不同人工晶状体植入对视觉质量影响的临床研究

doi:10.6040/j.issn.1673-3770.0.2021.392

摘要/Abstract

摘要： 目的比较At Lisa 809MP双焦点人工晶状体(IOL)与Tecnis Symfony连续视程IOL植入术后患者的视觉质量。方法选取2020年至2021年于济南市第二人民医院行白内障超声乳化抽吸术+人工晶状体植入术的患者共35例(43眼)。根据患者植入的类型不同,将植入AT LISA 809MP IOL的21例(27眼)记为双焦点IOL组,植入Tecnis Symfony IOL的14例(16眼)记为连续视程IOL组。记录两组患者术后3个月的裸眼远视力、裸眼中视力、裸眼近视力、最佳矫正远视力、最佳矫正远视力下的中视力、最佳矫正远视力下的近视力以及客观散射指数、调制传递函数截止空间频率(MTF cut off)、斯特列尔比值(SR)、对比度视力(CVA)、离焦曲线、主观调查问卷等进行分析对比。结果术后3个月,两组患者裸眼远视力及最佳矫正远视力无统计学差异(P>0.05),双焦点IOL组裸眼近视力及最佳矫正远视力下的近视力均优于连续视程IOL组(P<0.05),连续视程IOL组中视力及最佳矫正远视力下的中视力均优于双焦点IOL组(P<0.05)。两组客观散射指数、斯特列尔比值及100%对比度下的视力没有统计学差异(P>0.05),调制传递函数截止空间频率、20%及9%对比度下的视力双焦点IOL组均略低于连续视程IOL组(P<0.05)。两组离焦曲线在0D处(远距离)两组差异无统计学意义(P>0.05),在-1.5D处(中距离)连续视程IOL组视力优于双焦点IOL组,在-2.5D处(近距离)双焦点IOL组视力优于连续视程IOL组,差异均有统计学意义(P<0.05)。两组患者脱镜率、术后满意度均较好,眩光现象出现的概率无统计学差异。结论两种人工晶状体均能为患者提供较好的全程视力与脱镜率,双焦点人工晶状体的近视力较好,Symfony连续视程人工晶状体的中视力较好。

关键词: 双焦点人工晶状体, 连续视程人工晶状体, 视觉质量, 离焦曲线

Abstract: Objective The objective of this study is to evaluate and compare the visual quality between bifocal intraocular lens(IOL)(AT LISA 809MP; Zeiss)and extended depth IOL(Tecnis Symfony)implantation. Methods Thirty-five patients(43 eyes)who underwent cataract phacoemulsification with IOL implantation from 2020 to 2021 were randomly divided into groups A and B according to the type of implanted IOL. Twenty-seven eyes implanted with the AT LISA 809MP IOL and were assigned to group A, and 16 eyes implanted with the Tecnis Symfony IOL were assigned to group B. Three months after surgery, the uncorrected distant visual acuity(UDVA), uncorrected intermediate visual acuity(UIVA), uncorrected near visual acuity(UNVA), best corrected distant visual acuity(BCDVA), distant corrected intermediate visual acuity(DCIVA), distant corrected near visual acuity(DCNVA), objective scatter index(OSI), modulation transfer function(MTF)cutoff, Strehl ratio(SR), contrast visual acuity(CVA), and defocus curve were measured and analyzed, and a subjective questionnaire was administered. Results Three months after surgery, there was no statistical difference in UDVA and BCDVA between the two groups(P>0.05). The UNVA and DCNVA of group A were better than that of group B(P<0.05), and the UIVA and DCIVA of group B were better than that of group A(P<0.05). There were no significant differences in OSI, SR, and visual acuity under 100% contrast between the two groups(P>0.05), and the visual acuity under 20% and 9% contrast under cutoff spatial frequency of MTF in group A was slightly lower than that in group B(P<0.05). There was no significant difference between the two groups at the defocus curve at 0D(far distance)(P>0.05); the visual acuity at -1.5D(middle distance)was better in group B than in group A, and the visual acuity at -2.5D(near distance)was better in group A than in group B, and is statistically significant(P<0.05). The rate of spectacle independence and postoperative satisfaction were good in both groups. There was no statistical difference in the probability of glare phenomenon. Conclusion Both types of IOLs can provide patients with better overall visual acuity and spectacle independence. Bifocal IOLs have better near visual acuity, and Symfony continuous IOLs have better middle visual acuity.

Key words: Bifocal intraocular lens, Extended depth intraocular lens, Visual quality, Defocus curve

中图分类号:

R776.1

李璟,张辉,王晶. 不同人工晶状体植入对视觉质量影响的临床研究[J]. 山东大学耳鼻喉眼学报, 2022, 36(2): 90-95.

LI Jing, ZHANG Hui, WANG Jing. A clinical study on the effect of using different intraocular lens implants on visual quality[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 90-95.

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