单件式多焦点人工晶状体和单焦点人工晶状体植入术后的视觉质量对比研究

The visual quality observation of multifocal intraocular lens and monofocal intraocular lens implantation in cataract surgery

目的对比研究单件式多焦点人工晶状体植入与单焦点人工晶状体植入术后的视觉质量。方法共选择符合试验标准的73例(85只眼)白内障患者,其中41例(48只眼)植入单件式多焦点人工晶状体,其余32例(37只眼)植入单焦点人工晶状体。术后1 d、1个月和3个月进行随访,对两组患者的裸眼远近视力、对比敏感度、像差以及拟调节力进行比较。结果与单焦点组相比,多焦点组术后的裸眼远近视力明显较好(P <0. 05);而裸眼远视力无明显差别(P> 0. 05)。在术后3个月时,多焦点组的明视状态和暗视状态的对比敏感度、总像差、总高阶像差、慧差和球差均明显升高(P <0. 05),而离焦和散光无明显差异(P> 0. 05);与单焦点组相比,多焦点组患者术后波前像差在4. 0 mm和6. 0 mm这两种瞳孔下较高(P <0. 05)。结论与植入单焦点人工晶状体相比,植入单件式多焦点人工晶状体术后的远近视力和拟调节力较好,但是也存在一定的缺点,如导致高阶像差增加、降低对比敏感度,有可能使白内障患者的术后视觉质量降低。

Objective To compare the vision quality of monofocal intraocular lens （ZCB00） and multifocal intraocular lens （ZMB00） implantation in cataract surgery. Methods 73 patients （85 eyes） with cataract were selected. Of these, 41 （48 eyes） were implanted with multifocal intraocular lens （ZMB00） and the remaining 32 （37 eyes） were implanted with monofocal intraocular lens （ZCB00）. The vision quality, contrast sensitivity, aberration and pseudoaccommodation were measured at 1 day, 1 month and 3 months after surgery. Results The near vision acuity of multifocal intraocular lens group was significantly better than monofocal intraocular lens group at1day, 1 months and 3 months after surgery （ P 〈0.05）. There is no difference between monofocal intraocular lens and multifocal intraocular lens in distance vision acuity （ P 〉0.05）. The contrast sensitivity, total aberration, higher order aberration, coma, spherical aberration was significant increased, there was no significant difference between focal and astigmatism （ P 〈0.05）. At the status of 4.0mm pupil and 6.0mm pupil, the wavefront aberration in multifocal intraocular lens group was higher than monofocal intraocular lens group（ P 〈0.05）. In addition, the pseudoaccommodation in multifocal intraocular lens group was higher than monofocal intraocular lens group （ P 〈0.05）. Conclusions The monofocal intraocular lens implantation may lead to favorable near vision acuity and pseudoaccommodation, but also lead to increased high order aberration and deceased contrast sensitivity.