中国组织工程研究

中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (21): 3171-3177.doi: 10.3969/j.issn.2095-4344.2016.21.019

• 材料力学及表面改性 material mechanics and surface modification • 上一篇    下一篇

多焦点和单焦点非球面人工晶状体置入治疗老年性白内障后视觉功能的比较

王国强，赵 燕，赵延涛，丁 颖   

  1. 河北医科大学第一医院眼科，河北省石家庄市  050081
  • 收稿日期:2016-03-16 出版日期:2016-05-20 发布日期:2016-05-20
  • 通讯作者: 赵燕，副主任医师，河北医科大学第一医院眼科，河北省石家庄市 050081
  • 作者简介:王国强，男，1976年生，汉族，河北省石家庄市人，副主任医师，主要从事白内障的手术治疗研究。
  • 基金资助:

    河北省医学科学研究重点课题计划(20140099)

 Visual function of senile cataract patients after implantation of an aspheric multifocal versus an aspheric monofocal intraocular lens

Wang Guo-qiang, Zhao Yan, Zhao Yan-tao, Ding Ying   

  1. Department of Ophthalmology, the First Hospital of Hebei Medical University, Shijiazhuang 050081, Hebei Province, China
  • Received:2016-03-16 Online:2016-05-20 Published:2016-05-20
  • Contact: Zhao Yan, Associate chief physician, Department of Ophthalmology, the First Hospital of Hebei Medical University, Shijiazhuang 050081, Hebei Province, China
  • About author:Wang Guo-qiang, Associate chief physician, Department of Ophthalmology, the First Hospital of Hebei Medical University, Shijiazhuang 050081, Hebei Province, China
  • Supported by:

    the Medical Research Key Project Plan of Hebei, No. 20140099

PDF

310

被引次数

7

摘要：

 文章快速阅读：

文题释义：
单焦点非球面人工晶状体：以往的人工晶状体为单焦点、球面的，其中球面人工晶状体置入后人眼的成像质量有所下降，对比敏感度降低，影响夜间视物。非球面人工晶状体可弥补球面人工晶状体的上述不足，能够提高夜间视觉质量，提高对比敏感度，第一个非球面人工晶状体为由聚甲基丙烯酸甲酯材料制成的人工晶状体。单焦点人工晶状体能够使患者获得比较好的远视力，但近视力恢复较差，多数仍需要佩戴眼镜。
多焦点人工晶状体类型：①折射型多焦点人工晶状体：折射型多焦点人工晶状体的主要材料为聚甲基丙烯酸甲酯，呈双凸透镜，没有定位孔，光学面有不同屈光率，周边主要是视远，中央主要是视近，这种结构容易形成一个模糊一个清晰两个物象。折射型多焦点人工晶状体以改善患者的远视力为主，对患者的全程视力均有改善。但这种类型的人工晶状体受晶状体偏位和瞳孔直径影响，瞳孔直径太小者术后视力恢复不理想，另外置入早期对比敏感度可能会有下降，有视觉异常现象的发生。②衍射型多焦点人工晶状体：衍射型多焦点人工晶状体后表面为显微坡环，前表面为光滑球面，光学通过后可以形成远近2个焦点。衍射型多焦点人工晶状体可以较好改善患者的远近视力，提高脱镜率，并且可改善夜间、雨天及雾天的视力。与折射型多焦点人工晶状体相比，衍射型多焦点人工晶状体可以提高对比敏感度。衍射型多焦点人工晶状体对瞳孔没有严格要求，但改善中距离视力效果有限，不如折射型多焦点人工晶状体效果好。③折射加衍射型多焦点人工晶状体：折射加衍射型多焦点人工晶状体设计为周边是折射型，中间是衍射型，能够克服上述两组人工晶状体的不足。

背景：单焦点人工晶状体能够恢复白内障患者的远视力，但近视力恢复较差，多数仍需要佩戴眼镜；多焦点人工晶状体可弥补单焦点人工晶状体的不足，改善近视力，提高脱镜率。
目的：比较多焦点和单焦点非球面人工晶状体置入治疗老年性白内障后的视觉功能。
方法：将35例(50眼)老年白内障患者分为2组，试验组置入多焦点非球面人工晶状体，对照组置入单焦点非球面人工晶状体。置入后3个月，检测5 m裸眼远视力和最佳矫正远视力，30，60，100 cm裸眼近、中视力，以及明暗环境中0.8，1.5，6，18 cpd空间频率下的对比敏感度。
结果与结论：置入后3个月，两组5 m裸眼远视力均较置入前明显改善(P < 0.05)，两组间5 m、100 cm裸眼远中视力比较差异无显著性意义，但试验组30，60 cm裸眼近视力高于对照组(P < 0.05)。两组明环境下不同空间频率的对比敏感度无差异；试验组暗环境下6 cpd空间频率的对比敏感度低于对照组(P< 0.05)，两组其余频率下的对比敏感度无差异。结果表明，相较于单焦点非球面人工晶状体，多焦点非球面人工晶状体可有效改善患者的裸眼近、中视力。

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

ORCID: 0000-0002-0715-0533(赵燕)

关键词: 生物材料, 材料相容性, 多焦点, 单焦点, 人工晶状体, 球面, 非球面, 老年性, 白内障, 视觉功能

Abstract:

BACKGROUND: Monofocal intraocular lens can restore distant vision of cataract patients, but it is not suitable for near vision recovery, so most of patients still need to wear glasses. In contrast, multifocal intraocular lens can make up for the shortcomings of the single lens to improve near vision and increase the rate of taking off the spectacles.

 

OBJECTIVE: To compare the visual function of senile cataract patients after aspheric multifocal and monofocal intraocular lens implantation.

 

METHODS: Totally 30 senile cataract patients with 50 affected eyes were randomly divided into two groups: the eyes were implanted with aspheric multifocal and monofocal intraocular lens as experimental group and control group, respectively. At 3 months after implantation, distance visual acuity at a distance of 5 m, the best corrected distance visual acuity, as well as near and intermediate visual acuity at a distance of 30, 60 and 100 cm were detected, respectively. Besides, contrast sensitivity at a spatial frequency of 0.8, 1.5, 6 and 18 cpd under light and dark environment was measured.

 

RESULTS AND CONCLUSION: At 3 months after implantation, the distance visual acuity at a distance of 5 m in the two groups was significantly better than that before surgery (P < 0.05); no significant differences were found in near and intermediate visual acuities at a distance of 5 m and 100 cm between two groups, but the near visual acuities at a distance of 30 and 60 cm in the experimental group were significantly higher than those in the control group (P < 0.05). In addition, the contrast sensitivity at different spatial frequencies under light environment had no significant differences between two groups; and compared with the control group, contrast sensitivity at the frequency of 6 cpd under dark environment was significantly decreased in the experimental group (P < 0.05), but no significant differences were found in the other spatial frequencies. These results show that aspheric multifocal intraocular lens can significantly improve the near and intermediate visual acuity of senile cataract patients compared with the monofocal lens.

 

 

 

Key words: Lens, Introocular, Cataract, Contrast Sensitivity, Tissue Engineering

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