后的裸眼远、中、近视力及矫正远、中、近视力;矫正远视力的近视力;采用前段OCT定量测定1%pilocarpine诱导缩瞳后人工晶状体在眼内前后移动的幅度;同时观察患者调节力的变化.结果 所有患者随访3个月:两组的裸眼、矫正远视力及矫正近视力差异均无统计学意义(P＞0.05);福来视组的裸眼中、近视力及矫正远视力的近视力均优于对照组(P<0.05);福来视组人工晶状体移动度及调节力与对照组比较差异有统计学意义(P<0.05),而且人工晶状体移动度与调节力呈正相关(r=0.977.P=0.000).结论 福来视拟调节人工晶状体是安伞有效的,能使患者术后获得一定的调节力,与人工晶状体的移动度具有正相关性,提供良好的远、中、近视力.     

多焦点人工晶状体植入术后早期全程视力和拟调节力的临床观察

目的 对比AcrySof多焦点人工晶状体和单焦点人工晶状体植入术后的早期临床疗效及拟调节力.方法 选取行白内障超声乳化摘出并人工晶状体植入术的年龄相关性白内障患者138例158眼,根据植入的人工晶状体不同,分为观察组和对照组.观察组60例73眼,植入AcrySof ReSTOR SN6AD1多焦点人工晶状体;对照组78例85眼,植入AcrySof Natural单焦点人工晶状体,比较术后1周、1个月和3个月两组患者的裸眼及最佳矫正远、中、近视力,并对比术后3个月时两组患者的拟调节力和生活质量调查评分.结果 术后1周、1个月和3个月两组患者均能获得满意的远视力,观察组裸眼中视力分别为0.49±0.19、0.72±0.21、0.77±0.23,对照组分别为0.24±0.21、0.27±0.22、0.28±0.24,两组比较差异均有统计学意义(均为P＜0.05);裸眼近视力观察组分别为0.47 ±0.20、0.70±0.22、0.80±0.24,对照组分别为0.21 ±0.23、0.23 ±0.19、0.26±0.18,两组比较差异均有统计学意义(均为P＜0.05);两组患者的裸眼远视力及最佳矫正远、中、近视力比较差异均无统计学意义(均为P＞0.05).术后3个月,观察组的视远拟调节力和视近拟调节力分别为(2.56±0.82)D、(3.19±1.13)D,对照组分别为(0.87±0.57)D、(1.03 ±0.59)D,两组比较差异均有统计学意义(均为P＜0.05).观察组患者VF-14量表评分和视近时戴镜评分分别为(92.21±4.22)分、(4.23±0.85)分,对照组分别为(71.23±3.96)分、(2.01±0.71)分,两组比较差异均有统计学意义(均为P＜0.05).结论 多焦点人工晶状体能够帮助患者获得全程视力,解决单焦点人工晶状体视中、视近的不足,改善拟调节力,提高患者的生活视觉质量.     

可调节人工晶状体预留度数设计的临床观察

目的 观察可调节人工晶状体预留度数植入术后的视觉质量及调节力的变化.方法 将30例(60只眼)植入可调节人工晶状体,其中将15例(30只眼)植入度数设计(SRKT公式)为主视眼植入理论值过矫0.5D度数,非主视眼植入理论值过矫1.0D度数作为研究组;随机选取15例(30只眼)植入度数设计为主视眼和非主视眼均植入SRKT公式理论值度数作为对照组.手术后随访3个月以上,观察远视力、近视力,最佳矫正远、近视力;调节力的测定(分别用主观法和客观法);双眼合视的远、近视力.结果 研究组术后屈光度主视眼为(0.512±0.15)D,非主视眼为(1.13±0.12)D.研究组与对照组主视眼裸眼远视力及最佳矫正远视力分别为0.89±0.11、0.91±0.12和0.97±0.23、0.99±0.14,差异均无统计学意义.33cm近视力及最佳矫正近视力主视眼分别为0.63±0.16、0.48±0.23和0.97±0.25、0.86±0.14,差异有统计学意义;非主视眼最佳矫正近视力为0.99±0.15和0.89±0.14,差异有统计学意义.两组调节幅度主观法分别为(3.35±0.71)D和(3.27±1.32)D,差异无统计学意义;客观法主视眼分别为(0.38±0.12)D和(0.37±0.08)D,差异无统计学意义.双眼合视的远视力分别为0.99±0.11和0.98±0.21,差异无统计学意义;双眼合视的近视力分别为0.91±0.20和0.61±0.17,差异有统计学意义.结论 植入可调节人工晶状体预留度数设计的术后视力主视眼远视力及最佳矫正远视力、双眼合视远视力均无显著差异;33cm近视力和最佳矫正近视力主视眼和非主视眼差异均有统计学意义,双眼合视的近视力差异有统计学意义.可调节人工晶状体在自身调节能力基础上设计预留一定的度数,可明显改善近视力视功能.     

+3.00 D和+2.50 D近附加度数多焦点人工晶状体植入术后视觉质量比较

目的：比较+3.00 D和2.50 Diopter （D）近附加度数的渐进衍射型多焦点人工晶状体（IOL）植入术后的视觉质量。方法： 前瞻性临床研究。选择2014年5月至2015年12月在温州医科大学附属眼视光医院行白内障超声乳化吸除术的患者,根据植入多焦点IOL的类型分为2 组：近附加为+2.50 D的为观察组,近附加为+3.00 D的为对照组。术后3 个月检查屈光状态、视力（LogMAR）、离焦曲线、对比敏感度,采用客观视觉质量分析系统检测调制传递函数（MTF）、客观散射指数（OSI）等。采用问卷 调查术后生活质量。计量资料满足正态分布且方差齐,采用t 检验;方差不齐,采用校正t 检验。计数资料采用卡方检验。结果：对照组24 例（32 眼）,观察组28 例（33 眼）,2 组术后矫正远视力分别为0.03±0.06、0.05±0.07（t =-1.179,P =0.228）,远矫正下80 cm中距离视力分别为0.32±0.17、0.25±0.11（t =2.761,P =0.017）,远矫正下33 cm近距离视力分别为0.22±0.11、0.31±0.20（t =-4.188,P =0.019）。2 组的离焦曲线均形成双峰,但观察组的两峰之间曲线平缓。在-1.50 D时,观察组视力优于对照组（t =2.103, P =0.038）,在-3.00、-3.50、-4.00 D时对照组视力优于观察组（t =-3.183、-2.678、-3.330,P < 0.01）。不同环境亮度下,2 组在不同空间频率的对比敏感度差异均无统计学意义。2组的MTF截止频率、OSI值差异无统计学意义。主观视力满意度、完全脱镜率及视觉干扰现象,2 组比较差异均无统计学意义。结论：与近附加+3.00 D的多焦点IOL相比,近附加+2.50 D的多焦点IOL在远视力、客观视觉质量、患者主观视觉感受及术后脱镜率方面均无明显差异,但中间距离视力较好,30 cm处近距离视力较差。     

ICU人工晶状体植入术后的早期临床效果

目的:比较白内障超声乳化术联合ICU(德国HumanOptics公司)可调节人工晶状体植入术后效果与传统单焦后房型UV型(日本HOYA公司)人工晶状体植入术后效果之间的差异。方法:所有患者均行白内障超声乳化联合人工晶状体植入术。比较18例(20眼)患者ICU可调节人工晶状体植入及20例(20眼)患者UV型后房型人工晶状体植入术后1wk、1mo时的裸眼远视力、最佳矫正远视力、近视力(35cm)及矫正远视力的近视力(35cm)、主观调节近点、10g/L硝酸毛果芸香碱滴眼30min后利用A型超声波测量前房深度(anterior chamber depth,ACD)变化等多项指标之间的差异。结果:两组数据间比较,除术后远视力及最佳矫正远视力无显著性差异外,其它指标间比较均有非常显著性差异(P<0.01)。结论:ICU可调节人工晶状体相对于传统单焦后房型人工晶状体具有更高调节力、更佳的近视力,同时也具有良好的远视力。但术后调节幅度有限,长期效果如何有待进一步观察、研究。     

非球面多焦点人工晶状体＋3．0D视觉功能的临床研究

目的比较三种多焦点人工晶状体（IOL）ReSTOR＋4．0D、IQReSTOR＋4．0D和IQReSTOR＋3．0D的临床效果,评估植入IOReSTOR＋3．0D后的视觉功能。设计前瞻性病例系列研究。研究对象老年性白内障患者47例（72眼）。方法对以上患者行白内障超声乳化吸除和IOL植入术,按患者自愿原则,分别植入ReSTOR＋4．0D18例（27眼）,IQReSTOR＋4．0D15例（25眼）,IQReSTOR＋3．0D14例（20眼）。比较患者术后3个月的近距离、中距离和远距离视力、对比敏感度、波前像差和离焦曲线。主要指标近距离、中距离和远距离裸眼和矫正视力,对比敏感度,波前像差,离焦曲线和问卷调查。结果术后3个月,IQReSTOR＋3．0D组裸眼中距离LogMAR视力（0．169±0．07）较ReSTOR＋4．0D组（0．256±0．08）和IQReSTOR＋4．0D组（0．252±0．08）好,差异有统计学意义（P=0．000,P=0．001）。近距离和远距离视力,三组没有统计学差异（P均〉0．05）。离焦曲线显示IQReSTOR＋3．0D组的近距离视力在…2．0D2．5D,相当于眼前40～50cm范围有一高的平台,而ReSTOR＋4．0D组和IQReSTOR＋4．0D组仅为一个点。三组患者术后3个月的夜间视力模糊、眩光和光晕没有统计学差异。结论衍射多焦人工晶状体＋3．0D较＋4．0D能够提供更好的中距离视力和一定距离范围近视力。（眼科。2010,19：84-88）     

衍射型多焦点人工晶状体植入术后临床效果

目的:探讨衍射型多焦点人工晶状体植入术后的临床效果。方法:所有患者按照植入的人工晶状体类型分成多焦组和单焦组。多焦组植入衍射型多焦点人工晶状体AcrySof ReSTOR(Alcon),72例(109眼);单焦组植入单焦点人工晶状体AcrySof SA60AT(Alcon)作为对照,88例(130眼)。术后随访6~24mo,观察瞳孔直径,远近视力,最佳矫正视力,脱镜率,术后屈光状态、夜间视觉干扰现象等指标。结果:两组间在远视力和最佳矫正远近视力方面没有显著性差异,而近视力多焦组达到或超过J3的患者101眼(92.7%),单焦组12眼(9.2%),差异具有显著性(χ2=166.44,P=0.00)。两组完全脱镜率分别为98眼(89.9%)和9眼(6.9%)。多焦组完全脱镜的患者术后平均等效球镜为-0.03±0.45D(-1.0~+0.50D),6例7眼(6.4%)视近远时都需戴镜矫正,术后平均等效球镜+1.14D。结论:衍射型多焦点人工晶状体植入后能够使患者获得理想的远近视力,大大降低了患者对眼镜的依赖性。人工晶状体的屈光力测量精确性是增加术后脱镜率的重要因素,应该尽量避免术后等效球镜大于+0.50D。