1CU可调节人工晶状体眼的近期视觉质量评价

目的评价1CU可调节后房型人工晶状体（IOL）眼的视觉质量，并与非球面单焦点IOL眼进行比较。设计非随机对照试验。研究对象老年性白内障患者118例（118眼）。方法白内障超声乳化吸除术时植入1CU可调节IOL（1CU组）和非球面IOL（Tecnis ZA9003组）各为59例59眼。术后3个月时检查裸眼及矫正远、近视力，最佳矫正远视力下的近视力，波前像差，调制传递函数，40、63、100cm处对比敏感度，拟调节力，并比较脱近用镜率。主要指标视力、波前像差、调制传递函数值、对比敏感度、拟调节力、脱近用镜率。结果术后3个月1CU组的裸眼近视力（1．06±0．24）和最佳矫正远视力下的近视力（1．02±0．13）优于TecnisZA9003组（分别为0．43±0．14、0．43±0．11）（江8．85，P=0．00；t=13．05，P=0．00）。调节幅度1CU组为（2．58±0．37）D，大于非球面IOL组的（1．46±0．25）D（t=14．33，P=0．00）。1CU组3mm、5mm瞳孔下的球差（0．34±0．06、0．36±0．06）和总像差（0．47±0．14、0．49±0．14）均大于Tecnis ZA9003组（分别为0．06±0．06、0．07±0．04，0．30±0．07、0．30±0．58）（3mm瞳孔下t=18．48，P=0．00；t=5．70，P-0．00。5mm瞳孔下f=19．98，P=0．00；t=6．70，P=0．oo）。在40、63 cm1CU组视锐度得分（VAS）分值高于Tecnis ZA9003组（t=3．64，P=0．00；t=2．74，P=0．00；t=2．65，P=0．00；t=2．44，P=0．01）。脱近用镜率1CU组（85％）优于Tecnis ZA9003组（25％）（χ^2=41．95，P=0．00）。结论虽然1CU可调节后房型IOL对比敏感度较非球面单焦点IOL有损失，但可获得良好远、中、近视力，适合于迫切要求脱镜的患者。（眼科，2009，18：91-95）

Visual quality evaluation of short-term in pseudophakic eye with 1CU accommodating intraocular lenses

Objective To observe the short-term visual effects of cataract surgery patients with 1CU accommodating intraocular lens （IOL） compared with aspheric monofocal IOL. Design Non-randomed comparative trial. Partieipailts Consecutively 118 senile cataract patients （118 eyes）. Methods 59 cataract patients （59 eyes） were implanted 1CU accommodating IOL （1CU group）, and 59 cataract patients （59 eyes） were implanted aspherie monofoeal IOL （Teenis ZA9003 group）. All patients were assessed at 3 months post-operation in the aberrations of crystalline, the modulation transfer function contrast sensitivity of 10/100 percent in three sorts distance （40, 63, 100 cm）, uncorrected distanced visual acuity （UCDVA）, uncorrected near visual acuity （UCNVA）, best-corrected distance visual acuity （BCDVA）, best-corrected near visual acuity （BCNVA）, distance corrected near visual acuity （DCNVA）, pseudo-accommodation, and the rate of off-near glasses. Main Outcome Measures Visual acuity, aberrations, modulation transfer function, contrast sensitivity, pseudo-accommodation, the rate of off-near glasses. Results At 3 months postoperatively, both UCNVA and DCNVA were significantly better in 1CU group than in the aspheric monofocal IOL group （t=8.85, P=0.00; t=13.05, P=0.00）. The accommodative range was （2.58±0.37） D in 1CU group and （1.46±0.25） D in monofocal IOL group （t=14.33, P= 0.00）. In 3 mm and 5 mm pupil diameter the difference of the total aberration and spherical aberration in Tecnis ZA9003 group or 1CU group was significant （3 mm pupil t=18.48, P=0.00; t=5.70, P=0.00. 5 mm pupil t=19.98, P=0.00; t=6.70, P=0.00）. At 40 cm and 63 cm, VA scores were higher in 1CU group （85%） than in Tecnis ZA9003 group （25%） （t=3.64, P=0.00; t= 2.74, P=0.00; t=2.65, P=0.00; t=2.44, P=0.01）. The rate of off-near glasses in 1CU group was better than in the aspheric monofoeal IOL group（χ^2 =41.95, P=0.00）. Conclusions The 1CU accommodating IOL can provide better useful n