Potential of the 1 CU accommodative intraocular lens

AIM: To assess the accommodative power of a new foldable monofocal intraocular lens. METHOD: A prospective randomised non-masked clinical interventional study. The study included 40 patients attending the hospital for cataract surgery and who were randomly distributed into a study group receiving a new foldable monofocal intraocular lens with flexible haptics, and a control group receiving a standard foldable intraocular lens. Mean follow up period was 8.51 (SD 1.34) months (range 4-11 months) Standard cataract surgery consisted of clear cornea incision, capsulorrhexis, phacoemulsification, and intraocular lens implantation, with topical anaesthesia. The main outcome measures were preoperative and postoperative visual acuity for near and distance; range of accommodation; change in anterior chamber depth. RESULTS: In the study group compared with the control group, range of accommodation was significantly (p = 0.01) higher (1.01 (SD 0.4) dioptres versus 0.50 (0.11) dioptres) and change in anterior chamber depth was significantly more pronounced (0.82 (0.30) versus 0.40 (0.32), p = 0.01). Both groups did not vary significantly in best corrected vision (0.94 (0.12) versus 0.93 (0.18); p = 0.74). CONCLUSION: During a mean follow up period of 8 months after implantation, the new foldable monofocal intraocular lens with flexible haptics showed an accommodative power of about 1 dioptre, which was significantly higher than the accommodative power of a conventional monofocal flexible intraocular lens. The difference in the accommodative power between the two intraocular lenses was paralleled by a difference in the change of the anterior chamber depth.     

可调节人工晶状体植入术的早期疗效观察

目的探讨超声乳化白内障吸除可调节人工晶状体植入术的临床疗效和调节幅度。方法对75例(94只眼)白内障患者行超声乳化白内障吸除1CU型可调节人工晶状体植入术,观察并记录术眼的主观屈光状态、裸眼远视力、裸眼近视力、最佳矫正远视力、30cm处远视力矫正后近视力、30cm处最佳矫正近视力、主观调节幅度(分别采用主观移近法和负镜片法测量)。术后随访时间1～12个月,对术后1周、1个月及3个月的资料进行分析。结果术后1周、1个月及3个月裸眼近视力≥Jr5者分别占81.9%(77/94)、85.1%(80/94)及84.0%(79/94);远视力矫正后近视力≥Jr5者分别占78.7%(74/94)、79.8%(75/94)及74.5%(70/94)。采用主观移近法和负镜片法检查调节幅度,术后1周分别为(1.96±0.63)D(0.75～4.50D)和(1.74±0.59)D(0.75～4.50D),术后1个月分别为(1.89±0.54)D(0.75～3.25D)和(1.68±0.47)D(0.75～3.25D),术后3个月分别为(1.77±0.53)D(0.75～2.75D)和(1.66±0.50)D(0.75～2.75D)。术后1周、1个月及3个月2种方法测量的主观调节幅度比较,差异均无统计学意义(P>0.05)。远视力矫正后近视力和调节幅度之间为正相关(P=0.00)。结论早期观察结果显示1CU型可调节人工晶状体植入术后视功能恢复良好,患者在具有较好远视力的同时,具备良好的视近能力。远期效果有待进一步观察。     

可调节人工晶状体植入术后调节效果的观察

目的与可折叠单焦点AKREOS ADAPT人工晶状体(IOL)比较,通过检测视力和药物诱导下前房深度 (ACD)、瞳孔直径(PD)的变化,评价1CU可调节IOL(AIOL)植入术后的调节效果。设计非随机化临床试验。研究对象 44 例(53眼)老年性白内障患者分为两组:1CU AIOL组20例(23眼),对照组24例(30眼)。方法全部患者行白内障超声乳化吸除联合IOL植入术,术后3个月观察远、近视力,使用OCULUS Pentacam三维前房分析仪测量2％匹罗卡品眼液诱导前后的 ACD和PD值。主要指标非矫正远近视力、最佳矫正远视力、远视力矫正下的近视力,药物诱导前后的ACD、PD差值和ACD差值与远视力矫正下的近视力的相关关系。结果术后3个月1CU AIOL组与对照组矫正或非矫正远、近视力均无统计学差异。药物诱导下的ACD变化值1CU AIOL组与对照组分别为(0．07 0．02)mm、(0．05±0．03)mm(P=0．04);PD变化值1CU AIOL组与对照组分别为(0．32±0．19)mm、(0．57±0．30)mm(P=0．00)。药物诱导下的ACD变化值与远视力矫正下的近视力无显著相关(r= 0．1,P=0．5)。结论本研究显示1CU AIOL在眼内仅有O．07mm移动度,虽优于对照组但仍不足以产生明显的调节。需要以科学的态度采用客观的检测方法(如OCULUS Pentacam三维前房分析仪)评估AIOL的调节效果。未来的研究应考虑包括PD在内的鉴别假性调节的因素。     

Fellow eye comparison between the 1CU accommodative intraocular lens and the Acrysof MA30 monofocal intraocular lens

PURPOSE: To examine the near visual clinical performance of an accommodative intraocular lens (IOL) when compared with a standard monofocal IOL in a fellow eye comparison. DESIGN: Prospective, randomized fellow eye comparison. METHODS: Thirty patients (60 eyes) with bilateral cataracts but otherwise normal eyes were recruited from a single university hospital cataract waiting list. Patients were randomized to receive either the 1CU accommodative IOL in their first eye or the Acrysof MA30 monofocal IOL. The alternative lens was then implanted in the second eye 4 to 6 weeks later. At all follow-up visits, a full assessment was made of distance, near and reading visual performance, and accommodative amplitude. RESULTS: Data are available for all patients at 6 months and 20 patients at 1 year. At 6 months, no difference was found in distance-corrected visual acuity between the two IOLs. Of the 1CU eyes, nine patients (30%) could read J6 or better at a reading speed of 80 words/min or better. In these nine patients, the mean difference in the amplitude of accommodation between the two eyes was 0.71 diopters. CONCLUSIONS: No measurable variable distinguished eyes that developed functional reading vision from those that did not. The accommodative IOL appears to produce improved near vision in some eyes, but it does not work in all eyes, and in eyes where there is apparent accommodation, there is a discrepancy between subjective reading performance and the modest measured increase of accommodative amplitude.     

1CU可调节人工晶状体植入术后调节功能的临床观察

目的:观察分析1CU可调节人工晶状体植入术后近远期调节功能变化。方法:对2006/2008年在我院行白内障超声乳化联合1CU可调节人工晶状体植入术后的患者进行前瞻性随访研究2a,定期检测术眼裸眼远、近视力,最佳矫正远、近视力,分别用主觉近点法、离焦法检测术眼调节功能,并观察评价后囊膜混浊的发生。结果:1CU可调节人工晶状体植入术后1mo和6mo均可获得较好的裸眼远、近视力及最佳矫正远、近视力,其差异无统计学意义;术后1a远、近视力均下降,与6mo相比其差异有统计学意义(P<0.05)。近点法和离焦法检测的调节幅度在术后6mo和1a分别为(1.65±0.88)D,(1.78±0.67)D和(1.24±0.66)D,(1.15±0.62)D,其差异有统计学意义(P<0.05),术后2a为(0.92±0.44)D,(0.71±0.37)D,与术后1a相比差异有统计学意义(P<0.05)。发生后发性白内障的病例术后1a约占29%(10/34),术后2a约占47%(16/34)。结论:1CU可调节人工晶状体植入术后早期患者能够获得良好的远近视力及调节力,但随着后发性白内障的发生,术后1a以后远近视力及调节力均呈不同程度的下降,人工晶状体的特殊设计及晶状体材料可能与囊膜纤维化有较为密切的关系。     

Comparison of 6-month results of implantation of the 1CU accommodative intraocular lens with conventional intraocular lenses

OBJECTIVE: To evaluate the clinical results of implantation of the new 1CU accommodative intraocular lens (IOL) in cataract patients and to compare results with those of conventional IOLs. DESIGN: Nonrandomized comparative trial. PARTICIPANTS: Twenty eyes of 20 patients (mean age = 65.8+/-13.3 years) in the 1CU group and 20 eyes of 20 patients (mean age = 67.4+/-11.6 years) in the control group. METHODS: All patients underwent phacoemulsification and IOL implantation. The 1CU accommodative lens was used in 20 eyes, and conventional IOLs (polymethyl methacrylate, hydrophilic or hydrophobic acrylate) were used in the control group. Patients were observed prospectively, and 6-month data were analyzed. MAIN OUTCOME MEASURES: Accommodative ranges determined by 3 different methods (near point, defocusing, and retinoscopy). Secondary outcome measures were (1) increase of anterior chamber depth after topical application of 1% cyclopentolate eyedrops and (2) distance-corrected near visual acuity with Birkh?user reading charts at 35 cm. RESULTS: We observed a higher accommodative range with all 3 methods (mean = 1.83+/-0.49 vs. 1.16+/-0.27 diopters [D] [near point], 1.85+/-0.43 vs. 0.64+/-0.21 D [defocusing], and 0.98+/-0.55 vs. 0.17+/-0.22 D [retinoscopy]), a larger increase of anterior chamber depth after cyclopentolate eyedrops (mean = 0.42+/-0.18 vs. 0.11+/-0.06 mm), and better distance-corrected near visual acuity (median = 0.4 vs. 0.2) in the 1CU group relative to the control group. All differences between the 2 groups were statistically highly significant (P<0.001). CONCLUSIONS: In the present study, the 1CU accommodative IOL showed increased accommodative range and better near visual acuity than a control group with conventional IOLs. Further research is necessary to confirm these results in masked, randomized, prospective studies and to confirm further the accommodative power of this group of new IOLs.     

Longterm results of 1 CU accommodative intraocular lens implantation: 2-year follow-up study

PURPOSE: To evaluate the longterm efficacy of 1 CU accommodative intraocular lenses (IOLs) to restore near visual performance. METHODS: This prospective study comprised 14 eyes previously included in a 6-month, case-control clinical trial, undergoing phacoemulsification and implantation of a 1 CU accommodative IOL. The main outcome measures were subjective refraction, uncorrected distance visual acuity (UCDVA), best corrected distance VA (BCDVA), distance-corrected near VA (DCNVA), best corrected near VA (BCNVA), and subjective amplitude of accommodation (AA). In addition, anterior and posterior capsule opacification were assessed. Patients were examined over a 2-year follow-up period. RESULTS: Distance and near visual performance worsened after 6 months. Uncorrected DVA and BCDVA were 0.8 +/- 2.1 and 1.0 +/- 0.8 at 6 months and 0.4 +/- 0.1 and 0.6 +/- 0.1 at 1 year, respectively (p = 0.001). Distance-corrected NVA and BCNVA were 3.7 +/- 2.1 Jaeger (J) and 1.0 +/- 0.7 J at 6 months and 8.1 +/- 0.7 J and 1.5 +/- 0.5 J at 1 year, respectively (p = 0.001). Anterior and posterior capsule opacification were present, respectively, in 28% and 21% of patients at 6 months and in 100% of patients at 1 and 2 years (p < 0.001). After Nd:YAG laser capsulotomy (performed in 100% of patients), UCDVA and BCDVA increased to 0.7 +/- 0.2 (p = 0.007) and 1.0 +/- 0.1 (p = 0.001), respectively, at 2 years. Distance-corrected NVA improved to 7.3 +/- 0.5 J (p = 0.006). Mean AA was 1.9 +/- 0.8 D at 6 months, 0.3 +/- 0.2 D (p = 0.004) at 1 year and 0.3 +/- 0.2 D at 2 years. CONCLUSIONS: Patients implanted with 1 CU IOLs lost their accommodation capacities with time because of the high incidence and degree of anterior and posterior capsule opacification. The accommodative lens material and design may have played a role in capsule fibrosis.     

Short-term blood-aqueous barrier breakdown after implantation of the 1CU accommodative posterior chamber intraocular lens

PURPOSE: To quantify intraocular inflammation after phacoemulsification with implantation of an accommodative posterior chamber intraocular lens (IOL). SETTING: Department of Ophthalmology, University of Erlangen-Nürnberg, Erlangen, Germany. METHODS: Twenty cataractous eyes of 20 patients without preexisting blood-aqueous barrier (BAB) deficiencies or previous intraocular surgery were included in this study. The mean age of the patients was 64.6 years +/- 16.0 (SD). A single surgeon performed phacoemulsification through a superior sclerocorneal tunnel incision and implantation of a 1CU IOL (HumanOptics AG) though a 3.2 mm incision. The haptics of the single-piece acrylic 1CU lens are designed for anterior optic movement following ciliary muscle contraction. The postoperative treatment was standardized. Postoperative BAB breakdown was quantified by laser flare photometry (FC-1000, Kowa) at 1 day, 1 and 4 weeks, and 3 and 6 months. RESULTS: The mean aqueous flare was 6.3 photons/ms +/- 3.0 (SD) (range 4.0 to 12.2 photons/ms) 1 day postoperatively, with 64% of patients having normal aqueous flare values (<8.0 photons/ms). One week after surgery, the mean aqueous flare was 5.3 +/- 2.8 photons/ms (range 2.0 to 10.5 photons/ms). Four weeks postoperatively, aqueous flare was normal in all patients and remained stable below the normal limit for up to 6 months (mean 3.3 +/- 1.2 months; range 2.0 to 5.4 months). The number of aqueous cells did not increase at any follow-up and was normal in all eyes. No postoperative complications such as fibrin formation, synechias, macrophages on the IOL optic, or endophthalmitis were observed. CONCLUSIONS: Phacoemulsification with implantation of the 1CU accommodative IOL led to minimal and short-lasting BAB alteration. No signs of persistent inflammation or pigment dispersion were detected.     

Early visual results with the 1CU accommodating intraocular lens

PURPOSE: To prospectively assess the clinical outcome after implantation of the 1CU accommodating intraocular lens (IOL) and a foldable acrylic IOL (AcrySof, Alcon). SETTING: Department of Ophthalmology, Tokyo Dental College, Ichikawa Hospital, Ichikawa, and Minami Aoyama Eye Clinics, Tokyo, Yokohama, Japan. METHODS: Twenty-two eyes of 16 patients with cataract had phacoemulsification implantation of 1CU accommodating IOL. Twenty eyes of 10 age-matched and sex-matched patients with cataract had the same surgery but with a foldable acrylic IOL. All patients had assessments of the amplitude of accommodation, refraction, uncorrected and best corrected distance and near visual acuity, and distance corrected near visual acuity before surgery up to 12 months after surgery. Contrast visual acuities were measured 1 year after surgery. Anterior segment photography, intraocular pressure measurements, specular microscopy, and computerized topography were also performed. RESULTS: The final best corrected distance visual acuity was above 20/25 in all eyes with the 1CU and the AcrySof IOLs. The mean distance corrected near visual acuity was significantly higher in the 1CU IOL group than in the acrylic IOL group after 3 months. None of the eyes with the AcrySof IOL implants displayed an accommodative response at any examination. The peak mean amplitude of accommodation with the 1CU IOLs was observed at 3 months and was 0.5 diopters +/- 0.44 (SD). Accommodation amplitude declined after 6 months. CONCLUSION: The 1CU IOL provided additional near acuity postoperatively, but the benefit disappeared at 12 months with a concomitant decrease in accommodation amplitude owing to an increase in anterior and posterior capsular opacities.     

白内障超声乳化联合1CU可调节人工晶状体眼的调节及其视功能评估

目的研究白内障超声乳化术联合植入1CU可调节人工晶状体眼的近点调节力,并与传统单焦人工晶状体眼作对比,对其术后患者视功能进行评估。方法植入可调节式人工晶状体37只眼(1CU,Human Optics),同期对照组用随机数字法选取植入同样材质的折叠式人工晶状体(SN60ATAlcon,Human Optics Iol)病例。两组实验对象的平均年龄分别为67.6岁、65.3岁;术后第1个月、第3个月、第6个月随访,采用带状光检影法、Slataper视标法、1%匹罗卡品使用后前房深度变化测量法进行调节力和远近裸眼视力的测量。结果术后第3个月、第6个月用带状光检影法,Slat-aper视标法和前房深度变化值测量试验组的调节力分别为(0.93±0.44)D,(0.92±0.52)D;(3.61±0.31)D,(3.59±0.36)D;(0.55±0.12)mm,(0.56±0.11)mm;而对照组三种方法所测量的调节力分别为(0.36±0.12)D,(0.35±0.13)D;(2.07±0.59)D,(2.21±0.57)D;(0.34±0.20)mm,(0.30±0.12)mm。对两组的调节范围进行比较,差异均有非常显著性(P<0.001)。比较术后最佳视力,试验组在术后第3个月、第6个月有较好的裸眼近视力(4.71±0.15,4.70±0.16)和最佳远矫下近视力(4.77±0.17,4.73±0.18),与对照组比较(4.34±0.12,4.30±0.08;4.24±0.09,4.21±0.07)差异有非常显著性(P<0.001),其裸眼远视力、最佳矫正远视力、最佳矫正近视力与对照组比较差异无显著性。结论与传统单焦点人工晶状体相比,植入1CU可调节人工晶状体眼具有更大的调节力范围,且在术后获得良好远视力的同时,也具备良好的视近能力,但仍需更长时间的随访以观察调节力及视近能力的稳定性。     

Clinical study of the 1CU accommodating intraocular lens

PURPOSE: To compare the near functional capacities of patients with an accommodating intraocular lens (IOL) with those of patients with a conventional monofocal IOL. SETTING: Department of Ophthalmology, University of Chieti, Chieti, Italy. METHODS: This prospective double-blind case-control study comprised 42 eyes that had phacoemulsification and implantation of 1 of 2 types of IOLs: HumanOptics accommodating 1CU(R) (study group) and Eurocrystal IFP 3G 6.00 (control group). The main outcome measures were subjective refraction, uncorrected distance acuity, best corrected distance acuity, distance corrected near acuity at 40 cm, best corrected near acuity at 40 cm, and subjective amplitude of accommodation. Patients were examined 7, 30, 90, and 180 days after surgery. RESULTS: Postoperatively, both groups had excellent uncorrected distance acuity, best corrected distance acuity, and best corrected near acuity. In the study group, the mean distance corrected near acuity (Jaeger) was 5.43 +/- 0.98 (SD) (range 4 to 7) at 7 days, 2.33 +/- 0.48 (range 2 to 3) at 1 and 3 months, and 3.66 +/- 2.12 (range 2 to 7) at 6 months. In the control group, the mean distance corrected near acuity was 7.43 +/- 0.50 (range 7 to 8) during the entire follow-up. The differences between the groups was statistically significant (P<.001). The mean amplitude of accommodation was 0.00 diopter (D) in the control group and 1.14 +/- 0.44 D (range 0.75 to 2.00 D) in the study group at 7 days, 2.36 +/- 0.28 D (range 2.00 to 2.75 D) at 30 and 90 days, and 1.90 +/- 0.77 D (range 0.75 to 2.75 D) at 6 months. CONCLUSIONS: The 1CU accommodating IOL provided better useful spectacle-free near visual acuity than the conventional monofocal IOL. However, the accommodating mechanism can play a role in capsule fibrosis.     

Implantation of a new accommodative posterior chamber intraocular lens

PURPOSE: A new, potentially accommodative posterior chamber lens (PCIOL) was designed based on principles elaborated by Hanna using finite element computer simulation methods. We report 3-month postoperative results in patients. METHODS: In a prospective study, 12 eyes of 12 patients (age 45 to 87 yr) underwent phacoemulsification for cataracts and PCIOL implantation. The PCIOL, 1 CU, has haptics designed for anterior optic movement following ciliary muscle contraction. Patients were examined postoperatively after 1 and 2 days, 1, 2 and 6 weeks, and 3 months, and results were compared with a control group of 12 eyes that received standard PMMA or acrylic PCIOLs. RESULTS: Surgery was uncomplicated and all PCIOLs were well-tolerated and stable with good centration in the capsular bag. The results were (mean +/- SD [range] and median; 1 CU versus control PCIOL): near visual acuity (Birkh?user reading chart at 35 cm) with best distance correction 0.34 +/- 0.17 (0.2 to 0.6), 0.3 (J10-J1, median J7) versus 0.15 +/- 0.07 (0.1 to 0.3), 0.15 (J16-J7, median J13), P=.001; subjective near point 59 +/- 10 cm (40 to 100 cm), 53.5 cm versus 93 +/- 20 cm (64 to 128 cm), 86 cm, P=.004; retinoscopic accommodative range 1.2 +/- 0.4 D (0.63 to 1.5 D), 1.2 D versus 0.2 +/- 0.19 D (-0.25 to 0.5 D), 0.25 D, P < .001; decrease of anterior chamber depth after 2% pilocarpine 0.63 +/- 0.16 mm (0.40 to 0.91 mm), 0.63 mm versus 0.15 +/- 0.05 mm (0.08 to 0.20 mm), 0.17 mm, P < .001. CONCLUSIONS: The new PCIOL appears to be safe at short to medium term. Our results indicate pseudophakic accommodation secondary to focus shift with this PCIOL. Additional larger and long-term studies are necessary for exact evaluation of safety and accommodative power of this new PCIOL.     

可调节人工晶状体的研究进展

随着超声乳化白内障联合囊袋内人工晶状体植入技术的发展及人工晶状体制造技术的不断进步,改善白内障患者术后的裸眼全程视力,使其拥有一定的调节功能是眼科临床和基础研究共同追求的目标。可调节人工晶状体为白内障摘除术后老视症状提供了有效的解决办法。本文就其设计原理、发展历程、临床应用、功能评价及在临床应用中存在的问题等方面做一综述。     

ICU可调节人工晶体的初步临床研究

目的评估1CU可调节人工晶体的安全性、有效性。方法23例(30只眼)老年性白内障患者行超声乳化手术并植入1CU可调节人工晶体,另外26例(35只眼)植入AR40e人工晶体。观察患者术后的裸眼远近视力、矫正远近视力、最佳矫正远视力下的近视力、调节幅度及手术并发症。结果随访3个月,两组的裸眼远视力、矫正远视力、矫正近视力差异无显著意义(χ2=1.626、1.490、0.136,P>0.05),1CU组的裸眼近视力和最佳矫正远视力下的近视力好于AR40e组(χ2=7.987,8.126,P<0.05)。动态检影法测得调节幅度1CU组(2.58±0.37)D大于AR40e组(1.46±0.25)D(t=14.334,P<0.001)。前房深度法测得调节幅度1CU组(1.22±0.38)D大于AR40e组(0.45±0.25)D(t=9.711,P<0.001)。结论1CU可调节人工晶体是安全有效的,能使白内障患者术后获得一定的调节力,提供良好的远近视力。但其远期效果还需更大样本、更长时间的研究。     

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。     

后发性白内障治疗前后对1CU可调节人工晶状体移动度的影响

背景 后发性白内障的发生使1CU可调节人工晶状体(1CU AIOL)的拟调节力及远近视功能明显下降,影响其远期临床效果.目前国内外关于后发性白内障对IOL眼内移动度的影响及Nd∶YAG激光后囊膜切开术后是否可恢复IOL眼内移动度的研究报道较少. 目的 探讨后发性白内障及Nd∶YAG激光后囊膜切开术对1CU AIOL眼内移动度的影响.方法 采用系列病例观察试验设计.收集因单纯性白内障行白内障超声乳化摘出术联合1CU AIOL植入术后发生后发性白内障者20例24眼,分别于IOL植入术后3个月、Nd:YAG激光后囊膜切开术前1d、Nd∶YAG激光后囊膜切开术后3个月进行随访观察,检测术眼最佳矫正远视力下的近视力(DCNVA),并用IOL Master检测10 g/L匹罗卡品滴眼液点眼前及点眼后的前房深度,计算其差值作为IOL的眼内移动度.比较上述3个时间点IOL的眼内移动度变化,评价后发性白内障及激光治疗对1CU AIOL眼内移动的影响. 结果 1CU AIOL植入术后3个月IOL的眼内移动度为(0.44±0.21)mm,发生后发性白内障后,术眼行Nd:YAG激光后囊膜切开术前1 d IOL的眼内移动度为(0.27±0.11)mm,Nd:YAG激光后囊膜切开术后3个月IOL的眼内移动度为(0.34±0.10)mm,3个时间点间IOL的眼内移动度差异有统计学意义(F=7.180,P=0.001),与IOL植入术后3个月比较,Nd∶YAG激光后囊膜切开术前1d IOL的眼内移动度明显下降,差异有统计学意义(P=0.006);与后囊膜切开术前1d相比,Nd∶YAG激光后囊膜切开术后3个月IOL的眼内移动度略有增加,但差异无统计学意义(P=0.059).1CU AIOL植入术后3个月术眼DCNVA为(3.1±0.9)J,Nd∶YAG激光后囊膜切开术前1d为(6.2±0.8)J,Nd∶YAG激光后囊膜切开术后3个月为(3.4±0.7)J,3个时间点间的差异有统计学意义(F=110.270,P=0.000),其中Nd∶YAG激光后囊膜切开术前1d术眼DCNVA明显低于IOL植入术后3个月,差异有统计学意义(P＜0.05),与后囊膜切开术前1d相比,Nd∶YAG激光后囊膜切开术后3个月术眼DCNVA明显增加,差异有统计学意义(P＜0.05).IOL植入术后3个月、Nd∶YAG激光后囊膜切开术前1d、Nd∶YAG激光后囊膜切开术后3个月DCNVA与1CU AIOL的眼内移动度均无显著的相关性(r1=-0.150,P1=0.486;r2 =-0.320,P2=0.122:r3=-0.100,P3=0.633). 结论 后发性白内障使1CU AIOL的眼内移动度明显下降,Nd∶YAG激光后囊膜切开术对IOL的移动度并无明显影响,但术后术眼仍可恢复较好的视近功能,可能与多种因素产生的拟调节有关.     

Sarfarazi dual optic accommodative intraocular lens

The Sarfarazi accommodative intraocular lens, currently in clinical studies, is a single continuous silicon accommodative lens with dual optics and three haptics that mimic the action of the natural lens by using the contraction and relaxation of ciliary muscles. The lenses have been implanted in the eyes of patients. There have been no surgical or patient complications related to the lens, and its safety has been clearly demonstrated. Patient acceptance of the lens is excellent. Clinical enrollment will continue to expand.     

可调节人工晶状体的临床研究进展

具有调节能力的单焦点人工晶状体可为白内障患者提供较好的全程视力.目前主要的3种可调节人工晶状体已被临床证实有一定的调节功能.用于检测白内障患者术后调节力的方法也逐渐增多,并各有其优势及局限性.本文就以上内容做一综述.     

Validity of anterior chamber depth measurements for the evaluation of accommodation after implantation of an accommodative Humanoptics 1CU intraocular lens

BACKGROUND: Changes in the anterior chamber depth (ACD) after pilocarpin application are generally regarded as reflecting an accommodative effect of accommodative intraocular lenses (IOLs) METHODS: We implanted Humanoptics 1CU accommodative IOLs into 25 eyes of 20 patients aged 53.2+/-14.7 years (range: 30-83 years). In seven of these patients, we were able to measure anterior chamber depth changes after the application of pilocarpine (2%) eye drops 3 months postoperatively using a Zeiss IOLMaster, an Orbscan II topography system, as well as by ultrasound biomicroscopy (20 MHz-US-head). RESULTS: Uncorrected near acuity was on average 0.4+/-0.23 (0.1-0.8) and uncorrected distance acuity was 0.76+/-0.23 (0.3-1). Before pilocarpine, ACD was 3.19+/-2.11 mm (IOL-Master), 3.35+/-2.22 mm (Orbscan II) and 3.35+/-2.21 mm (US-biomicroscopy) ( P=0.96). After pilocarpine, ACD was 2.61+/-1.71 mm (IOL-Master), 2.63+/-1.78 mm (Orbscan II) and 3.15+/-2.08 mm (US-biomicroscopy) ( P=0.002). The average individual ACD change before/after pilocarpine was 0.83+/-0.25 mm with the IOL-Master, 1.04+/-0.39 mm with the Orbscan II System and 0.28+/-0.14 with US-biomicroscopy ( P=0.0004). DISCUSSION: The 1CU Humanoptics accommodative IOL presented with potential accommodative capabilities in clinical evaluation. Drug induced accommodation by pilocarpine does not reflect real accommodative effects. The differences in ACD measurements between three different methods were statistically significant. Evaluation methods for accommodative IOLs should be carefully analysed and further development of objective means for evaluation is needed.