衍射型Tecnis多焦点人工晶状体植入术对青年白内障患者视功能及视觉质量的影响

Effect of Tecnis multifocal intraocular lens implantation on visual function and visual quality in young patients with cataract

目的探讨衍射型Tecnis多焦点人工晶状体植入术对青年白内障患者视功能及视觉质量的影响。方法将65例青年白内障患者分为观察组和对照组。所有患者采用超声乳化术联合后房型人工晶状体植入术治疗,其中观察组运用衍射型Tecnis多焦点人工晶状体,对照组运用非球面Tecnis单焦点人工晶状体。比较两组患者的裸眼近视力(UCNVA)、裸眼中视力(UCIVA)、裸眼远视力(UCDVA)、最佳矫正近视力(BCNVA)、最佳矫正远视力(BCDVA)。采用视觉质量分析仪检测两组患者的客观视觉质量;采用视功能问卷(VFQ)评估患者主观视觉质量;采用视功能指数(VF-14)评估患者的视功能生存质量。结果观察组治疗后的UCNVA、UCIVA、UCDVA较治疗前均明显提高(P<0.05);术后1个月及3个月,观察组的UCNVA、UCIVA明显高于对照组同期的水平,差异有统计学意义(P<0.05);两组的BCNVA、BCDVA差异无统计学意义(P>0.05);对照组治疗后UCNVA、UCIVA、UCDVA的水平略升高,但差异无统计学意义(P>0.05);观察组的客观散射指数、斯特列尔比值、MTF截止空间频率、不同对比度视力(9%、20%、100%)明显高于对照组,差异有统计学意义(P<0.05);观察组的阅读脱镜率、近距离视物满意度、中距离视物满意度、VF-14评分明显高于对照组,差异有统计学意义(P<0.05)。结论衍射型Tecnis多焦点人工晶状体植入术能显著提高青年白内障患者的视功能及视觉质量。

Objective To investigate the influence of diffraction type Tecnis multifocal intraocular lens implantation on the visual function and visual quality in young patients with cataract.Methods Sixty-five young patients with cataract were divided into the observation group and control group.All cases adopted phacoemulsification combined with posterior chamber intraocular lens implantation.The observation group used diffractive Tecnis multifocal intraocular lenses and the control group used aspheric Tecnis single focus intraocular lens.The uncorrected visual acuity(UCNVA),uncorrected visual acuity(UCIVA),uncorrected distant vision(UCDVA),corrected near vision(BCNVA),and best corrected distant vision(BCDVA)were compared between the two groups;the visual quality analyzer was used to detect the objective visual quality of the two groups.The visual function questionnaire(VFQ)was used to assess the subjective visual quality;the visual function index(VF-14)was used to assess the patient′s visual function survival quality.Results The levels of UCNVA,UCIVA and UCDVA after treatment in the observation group were significantly improved compared with before treatment(P<0.05).At postoperative 1,3 months,the levels of UCNVA and UCIVA in the observation group were significantly higher than those at the same periods in the control group,the difference was statistically significant(P<0.05).There was no statistically significant difference in BCNVA and BCDVA between the two groups(P>0.05).The levels of UCNVA,UCIVA and UCDVA after treatment in the control group were increased slightly,but the difference was not statistically significant(P>0.05).OSI,SR,MTF cut-off space frequency,contrast visual acuity in the observation group(9%,20%,100%)were significantly higher than those in the control group,the differences were statistically significant(P<0.05).The taking off glass reading rate,visual satisfaction at close distance,visual satisfaction at meddle distance and VF-14 score in the observation group were significantly higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion The diffractive Tecnis multifocal intraocular lens implantation can significantly improve the visual function and visual quality in young patients with cataract.