可调节人工晶状体植入术后的视觉质量及拟调节力

目的:研究Tetraflex可调节人工晶状体(IOL)植入术后视力、调节幅度、对比敏感度及主观视觉功能的临床应用效果。方法:病例对照研究。选择2010-03/2012-12在我院接受白内障超声乳化摘除联合囊袋内IOL植入术的白内障患者48例72眼,其中23例35眼植入Tetraflex可调节IOL(Tetraflex组),25例37眼植入AcrySof SA60AT单焦点IOL(SA60AT组),对比研究两组患者术后1,3,6mo裸眼远视力、最佳矫正远视力、裸眼近视力、最佳矫正近视力、最佳矫正远视力下近视力、拟调节力、脱镜率以及患者满意度情况,采用主观移近法测量调节力。采用SPSS13.0统计软件包进行统计学处理。结果:术后随访期间,两组患者的裸眼远视力、最佳矫正近视力和最佳矫正远视力差异无统计学意义(P>0.05);Tetraflex组患者的裸眼近视力和最佳矫正远视力下近视力与单焦组比较差异有统计学意义(P<0.05)。术后Tetraflex组拟调节力均高于SA60AT组(P<0.05),于术后6mo Tetraflex组拟调节力有所下降,与1,3mo比较差异均有统计学意义(P<0.05),两组间对比敏感度差异无统计学意义。脱镜率及和主观视功能满意度,Tetraflex可调节IOL组均明显优于单焦组,差异有统计学意义(P<0.05)。结论:可调节IOL可提供较好的远近视力,增加拟调节力,有效降低患者术后对老视镜的依赖,改善主观视功能。但其拟调节力仍需要进一步的研究。

Clinical research on visual performance and pseudophakic accommodation of Tetraflex accommodative intraocular lens in cataract surgery

AIM: To obverse visual acuity, pseudophakic accommodation, visual performance after implantation of the Tetraflex accommodative intraocular lens(IOL)in patients with age-related cataract.

METHODS: Case -control study. Forty-eight patients(seventy-two eyes)with age-related cataract received phacoemulsification and implantation of artificial intraocular lens in our department during March 2010 to December 2012. The patients were randomly divided into 2 groups: Tetraflex group( 23 cases 35 eyes)and SA60AT group(25 cases 37 eyes). All patients were assessed for visual acuity, accommodation amplitude and contrast sensitivity visual acuity in 1, 3 and 6mo after the surgery. The indexes were analyzed by SPSS 13.0 statistics software.

RESULTS: There were no statistically significant differences in uncorrected distance visual acuity(UCDVA)and best-corrected distance visual acuity(BCDVA)between the two groups(P>0.05); while there were statistically significant differences in uncorrected near visual acuity(UCNVA)and distance-corrected near vision acuity(DCNVA)(P<0.05). There was no significant difference of contrast sensitivity between the 2 groups(P>0.05). The Tetraflex group has best accommodative amplitude than the SA60AT group(P<0.05), and there was no significant difference of contrast sensitivity between the 2 groups(P>0.05). The Tetraflex group had higher rate of spectable independence than the SA60AT group(82.9% vs 16.2%)(P<0.05).

CONCLUSION: Tetraflex provides an excellent distance and near visual acuity, good amplitude of accommodation and decrease the dependence of spectacle, and improve the visual performance. But its long-term effect remains to be observed.