术后 15 至 20 年，眼内人工晶状体的表面光散射和闪光对视觉功能的影响。
Influence of surface light scattering and glistenings of intraocular lenses on visual function 15 to 20 years after surgery.
机构信息
From the Department of Ophthalmology (Oshika), Faculty of Medicine, University of Tsukuba, Ibaraki, the Ando Eye Clinic (Ando), Kanagawa, the Inoue Eye Clinic (Inoue), Okayama, the Eguchi Eye Hospital (Eguchi), Hokkaido, the Yurinoki Clinic (Sato), Nagano, the Sugita Eye Clinic (Sugita) and Alcon Japan Ltd. (Sasaki), Tokyo, the Mikawa Eye Clinic (Nishimura), Saga, the Hayashi Eye Hospital (Hayashi), Fukuoka, the Fujita Eye Clinic (Fujita), Tokushima, the Miyata Eye Clinic (A. Miyata), Hiroshima, and the Miyata Eye Hospital (K. Miyata), Miyazaki, Japan.
From the Department of Ophthalmology (Oshika), Faculty of Medicine, University of Tsukuba, Ibaraki, the Ando Eye Clinic (Ando), Kanagawa, the Inoue Eye Clinic (Inoue), Okayama, the Eguchi Eye Hospital (Eguchi), Hokkaido, the Yurinoki Clinic (Sato), Nagano, the Sugita Eye Clinic (Sugita) and Alcon Japan Ltd. (Sasaki), Tokyo, the Mikawa Eye Clinic (Nishimura), Saga, the Hayashi Eye Hospital (Hayashi), Fukuoka, the Fujita Eye Clinic (Fujita), Tokushima, the Miyata Eye Clinic (A. Miyata), Hiroshima, and the Miyata Eye Hospital (K. Miyata), Miyazaki, Japan.
出版信息
J Cataract Refract Surg. 2018 Feb;44(2):219-225. doi: 10.1016/j.jcrs.2017.12.014.
PURPOSE
To assess the long-term influence of surface light scattering and glistenings of hydrophobic acrylic (Acrysof), silicone, and poly(methyl methacrylate) (PMMA) intraocular lenses (IOLs) on visual function.
SETTING
Eleven surgical sites, Japan.
DESIGN
Retrospective case series.
METHODS
Patients who had cataract surgery with implantation of a hydrophobic acrylic, silicone, or PMMA IOL from 1994 to 2000 were examined. Silicone and PMMA IOLs were not restricted to specific manufacturers or models. Patients were included if their corrected distance visual acuity (CDVA) within 3 months postoperatively (baseline CDVA) was 20/25 or better. The CDVA, contrast sensitivity, degree of surface light scattering measured with Pentacam densitometry, and glistening grades were recorded at the patient's latest visit.
RESULTS
Of the eyes, 31 had a hydrophobic acrylic IOL, 37 a silicone IOL, and 30 a PMMA IOL. Surface light scattering and glistenings were significantly greater with the hydrophobic acrylic IOL than with silicone and PMMA IOLs (P < .0001). The CDVA at the latest visit as well as the changes in CDVA from the baseline to the latest visit did not differ between the IOLs and was unaffected by surface light scattering and glistenings, as was the contrast sensitivity.
CONCLUSIONS
The hydrophobic acrylic IOL was associated with a significantly greater level of surface light scattering and glistenings than the silicone IOLs and PMMA IOLs 15 to 20 years postoperatively. However, the optical phenomena within the optics of the hydrophobic acrylic IOL did not influence the patients' visual function.
目的
评估疏水性丙烯酸（Acrysof）、硅树脂和聚甲基丙烯酸甲酯（PMMA）人工晶状体（IOL）表面光散射和闪光对视觉功能的长期影响。
地点
日本 11 个手术地点。
设计
回顾性病例系列。
方法
检查了 1994 年至 2000 年间接受白内障手术并植入疏水性丙烯酸、硅树脂或 PMMA IOL 的患者。硅树脂和 PMMA IOL 不受特定制造商或型号的限制。如果患者术后 3 个月内的矫正远视力（CDVA）（基线 CDVA）达到 20/25 或更好，则将其纳入研究。在患者的最新就诊时记录 CDVA、对比敏感度、Pentacam 密度计测量的表面光散射程度和闪光等级。
结果
31 只眼植入疏水性丙烯酸 IOL，37 只眼植入硅树脂 IOL，30 只眼植入 PMMA IOL。疏水性丙烯酸 IOL 的表面光散射和闪光明显大于硅树脂和 PMMA IOL（P <.0001）。最新就诊时的 CDVA 以及从基线到最新就诊时的 CDVA 变化在 IOL 之间没有差异，不受表面光散射和闪光的影响，对比敏感度也是如此。
结论
疏水性丙烯酸 IOL 在术后 15 至 20 年时与硅树脂 IOLs 和 PMMA IOLs 相比，表面光散射和闪光水平明显更高。然而，疏水性丙烯酸 IOL 光学器件内的光学现象并未影响患者的视觉功能。
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