两种不同的单眼视设计在合并高度近视白内障患者中的应用

目的　探讨超声乳化联合人工晶状体植入术中使用两种不同的单眼视设计治疗合并高度近视白内障患者的临床效果。方法　前瞻性非随机对照研究。选择２０１３年１月至２０１５年１月在我院行双侧超声乳化联合人工晶状体植入术的合并高度近视的白内障患者４３例（８６眼），根据不同的单眼视设计分成两组:Ａ组非主导眼的目标屈光度为－１Ｄ；Ｂ组非主导眼的目标屈光度为－２Ｄ。随访至术后第３个月，记录双眼远、中、近距离视力，近立体视锐度，视觉质量评分，脱镜率及满意度评分。结果　术后第３个月，两组间的远、中距离视力差异均无统计学意义（均为Ｐ＞０．０５），Ｂ组的近视力优于Ａ组（Ｐ＜０．０１）。两组间近立体视锐度差异无统计学意义（Ｐ＞０．０５）。两组的视远脱镜率均为１００％，视近脱镜率分别为５５％（Ａ组）和８７％（Ｂ组）。两组的视觉质量评价和满意度均达到了较好的水平，组间差异无统计学意义（Ｐ＞０．０５）。结论　－１Ｄ和－２Ｄ两种不同的人工晶状体眼单眼视设计，应用在合并高度近视的白内障患者中，都可以获得良好的临床效果，我们应当根据患者情况进行个性化选择。

Applications of two types of different preudophakic monovision designs in cataract combined with high myopia

Objective To investigate the effects of two types of different preudophakic monovision designs for patients with cataract combined with high myopia. Methods Prospective nonrandomized controlled study. From January 2013 to January 2015 ,43 patients with high myopia who underwent phacoemulsification in Anyang Eye Hospital were divided into two groups : Group A( the nondominant eye was corrected to - I D) and group B ( the nondonunant eye was corrected to - 2 D) . Parameters were analyzed at 3 months postoperatively included binocular distance visual acuity ( VA) , intermediate VA. near VA . near stereoscopic acuity , spectacle independence , visual function score and patient satisfaction score. Results There was no statistical difference in binocular distance VA .intermediate VA and near stereoscopic acuity between the two groups at 3 months postoperatively ( all P > 0. 05 ) . Near VA in group B was sigruficantly better than that in group A (P < 0. 01) . The rate of distant spectacle independence was 100% in both groups. The rates of near spectacle independence were 55% and 87% in group A and group B , respectively. Visual function score and patient satisfaction score had no significant difference between the two group (P > 0. 05 ) . Conclusion The two different preudophakic monovision designs are both effective approach for patients with cataract combined with high myopia, and we should make individual choices according to the patient ’ s condition.