三焦点人工晶状体植入术后长期临床观察

杨兴华 袁超群 夏颖

【摘要】目的观察三焦点人工晶状体（IOL）植入术后长期疗效。方法选取行三焦点IOL植入术的患者30例（50只眼），于术后6个月及12个月分别测试及随访。比较术后6、12个月视力情况、离焦曲线、后发性白内障、问卷调查结果。结果术后6个月远视力（0.038±0.06），中间视力（O.112±0.063），近视力（0.078±0.058）;术后12个月远视力（0.040±0.049），中间视力（0.108±0.06），近视力（0.060±0.053）。术后12个月与6个月远、中、近视力比较差异均无统计学意义（F=0.03、0.106、2.596，P>0.05）。术后6、12个月患者离焦曲线均在0.0 D处为最高峰，在+1.0 D-2.5 D离焦范围内平缓且处于较高值，视力均>0.2LogMAR。所有患者中仅一眼术后8个月时发生较明显后囊膜混浊，并行YAG激光切开治疗，激光后视力恢复至术后3个月水平。所有患者中有2只眼出现光晕，但不影响其日常生活，未见其他不适。

结论三焦点IOL植入可长期为患者提供良好的全程视力，且患者主观满意度较高，视觉质量较好。

【关键词】三焦点;人T晶状体;视觉质量;离焦曲线

DOI： 10.14163/j .cnki.1 1-5547/r.2020.19.014

Long-term clinical observation after trifocal intraocular lens implantation

YANG Xing-hua. YUANChao-qun， XIA Ying. Department of Oplzthalmology， Jiangsu Hospiial of Traditional Chinese Mededicine， Nanjing210029. China

【Abstract】Objective To observe the long-term efficacy of trifocal intraocular lens （IOL） implantation.Methods

A total of 30 patients （50 involved eyes） with trifocal IOL implantation in our hospital were testedand followed-up for 6 and 12 months after surgery. The visual acuity. defocusing curve， post-cataract andquestionnaire survey results 6 and 12 months after surgery were compared. Results 6 months after surgery， thefar vision. intermediate vision and near vision were （0.038±0.06）. （0.112±0.063） and （0.078±0.058）. which were.（0.040±0.049）. （0.108±0.06） and（0.060±0.053）12 months after surgery. There was no statistically significantdifference in far. intermediate and near vision between 12 months and 6 months after surgery （F=0.03，0.106， 2.596.P>0.05）. 6 and 12 months after surgery， the defocusing curve of the patients was the highest at 0.0 D， and thedefocusing curve was gentle and high in the range of +l.O D to-2.5 D. and the visual acuity was > 0.2 LogMAR. Inall patients， only I eye had significant posterior capsule opacification 8 months postoperatively. After YAC laserincision. the visual acuity recovered to 3 months postoperatively. Halo appeared in 2 eyes of all patients， but it didnot affect their daily life， and no other discomfort was found. Conclusion Trifocal IOL implantation implantationcan provide good whole course vision for a long time， and patients have higher subjective satisfaction and bettervisual quality.

【Key words】Trifocal： Intraocular lens; Visual qualitv： Defocus curve

目前白內障手术不仅仅是复明手术，而是一种屈光性手术。手术后获得清晰、舒适、持久的全程视力及良好的视觉质量是医患共同目标。近年来随着人们生活质量提高，中距离视力越来越受到关注，以往的IOL在中距离视力方面显得不够。ATLISA tri 839MP三焦点IOLf德国Carl ZEISS公司）的光学区在近距离增加+3.33 D，中距离补充+1.66 D，可以明显改善中间视力[1-3]，为医患双方提供更多的选择。本研究拟探讨术后长期疗效。

[2]Carhallo-Alvarez J， Vazquez-Molini JM. Sanz-Fernandez JG，et alVisual outcorues after bilateral trifocal diffrartive intraocular lensimplantation. BMC Ophthalmology， 2015，15（1）： 1-6.

[3]Kjell GG，Rick P. C.omparison of visual outcomes and subjectivevisual quality af'ter hilateral implantation of a diffractive trifocalintraocular lens and blended implantation apodized diffractivebifocal intraocular lenses. Clin Ophthalmol. 2016（10）： 805-811.

[4]Lindstrom RL. Macrae SM， Pepose JS，et al.Corneal inlays forpresbyopia corrertion. Current Opinion in Ophthalmology， 2013，24（4）：281-287.

[5]Peter M，Pahlo PG. Ivana L， et al.Outcomes of a new diffractivetrifocal intraocular lens. Journal of Cataract&Refractive Surgery，2014. 40（1）：60-69.

[6]Mendicute J， Kapp A， Levv P， et al.Evaluation of visual outcomesand patient satisfaction after implantation of a diffractive trifocalintraocular lens. Journal of Cataract&Refractive Surgery， 2016.42（2）：203-210.

[收稿日期：2020-02-06]

作者單位：210029江苏省中医院眼科