不同类型人工晶状体植入术后双眼视功能差异分析  

Analysis of difference in binocular visual function after implantation of different intraocular lenses

作　　者：李锦玉 孙斌 杨春华[2] 齐东来 姜善好 LI Jinyu;SUN Bin;YANG Chunhua;QI Donglai;JIANG Shanhao(Department of Ophthalmology,Yantai Affiliated Hospital of Binzhou Medical University,Binzhou 264000,Shandong Province,China;Shandong Technology Innovation Center of Molecular Targeting and Intelligen Diagnosis and Treatment of Binzhou Medical University,Binzhou 264000,Shandong Province,China)

机构地区：[1]滨州医学院烟台附属医院,山东省烟台市264000 [2]滨州医学院山东省分子靶向与智能诊疗技术创新中心,山东省烟台市264000

出　　处：《眼科新进展》2024年第7期544-548,共5页Recent Advances in Ophthalmology

基　　金：山东省泰山学者项目(编号:tsqn20190402);山东省自然科学基金(编号:ZR2021MH141)。

摘　　要：目的比较植入不同类型人工晶状体(IOL)后双眼视功能的差异。方法选择2021年10月至2023年6月于滨州医学院烟台附属医院行白内障超声乳化联合IOL植入术的年龄相关性白内障患者63例(126眼)为研究对象,其中双眼均植入单焦点IOL患者22例(44眼)为单焦点组,双眼分别植入单焦点和多焦点IOL患者21例(42眼)为混合组,双眼均植入多焦点IOL患者20例(40眼)为多焦点组,选择同期本院健康体检中心生理性老视受试者22例(44眼)作为对照组。术后随访3个月,记录并对比4组受试者双眼裸眼远视力(UDVA)、裸眼近视力(UNVA)、离焦曲线、调节幅度(AMP)、正相对调节(PRA)、负相对调节(NRA)、调节反应(BCC)、调节性集合/调节比值(AC/A)、集合近点(NPC)破裂点、远/近距离正融像性聚散(PFV)和负融像性聚散(NFV)破裂点以及立体视。结果随访3个月,4组受试者UDVA差异无统计学意义(P>0.05),多焦点组和混合组患者的UNVA优于对照组和单焦点组(均为P<0.05)。混合组和多焦点组患者离焦曲线呈双峰状。4组受试者的AMP、NRA、PRA和BCC差异均具有统计学意义(均为P<0.05);4组受试者的AC/A和远距离NFV、PFV破裂点差异均无统计学意义(均为P>0.05),NPC破裂点和近距离NFV、PFV破裂点差异均有统计学意义(均为P<0.05)。4组受试者间远距离立体视正常人数占比差异无统计学意义(P>0.05),混合组患者近距离立体视正常人数占比显著低于其他3组受试者(均为P<0.05)。结论多焦点IOL能够有效改善白内障患者术后UDVA和UNVA,双眼植入多焦点IOL有利于白内障患者术后在远距离和近距离条件下双眼视功能的重建,双眼混合植入单焦点和多焦点IOL短期内可影响患者近距离立体视功能的恢复。Objective To compare the difference in binocular visual function after implantation of different types of intraocular lenses(IOL).Methods A total of 63 patients(126 eyes)with age-related cataract who underwent phacoemulsification combined with IOL implantation in Yantai Affiliated Hospital of Binzhou Medical University from October 2021 to June 2023 were collected.Among them,22 patients(44 eyes)were implanted with monofocal IOL in both eyes(monofocal group),21 patients(42 eyes)were implanted with monofocal and multifocal IOL in both eyes,respectively(mixed group),and 20 patients(40 eyes)were implanted with multifocal IOL in both eyes(multifocal group).Another 22 patients(44 eyes)with physiological presbyopia were selected from the medical examination center of the same hospital during the same period as the control group.Uncorrected distance visual acuity(UDVA),uncorrected near visual acuity(UNVA),defocus curve,amplitude of accommodation(AMP),positive relative accommodation(PRA),negative relative accommodation(NRA),binocular cross-cylinder(BCC),accommodative convergence/accommodation ratio(AC/A),rupture point at the near point of convergence(NPC),near-far distance positive fusional vergence(PFV)and negative fusional vergence(NFV)rupture points,and near-far distance stereopsis of patients in the four groups were recorded and compared during the 3-month follow-up.Results After three months of follow-up,there was no significant difference in UDVA among the four groups(P>0.05),while the UNVA of patients in the multifocal group and the mixed group was better than that in the control group and the monofocal group(all P<0.05).The defocus curves of patients in the mixed group and the multifocal group were bimodal.There were statistically significant differences in AMP,NRA,PRA,and BCC among the four groups(all P<0.05).There was no statistically significant difference in the AC/A ratio and far-distance NFV and PFV rupture points among the four groups(all P>0.05).There were statistically significant differences in NPC ruptu

关 键 词：白内障 人工晶状体 视功能 离焦曲线 双眼视功能 

分 类 号：R776.1[医药卫生—眼科]