Tecnis Symfony连续视程人工晶状体在高度近视并发白内障患者中的应用

刘利娟 李仲 陈文彬 曾垂钦 赵广愚

[摘要]目的探討Tecnis Symfony 连续视程（ERV）人工晶状体在高度近视并发白内障患者中的临床应用疗效。方法选取2017年4月至2020年4月于福州东南眼科医院（金山新院）白内障科手术的16例（32眼）高度近视并发白内障患者，双眼植入TecnisSymfonyERV人工晶状体，观察患者术后1周、1个月、6个月远、中、近视力，电脑验光，离焦曲线，调制传递函数曲线（MTF）、像差、患者满意度调查问卷等临床指标。结果16例（32眼）患者均由同一术者顺利完成手术并完成6个月随访，单眼术后6个月裸眼远视力为LogMAR 0.21（-0.1～0.3），80 cm 平均中距离视力为0.18（0～0.2），40 cm 平均近视力为0.21（0～0.3）;双眼术后远视力为0.18（-0.1～0.3），平均中距离视力为0.16（0.1～-0.2），近视力为0.19（0～0.3）。32眼中78.1%远视力好于0.2，68.75%中距离视力好于0.1，65.63%近视力好于0.3（LogMAR）。双眼离焦曲线展示在-1.5～+2.5 D 间均在0.3以上的良好连续视程，脱镜率为87.50%（14/16）。结论高度近视并发白内障患者植入Tecnis Symfony ERV 人工晶状体实现了良好的远、中、近视力，患者满意度高，具有良好的临床效果。

[关键词]连续视程人工晶状体;高度近视;白内障;超声乳化

[中图分类号] R779.66  [文献标识码] A   [文章编号]2095-0616（2021）23-0218-05

Application of Tecnis Symfony extended range of vision intraocular lenses in patients with high myopia complicated with cataract

LIU  Lijuan    LI  Zhong    CHEN  Wenbin    ZENG  Chuiqin    ZHAO  Guangyu

South East Eye Hospital of Fuzhou City （Jinshan New Hospital）， Fujian， Fuzhou 350008， China

[Abstract] Objective To investigate the clinical effect of Tecnis Symfony extended range of vision intraocular lenses （ERV IOLs） in patients with high myopia complicated with cataract. Methods A total of Sixteen patients （32 eyes） with high myopia complicated with cataract who underwent cataract surgery in South East Eye Hospital of Fuzhou City （Jinshan New Hospital） from April 2017 to April 2020 were selected as objects. Tecnis Symfony ERV IOLs were implanted into both eyes. The clinical indexes such as distant visual acuity， middle visual acuity， near visual acuity， computer optometry， defocus curve， modulation transfer function （MTF） curve， phase difference and patient satisfaction questionnaire were observed at 1 week， 1 month and 6 months after operation. Results All the 16 patients （32 eyes） underwent the same operation successfully and were followed up for 6 months. Six months after surgery， the monocular uncorrected distant visual acuity （UDVA） was LogMAR 0.21（-0.1 to 0.3）， the average monocular uncorrected intermediate visual acuity （UIDA） of 80 cm was 0.18（0 to 0.2）， and the average monocular uncorrected near visual acuity （UNVA） of 40 cm was 0.21（0 to 0.3）. For binocular visual acuities， the UDVA was 0.18（-0.1 to 0.3）， the UIVA was 0.16（0.1 to -0.2）， and the UNVA was 0.19（0 to 0.3）. In 32 eyes， 78.1% of the distant vision was better than 0.2， 68.75% of the intermediate visual acuity was better than 0.1， and 65.63% of the near vision was better than 0.3（LogMAR）. The binocular defocus curve showed a sound extended range of vision of more than 0.3（between-1.5 to +2.5D）， with an spectacles-independent rate of 87.50%（14/16）. Conclusion Tecnis Symfony ERV IOLs implantation can achieve good distant， middle and near visual acuity， high patient satisfaction and good clinical effect for patients with high myopia complicated with cataract.

[Key words] Extended range of vision intraocular lenses; High myopia; Cataract; Phacoemulsification

近年来连续视程（extended range of vision，ERV）人工晶状体在白内障手术中的应用比例逐步提高，通过延长焦深来提供连续的全程视觉区域，从而使患者摆脱眼镜束缚，更加接近人眼的天然视觉功能，取得了较好的临床疗效。而高度近视并发白内障患者往往年纪偏轻，有远视力、近视力、工作视力和驾驶等多种视觉需求，如何选择满足这类患者需求的人工晶状体成为临床眼科医生新的挑战，本研究应用 ERV 人工晶状体植入治疗高度近视并发白内障患者，分析患者术后视觉质量及患者满意程度，为其进一步临床应用提供依据和参考。……