通讯作者:张红,tmuechong@sina.com作者单位:天津医科大学眼科中心,天津市南开区复康路251号300384单眼角膜散光白内障患者不同人工晶状体组合植入的对比研究田芳张红胡尊霞【摘要】目的对比单眼散光的白内障患者混合植入TORIC和多焦点或单焦点人工晶状体后的视功能。方法30例单眼角膜散光的年龄相关性白内障患者按自愿原则,采用非随机对照方式分成两组,试验组15例患者(30眼),按照双眼有无散光分别植入TORIC和ReSTOR(SN6AD1)人工晶状体,对照组15例患者(30眼),分别植人TORIC和AcrySofIQ人工晶状体。术后6个月以ETDRS视力表检测患者双眼的裸眼及最佳矫正远视力,以及在最佳矫正远视力基础上获得的近视力、中距离视力,综合验光仪检测其调节幅度,同时进行患者在明视暗视及有无眩光状态下的对比敏感度检测,近立体视力,并行视功能和视觉不良症状调查问卷。结果随访期间试验组裸眼双眼远中近视力为0.05±0.05LogMAR,0.24±0.10LogMAR,0.14±0.06LogMAR,与对照组相比,近视力上的差异有统计学意义(P=0.000)。试验组ReSTOR植入眼在高频的对比敏感度下降。试验组近立体视较对照组略有降低,但视近脱镜率和满意度明显提高(80%:25.5%),两组患者均无明显的不良视觉症状。结论双眼混合植入TORIC和多焦点人工晶状体虽然对患者的近立体视略有影响,但可以提供更好的双眼全程视力,增加焦深,提高脱镜率,对于单眼散光的白内障患者仍是一种合理的选择。【关键词】TORIC人工晶状体;多焦点人工晶状体;脱镜率Comparisonofdifferentcombinationofintraocularlensimplantationincataractpatientswithunilateralastigmatism.TIANFang,ZHANGHong,HUZun-xia.TianjinMedicalUniversityEyeCenter,Tianjin300384【Abstract】ObjectiveToassessthebinocularvisualfunctionaftercombinedimplantationofTORICandmultifocalormonofocalintraocularlensinunilateralastigmatismcataractpatients.MethodsAtotalof60eyesfrom30unilateralastigmatismpatientsundergoingphacoemulsificationwererecruited.AcrySofTORICIOLswereimplantedinastigmaticeyeofpatientswithReSTORorAcrySofIQcontralateraleyes.Sixmonthspostoperatively,patientswereassessedforvisualacuity(33.0cm,60.0cm,5.0m),contrastsensitivity,andstereopsis.Patientsweresurveyedforvisualdisturbancesandlifestylevisualquality.ResultsAt6monthspostoperatively,ofTORIC-ReSTORpatients,binocularuncorrectedvisualacuityat33cm,60cm,5mwere0.05±0.05LogMAR,0.24±0.10LogMAR,0.14±0.06LogMARrespectively.Thesevaluesdidnotachievedsignificantdifferencesexceptnearvision.ThecontrastsensitivityofReSTOReyeswaslowerat18cpdthanothereyes.AndthestereopsisofTORIC-ReSTOReyesdecreasedslightly.Meannearvisionpatientsatisfactionwasstatisticallysignificantlydifferent:80%forTORIC-ReSTORpatientsversus25.5%forTORIC-IQpatients.Therewerenovisualsymptomsinbothgroups.ConclusionsAlthoughcombinationofTORICandmutifocalintraocularlensimplantationresultsincompromisingstereoacuity,itcanstillprovidepatientswithhighlevelsofspectaclefreedomandgoodoverallbinocularvisualacuity.KeywordsTORICintraocularlensmultifocalintraocularlensspectacleindependence随着白内障屈光手术概念的深入人心,越来越多的具有屈光功能的高端人工晶状体(intraocularlensIOL)应用于临床。如何为患者合理的选择IOL,以最大限度的提高其视觉质量,是目前眼科医生们的关注热点。临床上时有面对单眼角膜散光的双眼白内障患者,本研究拟对其混合植入TORICIOL和+3DReSTORIOL后的视功能改变,以及是否可以在矫正其散光的基础上改善老视进行探讨。对象和方法1.一般资料研究对象为2009年8月至2010年4月于天津医科大学眼科中心行双眼超声乳化白内障吸出联合IOL植入的患者30例(60眼)。入选标准:手动角膜曲率计测量后,仅单眼角膜散光>1D的双眼年龄相关性白内障、排除其他眼部疾患、Lotmar>6/10的患者。按照非随机自愿原则分为试...