摘要
目的评价CACHET有晶状体眼人工晶状体植入术矫正高度近视的术后视觉质量。方法连续收集2010年4月至2011年10月在我院接受CACHET有晶状体眼人工晶状体植入术的高度近视患者22例(41眼),术后随访1a。统计分析术前与术后1个月、3个月、6个月、1a的裸眼视力(uncorrected visual acuity,UCVA)、最佳矫正视力(best spectacle corrected visual acuity,BSCVA)、近视力、屈光度、波前像差、对比敏感度及术后患者视觉症状和满意度。结果术后1a时,41眼UCVA≥0.5,36眼UCVA≥0.6,34眼UCVA≥0.8,24眼UCVA≥1.0;41眼BSCVA≥0.5,34眼BSCVA≥1.0。术后近视力与术前相比无明显差异,但阅读距离从术前的5～10(8.1±2.2)cm提高至术后的25～40(30.2±5.1)cm。术后1a时,等效球镜度数从术前的(-12.12±2.79)D降为(-0.45±0.36)D,差异有统计学意义(P<0.01),且在术后各随访阶段均保持稳定状态(P>0.05)。术后1个月时高阶像差中三叶草像差RMS值较术前增加(t=2.153,P<0.05),术后3个月、6个月及1a的球差、彗差、三叶草像差RMS值与术前相比,差异均无统计学意义(均为P>0.05)。术后1个月时对比敏感度与术前相比,差异均无统计学意义(均为P>0.05);术后3个月时,明视状态下3.0c·d-1、6.0c·d-1的对比敏感度Log值较术前有明显提高,差异均有统计学意义(均为P<0.05);术后6个月～1a的中低空间频率对比敏感度Log值均高于术前水平,差异均有统计学意义(均为P<0.05)。术后1个月时,17例(33眼)患者未出现任何视觉症状,2例(3眼)出现眩光,3例(5眼)出现光晕;术后3个月时,眩光和光晕症状的发生率分别为0和7.3%;术后6个月时,各视觉症状基本消失。结论 CACHET房角支撑型有晶状体眼人工晶状体植入术不仅有良好的屈光矫正效果,同时不引起高阶像差增加,并能提高术后对比敏感度,术后视觉症状少且轻。
Objective To evaluate the visual quality after CACHET phakic intraocular lens implantation for the correction of high myopia. Methods A total of 22 cases （41 eyes） with high myopia treated with CACHET phakic intraocular lens implantation were collected in our hospital from April 2010 to October 2011 and followed up for one year. Uncorrected visual acuity（ UCVA）, best spectacle-corrected visual acuity （ BSCVA）, near visual acuity, refraction, wavefront aberrations, contrast sensitivity, visu al symptoms and patient satisfaction were analyzed by statistical analysis before opera tion and I month,3 months,6 months, 1 year after operation. Results At postopera tive 1 year,41 eyes achieved a UCVA of 0.5 or better,36 eyes had a UCVA of 0.6 or bet ter,34 eyes had a UCVA of 0.8 or better,and 24 eyes had a UCVA of 1.0 or better;BSC VA of 0.5 or better was achieved by 41 eyes,34 eyes achieved a BSCVA of 1.0 or better. There was no statistically significant difference before and after operation in near visual acuity,but the reading distance increased from 5 - 10（8.1 ±2.2）cm to 25 -40（30.2 ± 5. 1 ） cm. The mean spherical equivalent refraction reduced significantly from preopera- tive（ - 12.12 ± 2.79 ） D to postoperative 1 year（ - 0.45 ± 0.36 ） D （ P 〈 0.01 ）, which re-mained stable at subsequent follow-up （P 〉 0.05 ）. At postoperative 1 month, RMS of trefoil aberration increased significantly （ t = 2.153 ,P 〈 0.05 ）, while RMS of coma, trefoil and spherical aberration did not change significantly before operation and 3 months,6 months and 1 year after operation（both P 〉 0.05 ）. There was no significant difference in contrast sensitivity before operation and 1 month after operation（both P 〉 0.05 ） ,but contrast sensitivity Log at 3.0 c . d- l and 6.0 c. d- 1 spatial frequencies under photopic condition both increased significantly 3 months after surgery（ both P 〈 0.05 ） ; Contrast sensitivity Log increased significantly at middle and central spatial frequencies from postoperative 6 months to I year（ both P 〈 0.05 ）. At postoperative 1 month, 17 patients （ 33 eyes） had no visual symptoms, while 2 patients （ 3 eyes） had glare and 3 patients （ 5 eyes） had halos;At postoperative 3 months, the percentage of glare and halos decreased to 0 and 7.3% respectively;At post-operative 6 months, all visual symptoms almost disappeared. Coneluslon CACHET phakic angle-supported intraocular lens implantation can provide excellent corrective effect of refractive error, dose not cause changes of higher order aberrations and can increase the contrast sensitivity ,and the postoperative visual symptoms are mild.
出处
《眼科新进展》
CAS
北大核心
2013年第6期546-550,共5页
Recent Advances in Ophthalmology
