区域折射型与衍射折射型多焦点人工晶状体植入术后患者视力与视觉质量对比研究

Comparison of patients' vision and visual quality following refractive rotationally asymmetric mutifocal intraocular lens and diffractive multifocal intraocular lens implantation

目的对比分析白内障患者植入区域折射型多焦点人工晶状体(SBL-3)与衍射折射型多焦点人工晶状体(Zeiss809)后的视力和视觉质量。方法选取2016年5月至2017年6月在我院就诊的白内障患者80例100眼,其中39例50眼植入SBL-3(SBL组),41例50眼植入Zeiss809(Zeiss组)。术前两组患者性别、年龄、眼轴长度和角膜曲率等差异均无统计学意义(均为P>0.05)。术后3个月观察指标包括患者裸眼远、中、近视力,绘制术眼离焦曲线,检测患者客观视觉质量的客观散射指数(OSI)、调制传递函数截止频率(MTFcutoff)、斯特列尔比(SR),进行主观视觉质量问卷调查。结果术后两组患者术眼情况稳定,无高眼压及并发症出现。SBL组和Zeiss组患者术后3个月的裸眼远视力均较术前明显提高,差异均有统计学意义(均为P<0.01)。术后两组患者间裸眼近视力、远视力差异均无统计学意义(均为P>0.05);SBL组患者较Zeiss组裸眼中视力更好,差异有统计学意义(P=0.04)。离焦曲线图显示SBL组在-1.50 D(70 cm)处裸眼中视力较Zeiss组好。两组患者术后OSI、MTFcutoff和SR均较术前明显改善,差异均有统计学意义(均为P<0.05)。术后3个月SBL组与Zeiss组OSI、MTFcutoff和SR差异均无统计学意义(均为P>0.05)。术后3个月SBL组和Zeiss组分别有3眼及4眼发生夜间光晕,两组间发生率差异无统计学意义(P>0.05)。结论区域折射型多焦点人工晶状体和衍射折射型多焦点人工晶状体植入均能给白内障患者术后提供较为满意的视力。两种人工晶状体植入后患者视觉质量均明显改善。

Objective To compare the vision and visual quality after implantation of refractive rotationally asymmetric mutifocal IO L（ SBL-3） and diffractive mutifocal IO L（ Z eiss809） in cataract surgery. Methods Totally 80 patients（ 100 eyes） who underw ent cataract surgery in our hospital from May 2016 to June 2017 were chosen in the research,follow ed by the implantation of SBL-3 in 39 patients（ 50 eyes,SBL group） and Z eiss809 in other 41 patients（ 50 eyes,Z eiss group）. The gender,age,length of optic axis and corneal curvature betw een the both groups were not significantly different（ all P〈0. 05） before surgery. Variables including far,middle and near uncorrected vision acuity,defocus curves,vision quality were observed 3 months after surgery. Objective scattering index（ OSI）,modulation transfer function cutoff frequency（ MT Fcutoff） and Strehl ratio（ SR） were detected,and objective optical quality analysis system was conducted. Results Both groups has no ocular hypertension and complications after surgery. The far uncorrected vision acuity of both groups in 3 months after surgery show ed significant statistic difference from preoperation（ both P〈0. 01）. There has no statistic difference betw een both groups in far and near uncorrected vision acuity 3 months after surgery（ both P〈0. 05）. SBL group show ed better outcomes than that in Z eiss group in the middle uncorrected vision acuity 3 months after surgery（ P =0. 04）. Defocus curves showed the better middle uncorrected vision acuity in SBL group than that in Z eiss group when the degree was-1. 50 D（ 70 cm）. The OSI,M TFcutoff and SR in both groups significantly improved after surgery when compared with before surgery（ all P〈0. 05）. And the OSI,M TFcutoff and SR 3 months after surgery had no statistic difference betw een the two groups（ all P〈0. 05）. Q uestionnaire results show ed there were 3 patients in SBL group and 4 in Z eiss group complaining glare at night,and there was no statistic difference betw een the two groups（ P〈0. 05）. Conclusion Both refractive rotationally asymmetric mutifocal IO L and diffractive multifocal IO L show s satisfactory vision acuity after cataract surgery. Significant improvement of vision quality in both groups can be presented after IO L implantation.