新型衍射型非球面多焦点人工晶状体的临床应用

Application of new diffractive aspheric multifocal intraocular lens

目的比较白内障超声乳化联合植入新型衍射型非球面多焦点人工晶状体Tecnis AMO00及非球面单焦点人工晶状体Tecnis的临床效果。方法选择老年性白内障患者,根据植入的晶状体不同分为2组:多焦点组46例62眼,植入Tecnis AMO00新型衍射型非球面多焦点人工晶状体,单焦点组42例68眼,植入Tecnis非球面单焦点人工晶状体。术后1个月和3个月随访,观察术后裸眼远视力、裸眼近视力、最佳矫正远视力、最佳矫正近视力及中间距离视力,术后3个月进行角膜内皮计数及角膜地形图检查,问卷调查了解视觉症状和视觉满意度。结果术后1个月及3个月两组间患者裸眼远视力、最佳矫正远视力和最佳矫正近视力均无显著差异。术后1个月及3个月多焦点组裸眼近视力分别为0.65±0.27和0.68±0.28,中间距离视力分别为0.64±0.22和0.67±0.25,相比单焦点组术后1个月及3个月的裸眼近视力(分别为0.28±0.26和0.30±0.25)和中间距离视力(分别为0.27±0.25和0.29±0.27),具有明显优越性,差异均有统计学意义(均为P<0.05)。两组患者术前、术后的散光状态差异均有统计学意义(均为P<0.01),术前、术后的角膜内皮细胞计数差异亦均有统计学意义(均为P<0.01),两组之间术后角膜内皮细胞丢失率差异无统计学意义(P>0.05)。多焦点组脱镜率(96.77%)明显高于单焦点组(25.00%),差异有统计学意义(P<0.01)。多焦点组4例患者诉轻度光晕、眩光,但在可以忍受范围内。结论新型衍射型非球面多焦点人工晶状体Tecnis AMO00能提供良好的全程视力,有效降低患者对老视镜的依赖,提高白内障患者术后的视觉质量。

Objective To compare the clinical effect between new diffractive aspheric multifocal intraocular lens（IOL） Tecnis AMO00 and aspheric monofocal IOL Tecnis after phacoemulsification for cataract.Methods Randomized clinical trials.Patients with age-related cataract were divided into two groups：Multifocal IOL group（46 patients,62 eyes） were implanted with Tecnis AMO00,and monofocal IOL group（42 patients,68 eyes） were implanted with Tecnis.The uncorrected distant visual acuity,uncorrected near visual acuity,best corrected distant visual acuity,best corrected near visual acuity and intermediate visual acuity were observed at 1 month and 3 months after operation,corneal endothelial counts and corneal topography were made at 3 months after operation.Questionnaire surveys recorded the visual satisfaction and visual symptoms of patients.Results There was no statistical difference in uncorrected distant visual acuity,best corrected distant visual acuity and best corrected near visual acuity at 1 month and 3 months after operation between multifocal IOL group and monofocal IOL group.The uncorrected near visual acuity of multifocal IOL group at 1 month and 3 months after operation were 0.65±0.27 and 0.68±0.28,which of monofocal IOL group were 0.28±0.26,0.30±0.25,and intermediate visual acuity of multifocal IOL group were 0.64±0.22 and 0.67±0.25,which of monofocal IOL group were 0.27±0.25,0.29±0.27;There were statistical differences between two groups（both P0.05）.The rate of wearing spectacles in multifocal IOL group was lower than that of monofocal IOL group（P〈0.01）.Four cases in multifocal IOL group had halo and glare,which can be endured.Conclusion New diffractive aspheric multifocal IOL Tecnis AMO00 can provide a high level of full vision,effectively reduces patient’s spectacle dependency and improves their postoperative visual quality.