新しい屈折型多焦点眼内レンズの臨床成績

Clinical appraisal of a new refractive multifocal intraocular lens

　わが国で初めて市販され，一般に使用が可能となったアイオプテックス屈折型多焦点眼内レンズの術後成績を検討した。直径1.5mmの中心遠用ゾーンを持つ6.0×6.0mmのPMMA製レンズである。近用加入度数は＋4.0Dである。65眼のうち，1.0以上の遠方視力が得られた症例は，裸眼で55％，矯正視力では92％であった。0.7以上の近方視力は，裸眼で79％，矯正視力で100％，遠方矯正下では91％で得られた。83％の症例は，裸眼あるいは単一の矯正で遠方視力0.7以上かつ近方視力0.4以上を得られていたが，実際の近用眼鏡装用状況は，両眼挿入例で17％であったのに対し，片眼挿入例で41％と高かった。コントラスト感度は片眼例と両眼例の間に差はみられず，単焦点レンズの場合と差はなかった。今回の屈折型多焦点眼内レンズは，正確なレンズパワーの設定や術後乱視の軽減によって良好な結果が得られた。片眼挿入例では得られた視力に比べて眼鏡依存性が高く，両眼挿入例のほうが効果的であると考えられた。

We reviewed 65 eyes implanted with a new refractive multifocal intraocular lens by Ioptex. It is made of PMMA and has a diameter of 6.0 mm with a central zone of additional +4.0 diopters for distance vision with a diameter of 1.5 mm. Distance visual acuity of 1.0 was obtained in 91% of eyes with correction and in 55% without. Near visual acuity of 0.7 or more was obtained in 91% of eyes under correction for distance, in 100% with correction for near and in 79% without. Distance visual acuity of 0.7 or more and near visual acuity of 0.4 or more could be achieved in 83% of the eyes either without or with single correction. Glasses for near were worn by 17% of bilaterally operated patients and by 41% of unilaterally operated ones. There was no difference in contrast sensitivity between bilaterally and unilaterally operated cases or between the present series and those receiving monofocal intraocular lens. The favorable results in the present series appeared to be due to exact setting of lens power and to efforts to minimize postoperative astigmatism. There was a higher rate of dependence on eyeglasses in unilaterally treated patients. The multifocal intraocular lens appeared to be more effective when inserted bilaterally.