非对称区域折射型多焦点人工晶状体与可调节型人工晶状体的临床效果研究

Clinical outcomes comparison between refractive rotationally asymmetric multifocal intraocular lens and accommodating intraocular lens

目的对比植入非对称区域折射型多焦点人工晶状体(multifocal intraocular lens,MIOL;SBL-3)与可调节型IOL(accommodating IOL,AIOL;Tetraflex HD)后的视觉质量。方法前瞻性队列研究。选取在我院诊断为单纯性白内障,并行白内障超声乳化联合IOL植入术的患者26例(38眼)为研究对象,其中植入SBL-3 MIOL者18眼为MIOL组,植入Tetraflex HD AIOL者20眼为AIOL组。术后1个月、3个月分别检查患者裸眼远、近视力,最佳矫正远、近视力及远视力矫正下近视力,3个月时使用视觉质量分析系统评估患者斯特列尔比率、调制传递函数截止频率(MTFcutoff)值及客观调节幅度。采用SPSS 18.0分析数据。结果术后3个月时两组患者间裸眼远视力及最佳矫正远、近视力差异均无统计学意义(均为P>0.05);MIOL组裸眼近视力及远视力矫正下近视力分别为(0.245±0.079)log MAR、(0.279±0.074)log MAR,均优于AIOL组的(0.303±0.094)log MAR和(0.339±0.077)log MAR,差异均有统计学意义(均为P<0.05);术后3个月时,视觉质量分析系统测得MIOL组和AIOL组斯特列尔比率值分别为0.19±0.29和0.15±0.05,客观调节幅度分别为(2.72±0.49)D和(2.19±0.49)D,两组相比差异均有统计学意义(均为P<0.05)。结论非对称区域折射型MIOL与AIOL在视觉质量方面具有差异性。

Objective To compare the intraocular optical quality between refrac- tive rotationally asymmetric multffocal hltraocular lens （ MIOL; SBL-3 ） and accommodat- ing IOL （AIOL, TetraflexHD ）. Methods Prospective comparative nonrandomized consecutive case series. Consecutive cataract patients were implanted of a refractive ro- tationally asymmetric MIOL （ SBL-3 ） or a AIOL （ TetraflexHD ）. Of the 25 cases （ 38 eyes）, 18 eyes were in MIOL group and 20 eyes were in AIOL group. The uncorrected distant and near visual acuity,best corrected distant and near visual acuity, distant-cor- rected near visual acuity were measured at 1 month, 3 months after surgery. SR, MTF cutoff and objective pseudoaccommodation range were evaluated at 3 months by optical quality analysis system （OQAS） postoperatively. The data was analyzed by SPSS 18.0. Results At 3 months postoperatively,there was no significant difference in the uncor- rected distant visual acuity, best corrected distant visual acuity and corrected near acui- ty between two groups （ P 〉 0.05 ）. Ucorrected near visual acuity and distance-corrected near visual acuity in MIOL group were （ 0. 245 ± 0. 079 ） logMAR, （ 0. 279 ± 0. 074 ） log- MAR,respectively,which were better than the AIOL group（0. 303 ± 0. 094 ）logMAR and （0. 339 ± 0. 077） logMAR, there were significant differences between groups （ all P 〈 0. 05）. At 3 months postoperatively, SR in MIOL group and AIOL group evaluated by OQAS were 0.19 ± 0. 29 and 0.15 ± 0.05, respectively, the objective pseudoaccommoda- tion range were （ 2.72 ± 0.49 ） D and （ 2.19 ± 0.49 ） D, respectively, there were significant differences between two groups （ all P 〈 0.05 ）. Conclusion There are differences in intraocular optical quality between rotationally asymmetric MIOL and AIOL.