高度近视合并白内障植入不同多焦点人工晶状体视觉质量分析

Comparison visual quality between different multifocal IOLs in cataract patients with high myopia

目的 比较高度近视合并白内障超声乳化吸除分别植入2种不同多焦点人工晶状体（multifocal intraocular lens.MIOL）的视觉质量.方法 回顾性系列病例研究.回顾性分析高度近视合并白内障患者40眼行超声乳化白内障吸除联合人工晶状体（intraocular lens,IOL）植入术后3mo的随访资料.患者分别植入AR40e（SENSAR,AMO）单焦点IOL（monofocal/single-focalintraocularlens,SIOL）20眼、REZOOM（NXG1,AMO）折射型MIOL8眼、TECNISZMA00衍射型MIOL12眼.使用Snellen标准视力表（5m）及Colenbrander Mixed Contrast Card Set视力测试卡（0.4m）分别测量裸眼远近视力、最佳矫正远视力及最佳矫正远视力下近视力.使用iTrace波前像差仪测量5mm瞳孔直径下的眼内像差及调制传递函数（medulation transfer function,MTF）曲线.满足正态分布和方差齐性的行单因素方差分析,采用SNK-q检验进行组间两两比较.不满足的行K-W检验.结果 3组患者术后3个月裸眼远视力,最佳矫正远视力下近视力比较有统计学意义（P〈0.05）.裸眼近视力,最佳矫正远视力差异无统计学意义（P〉0.05）.3组患者在瞳孔5mm直径时,眼内球差差异有统计学意义（P〈0.05）,眼内彗差及三叶草比较无统计学意义（P〉0.05）;MTF值在5/10/15cpd时差异有统计学意义（P〈0.05）.结论 高度近视合并白内障患者更适合植入衍射型MIOL.

Objective To compare visual function of patients with cataract and high myopia after phacomulsification and multifocal intraocular lens（MIOL）implantation. Methods Forty high myopia cataract eyes undertaken phacoemulsification and IOL implantation were divided into three groups： monofocal/single-focal intraocular lens（SIOL, SENSAR, AR40e, AMO）with 20 eyes, retractive MIOL（REZOOM, NXG1,AMO）with 8 eyes and diffractive MIOL（TECNIS, ZMA00, AMO）with 12 eyes. Three months after surgery,uncorrected distant visual acuity（UCDVA）, uncorrected near visual acuity（UCNVA）, best corrected distant visual acuity（BCDVA）and distant corrected near visual acuity（DCNVA）were observed iTrace aberrometer test intraocular aberration and modulation transfer function（MTF）of different cycle per degree（CPD）in a 5 mm pupil. Results UCDVA and DCNVA between the three groups was statistically significant（P 〈0.05）. BCDVA and UCNVA between the three groups was not statistically significant（P 〉0.05）. Spherical aberration of intraocular between the three groups showed statistical significance（P 〈0.05）. Other aberration of intraocular between the three groups showed no statistical significance（P〉0.05）. Difference of MTF in 5/10/15 cpd was statistically significantly（P 〈0.05）. Conclusions Diffractive MIOL is more suitable for high myopia with cataract patients than refractive MIOL.