人工晶体在前节OCT中的位移表现与伪调节力的研究

目的 分析人工晶状体植入后生理状态下,在眼内的前后位移度及其和伪凋节力的关系.方法 选择病人46例(46只眼)行白内障超声乳化联合单焦点一体式折叠人工晶状体植入术,检测和分析术后人工晶状体在眼前节OCT图像中的位移表现,记录不同度数镜片附加时的前房深度和瞳孔直径变化值,测量患者术眼的伪凋节力,并进行相关性分析.平均随访(5.2±1.6)个月.结果 78.26%(36/46)术眼屈光矫正后近视力≥Jr5;患者术眼术后平均伪凋节力为(1.08±0.71)D.眼前节OCT图像显示附加负值镜片时人工晶状体向前位移,前房变浅,附加正值镜片时人工晶状体向后位移,前房变深,前房深度变化值为(0.26±0.09)mm;不同度数镜片附加时瞳孔直径变化值为(0.58±0.28)mm.伪凋节力与前房深度变化呈正相关(r=0.8267,P＜0.01),与瞳孔直径变化亦呈正相关(r=0.6724,P＜0.01).结论 白内障术后人工晶状体在生理状态下位置可前后移动,视近时睫状肌收缩、人工晶状体向前移动,是IOL眼产生伪凋节力的重要机制之一;瞳孔收缩也可部分补偿调节力.

Intraocular lens movement in anterior segment imaging system and pseudoaccommodation in eyes after phacoemulcification

Objective To evaluate the relationship between the position shift of posterior chamber in traocular lenses (PC IOLs) in physical condition and the amplitude of pseudoaccommodation in eyes after pacoemulcification.Methods This study analyzed 46 eyes of 46 patients after cataract surgery and PC IOLs implantation 3 months after surgery. The position shift of the IOL and radius of pupil were measured by anterior segment imaging system with different diopter spectacle plus. Pseudoaccommodation amplitude was also calculated. The relationship among pseudoaccommodation.IOL movement and pupil radius was analyzed. Results There were 78.26％(36/46 ) patients whose near visual acuity with best distance correction ≥ Jr5.With negative spectacles, IOLs moved forwards, with positive spectacles, IOLs moved backwards. The mean ACD decrease was (0.26±0.09 ) mm when plus with different spectacles, the change of pupil radius was (0.58±0.28 ) mm.The mean pseudoaccommodation amplitude (diopters) was ( 1.08±0.71 )D, The correlation between pseudoaccommodation and anterior movement of the IOL was significant (r =0.8267, P＜0.01 ), the correlation between pseudoaccommodation and the change of pupil radius was significant too (r =0.6724, P＜0.01 ).Conclusion The movement of PC IOLs in eyes after cataract surgery is an important mechanism for attaining good near vision without additional correction, constriction of pupil also account for part of the pseudoaccommadation.