折射型与折射衍射结合型多焦点人工晶状体植入术后的视功能比较

Visual function comparison after apodized diffractive and refractive multifocal intraocular lens implantation

目的通过比较折射型SA40N Array和折射衍射混合型Acrysof ReSTOR多焦点人工晶状体眼的视功能,了解不同类型多焦点人工晶状体在改善患者术后生活质量的效果。方法选择合适的老年性白内障患者,Acrysof ReSTOR组患者36例45眼;SA40N Array组患者50例60眼。分别植入多焦点人工晶状体,术后3个月观察2组患者术后视力(未矫正远视力、未矫正近视力、最佳矫正远视力、最佳矫正近视力、最佳矫正远视力下的近视力),屈光状态(球镜、柱镜),对比敏感度,中间距离视力(40cm、60cm、80cm),视觉症状。结果 Acrysof ReSTOR组:未矫正近视力为0.64±0.14,最佳矫正远视力下的近视力为0.69±0.16;SA40N Array组:未矫正近视力为0.49±0.07,最佳矫正远视力下的近视力值为0.57±0.07。Acrysof ReSTOR组在未矫正近视力、最佳矫正远视力下的近视力优于SA40NArray组,差异均有统计学意义(均为P<0.05),其余2组差异均无统计学意义(均为P>0.05)。2组术后屈光状态(球镜、柱镜)比较,差异均无统计学意义(均为P>0.05)。在焦点深度方面,SA40N Array组和Acrysof ReSTOR组比较,差异也无统计学意义(P>0.05),且波峰、波谷出现的位点基本一致。2组在100cd.mm-2、最佳矫正远视力情况下,各个空间频段比较,差异均无统计学意义(均为P>0.05)。Acrysof ReSTOR组和SA40NArray组植入术后的视觉症状比较,差异无统计学意义(P>0.05)。结论 Acrysof ReSTOR和SA40N Array均能在不损害近视力的前提下,提供良好的远视力,而Acrysof ReSTOR能提供较SA40N Array更好的近视力,患者的满意度较高。

Objective To compare the visual function in eyes with the new apodized diffractive Acrysof ReSTOR multifocal intraocular lens（IOL）and eyes with the refractive SA40N Array（AMO）multifocal IOL,and evaluate the effects of different multifocal IOL implantation after phacoemulsification on improving the quality of life.Methods Patients with age-related cataract were divided into Acrysof ReSTOR group（36 patients,45 eyes）and SA40N Array（AMO）group（50 patients,60 eyes）,the multifocal IOL were implanted respectively.Uncorrected distant visual acuity（UCDVA）,uncorrected near visual acuity（UCNVA）,best corrected distant visual acuity（BCDVA）,best corrected near visual acuity（BCNVA）,distant corrected near visual acuity（DCNVA）,spherical and cylindrical refraction,contrast sensitivity（CS）,intermediate visual acuity（40 cm,60 cm,80 cm）and visual symptoms were recorded at 3 months after operation.Results In the Acrysof ReSTOR group and SA40N Array group,UCNVA were 0.64±0.14 and 0.49±0.07,DCNVA were 0.69±0.16 and 0.57±0.07,respectively.The UCNVA and DCNVA in the Acrysof ReSTOR were better than those in the SA40N Array group,there were statistical differences（all P0.05）,and there was no statistical difference in other visual indexes（all P0.05）.There was no statistical difference in spherical and cylindrical refraction between two groups（all P0.05）.There was no statistical difference in the depth-of-focus value between two groups（P0.05）,and the peak and trough were almost in the same position on the 2 curves.Under photopic conditions（100 cd·m-2）with BCDVA,there was no statistical difference in CS with different frequency between two groups（all P0.05）.No statistical difference was found between two groups in the visual symptoms（P0.05）.Conclusions The Acrysof ReSTOR multifocal IOL and the Array multifocal IOL provide excellent near visual performance without compromising distant visual acuity.The Acrysof ReSTOR multifocal IOL provides better near visual acuity than the Array multifocal IOL.They all have high satisfaction from patients.