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.