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[摘要]
目的:评价Tetraflex可调节人工晶状体植入术后1a的临床效果。
方法:纳入研究组23例,均为老年性白内障患者,所有患者均在我院确诊并行白内障超声乳化摘除联合Tetraflex可调节人工晶状体植入术。术后12mo复诊时,分别记录患者的裸眼远视力、裸眼近视力、脱镜率、患者满意度以及异常视觉出现情况。另外,重点记录前、后囊膜的混浊情况。对照组为同期在我院行白内障手术并植入单焦点人工晶状体(SN60AT,Alcon)的患者共26例。
结果:12mo复诊时,Tetraflex组相较对照组拥有更好的裸眼远视力和裸眼近视力,但两者相比差异无统计学差异。两组的脱镜率分别为34.7%和26.9%,两者相比差异亦无统计学差异(χ2=0.355,P=0.551)。满意度调查显示两者之间无明显差异(χ2=2.367,P=0.124)。 前、后囊膜的混浊情况出现比率分别为34.8%和 7.7%(χ2=3.972,P=0.046),Tetraflex组明显高于对照组。另外,Tetraflex组有2例出现人工晶状体偏位,对照组无出现人工晶状体偏位现象(χ2=0.659,P=0.417)。两组患者均未诉异常视觉出现。
结论:长期来看,Tetraflex可调节人工晶状体并不能提供足够的裸眼远、近视力,而且发生囊膜混浊的比率高于普通单焦点人工晶状体。调查研究发现,患者的满意度较低,最主要的原因是昂贵的人工晶状体未能达到术前期待的足够调节力。所以,Tetraflex可调节人工晶状体应该谨慎植入,尤其是对于有可能发生囊袋混浊、收缩的患者。
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[Abstract]
AIM:To evaluate the clinical gains 1 year after implantation of Tetraflex accommodative intraocular lens(IOLs).
METHODS:This study comprised 23 patients(23 eyes)with cataract and undergone phacoemulsification and implantation of a Tetraflex accommodative IOL. At the 12-month follow-up visit, uncorrected distance visual acuity(UCDVA)and uncorrected near visual acuity(UCNVA)were measured to determine the efficacy of the IOL. Incidence of spectacle independence, patients' satisfaction and presence of visual disturbances were investigated. In addition, anterior and posterior capsule opacification were assessed. Twenty-six patients(26 eyes)with implantation of monofocal IOLs(SN60AT, Alcon)were recruited as control group.
RESULTS:At the 12-month follow-up visit, the patients in Tetraflex accommodative IOLs group had better UCDVA and UCNVA than those in control group, but no significant difference was found(P>0.05). There were 34.7% patients of Tetraflex accommodative IOLs group and 26.9% patients of control group achieving total spectacle independence, and no significant difference was found(χ2=0.355, P=0.551). Patients' satisfaction rates with two groups did not differ significantly too(χ2=2.367, P=0.124). Anterior and posterior capsule opacification were present, respectively, in 34.8% and 7.7% of patients(χ2=3.972, P=0.046). Two cases of accommodative IOLs displacement were discovered(χ2=0.659, P=0.417). No visual disturbances were mentioned in both groups.
CONCLUSION: In the long run, compared with monofocal IOLs, Tetraflex accommodative IOLs can not provide efficient uncorrected visual acuity and had higher incidence and degree of anterior and posterior capsule opacification. Patients implanted have lower satisfaction rate due to poor accommodative ability versus expensive material. So, accommodative IOL should be implanted prudently, especially to the patients with high risk factors for capsule fibrosis.
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