双眼植入折射多焦点人工晶体术后视觉质量研究

Clinical observation of visual performance in patients with bilateral refractive multifocal intraocular lens

目的比较双眼植入折射多焦点人工晶体和单焦点人工晶体后的视觉质量。方法选取25例(50只眼)年龄相关性白内障患者,根据植入人工晶体的不同分为多焦点组(MIOL组)和单焦点组(SIOL组)。所有患者常规行白内障超声乳化手术,双眼手术间隔不超过3个月。MI-OL组10例共20只眼,双眼植入折射型多焦点人工晶体(ReZoom NXG1),SIOL组15例30只眼,双眼植入单焦点球面人工晶体(AR40e)。术后3个月测单眼、双眼裸眼远视力(UCDVA),裸眼近视力(UCNVA),最佳矫正远视力(BCDVA)、最佳矫正近视力(BCNVA),中文阅读视力,测对比敏感度(CS),立体视,发放视觉症状、脱镜率及满意度调查问卷。结果术后3个月两组患者均获得满意的单眼UCDVA和BCDVA,MIOL组双眼UCDVA略好于SIOL组,MIOL组UCNVA明显优于SIOL组(P<0.01)。MIOI组患者的裸眼中文阅读视力和矫正远视力下阅读视力显著高于SIOL组(P<0.05)。MIOL组在明视高空间频率(18c/d)、暗视有眩光中空间频率(6c/d)CS下降,差异有统计学意义(P<0.05)。MIOL组裸眼近立体视锐度和矫正近视力下近立体视锐度明显优于SIOL组,差异有统计学意义(P<0.05)。MIOL组在中、近距离工作和阅读时的脱镜率达90.00%,SIOL组视近脱镜率26.66%,差异有统计学意义(P<0.05)。问卷调查两组少数患者有轻度视觉(眩光、光晕等)症状,差异无统计学意义。总体满意度MIOL组91.12%,SIOL组86.11%。结论双眼植入折射多焦点人工晶体可以获得较好的全程视力,立体视觉更好,近用脱镜率高,患者满意度高。

Objective To evaluate and compare the visual performance between the patients with the bilateral refractive multifocal and monofocal intraocular lens(10 L).Methods It was a prospective nonrandomized controlled study.Twenty five patients(50 eyes)received phacoemulsification and IOL implantation were divided into two groups,10 patients(20 eyes)in the multifocal group,and 15 patients(30 eyes)in the monofocal group.Three months after surgery,the results of the uncorrected distance and near vision,the best corrected distance and near vision,Chinese reading vision,the contrast sensitivity and stereopsis acuity were measured,the subjective visual performance after surgery was evaluated by the questionnaire.Results The difference of the uncorrected distance,the best corrected distance and near vision between the multifocal and monofocal groups was not statistical significant.The uncorrected near vision and Chinese reading vision were statistically better in the multifocal group than the monofocal group.Photopic contrast sensitivity at high spatial frequency(18 c/d) and mesopic sensitivity with glare at medium frequency(6 c/d) were statistically lower in the multifocal group(P<0.05).The spectacle independent rate of multifocal and monofocal group were 90.00% and 26.66% respectively.The mild and moderate glare and halo were existent in both groups.No serious glare and halo phenomenon were reported.Conclusions Compared with the monofocal intraocular lens,the refractive multifocal intraocular lens could provide a satisfactory recovery of vision function and good visual performance except the slight decrease of the contrast sensitivity.