不同年龄人群植入可调节人工晶状体的伪调节力对比研究  

Pseudoaccommodation with accommodating intraocular lens in patients at different ages

作　　者：蓝婕[1] 黄钰森[1] 韩冬生[1] 代云海[1] 吴晓明[1] 谢立信[1] 

机构地区：[1]山东省医学科学院山东省眼科研究所青岛眼科医院,266071

出　　处：《中华眼科杂志》2013年第2期139-143,共5页Chinese Journal of Ophthalmology

摘　　要：目的比较不同年龄组人群植入可调节人工晶状体（IOL）的伪调节力。方法回顾性系列病例研究。2007年9月至2010年4月于青岛眼科医院诊断为年龄相关性白内障并行超声乳化白内障吸除联合可调节IOL植入术患者47例（47只眼），根据患者年龄分为3个组，分别为≤45岁组，46～59岁组，≥60岁组。术后3个月以上对其裸眼远视力、最佳矫正远视力、裸眼近视力、远视力校正后近视力进行检查。应用超声活体显微镜（UBM）测量调节远近时的前房深度变化；并用A超测量使用2％匹罗卡品缩瞳前后的前房深度变化；使用移近法测量主观调节力。采用SPSS13．0统计学软件，对3个组数据进行方差分析及非参数检验，使用Bonferroni法和Mann—Whitney法进行两两比较。结果3个组术后裸眼远视力、最佳矫正远视力、裸眼近视力、远视力校正后近视力差别均无统计学意义（F=1．22，P=0．31；F：1．59，P=0．22；F=0．40，P=0．67；F=1．17，P=0．32）；UBM测量的调节远近时前房深度变化幅度3个组分别为（0．16±0．12）mm，（0．06±0．06）mm，（0．07±0．05）mm，≤45岁组高于46～59岁组和〉160岁组（Mann-Whitney法，P=0．001，P=0．008）；A超测量的缩瞳前后前房深度变化范围3个组分别为（0．68±0．44）mm、（0．43±0．20）mm、（0．17±0．14）mm，≥60岁组明显低于其他两组（Mann-Whitney法，P=0．001，P=0．000）；术后调节力分别为（2．87±0．52）D、（2．68±0．39）D及（2．32±0．88）D，≥60岁组低于≤45岁组（Bonferroni法，P=0．005）。结论植入可调节IOL后的调节能力随年龄增长呈下降趋势，但对不同年龄患者视力无明显影响。Objective To compare the clinical performances of patients in different ages with implantation of a accommodating IOLs. Methods It was a retrospective study. Forty-seven eyes （47 patients） were enrolled in 3 groups for phacoemulsifieation and a accommodating IOL implantation. According to their ages, they were divided into 3 groups： ≤ 45 years, 46--59 years, and≥ 60 years. Parameters analyzed after more than 3 months postoperation were uncorrected distance, best-corrected distance, uncorrected near, and distance-corrected near visual acuities; changes of anterior chamber depth （ACD） during accommodative measured using the ultrasound biomicroscopy （ UBM ） ; changes of ACD by instilling 2% pilocarpine using the A-ultrasonic scan; and the amplitude of accommodation using the pushing-up test. Results No significant difference was observed between distance and near visual acuities of IOL groups. The mean changes of ACD measured with UBM in the group of ≤45 years [ （ 0. 16±0. 12 ） mm ] was significantly higher than the other age groups [ 46-59 years, （0. 06 ±0. 06 ） mm, P = 0. 00 ; ≥ 60 years, （ 0. 07 ± 0.05 ） mm, P = 0. 008 ） ] . The mean changes of ACD stimulated by pilocarpine measured with A-ultrasonic scan in the group of ≥60 years [ （0. 17 ±0. 14）mm] was significantly lower than the other age groups [ ≤45 years, （ 0. 68 ± 0.44 ） mm, P = 0.00 ; 46-59 years, （ 0.43 ± 0. 20 ） mm, P=0.00]. The accommodative amplitude of the ≥60 years groups （（ 2. 32 ±0. 88 ）D）was lower than the group of≤45 years [ （ 2.87 ±0. 52 ） D, P= 0. 005 ]. Conclusions The accommodative amplitude ofpatients implanted with accommodating IOLs stepped down following the increase of age. However, no statistical differences were found in distance and near visual acuities between the different age groups.

关 键 词：晶体 人工 调节 眼 视敏度 年龄因素 

分 类 号：R779.66[医药卫生—眼科]