角膜破裂缝合联合白内障摘出人工晶状体植入

目的：探讨角膜破裂缝合、白内障摘出、人工晶状体植入三联手术的临床疗效。方法：36例（37眼）角膜破裂合并外伤性白内障患者，施行角膜破裂缝合、白内障摘出及人工晶状体植入联合手术。结果：术后最佳矫正视力＜0．1者2眼（5．4％），0．1－0．3者10眼（27％），0．4－0．5者20眼（54％）；＞0．5者5眼（13．6％）。结论：角膜破裂缝合、白内障摘出及人工晶状体植入三联手术，具有并发症少，术后视力恢复快，治愈率高及病程短等优点。     

反眉形小切口白内障囊外摘出人工晶状体植入

目的探讨小切口非超声乳化白内障囊外摘出术联合人工品状体植入术在农村白内障复明手术中的应用。方法经巩膜隧道行反眉形小切口白内障囊外摘出联合人工晶状体植入的老年性白内障96例（96眼），分析其术后并发症及术后恢复视力情况。结果术后3天，视力0．5以上者31眼（32．29％），0.3以上者24眼（25．00％）。4周后视力达0．6以上者46眼（47．92％），0．3以上者35眼（37．50％）。术后并发症在1月内消失。结论老年性白内障采用小切口非超声乳化白内障囊外摘出并人工晶状体植入术，手术组织损伤轻，术后视力恢复快，散光小，由于费用较低，易在广大农村基层医院推广。     

无缝线隧道式小切口白内障摘出术112例

目的：探讨无缝线隧道式小切口白内障摘出并人工晶状体植入术的手术技巧及临床效果。方法：对12例（136眼）白内障病人采用6mm挑眉式巩膜隧道切口完成白内障摘出并行人晶状体植入108例。结果：术后1周视力达0．5以上者96眼（71％），术后1月视力0．5以上者109眼（80％），术后无严重并发症，角膜散光轻，结论：该术式具有切口小，愈合快，术后散光少，视力恢复快及操作简单，无需特殊设备之优点。适合基层医院推广。     

角膜穿孔伤并白内障人工晶状体植入临床观察

目的探讨角膜穿孔伤合并外伤性白内障患者，人工晶状体植入联合手术方法及效果。方法对32例（32眼）角膜穿孔伤合并外伤性白内障施行的囊外摘出联合人工晶状体植入术进行回顾性分析。13眼采用Ⅰ期角膜缝合联合白内障囊外摘出联合人工晶状体植入术。19眼采用Ⅱ期白内障囊外摘出联合人工晶状体植入术。结果术后随访1-3月，视力≥1．0者4眼，占12．50％；0．5-0．9者19眼，占59．38％；0．1-0．4者6眼，占18．75％；0．1以下者3眼，占9．38％。结论角膜缝合，晶状体摘出和人工晶状体植入三联合手术的手术时机及术式的选择非常重要，同时须对术中、术后并发症采取合理的治疗措施。     

可调节折叠人工晶状体临床应用初步报告

目的：通过植入一种新型的可调节折叠人工晶状体1CU，观察患者术后远近视力，观察改型人工晶状体的拟调节力。方法：对10眼单纯老年性白内障患者实施超声乳化联合囊袋内可调节折叠人工晶状体植入术，同期随机抽取10眼单纯老年性白内障行超声乳化及单焦点折叠晶状体植入术作为对照，于术前、及术后1wk；1，3mo查裸眼远近视力、矫正视力，并进行主客观验光。结果：1CU组裸眼近视力优于对照组（0．01〈P〈0．02），裸眼远视力及矫正远近视力无显著差异（P，0．2），两组手术前后散光无显著差异（P〉0．05）。结论：植入可调节折叠人工晶状体后，术眼具有一定的假晶状体调节。     

小切口晶状体异物摘出白内障摘出联合折叠式人工晶体植入临床观察

目的探讨小切口晶状体异物摘出白内障摘出联合折叠式人工晶状体植入的方法疗效。方法根据异物部位不同采用不同摘出方法。结果术后视力1．0者2眼，0．8者4眼，0．6者2眼。结论采用此术式可废除分次手术的方法，住院时间短，及早恢复双眼单视功能，切口不缝合，散光小，视力提高快。     

Array多焦点人工晶状体的临床应用

目的　探讨Array多焦点人工晶状体的临床应用价值。方法　对5 0眼白内障实施晶状体超声乳化并植入Array多焦点人工晶状体(MIOL) ,对照组5 0眼植入眼力健单焦点人工晶状体(SIOL) ,观察术后1周裸眼远视力、矫正远视力、裸眼近视力、以视远矫正度数矫正近视力、中间距离视力、对比敏感度、视觉症状及MIOL组术前术后散光变化。随访3月,观察后发性白内障的发生率。结果　两组裸眼远视力、矫正远视力无明显差异(P >0. 0 5 ) ;裸眼近视力、视远矫正度数矫正近视力及中间距离视力,MIOL组明显优于SIOL组(P <0 . 0 5、P <0 . 0 1) ;后发性白内障MIOL组13眼(2 6 .0 0 % ) ;SIOL组5眼(10. 0 0 % ) ,二者具有统计学意义(P <0 .0 5 ) ;MIOL组手术前、后的散光状态无明显变化(P >0. 0 5 ) ;MIOL组对比敏感度明显下降。结论　MIOL在保证远视力的同时,又获得很好的中、近视力,取得近似“天然”的全程视力,使白内障术后患者生活质量大为提高。     

超声乳化后新型多焦点人工晶状体植入术疗效观察

目的观察和评估白内障超声乳化后Array多焦点人工晶状体植入术后的临床疗效。方法老年性白内障患者6例12眼(均为男性)进行超声乳化摘出Array多焦点人工晶状体植入手术,观察术中并发症、术后远近视力及角膜曲率。结果术后1周平均非矫正远近视力分别为0.98和0.55;术后1个月平均非矫正远视力及最佳矫正近视力均达1.0。术后角膜散光度与术前无明显变化。结论Array多焦点人工晶状体植入术后患者远近视力均较为理想,且手术引起的角膜散光度小,是一种较为理想的人工晶状体。     

边疆基层医院人工晶状体植入术后视力效果分析

目的 探讨边疆基层医院开展人工晶状体植入手术的效果及并发症的处理。方法 1998年10月～2004年2月对96例108眼各种白内障现代囊外摘出联合人工晶状体植入术，进行视力效果分析。结果 96例108眼病例在局麻下完成，术后矫正视力0．06～0．2者5例；0．3～0．5者51例；0．6～0．8者43例；1．0～1．5者9例。结论 在边疆基层医院开展人工晶状体植入手术．费用低，痛苦小，视力恢复快，对并发症及时处理，可恢复有用视力，可提高患者的生活质量，减轻社会和家庭的负担。     

中老年屈光参差患者晶状体超声乳化摘除及多焦点人工晶状体植入术的临床研究

目的 通过对中老年屈光参差患者进行晶状体超声乳化摘除联合多焦点人工晶状体植入术后远、近视力及立体视觉的研究,探讨Array SA-40NBTM多焦点人工晶状体植入治疗中老年双眼近视合并屈光参差的有效性和安全性。方法 收集我科2002年1月至2004年12月期间中老年双眼近视合并屈光参差(部分合并白内障)进行晶状体超声乳化摘除联合多焦点人工晶状体植入的病例,排除合并有其他眼病及伴有可能影响视力的全身疾病者,研究其术后远、近视力、立体视觉及其并发症。结果 术前近视为-2．50D～-12．5D,平均(-6．502±3．50)D;散光为0～1．50D,平均(0．75±0．50)D。双眼屈光度之差：近视为2．5D～6．5D,平均(3．5±1．25)D,散光为0～1．50D。术后随访3月～2年。术后20例患者的屈光参差均好转。两眼术后屈光度之差为0～1．25D,平均(0．5±0．5)D,14只眼(70％)术后最佳矫正视力较术前最佳矫正视力有显著提高。结论 多焦点人工晶状体植入术是安全有效的治疗屈光参差的手术方法,值得临床应用和推广。     

有晶状体眼后房型人工晶状体植入术矫正高度近视

探讨有晶状体眼后房型人工晶状体（phakic intraocular lens,PIOL）植入术矫正高度近视的有效性和安全性。 方法：本研究中高度近视患者17例33眼,术前屈光度-8.00～-24.00 (平均-15.46±6.26)D,眼轴长度25.33～33.77(平均30.22±2.55)mm。33眼植入后房型人工晶状体也称植入性接触镜（implantable contact lens,ICL& toric implantable collamer lens, TICL）。其中,22眼植入ICL,11眼植入TICL。术后观察视力、屈光度、眼压、人工晶状体位置等。 结果：所有病例均成功植入后房型人工晶状体。术后1wk,所有手术眼达到或超过术前最佳矫正视力,屈光度和眼压稳定。 结论：有晶状体眼后房型人工晶状体植入术治疗高度近视安全有效,适用屈光度范围广,术后屈光度稳定,视觉质量提高     

Near vision after implantation of monofocal versus multifocal intraocular lenses

AIM: Object of this study was to compare the near visual acuity between eyes with monofocal intraocular lens (MONO) and myopic target refraction in comparison with eyes after refractive multifocal intraocular lens (MIOL) implantation and emmetropic to slight hyperopic target refraction. PATIENTS AND METHOD: 89 eyes of 83 patients underwent cataract surgery, in 49 eyes a MONO (SI-40NB, Allergan) was implanted, in 40 eyes a refractive MIOL (SA-40N, Allergan). At day 2 after surgery and after 5 months the uncorrected near visual acuity, the near visual aculty with distance correction and with an addition of +3 diopters (D) were determined. The refractive outcome targeted in case of MIOL implantation was emmetropia to slight hyperopia and myopia for the MONO subjects. The eyes with MONO were classified in 4 categories depending on their postoperative refractive error (spherical equivalent, SE): category 1 with SE +1 to > 0 D, category 2 with SE 0 to > -1 D, category 3 with SE -1 to > -2 D and category 4 with a SE -2 to > -3 D. RESULTS: We found a statistically significant better uncorrected near visual acuity in eyes with MIOL than in MONO subjects for category 1-3. In category 4 there was no statistically significant difference between MONO and MIOL. With best distance correction near visual acuity in MIOL was statistically significant better than in all 4 MONO categories. After adding 3 D, there was no statistically significant difference between the groups. CONCLUSION: Even in case of a myopic target refraction near visual acuity in eyes of the MONO group was statistically significant worse than in the eyes of the MIOL group. Only in case of postoperative SE of < or = -2 D eyes of the MONO group had a near visual acuity similar to the eyes of the MIOL group. This advantage is accomplished with a decrease in the uncorrected distance visual acuity.     

ReSTOR diffractive versus Array 2 zonal-progressive multifocal intraocular lens: a contralateral comparison

PURPOSE: To evaluate near and distance visual performance after implantation of a diffractive multifocal intraocular lens (MIOL) (AcrySof ReSTOR) or a refractive MIOL (Array 2) in bilateral cataract surgery. METHODS: In this prospective, comparative trial, 18 patients with bilateral cataract were selected to have lens surgery with asymmetric MIOL implantation. Eighteen eyes received ReSTOR MIOL and the 18 fellow eyes were implanted with Array 2. Five months after second lens implantation, main postoperative outcomes were uncorrected and distance corrected near visual acuities (VA). Secondary outcomes were distance VA and near acuity with power add, contrast sensitivity with and without glare (Pelly-Robson Contrast Sensitivity Chart, CSV 1000 HGT). Quality of vision was measured by comparing the severity of visual symptoms as referred to a masked interviewer. RESULTS: Patients reported similar postoperative distance visual acuities for both eyes. ReSTORimplanted eyes showed better uncorrected and distance corrected near acuity than eyes with Array 2 (p=0.002 and p=0.003, respectively). Intermediate VA with distance correction was slightly higher with the Array 2 MIOL (p=0.058). No important difference was observed in contrast sensitivity, glare disability, and subjective rating of light sensations. Severe photic phenomena were reported only for one Array 2-implanted eye. CONCLUSIONS: The diffractive MIOL showed better uncorrected and distance corrected near VA. The refractive Array 2 MIOL had a tendency to better value for intermediate distance. Disturbing photic phenomena were observed only in one case with the Array 2 MIOL.     

ReSTOR多焦点人工晶状体植入术后全程立体视觉质量分析

目的 比较双眼植入ReSTOR＋3D多焦点人工晶状体（MIOL）与单焦点人工晶状体（SIOL）术后的近、中、远视力和立体视觉质量.方法 前瞻性对照研究.选择接受白内障超声乳化吸除联合人工晶状体植入术的患者共46例（92眼）,年龄45～67岁.按植入人工晶状体的不同分为两组：ReSTOR＋3D（AcrySof ReSTOR SN6AD1）MIOL组23例（46眼）,AcrySof IQ（AcrySof IQ SN60WF）SIOL组23例（46眼）,均非同期手术.患者分别于第二只眼术后3个月时检查裸眼及配戴最佳远距离矫正眼镜时的近、中、远视力和立体视锐度,并对术后患者主观立体视觉质量进行问卷调查.样本均数的比较采用配对t检验,样本率之间比较采用x2检验.结果 术后3个月,裸眼近、中视力及最佳矫正近、中距离视力比较,MIOL组明显优于SIOL组,差异均有统计学意义（x2分别为26.2、23.7、29.3、25.0,P均＜0.05） 裸眼远视力及最佳矫正远视力比较,两组差异均无统计学意义（P＞0.05）.裸眼及最佳矫正下的立体视锐度比较：MIOL组的近立体视锐度明显优于SIOL组,差异均有统计学意义（x2分别为26.3和23.5,P均＜0.05） MIOL组的中距离立体视锐度亦优于SIOL组,差异有统计学意义（x2分别为15.2和12.6,P均＜0.05） 而两组的远立体视锐度比较,差异均无统计学意义（P＞0.05）.MIOL组对近、中距离立体视觉质量的满意度为4.05±0.25和4.25±0.25,均高于SIOL组,差异有统计学意义（t分别为5.4和5.1,P均＜0.05） 而两组对远距离立体视觉质量的满意度差异无统计学意义（P＞0.05）.结论 ReSTOR＋3D MIOL的近、中距离视力和立体视锐度明显优于SIOL,可为患者提供更好的立体视觉质量,患者术后对近、中距离立体视觉质量的满意度更高.     

双眼多焦点人工晶状体术后远期双眼视觉变化

目的探讨双眼植入多焦点人工晶状体(MIOL)后远期患者视觉质量的恢复情况。方法观察16例32眼植入MIOL的患者和13例26眼双眼植入单焦点人工晶状体(SIOL)的患者术后6个月以上视力、立体视觉和影像不等的改变,并进行问卷调查。结果MIOL眼远期近视力和矫正远视度数下的近视力明显较SIOL好;裸眼状态下MIOL组近立体视锐度明显优于SIOL组;两组患者均只有一例出现影像不等的现象;MIOL组脱镜率明显高于SIOL组。结论双眼植入MIOL可以获得满意的双眼视觉及正常的远近立体视锐度,明显提高患者的视觉质量。     

Influence of astigmatism on multifocal and monofocal intraocular lenses

PURPOSE: To examine the influence of astigmatism on the visual acuity of patients with multifocal and monofocal intraocular lenses. METHODS: Thirty eyes of 30 patients who underwent five-zone refractive multifocal intraocular lens implantation and 30 eyes of 30 age-matched patients who had monofocal intraocular lens implantation were included. The visual acuities of these patients at 5.0, 3.0, 2.0, 1.0, 0.7, 0.5, and 0.3 m were measured by means of an all-distance vision tester after addition of a cylindrical lens of 0, 0.5, 1.0, 1.5, 2.0, and 2.5 diopters. RESULTS: Mean visual acuity at all distances decreased in proportion to the diopters of astigmatism in both the multifocal and monofocal intraocular lens groups. When astigmatism was 0.5, 1.0, or 1.5 diopters, distance visual acuity in the multifocal group was significantly worse than that in the monofocal group; with astigmatism of 2.0 diopters or more, intermediate visual acuity was also worse in the multifocal group. In contrast, near visual acuity in the multifocal group was significantly better than that in the monofocal group at all astigmatic diopters. When astigmatism was within 1.0 diopter, visual acuity in the multifocal group reached 20/29 at distance and 20/50 at near. Mean contrast sensitivity was also worse in the multifocal group than in the monofocal group. CONCLUSIONS: Both distance and intermediate visual acuity deterioration caused by astigmatism was greater with a multifocal intraocular lens than with a monofocal intraocular lens, whereas near visual acuity was better with the multifocal intraocular lens. When astigmatism was within 1.0 diopter, eyes with a multifocal intraocular lens achieved good visual acuity at both distance and near.     

有晶状体眼后房型人工晶状体植入矫正中高度散光

目的评价有晶状体眼后房型人工晶状体植入矫正中高度散光的有效性、安全性及稳定性。方法选取高度散光105例（187眼）,植入带散光的后房型人工晶状体。随访观察3～36个月。结果裸眼视力均有明显提高,3个月后裸眼视力≥术前最佳矫正视力者182眼占97.33%,散光度数在±1.00D以内者占91.27%,残留散光平均为（-0.56±0.3）D,矫正者占89.72%,术前与术后差异有统计学意义（P〈0.01）。术后2眼（1.07%）发生晶状体前囊下浑浊。结论有晶状体眼后房型人工晶状体植入矫正中高度散光具有有效性、安全性及稳定性。     

双眼多焦点人工晶状体ReSTOR植入术后视功能观察

目的 通过比较植入单、多焦人工晶状体(IOL)术后双眼视功能情况,以了解国人植入多焦点IOL的有效性及安全性.方法 选择年龄相关性白内障患者43例,按患者意愿植入多焦点或单焦点IOL.单焦点人工晶状体(MoIOL)组:双眼植入AcrysofNatural25例50只眼.多焦点人工晶状体(MIOL)组:双眼植入AcrysofReSTOR 18例36只眼.观察两组组患者术后双眼裸眼远视力(UCDVA)、裸眼近视力(UCNVA)、最佳矫正远视力(BCDVA)、最佳矫正近视力(BCNVA)、远矫正下的近视力(DCNVA),中间距离视力(40、60、80cm),对比敏感度(CS),视觉症状.结果 MIOL组UCNVA、DCNVA、中间距离视力均优于单焦点人工晶状体MoIOL组,差异有统计学意义(P＜0.05).两组之间,CS无明显差异.MIOL组术后视觉症状较轻,脱镜率80%,患者满意度高.结论 双眼植入MIOL能提供更好的近、中距离视力,视觉症状轻,更好地提高白内障患者术后生活质量.     

后房型有晶状体眼人工晶状体植入术治疗高度近视及散光

目的 探讨后房型有晶状体眼人工晶状体植入术治疗高度近视及散光的安全性和疗效性.方法 后房型有晶状体眼人工晶状体植人术治疗高度近视及散光22例39只眼.术前屈光度(等效球镜)为-7.0～-24.0D,平均(-14.50D±3.50)0;散光-0.50～-4.50D,平均(-2.25±1.32)D.术后检查视力、眼压、裂隙...     

Tecnis ZM900和Rezoom多焦点人工晶状体植入术后视功能比较

目的 比较Tecnis ZM900和Rezoom多焦点人工晶状体（MIOL）植入术后的视功能情况.方法 前瞻性对照研究.拟行白内障超声乳化吸除术患者36例（40眼）,年龄55～83岁.按照患者植入人工晶状体的不同分为两组：Tecnis组22例（25眼）,植入TecnisZM900 MIOL Rezoom组14例（15眼）,植入Rezoom MIOL.术后3个月,随访观察两组的屈光状态及最佳矫正远视力,远、中、近距离裸眼视力,并检查明、暗光条件下对比敏感度和球差.采用两样本t检验对结果进行分析.结果 术后3个月,两组最佳矫正远视力、裸眼远视力、100 cm中距离视力比较,Rezoom组优于Tecnis组（t=0.85、2.50、2.15,P＜0.05）.两组63 cm中距离视力和40 cm近视力比较,差异无统计学意义（t=1.55、0.45,P＞0.05）.33 cm近视力比较,Tecnis组优于Rezoom组（t=5.52,P＜0.05）.暗光条件下低频（3、6 c/d）对比敏感度比较,Tecnis组优于Rezoom组（t=2.15、3.01,P＜0.05） 而两组暗光下高频和明光下各空间频率对比敏感度比较,差异均无统计学意义（P＞0.05）.在3、4、5 mm瞳孔直径下,Tecnis组全眼球差均低于Rezoom组,差异有统计学意义（t=2.16、2.28、4.00,P＜0.05）.结论 Rezoom MIOL能提供较好的远、中距离视力,近视力相对较差 Tecnis ZM900 MIOL能提供较好的远、近视力,中距离视力相对较差.相对于Rezoom MIOL,Tecnis ZM900 MIOL的非球面设计降低了全眼球差,改善了暗光大瞳孔下的低频区对比敏感度.