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[多焦点人工晶状体植入的假晶状体眼与对侧透明晶状体眼的视力比较]

[Comparison of visual acuity in pseudophakic eyes with multifocal intraocular lens versus fellow eyes with clear lens].

作者信息

Li Jun-hua, Zhao Yun-e, Huang Fang, Zhao Yin-ying, Zheng Jing-wei

机构信息

Eye Hospital, Wenzhou Medical College, Wenzhou 325027, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2010 Aug;46(8):691-6.

Abstract

OBJECTIVE

To evaluate the visual acuity and subjective satisfaction of different aged monocular cataract patients who were implanted with ReSTOR multifocal intraocular lens (MIOL).

METHODS

Prospective comparative study: the objects are 24 cases of monocular cataract patients who consecutively received phacoemulsification and implantation of ReSTOR MIOL. The patients were divided into two groups by age: the presbyopic group has 17 cases with age ≥ 45 years, the non-presbyopic group has 7 cases with ages < 45 years. Research parameters: uncorrected and corrected distance (4 m), intermediate (80 cm, 60 cm), and near visual acuity; contrast sensitivity (CS); and questionnaire survey. All data were statistically analyzed with rank sum test.

RESULTS

Among presbyopia patients, the near vision of the eyes implanted with ReSTOR MIOL is better than that of the contralateral eyes with clear lens (Z = 2.864, Z = 2.911;P = 0.004), whereas the distance and intermediate vision and the CS results show no significant differences compared to that of contralateral eyes with clear lens (Z = 0.183 - 1.417, P = 0.855 - 0.156); the subjective satisfactions are 7 to 10 points with 70.6% (12/17) patients scoring higher than 9 points; and the spectacle-independent rate among presbyopia patients is 58.8% (10/17). In non-presbyopic group, the near and intermediate visions of ReSTOR MIOL implanted eyes are lower than that of the contralateral eyes with clear lens (Z = 2.197 - 2.371;P = 0.028 - 0.018); CS results of MIOL implanted eyes are also generally lower than that of the contralateral eyes, and the difference between CSs of bilateral eyes under night glare mode (3 cd/m(2)+28 Lux) with low spatial frequency (1.5 c/d) is statistically significant (Z = 1.997, P = 0.046); the subjective satisfactions are 6 to 9 points with 14.3% (1/7) patients scoring higher than 9 points; the spectacle-independent rate of both eyes is 85.7% (6/7).

CONCLUSIONS

The monocular cataract patients with presbyopia are suitable for implantation of ReSTOR MIOL, because their near visual acuity of ReSTOR MIOL implanted eyes is better than that of the contralateral clear lens eyes with higher subjective satisfaction and without decrease in distance and intermediate visions and CS. For non-presbyopic young patients with monocular cataracts, the near and intermediate visions of MIOL implanted eyes are lower than that of the contralateral clear lens eyes and with lower subjective satisfaction (compared to that of presbyopic patients), though the distance visions are similar. Therefore, although ReSTOR MIOL can be implanted in non-presbyopic group, a more detailed preoperative communication with these patients is needed.

摘要

目的

评估不同年龄的单眼白内障患者植入ReSTOR多焦点人工晶状体(MIOL)后的视力及主观满意度。

方法

前瞻性对照研究:对象为24例连续接受超声乳化白内障吸除术并植入ReSTOR MIOL的单眼白内障患者。按年龄将患者分为两组:老花眼组17例,年龄≥45岁;非老花眼组7例,年龄<45岁。研究参数:未矫正及矫正的远距(4 m)、中距(80 cm、60 cm)和近视力;对比敏感度(CS);问卷调查。所有数据采用秩和检验进行统计学分析。

结果

老花眼患者中,植入ReSTOR MIOL眼的近视力优于对侧透明晶状体眼(Z = 2.864,Z = 2.911;P = 0.004),而远距和中距视力及CS结果与对侧透明晶状体眼相比无显著差异(Z = 0.183 - 1.417,P = 0.855 - 0.156);主观满意度为7至10分,70.6%(12/17)的患者得分高于9分;老花眼患者的脱镜率为58.8%(10/17)。在非老花眼组中,植入ReSTOR MIOL眼的近视力和中距视力低于对侧透明晶状体眼(Z = 2.197 - 2.371;P = 0.028 - 0.018);植入MIOL眼的CS结果通常也低于对侧眼,在夜间眩光模式(3 cd/m(2)+28 Lux)下低空间频率(1.5 c/d)时双眼CS差异有统计学意义(Z = 1.997,P = 0.046);主观满意度为6至9分,14.3%(1/7)的患者得分高于9分;双眼脱镜率为85.7%(6/7)。

结论

单眼白内障老花眼患者适合植入ReSTOR MIOL,因为植入ReSTOR MIOL眼的近视力优于对侧透明晶状体眼,主观满意度较高,且远距和中距视力及CS无下降。对于非老花眼的单眼白内障年轻患者,植入MIOL眼的近视力和中距视力低于对侧透明晶状体眼,主观满意度较低(与老花眼患者相比),尽管远视力相似。因此,虽然ReSTOR MIOL可植入非老花眼组,但需要与这些患者进行更详细的术前沟通。

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