散光多焦点IOL植入术后视觉质量及患者满意度研究

目的：观察白内障超声乳化术后植入AT LISA Toric 909MP(909M)散光矫正型多焦点IOL和AT TORBI 709M(709M)散光矫正型单焦点IOL术后视觉质量及患者满意度。

方法：选取2017-12/2018-12在本院行超声乳化IOL植入术合并散光大于1.0D的白内障患者40例56眼,根据患者自愿植入单焦点散光或多焦点散光IOL分为2组,909M组23例35眼,709M组17例21眼,术后随访3mo,观察术后两组视力恢复情况、离焦曲线、残余散光度数、晶状体旋转度、术后视觉质量分析及患者满意度。

结果：治疗后两组的裸眼远视力及最佳矫正远视力较术前明显改善(P<0.05)。离焦曲线显示909M组在0D和-2.5D时有两个视力峰值,在-1D有一个低的峰值。709M组仅在0D有视力峰值。909M组脱镜率为91%(21/23),709M组的脱镜率仅为18%(3/17)。

结论：多焦点和单焦点IOL对于白内障合并散光有良好的矫正效果,旋转稳定性良好,且多焦点IOL为患者提供了良好的远近视力以及可以接受的中视力,提高了患者的脱镜率和满意度。     

后房型人工晶体植入术后高眼压及处理

目的探讨后房型人工晶体植入术后高眼压及处理。方法分析58例68眼后房型人工晶体植入患者的高眼压发生率。结果其中23眼（33．82％）术后第一天眼压大于21mmHg，睫状沟固定型高眼压发生率为30．5％     

Visual outcomes and patient satisfaction after bilateral implantation of a new trifocal diffractive intraocular lens

Purpose

To assess the visual outcomes, patient satisfaction and spectacle independence following implantation of new diffractive trifocal intraocular lenses.

Siderosis bulbi induced by intraocular lens implantation

A 43-year-old man had a silent intraocular foreign body at the ciliary body that was composed of iron. Siderosis bulbi was observed after an extracapsular cataract extraction with intraocular lens implantation was performed. The mechanical forces applied during the surgery might have been responsible for liberating the ferrous ion into the globe.     

Functional outcome and patient satisfaction after Artisan phakic intraocular lens implantation for the correction of myopia

PURPOSE: To determine patient satisfaction after Artisan phakic intraocular lens (PIOL) implantation to correct myopia. DESIGN: Non-comparative prospective case series. METHODS: One hundred twenty eyes of 60 patients who had undergone Artisan PIOL implantation to correct myopia were analyzed. A validated questionnaire that consisted of 66 satisfaction items were self-administered by patients 12 months after surgery. Clinical parameters (PIOL decentration, the difference between pupil size and PIOL optical zone, and optical aberrations) were measured. Main outcome measures of satisfaction scale scores (global satisfaction, quality of uncorrected and corrected vision, night vision, glare, day and night driving) were analyzed. Correlations with clinical parameters were obtained. RESULTS: After surgery, 98.3% of patients were satisfied, and 73.3% of patients considered their night vision to be the same or better; 44.1% of patients reported more bothersome glare. The night vision score correlated with spheric aberration (r = -0.303; P = .020). The glare score correlated with the difference between scotopic pupil size and PIOL optical zone (r = -0.280; P = .030) and vertical coma (r = -0.337; P = .009). The night driving score correlated with postoperative spheric equivalent (r = 0.375; P = .009), total root mean square aberrations (r = -0.337; P = .017), higher order root mean square aberrations (r = -0.313; P = .027), and vertical coma (r = -0.297; P = .036). CONCLUSION: Overall satisfaction after Artisan PIOL implantation for myopia is excellent. The quality of night vision and night driving were related to scotopic pupil size, individual higher order aberrations, and residual refractive error.     

Ocular dominance diagnosis and its influence in monovision

PURPOSE: To analyze the response of normal emmetropic subjects to different ocular dominance tests and to analyze the influence of this response in surgically induced monovision. DESIGN: A prospective study of diagnostic accuracy was carried out to analyze the different tests to determine ocular dominance, without a gold standard test. METHODS: Nine different tests were carried out in a group of 51 emmetropic subjects to determine both motor and sensory ocular dominance. For analysis, patients were divided into two groups according to age. Normal ophthalmologic examination results were the inclusion requirement, with normal binocular vision and good stereoacuity. RESULTS: A significant percentage of uncertain or ambiguous results in all tests performed was found, except in the hole-in-card and kaleidoscope tests. When the tests were compared, two by two, the correlation or equivalence found was low and was much lower if tests were compared three by three. CONCLUSIONS: No clear ocular dominance was found in most studied subjects; instead, there must be a constant alternating balance between both eyes in most emmetropic persons, but not in those with pathologic features. This fact would explain the great variability both between and within different kinds of tests. Also, it would establish that the monovision technique is well tolerated in most patients, with unsuccessful results only in those patients with strong or clear dominance. Consequently, it seems appropriate to evaluate patient's dominance before monovision surgery to exclude those individuals with clear dominance.     

Ocular pneumoplethysmography after lens implantation

A series of letters in this journal discussed the safety of ocular pneumoplethysmography (OPG-Gee) in pseudophakic patients. In the interval since these letters, experience with OPG-Gee tests performed on 115 pseudophakic eyes demonstrated no ocular morbidity associated with these procedures.     

Ocular dominance and the interocular suppression of blur in monovision

Presbyopic contact lens patients with monocular corrections (monovision) see clearly at all distances by virtue of an interocular suppression of anisometropic blur that occurs regionally between corresponding retinal areas. This suppression fails to occur with small high-contrast targets viewed under low luminance conditions. The effect of target size and contrast upon interocular suppression of blur was quantified by reducing contrast of a bright test spot, viewed binocularly while wearing various plus lenses monocularly, until the out-of-focus image was suppressed. The strength of interocular suppression was equivalent when the plus lens was before either eye. However, after subjects wore a plus lens over their nonsighting eye for one day, interocular suppression of blur became enhanced when the nonsighting eye was blurred, and it became reduced when the sighting eye was blurred. Successful monovision subjects suppressed blur at higher contrast levels than did unsuccessful subjects. These results suggest a possible clinical test for quantifying adaptation to monovision.     

人工晶状体植入术后眼压观察

目的 探讨白内障囊外摘出人工晶状体植入术后眼压的变化。方法 ６３例随机分为甲组（不用药组）、乙组（用降眼压药组）,观察和对比术后７２小时内眼压。结果 术后１２小时〉２．８０ｋＰａ者,甲组占５４．５％,乙组占２６．６７％。２４小时后眼压下降。７２小时平均眼压甲组明显高于乙组（Ｐ〈０．０５）。结论 术后预防性应用降眼压药对降低人工晶状体植入术后眼压升高有明显作用。     

Retinal detachment after intraocular lens implantation

Between August 1982 and July 1985, 19 eyes were operated for pseudophakic retinal detachment (PRD) (Anterior chamber lens in 13 eyes, posterior chamber lens in 3 eyes and iris supported lens in 3 eyes). The characteristics of these pseudophakic retinal detachments were very similar to those following intracapsular cataract extractions. Retina was re-attached in 18 eyes (95%), in 14 eyes, after one buckling procedure. In 4 eyes, altogether 12 surgical procedures were needed to re-attach the retina. Problems to visualize the peripheral retina, made it necessary to remove the IOL in 3 eyes (2 iris fixated and one in the anterior chamber).     

人工晶体眼的视网膜脱离

为分析人工晶体植入后的视网膜脱离的特殊性,对我院自９１年到９６年收治的人工晶体眼视网膜脱离４２例４４眼进行临床观察,并对其特殊性予以分析和讨论。结果：人工晶体眼视网膜脱离有发展快,裂孔难以寻找,增殖的后囊膜和人工晶体遮挡视路使检查很困难等特点,并易发展为复杂性视网膜脱离,治愈率为８０％。结论：在置入人工晶体时要尽量减少对手术眼的损伤,一旦发生视网膜脱离,要加大检查力度,尽早采取传统的视网膜脱离手术和现代玻璃体手术,以增加其疗效。     

人工晶状体植入术后的迟发性葡萄膜炎

目的探讨人工晶状体植入术后的迟发性葡萄膜炎的发病原因及预防方法。方法对不同类型的白内障囊外摘出联合人工晶状体植入术后所发生的迟发性葡萄膜炎11例(11眼)进行回顾性总结,分析其发病原因、发病时间、临床特点及预防方法。结果术后迟发性葡萄膜炎发生率为1.65%;自身免疫反应和术后抗生素、皮质类固醇用量不足是发病的主要原因;本病对皮质类固醇治疗敏感,只要及时治疗,一般预后良好。结论本病是由自身免疫变态反应引起的葡萄膜炎,术中尽量清理残余皮质,术后抗生素、皮质类固醇不可过早停药是降低本病的发生率的关键。     

Proliferative vitreoretinopathy after intraocular lens implantation

The first 3 patients with pseudophakic retinal detachment referred to the Helsinki University Eye Hospital are presented. All had undergone extracapsular cataract extraction with implantation of an iris-supported IOL in one case and a posterior chamber lens in two cases. All showed proliferative vitreoretinopathy (PVR) varying from Grade C2 to D1 when first examined for retinal detachment 6 to 16 weeks after cataract surgery. The retina was primarily re-attached in all cases, but re-detachment occurred in 2 of the 3 due to progressing PVR. Until now our incidence of pseudophakic retinal detachment is 0.3%.