单焦点、多焦点与可调节人工晶状体植入术后患者的拟调节力观察

目的 研究超声乳化白内障摘除植入不同人工晶状体（IOL）术后患者的拟调节力。方法 前瞻性队列研究。行白内障超声乳化吸除联合IOL植入术且随访资料完整的患者73例（82眼），依据植入IOL的不同分为3组：单焦点IOL组28例（32眼），多焦点IOL组24例 （27眼），可调节IOL组21例（23眼）。术后3 d、1周、1个月、3个月分别测量3组患者的裸眼远、中、近视力，最佳矫正远、近视力，及拟调节力。数据采用单因素方差分析。结果 3组的最佳矫正远、近视力及裸眼远视力差异无统计学意义，而裸眼中视力可调节IOL优于单焦点与多焦点IOL（F=4.50，P＜0.05），裸眼近视力多焦点、可调节IOL好于单焦点IOL（F=26.06，P＜0.05）。多焦IOL可以提供（2.67±0.49）D的主观拟调节力，（0.93±0.42）D的客观拟调节力；可调节IOL可以提供（3.00±0.78）D主观拟调节力，（0.91±0.58）D客观拟调节力；优于单焦点IOL的（1.78±0.26）D的主观拟调节力（F=18.51，P＜0.05），和（0.37±0.22）D的客观拟调节力（F=7.39，P＜0.05）。结论 多焦点IOL与可调节性IOL均可提供较好的全程视力及拟调节力。

Clinical study of pseudoaccommodation in patients after the implantation of different intraocular lenses

Objective To compare pseudoaccommodation after cataract phacoemulsification combined with the implantation of different intraocular lenses （IOLs）. Methods In a prospective study， 73 patients （82 eyes） who had received IOL implants after cataract extraction were divided into three groups according to the implanted IOL： group 1， monofocal IOL， 28 patients， 32 eyes； group 2， multifocal IOL， 24 patients， 27 eyes； and group 3， accommodative IOL， 21 patients， 23 eyes. The uncorrected distance， intermediate and near visual acuity； best-corrected distance and near visual acuity； and pseudoaccommodation （respectively measured by Integrated Refractometer and iTrace Visual Function Analyzer 3.1） were measured. The data were collected at 3， 7， 30 and 90 days after surgery， and analyzed by a single-factor analysis of variance. Results The differences in the best-corrected distance visual acuity， near visual acuity and uncorrected distance visual acuity was not statistically significant， while uncorrected intermediate distance visual acuity of group 3 was better than groups 1 and 2 （F=4.50， P＜0.05）. The near visual acuity of groups 2 and 3 was better than group 1 （F=26.06， P＜0.05）. Subjective pseudoaccommodation of group 2 was 2.67±0.49 D and objective pseudoaccommodation was 0.93±0.42 D. Subjective pseudoaccommodation of group 3 was 3.0±0.78 D and objective pseudoaccommodation was 0.91±0.58 D. Both groups had better pseudoaccommodation than group 1 with 1.78±0.26 D for subjective pseudoaccommodation （F=18.51， P＜0.05） and 0.37±0.22 D for objective pseudoaccommodation （F=7.39， P＜0.05）. Conclusion Multifocal and accommodative IOLs can temporarily provide better visual acuity and pseudoaccommodation.