多焦点人工晶状体临床应用观察

目的观察白内障超声乳化及AMO Array多焦点人工晶状体(multifocal intraocular lens,MIOL)植入的临床应用效果。方法按病例选择标准选取年龄相关性白内障患者,分为两组。多焦点人工晶状体(MIOL)组:13例20眼,植入AMO Array SA-40N多焦点人工晶状体。单焦点人工晶状体(monofocal intraocular lens,SIOL)组:16例20眼,植入AMOSI-40NB单焦点人工晶状体。术后观察两组患者的裸眼远视力、最佳矫正远视力、裸眼近视力、最佳矫正近视力及对比敏感度值,并进行视觉症状的调查。结果术后第1天、第1周、第1个月MIOL组的裸眼近视力均明显优于SIOL组(P<0.01),两组间裸眼远视力及最佳矫正远近视力差异无显著性(P>0.05)。采用VCTS6000对比敏感度测试卡于术后第1天、第1周、第1个月测得两组的对比敏感度,它们在各空间频率段差异均无显著性(P>0.05)。术后第1个月采用CGT-1000对比敏感度眩光测试仪检查得两组间的对比敏感度值在各不同视标空间频率段差异均无显著性(P>0.05)。MIOL组中4例6眼(占30%)、SIOL组中2例2眼(占10%)诉有术前没有的视觉症状发生。患者满意率MIOL组为95%,SIOL组为100%。结论AMOArray多焦点人工晶状体植入术后患者无需戴镜即可获得良好的远视力和近视力。术后患者对比敏感度值明显上升,其大小与植入多焦点或是单焦点人工晶状体无关。多焦点人工晶状体植入术后有一定比例的视觉症状发生,较单焦点人工晶状体植入术后多,但不严重影响生活,患者满意率高。

Clinical observation of multifocal intraocular lens

Objective To evaluate the clinical effects of implanting an AMO Array multifocal intraocular lens(MIOL)after cataract surgery.Methods Patients with age-related cataract were selected for this study.Twenty eyes(13 patients)received an AMO Array MIOL after phacoemulsification.A control group of 20 eyes(16 patients)received a monofocal intraocular lens(SIOL).Distance and near visual acuity,contrast sensitivity(using a VCTS 6000 contrast sensitivity chart and a CGT-1000 contrast glaretester)and subjective photic phenomena were evaluated.Results After surgery,the uncorrected near vision of the MIOL group was much better than that of the SIOL group(P<0.01).The uncorrected distance vision and the corrected distance and near vision in the MIOL group did not differ from that of the SIOL group(P>0.05).Contrast sensitivity(CS)at all spatial frequencies in both groups increased after surgery(P<0.01).There were no significant differences between the MIOL and SIOL groups in CS for all spatial frequencies 1 day,1 week and 1 month after surgery(P>0.05).Six eyes with MIOLs and 2 eyes with SIOLs reported photic phenomena that had not been noticed before cataract surgery.However,satisfaction rates were high for both groups.Conclusion The AMO Array MIOL provided good distance and near vision and reduced spectacle dependency.Contrast sensitivity values in both groups increased after surgery,but there was no significant difference between the values for the MIOL and SIOL groups.Subjective photic phenomena were experienced more often by patients in the MIOL group than by those who had SIOLs,but the levels were acceptable.