可调节人工晶状体预留度数设计的临床观察

目的 观察可调节人工晶状体预留度数植入术后的视觉质量及调节力的变化.方法 将30例(60只眼)植入可调节人工晶状体,其中将15例(30只眼)植入度数设计(SRKT公式)为主视眼植入理论值过矫0.5D度数,非主视眼植入理论值过矫1.0D度数作为研究组;随机选取15例(30只眼)植入度数设计为主视眼和非主视眼均植入SRKT公式理论值度数作为对照组.手术后随访3个月以上,观察远视力、近视力,最佳矫正远、近视力;调节力的测定(分别用主观法和客观法);双眼合视的远、近视力.结果 研究组术后屈光度主视眼为(0.512±0.15)D,非主视眼为(1.13±0.12)D.研究组与对照组主视眼裸眼远视力及最佳矫正远视力分别为0.89±0.11、0.91±0.12和0.97±0.23、0.99±0.14,差异均无统计学意义.33cm近视力及最佳矫正近视力主视眼分别为0.63±0.16、0.48±0.23和0.97±0.25、0.86±0.14,差异有统计学意义;非主视眼最佳矫正近视力为0.99±0.15和0.89±0.14,差异有统计学意义.两组调节幅度主观法分别为(3.35±0.71)D和(3.27±1.32)D,差异无统计学意义;客观法主视眼分别为(0.38±0.12)D和(0.37±0.08)D,差异无统计学意义.双眼合视的远视力分别为0.99±0.11和0.98±0.21,差异无统计学意义;双眼合视的近视力分别为0.91±0.20和0.61±0.17,差异有统计学意义.结论 植入可调节人工晶状体预留度数设计的术后视力主视眼远视力及最佳矫正远视力、双眼合视远视力均无显著差异;33cm近视力和最佳矫正近视力主视眼和非主视眼差异均有统计学意义,双眼合视的近视力差异有统计学意义.可调节人工晶状体在自身调节能力基础上设计预留一定的度数,可明显改善近视力视功能.

Clinical observation on preserved degrees of accommodative intraocular lens

Objective To observe the vision circumstance and the change of accommodation after implantation of preserved degrees of accommodative intraocular lens. Methods Thirty cases (60 eyes) were implanted with accommodative intraocular lens, among which the SRKT for the research group, 15 cases (30 eyes), was theoretically over-corrected 0.5D in the major visual eyes and over 1.0D in the minor visual eyes; the SRKT for the control group, 15 cases (30 eyes) randomly chosen, was equal to the theoretical value for both the major and minor visual eyes. After the implantation, follow-up visits were above 3 months to observe the distant vision, near vision, optimal corrected distant and near visions, to determine the accommodation by objective and subjective methods and to test the combined distant and near visions of both eyes. Results In the research group, the diopter (D) of the major and minor visual eyes was 0.512±0.15 and 1.13± 0.12 respectively.The distant visions of the naked major visual eyes and the optimal corrected distant visions of the research and the control groups were 0.89± 0.11 and 0.91± 0.12, 0.97± 0.23 and 0.99± 0.14 respectively, exerting no significant difference. The 33 cm near visions of the major visual eyes and the optimal corrected near visions of the major visual eyes were 0.63± 0.16 and 0.48± 0.23, 0.97±0.25 and 0.86± 0.14, exerting significant difference. The optimal corrected near visions of the minor visual eyes are 0.99± 0.15 and 0.89± 0.14, having significant difference. For the accommodation (D) of two groups by the subjective method, it was 3.35± 0.71 and 3.27± 1.32 respectively without significant difference; while by the objective method, it was 0.38± 0.12 and 0.37±0.08 without significant difference. The distant vision of the combined eyes of two groups was 0.99±0.11 and 0.98± 0.21, exerting no significant difference. The near vision of the combined eyes of two groups was 0.91± 0.20 and 0.61± 0.17, exerting very significant difference. Conclusions There is no significant difference of implanting preserved degrees of accommodative intraocular lens on aspects of major visual eye's distant vision, optimal corrected vision, and distant vision of combined two eyes. As for 33 cm near vision and the optimal corrected near vision of the major and minor eyes, they both have significant difference. There is very significant difference on the near vision of the combined two eyes. To preserve some certain degrees of the accommodative intraocular lens on the basis of self-adjustment can obviously improve the visual function of the near vision.