摘要目的 探讨1CU可调节式后房型人工晶状体(IOL)植入术后的长期临床疗效及调节效果.方法 前瞻性病例系列研究.2004年3月至2007年12月对23例(28只眼)单纯性白内障患者行超声乳化白内障吸除联合1CU可调节后房型IOL植入术,在术后3～6个月(早期)、12～24个月(中期)及36个月以上(晚期)患者进行随访,观察其远视力、最佳矫正远视力,35 cm近视力、最佳矫正近视力,前房深度的变化及调节力的测定(主观法和客观法).不同时间点的测量数据采用重复测量数据的方差分析,组间多重比较采用LSD检验.结果 1CU可调节后房型IOL具有很好的组织耐受性,在囊袋中稳定,居中性好.手术后早、中、晚3期裸眼远视力分别为0.84±0.23、0.81±0.19及0.78±0.17,3者之间差异无统计学意义(F=0.759,P＞0.05);最佳矫正远视力分别为0.97±0.13、0.99±0.17及1.00±0.17,差异无统计学意义(F=0.17,P＞0.05);35 cm近视力分别为0.66±0.24、0.52±0.14及0.47±0.12,差异有统计学意义(F=9.312,P＜0.01);最佳矫正近视力分别为0.97±0.13、0.94±0.22及0.90±0.21,差异无统计学意义(F=0.915,P＞0.05);调节幅度客观法(D)分别为0.89±0.34、0.72±0.17及0.56±0.16,差异有统计学意义(F=13.43,P＜0.01);调节幅度主观法(D)分别为3.58±0.54、3.01±0.89及2.50±0.54,差异有统计学意义(F=17.886,P＜0.01).在用2%毛果芸香碱后前房深度(mm)变浅,分别为0.88±0.40、0.54±0.23及0.33±0.20,差异有统计学意义(F=26.589,P＜0.01).结论 1CU可调式后房型IOL植入可使患者早期具有良好的术后视功能,比单焦IOL具有更大的调节范围,但是随着手术后时间的延长其调节能力逐渐下降,主观近点逐渐远移.

abstractsObjective To evaluate the clinical effectiveness and accommodative range after implanting the 1 CU. Methods It was a prospective case series study. From March in 2004 to December in 2007,23 cases (28 eyes) had phacoemulsification and implantation of 1CU (HumanOptics). Naked and best corrected distant acuity, Naked acuity at 35 cm and best corrected near, the amplitude of accommodation measured with subjective and objective techniques and the change in the anterior chamber depth were measured at 3-6 months,18-24 months and over 36 months after surgery. Results After implantation,the 1CU had good centered and stable and no IOL-specific complications. Naked distant acuity of the three groups are 0. 84 ± 0. 23,0. 81 ± 0. 19 and 0. 78 ± 0. 17, between them there are no significantly statistical differences( F =0. 759 ,P ＞0. 05 ). The best corrected distant acuity of the three groups were 0. 97 ± 0. 13,0. 99 ± 0. 17 and 1.00 ±0. 17, between them there are no significantly statistical differences( F = 0. 17, P ＞0. 05 ). The near acuity at 35 cm was 0. 66 ± 0. 24,0. 52 ± 0. 14 and 0.47 ± 0. 12, between them there are significantly statistical differences ( F = 9. 312 ,P ＜ 0. 01 ). The best corrected near acuity were 0. 97 ± 0. 13,0. 94 ±0. 22 and 0. 90 ± 0. 21, between them there are no significantly statistical differences (F = 0. 915,P＞0. 05). The accommodative range measured with subjective were 0. 89 ±0. 34,0. 72 ±0. 17 and 0. 56 ±0. 16, between them there are significantly statistical differences ( F = 13.43 ,P ＜0. 01 ). The accommodative range measured with objective were 3.58 ± 0. 54,3.01 ± 0. 89 and 2. 50 ± 0. 54, between them there were significantly statistical differences ( F = 17. 886, P ＜ 0. 01 ) . The anterior chamber depth measured by application of 2% pilocarpine eyedrops were 0. 88 ± 0. 40,0. 54 ± 0. 23 and 0. 33 ± 0. 20, between them there were significantly statistical differences (F=26.589, P＜0.01). Conclusions The eyes with 1CU have good visual acuity and increased accommodative range more than the single-focus IOL. With the extension of time after surgery, the ability of 1CU regulation gradually declines, and nears point swift away gradually.