双侧人工晶状体眼立体视的临床观察

目的:观察老年性白内障患者双眼人工晶状体植入术后近立体视的恢复。方法:分为双眼人工晶状体组及正常老年人组,检影验光后测量远矫正下和近矫正下的近视力并应用Randot stereotests图分别检查两种矫正下的近立体视锐度。结果:远矫正下两组的双眼近视力分别是0．51±0．15和0．52±0．17(LogMar),立体视锐度分别是(101±59)弧秒和(112±55)弧秒。近矫正下两组的双眼近视力分别是0．09 0．10和0．11± 0．11,近立体视锐度分别是(33±11)弧秒和(34±10)弧秒,两组间两种矫正下的近视力和近立体视锐度均无差异(P>0．05),两组内近矫正下的近视力和近立体视锐度均明显优于远矫正下(P<0．01)。结论:老年性白内障患者双眼人工晶状体植入术后近立体视锐度可以恢复到正常同龄人水平。     

单眼视设计的人工晶状体眼视功能临床研究

目的 探讨应用单眼视原理设计双眼白内障超声乳化联合植入单焦点人工晶状体术后的视功能情况.方法 对双眼年龄相关性白内障患者42例(84只眼),分为常规组21例(42只眼)及单眼视组21例(42只眼).常规行白内障超声乳化联合折叠式人工晶状体植入术.分别记录术前最佳矫正视力及术后1周单眼裸眼远、近视力及双眼裸眼远、近视力.采用SAS8.2统计软件对结果进行统计学分析.结果 (1)术前平均最佳矫正视力常规组4.44,单眼视组4.47(P ＞0.05),患者平均年龄常规组71岁,单眼视组69.5岁(P ＞0.05),差异无统计学意义.(2)术后1周单眼裸眼远视力常规组4.90,单眼视组:优势眼4.94(P ＞0.05),与常规组比较差异无统计学意义;非优势眼4.71(P < 0.05),与常规组比较差异有统计学意义.术后1周单眼近视力常规组4.36,单眼视组:优势眼4.37(P＞0.05),与常规组比较差异无统计学意义;非优势眼4.78(P < 0.05),与常规组比较差异有统计学意义.(3)术后1周双眼裸眼远视力常规组4.91,单眼视组4.91(P ＞0.05),与常规组比较差异无统计学意义;术后1周双眼近视力常规组4.42,单眼视组4.78(P < 0.05),与常规组比较差异有统计学意义.结论 单眼视设计的人工晶状体眼术后双眼远视力与常规设计人工晶状体眼相同,但近视力明显好于常规设计.按照单眼视原理设计人工晶状体可以较好的临床应用.     

白内障摘出人工晶状体植入术后双眼视的分析

目的分析白内障摘出人工晶状体植入术后影响双眼视恢复的因素。方法对76例(105眼)白内障摘出人工晶状体植入术后进行Worth四点灯、同视机及颜氏立体视图谱检查。结果屈光参差及双眼视力差值均与立体视锐度值(弧秒)呈正相关,外伤性白内障受伤与手术相距时间与立体视锐度值(弧秒)呈正相关,老年性白内障单眼组与双眼组立体视锐度的差异具有统计学意义。结论屈光参差、双眼视力差值以及外伤性白内障受伤与手术相距时间是影响术后双眼视恢复的主要因素。     

单眼视(monovision)原理应用于高度近视白内障手术的研究

目的 研究单眼视(monovision,MV)原理在高度近视白内障患者中应用的效果.方法 高度近视伴白内障54例,行白内障超声乳化并单焦点人工晶状体植入术,应用单眼视原理,使术后主导眼(优势眼)形成正视,非主导眼保留-1.0D以上的近视,按屈光参差的程度分为3组,检查术后3个月双眼裸眼远视力、近视力、立体视及对比敏感度,并进行人为加镜形成双眼平衡全矫状态加以对照.最后进行视功能损害眼病患者生存质量量表问卷及满意率调查.结果 远视力及立体视3组比较差异无统计学意义(P＞0.05),近视力比较3组单眼视矫正患者均明显优于完全矫正,差异有统计学意义(P＜0.05).在100％对比度明视白背景下,第3组患者(屈光参差≥2.75D)单眼视矫正视力低于完全矫正,差异有统计学意义(P＜0.05).明暗视时,红蓝背景下敏感度检查比较差异无统计学意义(P＞0.05).术后问卷及满意率调查,3组患者间差异无统计学意义(P＞0.05).结论 单眼视原理应用于高度近视伴白内障患者的屈光矫正,可有效提高患者远、近视力,非主导眼宜保留-1.5D以上的近视,具体情况还需根据患者个体差异而定.屈光参差≥2.75D的患者术后需注意夜间眩光现象.     

飞秒激光辅助超乳联合Toric IOL植入术矫正高度近视白内障合并角膜规则散光

目的:通过飞秒激光技术,量化撕囊口直径,测量高度近视白内障合并角膜散光患者术后远、中、近视力,近立体视功能等指标,评估Toric IOL在高度近视的可行性及必要性。方法:前瞻性病例对照研究。选择我院双眼高度近视白内障合并角膜规则散光,并双眼均接受飞秒激光辅助白内障手术的患者,按人工晶状体不同分为两组：A组：Toric IOL组20例40眼,B组：IQ IOL组20例40眼。对比两组患者术前角膜散光、等效球镜及术后7d, 1、3mo最佳矫正远视力、裸眼中视力、近视力、实际残留散光、近立体视锐度、全眼高阶像差、全眼球差等指标。结果:高度近视白内障合并角膜散光患者植入Toric IOL,较IQ组,显著改善了术后7d, 1、3mo裸眼中、近视力,Titmus近立体视锐度及残留散光度(均P<0.05),减少了术后对眼镜的依赖程度;而术后7d, 1、3mo两组最佳矫正远视力、全眼高阶像差及全眼球差无差异(均P>0.05)。结论:高度近视白内障合并角膜散光患者植入Toric IOL,能有效矫正角膜规则散光,提高术后裸眼中、近视力及近立体视功能,减少高度近视患者术后对眼镜的依赖程度,提升双...     

双眼多焦点人工晶状体植入术后立体视觉临床研究

目的比较双眼植入多焦点人工晶状体(multifocal intraocular lens,MIOL)与单焦点人工晶状体(simple focus intraocu-lar censes,SIOL)患者术后视力和立体视觉的差异,评价MIOL植入的有效性及优越性。方法将60例双眼老年性白内障患者按自愿选择的原则分为两组,每组30例,行超声乳化白内障吸出术,MIOL组双眼植入Alcon Acrysof ReSTOR MIOL,SIOL组双眼植入Alcon Acrysof Natural SIOL。术后3个月对裸眼远视力、最佳矫正远视力、裸眼近视力、最佳矫正近视力,最佳矫正远视力下的近视力、裸眼远立体视觉、裸眼近立体视觉、最佳矫正远立体视觉、最佳矫正近立体视觉和最佳矫正远视力下近立体视觉等视功能进行检查。结果术后3个月,两组裸眼远视力、最佳矫正远视力及最佳矫正近视力无明显差异(均为P>0.05);MIOL组的裸眼近视力和最佳矫正远视力下近视力分别为0.0750±0.1144和0.1050±0.1407,均优于SIOL组0.5150±0.2692和0.5400±0.2286,差异均有统计学意义(均为P=0.000);两组裸眼远立体视觉、最佳矫正远立体视觉和最佳矫正近立体视觉无明显差异(均为P>0.05);植入MIOL眼的裸眼近立体视觉和最佳矫正远视力下近立体视觉均优于植入SIOL眼,两组比较χ2值分别为22.315、18.924(均为P=0.000)。结论 MIOL植入有效而优越,不但可以提供与SIOL一样良好的远视力和远立体视觉,而且近视力、近立体视觉更好。良好的近视力是近立体视觉的基础。     

儿童共同性斜视矫正术后功能治愈情况的研究和手术时机探讨

目的了解儿童共同性斜视矫正术后的功能治愈率及其影响因素,为斜视手术治疗的时机选择提供依据。方法选择在斜视矫正术后获得眼正位的113例共同性斜视儿童患者作为研究对象。使用同视机及颜少明远用和近用随机点立体图对其进行双眼视功能和远、近距离立体视锐度的检测。结果①113例中术后有111例(98．23％)获得Ⅰ级以上的双眼视功能,49例(43．36％)获得≤60″近立体视锐度,54例(47．79％)获得≤60″远立体视锐度。②外斜视组84例,术后近立体视锐度≤60″者46例(54．26％),远立体视锐度≤60″者49例(58．33％);内斜视组29例,术后近立体视锐度≤60″者3例(10．34％),远立体视锐度≤60″者5例(17．24％)。两组比较(P<0．001)。③间歇性外斜视50例,术后近立体视锐度≤60″者36例(72％);远立体视锐度≤60″者38例(76％)。两组比较(P< 0．001)。④内斜视组手术年龄与术后远、近立体视锐度秒角的相关关系:近立体视锐度r=0．472,P<0．01;远立体视锐度r=0．438,P<0．05。内斜视组病程与术后远、近立体视锐度秒角的相关关系:近立体视锐度:r=0．534,P<0．01;远立体视锐度:r=0．536,P<0．01。结论①儿童后天性共同性斜视患者在视力发育敏感期内得到正确的手术治疗,功能治愈率良好。②内斜视患者术后立体视重建率低于外斜视,间歇性外斜视的功能治愈率高于恒定性外斜视。术前有一定的双眼单视功能有利于术后获得更敏锐的立体视觉。③手术时机应取决于斜视类型,并参考术前双眼单视功能检查的结果。     

双眼多焦点人工晶状体眼的远期立体视觉研究

目的比较双眼植入多焦点人工晶状体(MIOL)和单焦点人工晶状体(SIOL)植入术后远期的立体视觉,评价MIOL植入眼远期的立体视觉,进一步完善MIOL植入眼远期视功能的研究。方法观察2000年至2004年在我院接受白内障超声乳化吸除联合人工晶状体植入的患者共29例,其中双眼MIOL16例,双眼SIOL13例,术后随访时间>7m,分别检查术后非矫正近、远视力,矫正近、远视力,屈光,非矫正视力下远、近立体视锐度,矫正视力下远、近立体视锐度,问卷调查术后满意度、视觉症状。结果81.25%的MIOL眼非矫正近视力≥0.5,优于SIOL眼的15.38%(χ2=25.16,P<0.001,差异具有极显著性);非矫正远视力、矫正远视力及矫正近视力MIOL眼与SIOL眼差异无显著性(P>0.05);非矫正近视力下近立体视锐度,68.75%双眼植入MIOL者≤60s,而双眼植入SIOL者则无≤60s,两组间差异极具显著性(χ2=25.294,P<0.001);矫正近视力下近立体视锐度,93.75%的双眼植入MIOI者≤60s,相比双眼植入SIOL者的46.15%差异极具显著性(χ2=9.650,P=0.008,P<0.01);非矫正远视力下及矫正远视力下远立体视锐度,双眼植入MIOL组与双眼植入SIOL组间差异均无显著性;植入MIOL者术后满意度高于植入SIOL者(t=3.512,P=0.001,P<0.01)。结论术后远期,双眼MIOL植入者近立体视觉优于双眼SIOL植入者,植入MIOL患者满意度高于植入SIOL患者。     

屈光参差与双眼视觉相关性的临床观察

目的:观察远、近视性屈光参差对患者双眼视功能的影响。方法:采用颜少明等的《立体视觉检查图》和同视机,对矫正视力≥0.9的近视和远视性屈光参差患者174例,分别测定其近立体视和同视机三级视功能。结果:(1)远、近视性屈光参差患者视力矫正后双眼视功能明显好于裸眼,两者矫正前后比较差异均有统计学意义(P均<0.05)。(2)矫正后近视性屈光参差近立体视及融合功能正常者的例数明显多于远视性屈光参差者(P均=0.000);远视性屈光参差远立体视功能正常者的例数明显多于近视性屈光参差者(P=0.000)。(3)矫正后近视性屈光参差者的近立体视锐度与屈光参差差值大小相关(P=0.000),屈光参差差值越大,近立体视功能越差;远视性屈光参差者的近立体视锐度与屈光参差差值大小相关性不明显(P=0.159)。(4)远、近视性屈光参差患者矫正后,近立体视正常患者的构成比小于正常范围为17%及44%。结论:(1)远、近视性屈光参差对双眼视功能的影响不相同,远视性屈光参差对双眼视功能的影响大于近视性屈光参差。(2)无论近视或远视性屈光参差,其对双眼视觉的损害是明显的。     

假晶体眼的放大率与不等像

目的 :分析假晶体眼放大率变化特点 ,从双眼视角度探讨单眼白内障的合理人工晶体度数和类型选择。方法 :测量单眼假晶体眼 (12例 )的不等像 ,按Gullstrand模型眼计算人工晶体眼放大率的变化。结果 :临床测量 :术后近视眼或者接近健眼屈光状态的 7例不等像小于或者等于 3% ;术后远视的 5例不等像大于3% (4例大于 5 % )。模型眼光学分析 :放大率变化是由于假晶体眼的主点发生了位移造成 ;主点前移 ,放大率增大 ,不等像也增大。结论 :假晶体放大率变化通过主点移位产生 ;后房型人工晶体较接近人眼的晶状体 ;为了单眼白内障术后有较好的双眼视功能 ,青年宜选择术后偏向一点近视 ,老年人宜选择术后正视     

Stereopsis after Implantation of Intraocular Lens in Patients under 40 Years Old with Unilateral Cataract

 PURPOSE:To investigate the stereopsis after single focus intraocular lens (SIOL) implantation in patients aged <40 years with unilateral cataract. METHODS:In total, 36 patients (36 eyes) were divided into emmetropia and myopia groups. Twenty seven subjects with good uncorrected distance visual acuity (UCDVA) after surgery were enrolled in the emmetropia group. The myopia group consisted of 9 subjects whose one eye had mild myopia postoperatively and the other was emmetropic or myopic. Visual acuity, distance and near stereoacuity were measured post-operatively. RESULTS:In the emmetropia group, uncorrected near visual acuity (UCNVA) did not differ significantly between eyes (t=1.87, P>0.05). The LogMAR UCNVA of the operated and fellow eyes were (0.71±0.12) and (-0.05±0.07, t = 28.4, P<0.001) respectively. Distance stereoacuity was 60"; the near stereoacuity with uncorrected visual acuity and BCNVA in the operated eyes were 200" and 30" respectively (Z=－4.121, P<0.001). In the myopia group, the BCDVA did not differ significantly between the operated and fellow eyes (t =-0.636, P>0.05). The UCNVA of the operated eyes (0.18±0.12) was significantly better compared with that of the fellow eyes (-0.04±0.10, t = 4.2252, P<0.001). The distance stereoacuity with uncorrected visual acuity and BCDVA in the operated eyes were 200" and 60" respectively (Z =-2.371, P<0.05). The near stereoacuity with uncorrected visual acuity was 50". CONCLUSION:For patients with unilateral cataract aged <40 years, stereopsis is closely associated with refractive status after IOL implantation. Near stereoacuity in emmetropic eyes can be improved with refraction, and that in mildly myopic eyes can be enhanced by leaving myopia uncorrected.     

Stereopsis in bilaterally pseudophakic patients

PURPOSE: To investigate the stereoacuity in patients who have had implantation of a monofocal intraocular lens (IOL) in each eye and to identify the principal risk factors for impaired stereoacuity. SETTING: Hayashi Eye Hospital, Fukuoka, Japan. METHODS: One hundred patients scheduled for bilateral phacoemulsification and monofocal IOL implantation were recruited. Near stereoacuity was measured approximately 2 weeks after surgery using the Titmus test. Various parameters that may be associated with stereoacuity in pseudophakic patients were measured using the New Aniseikonia Test (Handaya Corp.). Parameters included age, visual acuity, spherical equivalent, astigmatism, axial length, pupil diameters, IOL decentration and tilt, and aniseikonia. Stepwise multiple regression analysis was performed to identify independent predictors of impaired stereoacuity. RESULTS: The mean stereoacuity was 57.1 seconds of arc +/- 36.9 (SD); 90 patients (90%) had a good stereoacuity (ie, 100 seconds of arc or better). Simple regression analysis showed that a larger difference in spherical equivalent between fellow eyes and older age was significantly associated with poor stereoacuity. The best final model (R(2) = 0.375) in the multiple regression analysis identified a greater difference in spherical equivalent to be the most significant predictor of impaired stereoacuity, followed by older age and a larger pupil diameter. CONCLUSIONS: Ninety percent of patients with bilateral pseudophakia had useful stereoacuity. The main risk factor for poor stereoacuity was a greater difference in the spherical equivalent between the eyes, followed by older age and a larger pupil diameter. These results indicate the need for an accurate preoperative IOL power calculation.     

人工晶体眼的不等像双眼视临床分析

目的了解探讨白内障超声乳化摘除联合折叠型人工晶体囊袋内植入术后患者的双眼单视功能,以及人工晶体植入术后对双眼影像不等的影响、患者保持双眼单视功能所允许的像差程度和范围。方法随机抽取了术后视力在0.7以上的29例白内障超声乳化摘除联合折叠型人工晶体囊袋内植入术后患者,年龄41～74岁,按双侧或单侧人工晶体眼分成A、B两组;术后一周应用刘蔼年编《双眼影像不等检查图》检测患者的双眼单视功能和双眼影像不等的程度,并分别与正常眼以及两组之间进行比较。结果除B组3例患者没有立体视外,其余患者均有Ⅲ级双眼单视功能。且两组间的各级影像不等像差值无统计学差异(P>0.05)。与正常眼相比,A和B组的Ⅰ级同时视和Ⅱ级融合功能的双眼影像不等像差值均无统计学差异(P>0.05),Ⅲ级立体视功能的双眼影像不等值与正常对照有显著性差异(P<0.01),可能因3例单侧人工晶体无立体视有关。结论白内障超声乳化摘除联合囊袋内植入的人工晶体,除了获得良好的视力恢复外,并获得正常的Ⅲ级双眼单视功能,不引起Ⅲ级视功能的像差异常改变,是极理想的手术方式。     

双眼植入不同类型多焦点人工晶状体术后视功能的临床观察

目的 探讨超声乳化白内障吸除联合双眼分别植入折射型与衍射型多焦点人工晶状体(MIOL)术后的波前像差、对比敏感度(CS)及立体视功能.方法 前瞻性研究.将年龄相关性白内障患者分为MIOL组与单焦点人工晶状体(SIOL)组,每组各15例(30只眼),行超声乳化白内障吸除联合人工晶状体(IOL)植入术.MIOL组为主导眼植入ReZoom NXG1 IOL(即NXG1组),对侧眼植入Tecnis ZM900 IOL(即ZM900组);SIOL组为同期双眼植入Sensar AR40e IOL(即AR40e组).观察患者术后波前像差、CS、眩光敏感度(GS)及近立体视锐度.两组中波前像差和近立体视锐度比较分别采用单因素方差分析,CS和GS比较采用析因设计方差分析,两两比较采用ISD检验.结果 术后1个月观察发现,ReZoom NXG1 IOL眼、Tecnis ZM900 IOL眼的球差明显低于Sensar AR40e IOL眼的球差(F=11.734;P=0.001,0.000),三者之间的总体像差和高阶像差间的差异无统计学意义(F=0.724,0.173;P=0.493.0.842).ReZoom NXG1 IOL眼、Tecnis ZM900 IOL眼和Sensar R40e IOL眼在各视角的CS及CS比较,差异均无统计学意义(CS:F=0.959,0.978,2.779,0.590,0.485,0175; P=0.398,0.388,0.079,0.564,0.625,0.847;GS:F=0.117,0.479,0.806,1.235,0.531,1.144;P=0.902,0.627,0.458,0.309,0.597,0.383).MIOL组患者术后近立体视锐度可达45.6弧秒,与SIOL组比较差异有统计学意义(F=2.923;P=0.010,0.014).结论 双眼联合植入折射型与衍射型IOL,在一定程度上可以使患者获得良好的视功能.     

Stereoacuity and aniseikonia after unilateral and bilateral implantation of the Array refractive multifocal intraocular lens.

PURPOSE: To evaluate stereoacuity and aniseikonia in eyes with unilateral and bilateral implantation of the Allergan Array refractive multifocal intraocular lens (MIOL). SETTING: Department of Ophthalmology, University Hospital, Kiel, Germany. METHODS: This study comprised 31 patients with a unilateral MIOL and a phakic fellow eye and 29 patients with bilateral MIOLs. In all pseudophakic eyes, an Array MIOL had been implanted between 1991 and 1994 during a prospective clinical trial. In the present study, patients were re-examined. Near and distance visual acuity were tested; binocular functions were assessed using Bagolini lenses, the Worth 4-dot test, the Lang random-dot test, and the Titmus fly chart. Aniseikonia was evaluated using Aulhorn's phase-difference haploscope. Mean follow-up was 43 months in both groups. RESULTS: After unilateral implantation 87.1% of patients and after bilateral implantation 93.1% of patients correctly perceived the stereograms of the Lang random-dot test. The mean subjective height of the measured Titmus fly was 4.2 cm after unilateral and 4.3 cm after bilateral implantation. The stereoacuity tests revealed no statistically significant differences between the groups. Distance and near aniseikonia were significantly less after bilateral than after unilateral implantation. CONCLUSION: Despite the simultaneous formation of multiple retinal images, the Array MIOL allowed good binocular vision including random-dot stereopsis. Functional aniseikonia developed but did not interfere with normal binocular vision.     

可调节人工晶状体矫治老视的效果

目的探讨可调节人工晶状体矫治老视的可行性。方法均为要求阅读时不配戴凸透镜的老视患者,同时伴有不同程度的晶状体浑浊,共31例（62只眼）。均常规行白内障超声乳化吸出联合囊袋内植入后房型Tetraflex可调节人工晶状体。记录术后裸眼远视力、裸眼近视力、矫正远视力下的近视力、调节幅度、脱镜率、满意度等。术后随访6个月,并与植入Akros单焦点人工晶状体30例（60只眼）进行比较。结果在随访期内,术后3个月两组的裸眼远视力无统计学差异（t=0．366,P〉0．05）,两组的裸眼近视力和矫正远视力下的近视力均有统计学差异（t=10．074,t=9．966,P〈0．05）。术后1周、3个月、6个月的调节幅度,两组之间均有统计学差异（t=28．875,t=31．007,t=30．227,P〈0．05）。术后6个月视近时的脱镜率和对疗效的满意度,两组之间均有统计学差异（Z=-4．901,Z=-5．974,Z=-9．282,P〈0．05）。结论Tetranex可调节人工晶状体具有一定的调节能力,可以为患者提供良好的近视力,同时术后远视力和中距离视力也有所改善。     

可调节型与普通人工晶状体植入术效果对比

目的比较并分析非球面可调节IOL与普通非球面IOL植入术后早中期的临床效果差异。方法双眼老年性白内障行超声乳化IOL植入术45例（60只眼）,随机分为两组,A组植入非球面可调节IOL,20例（30只眼）;B组植入普通非球面IOL,25例（30只眼）,观察两组术后1个月和6个月的裸眼远视力、最佳矫正远视力、裸眼近视力、最佳矫正近视力、伪调节力及6个月时的对比敏感度。结果随访期间,两组患者的裸眼远视力、最佳矫正远视力及最佳矫正近视力差异均无统计学意义（P〉0．05）;裸眼近视力两组比较各时期差异均有统计学意义（P〈0．05）。术后伪调节力1个月时A组为（1．33±0．26）D,B组为（0．75±0．25）D;6个月时A组为（1．53±0．21）D,B组为（0．5±0．25）D;各期两组比较差异均有统计学意义。6个月时视远对比敏感度两组比较差异无统计学意义（P〉0．05）,但视近时在6c．d-1和12c．d-1空间频率对比敏感度两组比较差异具有统计学意义（P〈0．05）。结论非球面可调节IOL可以使白内障患者术后早期获得良好的裸眼远、近视力,提高患者视远、视近时的对比敏感度,获得良好的视觉质量。     

近视患者应用阶梯渐进衍射型多焦点人工晶状体的初步观察

目的评价阶梯渐进衍射型多焦点人工晶状体（IOL）应用于近视患者的临床效果及安全性。设计前瞻性病例系列。研究对象近视合并白内障患者30例（44眼）。方法对以上患者行白内障超声乳化吸除术,按自愿原则分别植入Acrysof ReSTOR多焦点IOL 14例（22眼）或普通单焦点IOL16例（22眼）。比较两组患者术后1周、1个月、3个月远、近视力及焦点深度范围。主要指标裸眼远近视力、矫正远近视力、最佳矫正远视力下近视力及焦点深度范同。结果阶梯渐进衍射型多焦点IOL组患者和单焦点IOL组患者的术后3个月平均裸眼远视力分别为0．84±0．14、0．70±0．23（P=0．018）;平均裸眼近视力分别为0．69±0．34、0．32±0．13（e=0．000）;矫正远视力下近视力分别为0．69±0．20、0．27±0．12（P=0．000）;焦点深度范围分别为（5．54±0．53）D、（3．57±0．93）D（P=0．000）。结论近视患者植入阶梯渐进衍射型多焦点IOL可获得良好的远、近视力,效果满意。（眼科,2009,18：88．90）     

Initial experience with a refractive multifocal intraocular lens in a Japanese population

PURPOSE: To evaluate a poly(methyl methacrylate) refractive, zonal-progressive multifocal intraocular lens (IOL) in patients requiring cataract surgery. SETTING: Department of Ophthalmology, Saiseikai Kurihashi Hospital, Saitama, Japan. METHODS: This open-label noncomparative study evaluated 58 eyes of 31 Japanese patients who had cataract surgery and implantation of a multifocal IOL (Array(R) PA154N, Allergan Surgical). The main outcome measures were visual acuity (VA) (distance and near, with and without correction), glare disability, and contrast sensitivity (CS) (distance and near, with and without glare under day and night conditions). A questionnaire was used to evaluate the effectiveness of the multifocal IOL. RESULTS: Uncorrected distance VA was 0.7 or better (20/30) in 56 eyes (97.0%) and uncorrected near VA, 0.5 or better (20/40) in 52 eyes (89.7%). Corrected distance VA was 0.7 or better in all eyes. Near VA with distance correction was 0.5 or better in 51 eyes (87.9%). Daytime CS was within the normal range. However, nighttime CS with central glare for both distance and near was markedly decreased. Under all conditions, distance CS was significantly better than near CS from middle- to high-frequency areas. Seventy-four percent of patients with the IOL in both eyes did not need glasses for daily activities, and the others needed glasses only to read for long periods. CONCLUSIONS: The results indicate that this refractive multifocal IOL is distance dominant and is beneficial in Japanese patients. However, since there are differences between Western countries and Japan in distance reading of characters and letters, further modification of this multifocal IOL may be required for use in Japanese patients.