Objective To evaluate the changes of accommodative function after implantation of irisfixated phakic intraocular lens (IFPIOL) for correction of high myopia, and compared with gender and age matched emmetropes. This study also provides clinical basis for assessing the quality of life after implantation of the IFPIOL. Methods It was a case-control study. Iris-fixated in phakic intraocular lens implantation was performed in 23 eyes of 12 high myopic patients. Control group included 22 eyes in 11 emmetropes. All patients and controlled subjects had the same examinations including amplitude of accommodation, accommodative facility test, and negative/positive relative accommodation before, 1 month and 3 months after operation. Surgery was performed by the same surgeon. Randomized block design analysis of variance was applied to analyze accommodative function between the patients preoperative and postoperative, and two independent samples t-test was applied to analyze accommodative function between the control group and the patients. P value less than 0.05 was considered significant. Results The mean amplitude of accommodation at 1 month and 3 months was (8. 90 ± 2. 13) D and (9. 10 ±1.72) D after IFPIOL implantation, respectively. Mean amplitude of accommodation after the operation was significantly greater than that from preoperative eyes ( 7. 35 ± 2. 20 ) D, ( F = 19. 88, P < 0. 01 ). Mean amplitude of accommodation at 3 months in eyes after IFPIOL implantation showed no significant difference (t = - 1.76, P = 0.09) as compared with the control group (10. 10 ±2.09) D. Mean accommodative facility at 1 month and 3 months after IFPIOL implantation was (8. 17 ± 2. 09) cyc/min and (8. 67 ± 1. 80) cyc/min, respectively. This was significantly increased from preoperative data which was (5. 67 ± 1. 53) cyc/min,(F = 64. 27, P < 0. 01). Mean accommodative facility at 3 months after IFPIOL implantation had no statistically significant difference (t = -6.29, P < 0. 01) as compared with the control group ( 14. 51 ± 3.81) cyc/min. In addition, mean positive relative accommodation (2.45 ± 0. 81) D was significantly greater than that in preoperative eyes ( 1. 61 ±0. 80) D, (F -6. 10,P = 0. 01 ) but, not significantly different (t = -2.83, P = 0. 01) from the control group ( 3. 89 ± 1. 49 ) D. Conclusions Patients can obtain physioloGlcal accommodative function after the implantation of IFPIOL for correction of high myopia. Moreover, the accommodative function increases with time and is stable. Nevertheless, accommodative function could not reach the level of normal emmetropic eyes. Longer-term results would be further observed.%目的 评价虹膜夹型有晶状体眼人工晶状体(IFPIOL)植入治疗高度近视术后患者调节功能的变化,为IFPIOL植入术后患者的生活质量评估提供临床依据.方法 病例对照研究.试验组为IFPIOL植入术治疗高度近视患者12例(23只眼),对照组选择年龄、性别匹配的正视眼11例(22只眼),试验组在术前、术后1个月及术后3个月时检查调节幅度、单眼调节灵活度和双眼正和(或)负相对性调节.对照组也做同样检查.采用随机区组设计定量资料方差分析对试验组手术前后调节功能的数据进行分析;试验组和对照组之间的比较行两独立样本t检验.结果 术后1个月和3个月时调节幅度分别为(8.90 ±2.13)D、(9.10 ±1.72)D,明显高于术前(7.35 ±2.20)D,差异有统计学意义(F=19.88,P<0.01),且术后3个月时与对照组(10.10 ±2.09)D相比,差异无统计学意义(t=-1.76,P=0.09).调节灵活度在术后1个月和3个月时分别为(8.17±2.09)cyc/min、(8.67±1.80)cyc/min,明显高于术前(5.67±1.53)cyc/min(F=64.27,P<0.01),且术后3个月时低于对照组的(14.51 ±3.81)cyc/min,差异有统计学意义(t=-6.29,P<0.01).正相对性调节术后3个月时为(2.45±0.81)D,明显高于术前(1.61±0.80)D(F=6.10,P=0.01),且术后3个月时显著低于对照组(3.89 ±1.49)D(t=-2.83,P=0.01).结论 IFPIOL植入术后患者保留了正常的调节功能,而且有一定程度的提高,并随着时间的推移保持稳定,但与正视眼相比仍有差距,较长期的影响尚有待进一步观察.
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