功能性人工晶状体分类进展
Advances in the functional classification of intraocular lenses
摘要 随着人工晶状体(IOL)技术的迅速发展,传统基于光学设计的分类体系已难以准确反映IOL特性及患者真实视觉体验。因此,欧洲白内障与屈光手术学会功能视觉工作组于2024年提出以单眼最佳矫正视力离焦曲线、景深、中近视力增量为量化指标的IOL循证功能分类框架,将IOL划分为六大功能亚型;后续经美国、亚太、拉美国际眼科学会研讨完善,于2026年正式发布全球多学会共识。该新型分类实现从“光学结构命名”转向“术后实际视觉功能分级”,可协助医生客观了解不同IOL的临床功能,助力术前个性化人工晶状体选型。对国内完善IOL注册与集采分级管理也具有借鉴意义。本文系统梳理该分类体系的提出背景、核心方法,以及中国IOL分类现状及临床应用,旨在帮助中国眼科临床医生深入理解并合理运用这一循证导向的新型分类方法。
Abstract:
With the rapid development of intraocular lens (IOL) technology, the traditional classification system based on optical design has become unable to accurately present IOL properties and predict patients′ real-world visual outcomes. In 2024, the Functional Vision Working Group (FVWG) of the European Society of Cataract and Refractive Surgeons (ESCRS) first proposed an evidence-based functional classification framework quantified by monocular best-corrected visual acuity defocus curves, depth of field and visual acuity increase from intermediate to near, which categorizes IOLs into six functional subtypes. Further refined by the American Society of Cataract and Refractive Surgery, the Asia Pacific Association of Cataract and Refractive Surgeons, and the Latin American Society of Cataract and Refractive Surgeons, this framework was formally endorsed in a global multi-society consensus in 2026. Shifting from nominal classification by optical configuration to quantitative grading based on actual postoperative visual performance, the new system enables ophthalmologists to objectively evaluate IOL functional profiles and facilitates individualized preoperative IOL selection; it also provides valuable references for optimizing domestic IOL registration and volume-based procurement categorization in China. This article systematically reviews the background, methodology, evolutionary process, current domestic situation and clinical application of this classification system, aiming to help Chinese ophthalmologists fully understand and standardize the clinical application of this novel evidence-based classification method.
刊 名 中华眼科杂志 ISTICPKU
年,卷(期): 2026, 62(10)
在线出版日期: 2026年10月11日