目的 评估可疑原发房角关闭（PACS）合并老视患者接受透明晶状体摘除联合景深延长型（EDOF）人工晶状体植入能否在开放周边房角结构的同时提高患者的视觉质量。 方法 选取PACS合并老视且晶状体透明的患者80例，根据植入的晶体类型分为对照组46例和观察组34例。对照组行透明晶状体摘除联合单焦点人工晶状体植入术，观察组行透明晶状体摘除联合EDOF人工晶状体植入术。比较术前及术后3个月视力、眼压、眼前节相干光断层扫描（AS-OCT）所测量的房角结构、离焦曲线及Catquest 9SF-CN量表评分，同时填写不良事件表进行安全性研究。 结果 对于房角结构，治疗3个月后，AS-OCT结果显示两组中央前房深度、750 μm前房角开放距离、750 μm前房角隐窝面积、750 μm小梁网与虹膜间面积、750 μm小梁网与虹膜间夹角均较术前增加（均P < 0.01），两组间差异无统计学意义（均P > 0.05）。对于离焦曲线，治疗3个月后，观察组在-1.0 D至-4.0 D时视力优于术前（均P < 0.05），对照组在+0.5、-0.5、-1.0、-2.0、-3.0、-3.5、-4.0 D时视力优于术前（均P < 0.05），且观察组在+1.0 D至-4.0 D时优于对照组（均P < 0.05）。对于Catquest 9SF-CN量表，治疗3个月后，两组术后3个月评分均优于术前（P < 0.01），且观察组术后3个月评分优于对照组（P < 0.01）。研究过程中7例患者（其中对照组3例、观察组4例）出现了一过性眼压升高，两组均无严重不良反应发生。 结论 PACS合并老视患者在接受透明晶状体摘除术后，房角结构得到显著改善；与植入单焦点人工晶状体相比，EDOF 人工晶状体的植入能够显著改善患者术后视觉质量。

Objective To assess the efficacy of clear lens extraction combined with extended depth of focus （EDOF） intraocular lens （IOL） implantation in enhancing visual quality and concurrently opening peripheral angle structures in patients diagnosed with primary angle closure suspect （PACS） and presbyopia. Methods A total of 80 patients with PACS， presbyopia， and transparent lenses were enrolled and divided into two groups based on the type of implanted lens： a control group （n = 46） and an experimental group （n = 34）. The control group underwent clear lens extraction followed by monofocal intraocular lens implantation， while the experimental group underwent clear lens extraction followed by extended depth of focus （EDOF） intraocular lens implantation. Preoperative and postoperative evaluations at 3 months included visual acuity， intraocular pressure， anterior segment structure， defocus curve， and Catquest 9SF?CN questionnaire scores. Adverse events were recorded to assess safety. Results Regarding the angular structure， after 3 months of treatment， results indicated significant increases in central anterior chamber depth， angle opening distance at 750 μm， angle recess area at 750 μm， trabecular?iris space area at 750 μm， and trabecular?iris angle at 750 μm in both groups compared to preoperative values （all P < 0.01）. However， no significant differences were observed between the two groups （all P > 0.05）. For the defocusing curve， visual acuity in the experimental group improved from +1.0 D to -4.0 D after 3 months of treatment （all P < 0.05）， while the control group showed improvements at +0.5 D， -0.5 D， -1.0 D， -2.0 D， -3.0 D， -3.5 D， and -4.0 D （all P < 0.05）. Postoperatively at 3 months， the experimental group exhibited superior visual acuity to the control group at -1.0 D to -4.0 D （all P < 0.05）. According to the Catquest 9SF?CN scale， scores in both groups significantly improved after 3 months of treatment （P < 0.01）， with the experimental group scoring higher than the control group （P < 0.01）. During the study， transient intraocular pressure elevation occurred in 7 patients （3 in the control group and 4 in the experimental group）， but no serious adverse reactions were reported in either group. Conclusions In patients with pseudoexfoliation glaucoma combined with presbyopia， significant improvements in angle structures were observed following clear lens extraction. The implantation of an EDOF IOL notably enhanced postoperative visual quality compared to monofocal IOLs.