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中华眼科医学杂志(电子版)

中华眼科医学杂志(电子版) ›› 2019, Vol. 09 ›› Issue (05) : 257 -266. doi: 10.3877/cma.j.issn.2095-2007.2019.05.001

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把握白内障手术的发展趋势与精准运用人工晶状体各种类型的特点
张旻1, 蒋永祥1,†()   
  1. 1. 200031　上海，复旦大学附属眼耳鼻喉科医院眼科　国家卫生健康委员会近视眼重点实验室（复旦大学）　中国医学科学院近视眼重点实验室和上海市视觉损伤与重建实验室
  • 收稿日期:2019-08-28 出版日期:2019-10-28
  • 通信作者: 蒋永祥
  • 基金资助:
    近视眼重点实验室专项基金项目(JSY2019-02); 上海市科学技术委员会科技创新行动计划项目(18411965200)

Grasp the development trend of cataract surgery and the characteristics of precise use of intraocular lenses

Min Zhang1, Yongxiang Jiang1,†()   

  1. 1. Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, Shanghai 200031, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai 200031, China
  • Received:2019-08-28 Published:2019-10-28
  • Corresponding author: Yongxiang Jiang
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张旻, 蒋永祥. 把握白内障手术的发展趋势与精准运用人工晶状体各种类型的特点[J]. 中华眼科医学杂志(电子版), 2019, 09(05): 257-266.

Min Zhang, Yongxiang Jiang. Grasp the development trend of cataract surgery and the characteristics of precise use of intraocular lenses[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2019, 09(05): 257-266.

白内障手术在部分地区已由单纯的复明手术转变为屈光手术，"低散光、低球差、无老花"、提高脱镜率、改善术后视觉质量已经成为眼科医师和白内障患者共同的目标。了解不同IOL的生物学和光学特点，是眼科医师为患者挑选合适的IOL类型、设计恰当的IOL屈光度的前提，是实现对白内障患者精准治疗需要解决的重要问题。一般对IOL的分类主要基于其光学区的功能设计，植入非球面IOL改善高阶像差已经成为普遍做法，临床上也越来越多的开始采用Toric IOL、MIOL和双焦或多焦联合Toric设计的IOL和EDOFIOL等功能性IOL。其他分类标准还有IOL材质、IOL形状设计(包括光学区、襻和IOL整体)等，肝素处理、防蓝光处理的选择越来越多，各型号IOL材质和外形设计也各有优势。考虑到我国各地区白内障手术定位不同，对IOL功能和形态上选择还有很大差异。本文旨在根据不同分类，对现有不同类型的IOL进行归纳和总结，方便临床医师在临床工作中针对不同患者情况选择合适类型的IOL。

关键词: 白内障, 人工晶状体, 人工晶状体, 应用, 分类

Cataract surgery has transformed form vision rehabilitation surgery into refractive surgery. Both ophthalmologists and cataract patients would like to achieve the goal of " lower astigmatism, lower spherical aberration, less presbyopia" , more spectacle-independence and higher post-operative visual quality. The first step for ophthalmologists to choose appropriate type and refractive power of intraocular lenses (IOLs) is to know more about the biochemical and optical properties of IOLs. It is also the important lesson to learn for the precision medication of cataract patients. In general, the IOLs are classified by the design of their optical functions. It is quite common in clinical practices to have aspheric IOLs in correction of high-order aberrations. More and more toric IOLs, multifocus IOLs with or without toric design and extended depth of focus (EDOF) IOLs, these high-level functional IOLs. Others include classifications according to IOL material, IOL shape design (including optical area, haptics and the integrity) and so on. Heparin surface-modified and blue light-filting IOLs are more and more popular. Different types of IOLs have their own advantages. Considering the different stages of cataract surgery development around the country, varied preferences in IOL function and design do exist. This paper aims to make summaries on IOLs for the convenience of ophthalmologists in choosing appropriate IOLs for cataract patients in different clinical conditions.

Key words: Cataract, intraocular lens, IOL, application, classification
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