可调节人工晶状体眼的调节机制及其影响因素研究

可调节人工晶状体（AIOL）能模拟人眼晶状体的调节。然而，临床上部分AIOL植入者术后近期或远期近视力并不佳，提示其调节过程可能存在缺陷。AIOL主要通过位移和形变实现调节，但研究并未对某些异常调节做出合理解释。我们认为，AIOL眼的调节过程是由眼调节负反馈环调控，任何环节异常都可导致其调节异常甚至中止，如睫状肌收缩力不能完全传递给AIOL，或AIOL异常形变改变视网膜信号使中枢对睫状肌的指令异常，或某些老年人睫状肌收缩力不足。因此，动态观察调节负反馈环各关键环节如AIOL、睫状肌及视网膜像质变化特征及相关性对研究AIOL眼的调节机制及影响因素必不可少。我们利用AIOL眼调节系统综合检测平台，从眼前节形态、调节反应及视网膜像质等全面研究AIOL眼的调节过程；通过横纵向研究，探究其调节系统的特征及异常环节，以进一步阐明其调节机制及影响因素；为其植入术后临床评价、干预及新产品研发提供理论依据。

Accommodative intraocular lens (AIOL) can simulate the accommodation of crystalline lens. However, the near vision in the near or long-dated future of some patients with AIOL was found not good in the clinical practice. This may indicate that there are some defects in their accommodative process. It has been documented that the accommodation of AIOL is achieved by its shift and deformation, but the abnormal accommodation has never been interpreted rationally. We considered that the accommodative process of AIOL was controlled by the negative feedback loop of human accommodation. The abnormality happened in any link of the loop may contribute to the abnormality or even the suspension of accommodation. For example, the contractility of ciliary muscle can not be fully transferred to AIOL, or the deformation of AIOL changes the retinal signal which makes the central nervous system emit the wrong instruction to the ciliary muscle, or the insufficient contractility of ciliary muscle happens in some aged patients. Consequently, for the study of the accommodative mechanism and influence factors of the eye with AIOL, it is indispensable to dynamically investigate the characteristics of each key link and their relationship, like the AIOL, ciliary muscle and the optical quality of the retinal image. In the present project, we will establish a novel technical platform for the accommodation system examination of the eyes with AIOL. This platform can precisely qualify the accommodative process of the eye with AIOL, including the changes in the morphology of the anterior segment, the accommodative response, and the optical quality of the retinal image during accommodation. Through the transverse and longitudinal study, we aimed to determine the characteristics and the abnormal link of accommodative system in turn. The outcome will benefit the clarification of the accommodative mechanism and influence factors of the eye with AIOL. In addition, it can also provide the theory evidence for the clinical evaluation, intervention in patients with AIOL and the development of new products of the AIOL.