两种非球面衍射多焦点人工晶状体植入术后视觉质量评价

Clinical visual quality study after implantation of two kinds of AcrySof ReSTOR aspherical IOL

目的:综合评价非球面AcrySof ReSTOR+4D和非球面AcrySof ReSTOR+3D两种多焦点IOL植入术后患者的视觉质量,并探讨其相关影响因素。方法:白内障患者40例80眼,随机分为两组。A组:非球面AcrySof ReSTOR+3D(SN6AD1)IOL植入组;B组:非球面AcrySof ReSTOR+4D(SN6AD3)IOL植入组,其中A组为实验组,B组为对照组。术后1d;1wk;1,3mo行常规检查,并检查术眼裸眼远(UCDVA)、中(UCIVA)、近视力(UCNVA)。术后3mo检查最佳矫正远(BCDVA)、近视力(BCNVA),以及最佳矫正远视力下的近(DCNVA)、中视力(DCIVA);检查对比敏感度及波前像差;绘制离焦曲线,并进行主观问卷调查评分。结果:术后1d;1wk;1,3mo,两组的UCDVA差异均无统计学意义(P>0.05),UCIVA的差异均有统计学意义(P<0.05)。UCNVA在术后第1d,两组间的差异有统计学意义(P<0.05),而在其余时间段,两组间差异无统计学意义(P>0.05)。术后3mo时,两组的BCDVA,BCNVA,DCNVA,DCIVA差异均无统计学意义(P>0.05);两组间总像差、高阶像差、球差间,差异无统计学意义(P>0.05);在各个视角水平有/无眩光下,对比敏感度差异无统计学意义(P>0.05)。离焦曲线显示:B组在+0.0D和-3.0D处形成两个焦点,而A组不仅在+0.0D和-2.5D处形成两个焦点,而且在-2.0～-2.5D之间可形成一个平台期。问卷调查显示:两组患者视远、视近的满意度较高;而视中距离时,A组患者满意度明显高于B组。两组患者术后视觉不良症状发生率,差异无统计学意义(t=-0.87,P>0.05)。结论:非球面AcrySof ReSTOR+3D IOL植入术后,为患者提供了良好的远、中、近全程视力,尤其是中距离视力较非球面AcrySof ReSTOR+4D IOL有了显著的改善,且没有明显的视觉干扰,提高了患者的视觉和生活质量。

AIM： To evaluate the clinical visual quality after implantation of two kinds of AcrySof ReSTOR aspherical intraocular lens （IOL）, and also to analyze the relative factors. METHODS. Forty patients with cataract （80 eyes） were divided into two groups： Group A（20 patients, 40 eyes）. implanted with AcrySof ReSTOR＋3D（SN6AD1 ） ; Group B （20 patients, 40 eyes）： implanted with AcrySof ReSTOR＋ 4D （ SN6AD3 ）. Uncorrected distance visual acuity （ UCDVA ）, uncorrected intermediate visual acuity （ UCIVA）, uncorrected near visual acuity（UCNVA） were observed at 1 day, 1 week, 1 month, 3 month postoperatively. BCDVA, BCNVA, DCNVA, DCIVA, aberration, contrast sensitivity were examined at 3 month postoperatively. Binocular defocus curve-a full range of vision also were examined at 3 month postoperatively. RESULTS： All of the eyes had best UCDVA, but, group A showed statistical superiority in UCIVA at 1 day, 1 week, 1 month and 3 month （ P〈0.05）. It showed no statistical difference in UCNVA at 1 week, 1 month and 3 month, but except 1 day after surgery. Both two groups showed no statistical difference in BCDVA, BCNVA, DCNVA, DCIVA, aberration and contrast sensitivity at 3 month postoperatively（P〉0.05）. Binocular defocus curve-a full range of vision showed that group A had two focuses at ＋0.0D and -3.0D, but, besides the two focus： ＋0.0D and -2.5D, group B also had a platform level from -2.0D to -2.5D. Questionnaire showed that both of two groupshad no obviously visual disturbance（ t= -0.87, P〉0.05）. But, aspherical AcrySof ReSTOR＋ 3D IOL showed more superior vision performance in intermediate vision. CONCLUSION. The aspherical AcrySof ReSTOR＋3D IOL can provide patients with excellent outcomes in distant, intermediate and near vision. Compared with aspherical AcrySof ReSTOR ＋ 4D, it shows more superior vision performance in intermediate vision, reduces the dependence on spectacles and improves the quality-of- life.