【摘要】： 目的：本研究通過(guò)比較年齡相關(guān)性白內(nèi)障患者，行超聲乳化分別聯(lián)合應(yīng)用階梯漸進(jìn)衍射型多焦點(diǎn)人工晶體（Acrysof ReSTOR MIOL）與折射型多焦點(diǎn)人工晶體（AMO ReZoom MIOL）植入術(shù)后的近期全程視力（包括遠(yuǎn)、中、近距離視力）及主觀感覺(jué)等情況，評(píng)價(jià)臨床上兩種多焦點(diǎn)人工晶體植入術(shù)后的臨床效果及應(yīng)用價(jià)值。 方法：方法為非隨機(jī)對(duì)照臨床試驗(yàn)。收集在惠州市中心人民醫(yī)院行超聲乳化白內(nèi)障吸除聯(lián)合多焦點(diǎn)人工晶體植入的患者33例（45眼），按植入多焦點(diǎn)人工晶體種類(lèi)的不同分為ReSTOR組（15例23眼）和ReZoom組（18例22眼），術(shù)后3個(gè)月用標(biāo)準(zhǔn)對(duì)數(shù)視力表測(cè)量患者裸眼遠(yuǎn)視力，應(yīng)用標(biāo)準(zhǔn)近視力表測(cè)量裸眼近視力，應(yīng)用Colenbrander MIXEDCONTRAST CARD SET測(cè)量患者裸眼中程視力（40、63、100cm），觀察兩組患者在不同照明條件下（20、400lux）的單眼裸眼遠(yuǎn)、中距離（40、63、100cm高低對(duì)比度）、近視力，術(shù)前存在影響視力的其他疾病或者術(shù)中發(fā)生并發(fā)癥等患者均排除于本研究。問(wèn)卷調(diào)查項(xiàng)目包括日常生活視物舒適度(遠(yuǎn)、中、近距離)，讀書(shū)看報(bào)是否需要近用鏡，不同照明條件對(duì)視物有無(wú)影響及其它視覺(jué)癥狀。結(jié)果采用spss15.0統(tǒng)計(jì)軟件進(jìn)行t檢驗(yàn)和χ2檢驗(yàn)。 結(jié)果：術(shù)后3個(gè)月，兩組患者術(shù)中術(shù)后均無(wú)嚴(yán)重并發(fā)癥，散瞳后行裂隙燈檢查未發(fā)現(xiàn)晶體偏心、移位，無(wú)后發(fā)性白內(nèi)障發(fā)生。術(shù)后3個(gè)月，20lux和400lux照明條件下ReSTOR組和ReZoom組患者均可獲得良好的裸眼遠(yuǎn)視力,分別為0.34±0.20，0.36±0.14（20lux）及0.71±0.20，0.77±0.21（400lux），差異無(wú)顯著統(tǒng)計(jì)學(xué)意義；20lux照明條件下，兩組裸眼近視力分別為0.20±0.07，0.20±0.08（p0.05），400lux照明條件下0.33±0.10，0.27±0.10（400lux），ReSTOR組近視力優(yōu)于ReZoom組（p0.05）；ReZoom組在40cm、63cm、100cm的裸眼高低對(duì)比度視力均明顯優(yōu)于ReSTOR組（p0.05）。不同照明條件下，兩組患者裸眼遠(yuǎn)中近視力均隨著照明條件的改善而有所提高。術(shù)后問(wèn)卷調(diào)查顯示ReSTOR組患者術(shù)后脫鏡率高于ReZoom組（p0.01)，但術(shù)后眩光等不適兩組無(wú)明顯差異。在患者的滿(mǎn)意度評(píng)價(jià)上，在看遠(yuǎn)上，兩組患者滿(mǎn)意度無(wú)統(tǒng)計(jì)學(xué)差異，在近視力滿(mǎn)意度上ReSTOR多焦組明顯高于ReZoom多焦組，而視中距離滿(mǎn)意度上，，ReZoom多焦組則優(yōu)于ReSTOR組。 結(jié)論：初步應(yīng)用表明兩種多焦點(diǎn)人工晶體術(shù)后近期均能提供較好的遠(yuǎn)視力，但ReSTOR MIOL近視力較好，術(shù)后脫鏡率較高；ReZoom MIOL則能提供良好的中程視力。故臨床上應(yīng)根據(jù)患者的不同需求而選擇植入相應(yīng)的人工晶體。
[Abstract]:Objective: to compare age-related cataract patients. Phacoemulsification was performed in combination with stepwise progressive diffraction intraocular lens (Acrysof ReSTOR MIOL) and refraction multifocus intraocular lens (AMO ReZoom MIOL) implantation. The clinical effect and application value of two kinds of multi-focus intraocular lens implantation were evaluated. Methods: non-randomized controlled clinical trial. Thirty-three patients (45 eyes) with phacoemulsification combined with multi-focus intraocular lens implantation in Huizhou Central people's Hospital were collected. According to the type of multi-focus intraocular lens implanted, the patients were divided into ReSTOR group (15 cases, 23 eyes) and ReZoom group (18 cases, 22 eyes). The median naked visual acuity (40 ~ 63100cm) was measured by Colenbrander MIXEDCONTRAST CARD SET. The distance of uncorrected eyes (20400lux), middle distance (400.63100cm high contrast) and near visual acuity (NVA) were observed in two groups under different illumination conditions (20400lux). Patients with preoperative vision-related diseases or intraoperative complications were excluded from the study. The items of the questionnaire included the comfort of visual objects in daily life (far, middle and close distance), the need of reading and newspaper reading, the influence of different lighting conditions on the visual objects and other visual symptoms. Results t test and 蠂 2 test were performed by spss15.0 software. Results: three months after operation, there were no serious complications in both groups. No eccentricity, displacement and no posterior cataract were found after pupil dilation by slit lamp examination. 3 months after operation, the patients in ReSTOR group and ReZoom group under 20lux and 400lux illumination could obtain good naked far visual acuity (20lux) 0.34 鹵0.20 鹵0.36 鹵0.14 (20lux) and 0.71 鹵0.20 鹵0.77 鹵0.21 (400lux), respectively. There was no significant difference between the two groups. Under 20lux illumination, the near-visual acuity of the two groups was 0.20 鹵0.07 鹵0.08 (p0.05) and 0.33 鹵0.10 鹵0.27 鹵0.10 under 400lux illumination respectively. The near visual acuity of 400lux), ReSTOR group was better than that of ReZoom group (p0.05). The visual acuity of high and low contrast in ReZoom group was better than that in ReSTOR group at 40 cm, 63 cm or 100 cm (p0.05). Under different illumination conditions, the open eye distant near visual acuity of the two groups improved with the improvement of lighting conditions. Post-operative questionnaire survey showed that the rate of postoperative removal of endoscopy in ReSTOR group was higher than that in ReZoom group (p0.01), but there was no significant difference in postoperative glare and discomfort between the two groups. In the evaluation of patients' satisfaction, there was no statistical difference in satisfaction between the two groups. The ReSTOR multi-focus group was significantly higher than the ReZoom multi-focal group in the near vision satisfaction, while the ReZoom multi-focus group was superior to the ReSTOR group. Conclusion: the preliminary application shows that the two kinds of multi-focus intraocular lens can provide better distant visual acuity in the short term, but the near visual acuity of ReSTOR MIOL is better, and the higher rate of removal of endoscopy after operation,; ReZoom MIOL can provide good intermediate visual acuity. Therefore, we should choose to implant intraocular lens according to the different needs of patients.
【學(xué)位授予單位】：汕頭大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類(lèi)號(hào)】：R779.66

【參考文獻(xiàn)】

相關(guān)期刊論文 前8條

1 陳旭;袁非;;Array多焦點(diǎn)人工晶體與1 CU可調(diào)節(jié)人工晶體的視力比較[J];中國(guó)臨床醫(yī)學(xué);2005年06期

2 莫?jiǎng)潘?張翠薇;楊曄;林少雄;林振德;;ReZoom折射型多焦點(diǎn)人工晶狀體植入術(shù)后的近期中距離視力觀察[J];臨床眼科雜志;2008年05期

3 曾珍;葉劍;;TecnisZM900非球面多焦點(diǎn)人工晶狀體的臨床研究[J];內(nèi)蒙古中醫(yī)藥;2007年12期

4 卓建;蔡可麗;;ReSTOR多焦點(diǎn)人工晶體的臨床應(yīng)用研究[J];山東大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2009年07期

5 尹則琳;張金華;鄭曰忠;;老年性白內(nèi)障人工晶狀體眼的調(diào)節(jié)融合和立體視研究[J];眼科新進(jìn)展;2008年05期

6 畢宏生;;提高多焦點(diǎn)人工晶狀體植入患者的滿(mǎn)意度[J];眼科;2008年02期

7 李永華;林振德;李士清;羅書(shū)科;俞阿勇;姜良柱;;階梯漸進(jìn)衍射型多焦點(diǎn)人工晶狀體植入術(shù)后的臨床觀察[J];眼外傷職業(yè)眼病雜志(附眼科手術(shù));2007年06期

8 王俊,盧奕,王曉瑛,鄧麗賢;可調(diào)節(jié)式人工晶狀體調(diào)節(jié)力的臨床研究[J];中華眼科雜志;2005年03期

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