[单焦点和多焦点人工晶状体联合植入矫正白内障患者老花眼]

Mayer S, Böhm T, Häberle H, Pham D-T, Wirbelauer C

Klinik für Augenheilkunde, Vivantes Klinikum Neukölln, Berlin.

Klin Monbl Augenheilkd. 2008 Sep;225(9):812-7. doi: 10.1055/s-2008-1027604.

BACKGROUND

The purpose of this study was to assess uncorrected far and near vision after implantation of a multifocal intraocular lens (IOL) in the second eye in patients with a unilateral monofocal IOL.

PATIENTS AND METHODS

13 cataract patients with a monofocal intraocular lens in one eye (SA60AT, Alcon) and postoperative emmetropia received a multifocal lens in the second eye (ReSTOR, Alcon). Two and six months postoperatively the clinical examination, far and near vision, near aniseikonia (AWAYA-New Aniseikonia Test), stereo vision (Lang I test) and the mesopic contrast sensitivity (F. A. C.T) were tested. In addition, the grade of satisfaction without glasses in general, and with far and near vision were noted on a visual analogue scale (0 - 10). Furthermore, independence from glasses and the presence of optical phenomena were assessed.

RESULTS

The mean uncorrected far visual acuity 6 months postoperatively was 1.06 +/- 0.28 for the monofocal lens, 0.88 +/- 0.23 for the multifocal lens, and 1.16 +/- 0.24 binocularly. The uncorrected near visual acuity was Nieden 1 binocularly for all patients and ranged from Nieden 1 - 3 for the multifocal lens to Nieden 2 - 11 for the monofocal lens. 77% of the patients received the multifocal lens in their far dominant eye. The mean uncorrected near aniseikonia was < 1%. The mesopic contrast sensitivity showed no significant differences between the two IOL types and compared to binocular values. The satisfaction with the uncorrected visual acuity was in general 8.88 +/- 1.21, with the far visual acuity 9.42 +/- 1.24, and 7.33 +/- 1.72 with the near visual acuity. After 6 months 67% of the patients used glasses only for periods of prolonged reading. Halos and a low degree of glare were noted by 38.5% of patients 2 months postoperatively. At the 6 months visit 33.3% still had halos and only 8% glare.

CONCLUSIONS

This first experience with the combined implantation of a monofocal and a multifocal lens revealed a marked improvement of the uncorrected near visual acuity compared to bilateral monofocal IOL implantation along with a high patient satisfaction.

背景

本研究的目的是评估单眼植入单焦点人工晶状体（IOL）的患者，其第二眼植入多焦点人工晶状体后的未矫正远视力和近视力。

患者与方法

13例一只眼植入单焦点人工晶状体（SA60AT，爱尔康）且术后屈光正常的白内障患者，在其第二眼植入多焦点晶状体（ReSTOR，爱尔康）。术后2个月和6个月进行临床检查，检测远视力和近视力、近像不等（AWAYA - 新型像不等测试）、立体视（Lang I测试）以及中视对比敏感度（F.A.C.T）。此外，使用视觉模拟量表（0 - 10）记录患者对不戴眼镜时总体、远视力和近视力的满意度。另外，评估患者对眼镜的依赖程度以及光学现象的存在情况。

结果

术后6个月，单焦点晶状体组未矫正远视力平均为1.06±0.28，多焦点晶状体组为0.88±0.23，双眼为1.16±0.24。所有患者双眼未矫正近视力均为Nieden 1级，多焦点晶状体组单眼未矫正近视力范围为Nieden 1 - 3级，单焦点晶状体组为Nieden 2 - 11级。77%的患者在其远用优势眼植入了多焦点晶状体。平均未矫正近像不等＜1%。两种人工晶状体类型的中视对比敏感度与双眼值相比无显著差异。患者对未矫正视力的总体满意度为8.88±1.21，对远视力的满意度为9.42±1.24，对近视力的满意度为7.33±1.72。6个月后，67%的患者仅在长时间阅读时使用眼镜。38.5%的患者术后2个月出现光晕和低度眩光。在6个月随访时，33.3%的患者仍有光晕，仅有8%的患者有眩光。