多焦点人工晶状体植入术后早期双眼视觉分析

目的研究多焦点人工晶状体（MIOL）植入术后早期患者的双眼视觉恢复情况。方法31例（46只眼）白内障患者植入MIOL作为MIOL组,其中单眼手术16例,设为Ms组,双眼手术15例,设为Md组。32例（47只眼）白内障患者植入单焦点人工晶状体（SIOL）作为SIOL组,其中单眼手术17例,设为Ss组,双眼手术15例,设为Sd组。术后3周,观察患者的双眼视觉即同视功能、融合功能及远、近距离立体视功能及视力、视觉症状等。结果全部患者具有良好的同视功能及融合功能,两组比较差异均无统计学意义（P〉0．05）。具有远距离立体视功能者MIOL组占38．7％（12／31）,SIOL组占40．6％（13／32）,两组比较差异无统计学意义（P〉0．05）。具有近距离立体视功能者MIOL组占41．9％（13／31）,SIOE组占15．6％（5／32）,两组比较差异有统计学意义（P〉0．05）。Ms与Md、Ss与Sd比较远、近距离立体视功能差异均无统计学意义（P〉0．05）。仅2例（6．5％）单眼植入MIOL患者诉夜间出现眩光症状,其他患者均无明显不适,满意程度较高。MIOL组80．6％（25／31）、SIOL组56．2％（18／32）患者诉用餐夹菜、冲热水壶、上下楼梯等立体视觉明显改善,两组比较差异有统计学意义（P〉0．05）。结论MIOL植入术后早期患者立体视功能已达到老年人正常水平;且单眼与双眼植入立体视功能恢复相当。近距离立体视功能MIOL组较SIOL组恢复快。MIOL在为患者提供良好的全程视力及立体视功能方面具有明显优势。

Study of binocular function in early stage after implantation of multifocal intraocular lens

OBJECTIVE: To evaluate binocular function in the early stage after implantation of multifocal intraocular lens. METHODS: Three weeks postoperatively, simultaneous perception, fusion, near and far-distance stereoacuity, visual acuity and visual symptoms were observed in 31 cases (46 eyes) with multifocal intraocular lens implantation (MIOL) MIOL group, in which 16 cases with unilateral implantation (Ms) and 15 cases with bilateral implantation (Md)] and 32 cases (47 eyes) with single-focal intraocular lens implantation (SIOL) SIOL group, in which 17 cases with unilateral implantation (Ss) and 15 cases with bilateral implantation (Sd)]. RESULTS: All patients obtained simultaneous perception and fusion sense, there was no significantly statistical difference between these two group (P > 0.05). Foveal far-distance stereoacuity was established in 38.7% cases among MIOL group (12/31) and 40.6% in SIOL group (13/32), with no statistically significant difference between these two groups (P > 0.05). Foveal near-distance stereoacuity was established in 41.9% MIOL cases (13/31) and in 15.6% SIOL group (5/32), the difference was statistically significant (P < 0.05). Foveal near and far-distance stereoacuity of either Ms and Md or Ss and Sd revealed no significantly statistical difference (P > 0.05). Two patients (6.5%) with MIOL in only one eye complained glare at night, others were satisfied. The stereopsis visual performance such as the quality of vision during eating, up-and-down stairs was improved in MIOL group 80.6% (25/31)] and in SIOL group 56.2% (18/32)], the difference was statistically significant (P < 0.05). CONCLUSIONS: There is a complete recovery of binocular vision in the early post-operative stage of MIOL implantation as compared with the normal value of aged people. Foveal near and far-distance stereoacuity after bilateral and unilateral implantation of either MIOL or SIOL revealed no statistically significant difference. Foveal near-distance stereopsis acuity of MIOL group was improved more quickly than that of SIOL group. MIOL has distinct advantage in providing whole-distance visual acuity and stereoacuity.