三焦點人工晶狀體植入術后長期臨床觀察

楊興華 袁超群 夏穎

【摘要】目的觀察三焦點人工晶狀體（IOL）植入術后長期療效。方法選取行三焦點IOL植入術的患者30例（50只眼），于術后6個月及12個月分別測試及隨訪。比較術后6、12個月視力情況、離焦曲線、后發性白內障、問卷調查結果。結果術后6個月遠視力（0.038±0.06），中間視力（O.112±0.063），近視力（0.078±0.058）;術后12個月遠視力（0.040±0.049），中間視力（0.108±0.06），近視力（0.060±0.053）。術后12個月與6個月遠、中、近視力比較差異均無統計學意義（F=0.03、0.106、2.596，P>0.05）。術后6、12個月患者離焦曲線均在0.0 D處為最高峰，在+1.0 D-2.5 D離焦范圍內平緩且處于較高值，視力均>0.2LogMAR。所有患者中僅一眼術后8個月時發生較明顯后囊膜混濁，并行YAG激光切開治療，激光后視力恢復至術后3個月水平。所有患者中有2只眼出現光暈，但不影響其日常生活，未見其他不適。

結論三焦點IOL植入可長期為患者提供良好的全程視力，且患者主觀滿意度較高，視覺質量較好。

【關鍵詞】三焦點;人T晶狀體;視覺質量;離焦曲線

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

目前白內障手術不僅僅是復明手術，而是一種屈光性手術。手術后獲得清晰、舒適、持久的全程視力及良好的視覺質量是醫患共同目標。近年來隨著人們生活質量提高，中距離視力越來越受到關注，以往的IOL在中距離視力方面顯得不夠。ATLISA tri 839MP三焦點IOLf德國Carl ZEISS公司）的光學區在近距離增加+3.33 D，中距離補充+1.66 D，可以明顯改善中間視力[1-3]，為醫患雙方提供更多的選擇。本研究擬探討術后長期療效。

[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江蘇省中醫院眼科