非球面人工晶体的临床研究

Clinical Study on the aspheric intraocular lens

目的客观评价非球面人工晶体、多焦点人工晶体和单焦点人工晶体的临床疗效。方法选择行白内障超声乳化联合人工晶体（IOL）植入术的患者90例,分成三组,植入Tecnis IOL 30例、Array IOL 30例及Sensar IOL 30例。观察患者手术后1w、3m的远、近视力,术后3m三组的对比敏感度、视觉症状和生存质量等变化。结果手术后1w、3m三组间近视力两两进行比较,P值均〈0.05,三组间差异均有统计学意义,其中Array组近视力最好,Tecnis组其次,Sensar组相对较差。术后1w、3m三组间远视力两两进行比较,P值均〉0.05,三组间无统计学意义。术后3m三组间在无眩光背景下对比度值比较,P值均〈0.05,故三组间差异性均有显著性,其中Tecnis组对比度值最小,即对比敏感度最好,Sensar组其次,Array组对比度值最大,即对比敏感度相对较差。术后3m三组间在有眩光背景下对比度值比较,Tecnis组与Array组比较P〈0.05,Tecnis组与Sensar组比较P〈0.05,差异具有显著性;Array组与Sensar组比较P〉0.05,无显著性差异性;故在有眩光背景下Tecnis组对比度值最小,即对比敏感度最好,而Array组与Sensar组两组无明显差异性。术后3m三组间暗适应时间比较,P值均〈0.05,故三组间差异性均有显著性,其中Tecnis组暗适应时间最短,Sensar组其次,Array组暗适应时间最长。术后3m三组间视功能量表分值比较P〉0.05,故三组间视功能质量无显著性差异。结论对于患有老年性白内障施行超声乳化联合IOL植入术的患者来说,无论植入何种IOL,手术后均可大大提高和改善患者的视功能和生存质量。但在IOL的选择上,植入多焦点人工晶体可以使患者获得较好的近视力,但伴有对比敏感度的下降,植入非球面人工晶体可以获得相对较好的对比敏感度,避免了术后眩光、光晕和夜间视力下降等不良现象的发生,提高视觉质量。

Objective The study is to impersonally estimate the clinical curative effect of the aspheric intraocular lens,multifocal intraocular lens and single focus intraocular lens. Methonds Ninety suitable patients who were performed phacoemulsification whith intraocular lens implantation were allocated to three groups：thirty patients were implanted Tecnis intraocular lens,thirty patients were implanted Array intraocular lens, and the rest thirty patients were implanted Sensar intraocular lens.Distance vision,near vision were evaluated at one week and three months after surgery, three months after surgery, we observe contrast sensitivity, vision symptom and quality of life again. Results The near vision of the Array intraocular lens group was significantly higher than the other two groups（P〈0.05）at one week and three months after surgery, the Tecnis group was in the next place,the Sensar group was the worst comparatively.There was no statistical difference （P〉0.05）in distance vision between the three groups at one day one week and three months after operation.In the patients with Tecnis intraocular lens implantation,the contrast sensitivity without dazzle light was significantly higher than the other tow groups（P〈0.05）,the Sensar group was in the next place,the Array group was the worst comparatively.In the patients with Tecnis intraocular lens implantation,the contrast sensitivity with dazzle light was also significantly higher than the other tow groups（P〈0.05）,but There was no statistical difference（P〉0.05） btween the Array group and the Sensar group.simultaneity, the dark adaptation time of the Tecnis group was the shortest,next was the Sensar group,the dark adaptation process of the Array group was the longest.There was no statistical difference（P〉0.05）in visual quality of life between the three groups.Conclusion The study indicated that phacoemulsification and intraocular lens implantation could improve the quality of life of the patients,in despite of which sort intraocular lens were implanted. However,the patients with multifocal intraocular lens implantation could get the better near vision,at the same time ineluctably obtain the lower contrast sensitivity; the patients with aspheric intraocular lens implantation could gain better contrast sensitivity,Further to acquire the ameliorative visual quality and avoid the negative phenomena of glare,halation and low vision at night.