非球面单焦点及多焦点人工晶体眼高阶像差及对比敏感度比较

目的探讨非球面、单焦点及多焦点人工晶体眼的对比敏感度及高阶像差的差别。方法病人进行随机分组,其中一组病人植入非球面人工晶体Z9001,一组植入单焦点人工晶体SA60AT,一组植入多焦点人工晶体SA40N,共124只眼进入本研究。术后由Allegretto Wave Analyzer(Allegretto,Germany)像差仪测量高阶像差,由CSV-1000E(Vector Vision,USA)测量对比敏感度。结果术后的最佳矫正视力,瞳孔直径,撕囊口直径的大小及角膜高阶像差比较,组间差异不具有统计学意义。术后的高阶像差测量,其中球面像差、4阶高阶像差及总体像差比较中SA40N组大于SA60AT组,SA60AT组大于Z9001组。对比敏感度比较,在所有的空间频率3、6、12、18cpd,Z9001组大于SA60AT组,SA60AT组大于SA40N组。结论多焦点人工晶体眼较单焦点人工晶体相比,可以引起眼的高阶像差增加,对比敏感度降低。非球面人工晶体可以减少球面像差、增加对比敏感度。     

多焦点人工晶状体眼对比敏感度的研究

目的观察多焦点人工晶状体植入术后对比敏感度的改变情况,并与单焦点人工晶状体植入者进行比较。方法我院住院的老年性白内障44例(60眼),随机分为两组,每组30眼,均行晶状体超声乳化吸出术。A组植入多焦点人工晶状体,B组植入单焦点人工晶状体。术后1天检查远、近视力,3月进行远、近视力及对比敏感度等视功能的检查,并问卷调查视物情况及视觉症状。结果A组具有与B组一样良好的非矫正远视力(分别为1.00±0.27和0.89±0.23,P>0.05),非矫正近视力A组明显优于B组(分别为0.86±0.27和0.45±0.14,P<0.05);两组患者对比敏感度在低、中空间频段均位于正常范围内,高空间频段则有部分病例稍下降,但两组差异无统计学意义(P>0.05)。多数患者对手术效果满意,A组近距离作业满意度高于B组(85.71%3、4.78%、P<0.05);脱镜两组患者视觉症状均较少(10.00%、3.33%,P>0.05)。结论两种人工晶状体植入术后患者对比敏感度改变无差别,但多焦点人工晶状体植入术后近视力更好,减少了对近用镜的依赖,患者满意度高。     

Comparison of pseudophakic visual quality in spherical and aspherical intraocular lenses

Objective: This study compares the visual performance of spherical and aspherical intraocular lenses (lOLs) by measuring higher-order aberration and contrast sensitivity (CS) values.Design: Prospective controlled study.Participants: Fifty-seven patients with age-related cataract (61 eyes).Methods: Patients were randomly allocated to 1 of 3 groups and implanted with either aspherical IOLs, Acrysof IQ (SN60WF) or Tecnis Z9001, or a spherical IOL, Acrysof Natural. Patients underwent routine examinations, including visual acuity, slit-lamp checks, and best-corrected visual acuity (BCVA), as well as measurement of higher-order aberrations and CS values, preoperatively and at 1 week, 1 month, and 2 months postoperatively.Results: All the patients had a BCVA better than 20/30 postoperatively. The spherical aberrations of the IQ group and Tecnis group were both lower than in the Natural (control) group (IQ: p <Tecnis: p < 0.05); there was no significant difference in coma and higher-order aberration. No statistically significant difference was found in spherical aberration, coma, or higher-order aberration between the IQ and Tecnis groups. Under glare conditions, the CS values of the 2 aspherical IOLs were obviously better (IQ: p < 0.05; Tecnis: p < 0.05) than the CS value of the spherical IOL group at low frequency (IQ: 6.3°, Tecnis: 4.0°); under non-glare conditions there was a significant difference in CS values between the aspherical IOL groups and the control group (IQ: p <Tecnis: p < 0.01) at low frequency (both 6.3°). There was no statistical difference between the IQ and the Tecnis groups with or without glare.Conclusions: An aspherical IOL can effectively reduce spherical aberration after cataract surgery, enhance CS values, and improve visual quality compared with traditional spherical IOLs for age-related cataract. However, there was no statistically significant difference in postoperative aberration and CS values between the Acrysof IQ and Tecnis Z9001 aspherical IOLs.     

不同类型人工晶状体对白内障术后对比敏感度的影响

目的:研究不同类型人工晶状体植入术后暗视和明视下对比敏感度(contrast sensitivity,CS)的变化,评估患者术后的视觉质量。方法:采用对照研究的方法:实验组为2010-03/10期间于我院行超声乳化白内障吸除联合人工晶状体植入术的老年性白内障患者50例55眼。全部患者分为3组,分别植入Sensar AR40e人工晶状体17眼,Bausch&Lomb LI61SE人工晶状体18眼和Array SA40N多焦点人工晶状体20眼,对照组为年龄相匹配的志愿者12例24眼。SensarAR40e人工晶状体的光学材料为疏水性丙烯酸酯,另外2种人工晶状体的光学材料为硅凝胶。检查患者术后和志愿者的最佳矫正视力后暗视和明视下对比敏感度。结果:Array SA40N组的CS除明视下0.8cpd以外在各空间频率较正常对照组均明显下降;Bausch&Lomb LI61SE组的CS在除0.8cpd以外其余各空间频率较正常对照组均明显下降;Sensar AR40e组在0.8cpd,1.5cpd的CS与正常对照组无明显差异,在其余各空间频率较正常对照组均明显下降。Array SA40N组在12cpd,20cpd的CS较其他两组人工晶状体眼下降。Sensar AR40e组和Bausch&LombLI61SE组各空间频率的CS相比较均无明显差异。结论:人工晶状体眼的CS较同龄正常对照组均明显下降;多焦点人工晶状体眼较单焦点人工晶状体眼的CS在高频区明显下降;疏水性丙烯酸酯与硅凝胶两种材料的人工晶状体对白内障术后CS的影响无明显差异。     

ARRAY新型多焦点与单焦点人工晶状体的疗效比较

多焦点人工晶状体植入治疗白内障在临床上的应用日益广泛。与单焦点人工晶状体相比它虽有可能出现对比敏感度下降、夜间眩光感等缺点,但能获得满意的远、近及中等距离视力,且有配镜率低等优点。只要手术适应证掌握得当,植入ARRAY新型多焦点人工晶状体患者术后总满意率是较高的。我们对ARRAY新型多焦点人工晶状体与单焦点人工晶状体的临床疗效比较作一综述。     

球面与非球面IOL在不同瞳孔直径时的对比敏感度与眩光对比敏感度

目的比较球面与非球面人工晶状体（intraocularlens,IOL）在环境照度为85cd.m-2时在3种瞳孔直径：2.0-2.5mm、4-5mm、8mm下的对比敏感度（contrast sensitivi-ty,CS）和眩光对比敏感度（glare contrast sensitivity,GS）的差异。方法收集年龄相关性白内障患者48例（60眼）,行白内障超声乳化吸除或小切口手法摘出联合后房型IOL植入术。根据植入IOL的不同将患者分为2组：球面组和非球面组。30例（35眼）植入球面IOL,18例（25眼）植入非球面IOL。术后1个月检查2组患者在3种瞳孔直径下分别在低频3cycle/degree（cpd）、中频（6cpd）、高频（12cpd、18cpd）时的CS和GS。结果球面IOL组：瞳孔2.0-2.5mm时,各个空间频率的CS与GS之间的差异均无统计学意义;瞳孔4-5mm时,在6cpd、12cpd的CS与GS之间的差异有统计学意义;瞳孔8mm时,全部频率的CS与GS之间的差异均具有统计学意义。非球面IOL组：3个瞳孔直径下各个空间频率的CS与GS之间的差异均无显著性意义。球面与非球面IOL的比较：瞳孔直径2.0-2.5mm及5mm时,在高频段球面与非球面IOL的CS之间的差异有统计学意义;瞳孔8mm时,在低频段两者之间的GS差异有统计学意义,在中频段两者的CS及GS之间差异均具有统计学意义。结论在球面IOL组,随着瞳孔直径的增大,CS及GS均下降,且瞳孔越大,附加眩光时引起CS的下降效应越明显。在非球面IOL组,在各个瞳孔直径时附加眩光均不引起CS的明显下降。瞳孔直径越大,非球面IOL补偿正性球差、减少球面像差的作用越明显。     

非球面多焦点IOL眼的对比敏感度和拟调节力分析

目的评价白内障超声乳化摘出联合非球面衍射型多焦点人工晶状体植入术后患者的视觉质量和拟调节力。方法 54例(75眼)于我院行白内障超声乳化摘出联合人工晶状体植入术的患者进行分组,其中SN6AD3组17例(25眼)植入非球面多焦点人工晶状体Acrysof ReSTOR SN6AD3,SN60D3组18例(25眼)患者植入多焦点人工晶状体Acrysof ReSTOR SN60D3,SN60WF组19例(25眼)植入单焦点非球面人工晶状体Acrysof SN60WF。术后3个月时检查裸眼及矫正远视力、裸眼近视力、最佳矫正远视力下的近视力、拟调节力、对比敏感度,并比较3组患者脱近用镜率。结果术后3个月,三组患者裸眼远视力和最佳矫正远视力差异均无统计学意义(均为P>0.05);SN60D3组和SN6AD3组术后裸眼近视力(0.205±0.111、0.192±0.120)和最佳矫正远视力下的近视力(0.212±0.114、0.250±0.130)明显优于SN60WF组(0.661±0.278与0.661±0.278;均为P<0.01),SN60D3组和SN6AD3组间差异无统计学意义(P>0.05)。眩光及无眩光时,在各空间频率下SN60WF组和SN6AD3组对比敏感度均大于SN60D3组。SN6AD3组调节幅度为(0.925±0.549)D,SN60D3组为(0.964±0.582)D,SN60WF组为(0.390±0.235)D,SN6AD3组与SN60D3组间差异无统计学意义(P=0.993),SN6AD3组与SN60D3组的调节幅度均高于SN60WF组(P<0.01)。SN6AD3组脱近用镜率80%、SN60D3组72%,两组均优于SN60WF组(24%,均为P<0.01)。结论 ReSTOR非球面衍射型多焦点人工晶状体SN6AD3能提供良好的远、近视力,植入后术眼具有较SN60D3更高的对比敏感度,能有效改善白内障患者术后的视觉质量。     

衍射型非球面多焦点人工晶状体眼视功能的初步观察

目的:初步观察植入TecnisZM900衍射型非球面多焦点人工晶状体眼视功能,以评价TecnisZM900衍射型非球面多焦人工晶状体植入的有效性及安全性。方法:共21例(30眼)行白内障超声乳化术患者植入Tec-nisZM900衍射型非球面多焦点人工晶状体,观察患者术后远、近视力,角膜散光度数,对比敏感度,手术并发症,问卷形式调查脱镜率、视觉不良症状和满意度,随访时间为术后3～12mo。结果:植入TecnisZM900MIOL患者术后3mo裸眼远、近视力分别为1.00±0.20,0.86±0.27;术前与术后3mo角膜散光度数比较,差异无显著意义(P>0.05);对比敏感度在低、中空间频率段均位于正常范围内,高空间频率段则有部分病例稍下降;脱镜率为86%(18/21)。结论:TecnisZM900衍射型非球面多焦点人工晶状体可为患者提供良好的远、近视力,86%的患者可摘掉眼镜。     

三焦点与单焦点人工晶状体植入术效果的比较

目的：观察并比较AT LISA tri 839MP三焦点人工晶状体及CT SPHERIS 209M单焦点人工晶状体植入术后白内障患者的视力、对比敏感度和视觉质量。

方法：行白内障超声乳化摘除联合人工晶状体植入术的患者52例52眼,其中三焦点组26例26眼,术中植入AT LISA tri 839MP三焦点人工晶状体; 单焦点组26例26眼,术中植入CT SPHERIS 209M单焦点人工晶状体。术后3mo检查患者的裸眼远距离视力(UCDVA)、裸眼中距离视力(UCIVA)、裸眼近距离视力(UCNVA)、最佳矫正远视力(BCDVA)、远视力矫正下的中距离视力(DCIVA)、远视力矫正下的近距离视力(DCNVA),明、暗环境中不同空间频率(3、6、12、18c/d)下的对比敏感度,并进行脱镜率、不良视觉症状和满意度等问卷调查。

结果：术后3mo三焦点组UCIVA、UCNVA、DCIVA和DCNVA、脱镜率及满意度均优于单焦点组(P<0.05)。在暗环境中的18c/d空间频率,单焦点组的对比敏感度优于三焦点组(P=0.041)。两组均有轻度眩光和光晕不适主诉(P=0.668)。

结论：AT LISA tri 839MP三焦点人工晶状体较CT SPHERIS 209M单焦点人工晶状体为患者提供了更好的中、近视力,脱镜率和满意度均高于单焦点人工晶状体。     

三种折叠式单焦球面设计人工晶状体对比敏感度及眩光敏感度的比较研究

目的比较3种折叠式单焦球面设计人工晶状体在植入术后,其对比敏感度和眩光对比敏感度的差异。方法将所有待植入人工晶状体的单纯老年性白内障患者120例120眼随机分成3组:A组植入一片式肝素表面处理亲水性丙烯酸酯人工晶状体(HQ-201HEP,Hexa Vision),B组植入三片式疏水性丙烯酸酯人工晶状体(Sensar AR40e,AMO),C组植入蓝光滤过人工晶状体(AcrySof Natural SN60AT,AL-CON);另选取一组与病例组年龄相近的正常人作为对照组;每组均40例40眼。术后测量各组最佳矫正视力。使用CSV-1000E对比敏感度仪测量对比敏感度及眩光对比敏感度进行比较。结果对比敏感度及眩光对比敏感度在各空间频率(3cpd、6cpd、12cpd、18cpd)的互相比较,其差异均无统计学意义(P>0.05),但均低于同年龄正常组。结论白内障摘出植入单焦球面人工晶状体可部分恢复患者因白内障引起的对比敏感度降低,但尚未达到正常同龄人水平。人工晶状体的设计原理对对比敏感度的影响尚需进一步探讨。     

Visual and optical performance of eyes with different corneal spherical aberration implanted with aspheric intraocular lens

AIM: To compare the visual and optical performance of eyes with different corneal spherical aberration (SA) implanted with spherical aberration-free intraocular lens (IOLs). METHODS: Thirty-six patients with different corneal SA had phacoemulsification with implantation of spherical aberration-free IOLs. Patients were divided into 3 groups according to the value of preoperative corneal SA. Eyes with corneal SA <0.10μm were assigned to group A, those with 0.10 ≤corneal SA <0.20μm to Group B, and those with 0.20≤ corneal SA <0.35μm to Group C. Best-corrected visual acuity (BCVA), contrast sensitivity, corneal SA, total ocular aberrations, and depth of focus were recorded 3 months postoperatively. Distance-corrected near and intermediate visual acuity was studied to measure depth of focus. RESULTS: BCVA and contrast sensitivity were similar between groups. There were no significant differences in distance-corrected near or intermediate visual acuity. Corneal SA was similar before and 3 months after surgery in the 3 groups. With a 5.0mm pupil diameter, root mean square values for total ocular higher-order aberrations (HOAs) were lower in groups A and B than in group C. Total ocular SA was lower in group A than in groups B and C. SA was also lower in group B than in group C. Coma and trefoil were similar between the groups. CONCLUSION: Implantation of spherical aberration-free IOLs in eyes with different corneal SA results in similar visual performance at BCVA, contrast sensitivity and depth of focus.     

Visual and optical performance of eyes with different corneal spherical aberration implanted with aspheric intraocular lens

AIM: To compare the visual and optical performance of eyes with different corneal spherical aberration (SA) implanted with spherical aberration-free intraocular lens (IOLs). METHODS: Thirty-six patients with different corneal SA had phacoemulsification with implantation of spherical aberration-free IOLs. Patients were divided into 3 groups according to the value of preoperative corneal SA. Eyes with corneal SA <0.10μm were assigned to group A, those with 0.10 ≤corneal SA <0.20μm to Group B, and those with 0.20≤ corneal SA <0.35μm to Group C. Best-corrected visual acuity (BCVA), contrast sensitivity, corneal SA, total ocular aberrations, and depth of focus were recorded 3 months postoperatively. Distance-corrected near and intermediate visual acuity was studied to measure depth of focus. RESULTS: BCVA and contrast sensitivity were similar between groups. There were no significant differences in distance-corrected near or intermediate visual acuity. Corneal SA was similar before and 3 months after surgery in the 3 groups. With a 5.0mm pupil diameter, root mean square values for total ocular higher-order aberrations (HOAs) were lower in groups A and B than in group C. Total ocular SA was lower in group A than in groups B and C. SA was also lower in group B than in group C. Coma and trefoil were similar between the groups. CONCLUSION: Implantation of spherical aberration-free IOLs in eyes with different corneal SA results in similar visual performance at BCVA, contrast sensitivity and depth of focus.     

微切口人工晶状体植入术后早期波前像差及对比敏感度比较

目的:探讨微切口Acri.smart 36A人工晶状体(德国Acri.tec公司)的非球面设计对人工晶状体眼的视觉质量和光学质量的影响.方法:老年性白内障患者26名28眼随机1眼植入Acri.smart 36A或者Acri.smart 46S,如另外1眼需要白内障手术,选择相同型号的人工晶状体.人工晶状体Acri.smart36A组13眼,46S组Acri.smart 15眼,患者年龄,术前散光度数,所植入人工晶状体的度数,昏暗环境下瞳孔直径,药物散瞳后瞳孔直径大小均无统计学差异.两种微切口人工晶状体都通过1.4mm微切口植入.术后1mo测散瞳下波前像差(日本Nidek OPD-Scan波前像差仪);散瞳前后分别矫正到最佳视力后用OPTEC6500(美国Stereo optic公司)对比敏感度仪测得对比敏感度.结果:正常瞳孔下,两组人工晶状体不同空间频率(1.5,3,6,12,18cpd)的对比敏感度没有显著差别(Mann-Whitneytest P＞0.05).散瞳后Acri.smart 36A组"白天"(75cd/m2亮度)下12c/d和"白天 眩光"下1.5,18c/d的对比敏感度比Acri.smart 46S组大(Mann-Whitney test P＜0.05);Acri.smart 36A组"夜晚"(3cd/m2亮度)1.5,3c/d及"夜晚 眩光"下1.5,6,12c/d的对比敏感度比组高(Mann-Whitney test P＜0.05).3mm瞳孔直径下两组患者的球差无显著差别(Mann-Whitney test P＞0.05),而4mm和5mm瞳孔直径下Acri.smart 36A组的球差明显比Acri.smart 46S组小(Mann-Whitney test,分别为P＜0.05和P＜0.01).结论:Acri.smart 36A非球面人工晶状体植入术后波前像差和对比敏感度比Acri.smart 46S人工晶状体有优势.对于瞳孔直径大的患者选择Acri.smart 36A更具有优势.     

人工晶状体光学区的非球面设计对视网膜成像的影响

目的通过对比球面人工晶状体眼和非球面人工晶状体眼的波前相差及对比敏感度表现,探讨人工晶状体光学区的不同设计对视网膜成像影响的差异。方法对我院进行白内障超声乳化联合人工晶状体植入手术的老年性白内障患者60例（60只眼）,分为2组,每组30例（30只眼）,植入的人工晶状体为球面人工晶状体Acrysof SN60（Alconco,ltd）和非球面人工晶状体Acysof SN60WF（Alcon co,ltd）。于术前、术后3个月应用OrbseanⅡ眼前节分析系统（Baush ＆ Lomb co,hd）对2组病例进行角膜曲率和Q值的检查,同时将瞳孔散大至6．0mm后,应用Zywave波前相差仪（Baush＆Lomb co,hd）进行波前相差检查。应用Opts＆500（Swreo Optical,USA）对比敏感度检测仪进行明视及暗视对比敏感度检查。应用配对的t检验进行数据分析。结果白内障手术后,患者的视力明显改善,术后的总体相差、高阶相差和球差均明显低于术前（P〈0．01）;非球面组与球面组的术后视力没有显著差别（P〉0．05）;在6．0mm瞳孔直径状态下,非球面人工晶状体组的高阶相差明显低于球面人工晶状体组（P〈0．05）。SN60WF人工晶状体组在明视1．5、3．06、6．0、12、18cod及暗视1．5、3．0、6．0、12、18cod的对比敏感度均明显优于SN60人工晶状体组,差别有统计学意义（P〈0．05）。结论白内障手术在明显提高视力的同时,可同时降低术前存在的波前相差和高阶相差。与球面人工晶状体相比,非球面人工晶状体可提高某些频率的对比敏感度。在暗环境（大瞳孔）状态下,非球面人工晶状体眼的高阶相差,尤其是球差,低于球面人工晶状体眼。人工晶状体光学区的非球面设计有利于改善患者的视觉质量。     

白内障超声乳化联合人工晶状体植入术后眼高阶像差与对比敏感度的相关性研究

目的观察白内障超声乳化联合人工晶状体（IOL）植入术后眼高阶像差与对比敏感度（CS）、眩光对比敏感度（GS）之间的关系,探讨改善白内障术后视觉质量的方法。方法采用Zywave波前像差仪检测白内障超声乳化联合IOL植入术后129例129眼的总高阶像差、球差、彗差等各高阶像差均方根值（RMS）,采用CSV-1000E对比敏感度测试仪检测其CS和GS,对白内障超声乳化联合IOL植入术后高阶像差与CS或GS间的相关性进行Spearman秩相关分析。结果白内障超声乳化联合IOL植入术后,眼高阶像差与无眩光CS之间相关性较小,总高阶像差与12 c/d CS之间（r=0.23,P〈0.05）、Z400与3 c/d CS之间（r=0.17,P〈0.05）均呈正相关;Z440与9 c/d CS之间（r=-0.21,P〈0.05）、Z550与12 c/d CS之间（r=-0.18,P〈0.05）均呈负相关。眼高阶像差与GS之间多呈负相关,包括Z331与6 c/d之间（r=-0.18,P〈0.05）,Z420与9 c/d之间（r=-0.25,P〈0.05）,Z420与12 c/d之间（r=-0.21,P〈0.05）,Z440与9 c/d之间（r=-0.21,P〈0.05）,Z440与12 c/d之间（r=-0.23,P〈0.05）,Z510与9 c/d之间（r=-0.18,P〈0.05）,Z530与12 c/d之间（r=-0.23,P〈0.05）均呈负相关,但Z441与9 c/d之间呈正相关（r=0.19,P〈0.05）,与GS相关的高阶像差主要集中在4阶,与高阶像差相关的GS主要集中在中高空间频率段。结论白内障超声乳化联合IOL植入术后眼高阶像差的变化不影响无眩光CS,但能影响GS。     

Differences in contrast sensitivity between monofocal,multifocal and accommodating intraocular lenses: long‐term results

Background: To evaluate long‐term contrast sensitivity (CS) and visual acuity following implantation of monofocal, accommodating, refractive and diffractive multifocal intraocular lenses (IOLs) in patients with unilateral cataract Methods: In this prospective non‐randomized clinical trial, 87 patients with unilateral cataract were enrolled in four groups for phacoemulsification and IOL implantation in Ophthalmology Department of Goztepe Training and Research Hospital. Twenty‐four patients had monofocal (Alcon Acrysof; group 1), 21 patients accommodating (Human Optics 1CU; group 2), 22 patients diffractive multifocal (Tecnis ZM900; group 3) and 20 patients refractive multifocal (AMO Rezoom; group 4) IOL implantations. Ages of patients were between 40 and 70. Parameters analysed at the 18th postoperative month were subjective refractions, monocular and binocular distance and near photopic CSs, visual acuities. Results: Near visual acuities were statistically better in group 3 than the other groups (P < 0.05). At low spatial frequencies, mean monocular distance CSs of group 1 and mean monocular near CSs of groups 1 and 2 were statistically higher than those of group 4 (P < 0.05). There was no significant difference between binocular CSs of group 4 and the other groups at low spatial frequencies. At high spatial frequencies, monocular and binocular CSs of groups 1 and 2 were statistically higher than those of groups 3 and 4 (P < 0.05). Near CSs was better in group 3 than group 4. Conclusions: In patients with unilateral cataract, monofocal, accommodating and partially diffractive multifocal IOL provided higher CS scores when compared with refractive multifocal IOL and in multifocal IOL groups binocular CSs were better than monocular CSs when compared with other groups.     

多焦点和单焦点人工晶状体植入的对比研究

目的：通过对多焦点和单焦点人工晶状体植入术后视力；拟调节力及视觉症状的对比研究，探讨Array SA-40NB^TM多焦点人工晶状体植入术临床应用的有效性和安全性。方法：2002-08／2004-08施行白内障超声乳化人工晶状体植入术984眼，排除合并有其他眼病及伴有可能影响视力的全身疾病者后，分为S组术中植入单焦点人工晶状体；M组术中植入多焦点人工晶状体。观察两组术后远、近视力；拟调节力及视觉症状；采用SPSS10．0软件对术后远、近视力和拟调节力进行统计学处理。结果：M组和S组比较，术后远视力无明显差异；而术后近视力和拟调节力差异有显著性意义，M组明显优于S组。结论：多焦点人工晶状体植入术可以获得等同于单焦点人工晶状体植入术的术后远视力，但是其术后拟调节力较大，术后裸眼近视力显著高于单焦点人工晶状体植入术的患眼，是一种安全的、能有效改善患者视觉功能的手术，值得临床应用和推广。     

多焦点人工晶状体临床应用观察

目的观察白内障超声乳化及AMO Array多焦点人工晶状体(multifocal intraocular lens,MIOL)植入的临床应用效果。方法按病例选择标准选取年龄相关性白内障患者,分为两组。多焦点人工晶状体(MIOL)组:13例20眼,植入AMO Array SA-40N多焦点人工晶状体。单焦点人工晶状体(monofocal intraocular lens,SIOL)组:16例20眼,植入AMOSI-40NB单焦点人工晶状体。术后观察两组患者的裸眼远视力、最佳矫正远视力、裸眼近视力、最佳矫正近视力及对比敏感度值,并进行视觉症状的调查。结果术后第1天、第1周、第1个月MIOL组的裸眼近视力均明显优于SIOL组(P<0.01),两组间裸眼远视力及最佳矫正远近视力差异无显著性(P>0.05)。采用VCTS6000对比敏感度测试卡于术后第1天、第1周、第1个月测得两组的对比敏感度,它们在各空间频率段差异均无显著性(P>0.05)。术后第1个月采用CGT-1000对比敏感度眩光测试仪检查得两组间的对比敏感度值在各不同视标空间频率段差异均无显著性(P>0.05)。MIOL组中4例6眼(占30%)、SIOL组中2例2眼(占10%)诉有术前没有的视觉症状发生。患者满意率MIOL组为95%,SIOL组为100%。结论AMOArray多焦点人工晶状体植入术后患者无需戴镜即可获得良好的远视力和近视力。术后患者对比敏感度值明显上升,其大小与植入多焦点或是单焦点人工晶状体无关。多焦点人工晶状体植入术后有一定比例的视觉症状发生,较单焦点人工晶状体植入术后多,但不严重影响生活,患者满意率高。     

白内障眼的波前像差、对比敏感度及眩光敏感度研究

目的分析早期年龄相关性白内障患者的波前像差、对比敏感度和眩光敏感度改变。设计前瞻性病例对照研究。研究对象年龄相关性白内障患者62例(107眼),其中皮质性白内障组31例(50眼)、核性白内障组17例(32眼)、后囊下白内障组14例(25眼);正常对照组36例(36眼)。方法使用主观像差仪和自动眩光对比敏感度检查仪对受试者进行波前像差、对比敏感度及眩光敏感度检测。主要指标波前像差、对比敏感度及眩光敏感度。结果各组白内障患者整体像差和总高阶像差普遍高于正常对照组(P均<0．05)。皮质性白内障组和核性白内障第5阶像差高于正常组(P均<0．05)。所有受试者眩光敏感度均比对比敏感度下降明显(P均<0．05)。与正常组相比,皮质性白内障组的对比敏感度和眩光敏感度在低频段和中频段下降显著,核性白内障组的对比敏感度和眩光敏感度在低频段下降显著,后囊下白内障组的对比敏感度和眩光敏感度在全频段下降显著(P<0．05)。白内障组对比敏感度及眩光敏感度和高阶像差存在相关性,但在不同类型白内障,在对比敏感度和眩光敏感度的不同频段,在各阶像差中结果有所不同(r=-0．716-0．191,P<0．05)。结论早期白内障患者波前像差增高,对比敏感度及眩光敏感度下降。对比敏感度及眩光敏感度检查和波前像差测定结合进行,可有效、客观、定量地反映早期白内障患者的视觉质量下降。     

新型折叠式多焦点人工晶状体植入38眼

目的观察白内障超声乳化新型折叠式多焦点人工晶状体植入术的临床效果。方法随机选取老年性白内障共69例(73眼),分为2组。M组:38眼,植入AllerganArrnySA-40NTM多焦点人工晶状体。S组:35眼,植入AllerganSI-40NB单焦点人工晶状体。所有病例均由同一术者行3.0mm透明角膜切口超声乳化白内障摘除联合推注式折叠型人工晶状体植入术,术后定期随访远、近视力,最佳远、近视力球镜矫正度数,角膜曲率,并发症等指标。结果两组患者之间的远视力无显著性差异;近视力有显著性差异,M组的近视力明显优于S组的近视力。两组患者3月最佳远视力球镜矫正,无显著性差异;最佳近视力球镜矫正,有显著性差异。S组的患者视近需要配带花镜。两组病例术后的角膜曲率与术前相比无统计学差异,两组之间的并发症无明显差别。结论ArrnySA-40NTM多焦点人工晶状体可为患者提供良好的远、近视力,有47%的患者无需配戴花镜,降低了患者对眼镜的依赖性,功能明显优于单焦点人工晶状体,是目前较为理想的人工晶状体,值得临床推广应用。