区域折射型多焦人工晶状体SBL-3植入前后白内障患者视觉质量的变化分析

Mutation analysis of visual quality in cataract patients with regional refracted multifocal intraocular lens before and after SBL-3 implantation

目的比较区域折射型与全光面衍射型多焦人工晶状体(MIOL)对白内障患者视觉质量的影响,分析区域折射型MIOL SBL-3的临床应用价值。方法前瞻性对照研究保定市第一中心医院2017年10月～2018年4月收治的86例单眼白内障患者。使用随机数表将患者分为区域折射型组、全光面衍射型组各43例,均给予白内障超声乳化吸除术治疗,区域折射型组术中同步给予区域折射型MIOL SBL-3植入,全光面衍射型组术中给予全光面衍射型MIOL Tecnis ZMB00植入。比较两组患者视力、对比敏感度、离焦曲线、视觉质量变化及术后3个月视觉质量满意度。结果区域折射型组、全光面衍射型组术后并发症发生率分别为9.30%、4.65%,组间比较差异无统计学意义(P> 0.05)。术后3个月,区域折射型组UIVA、UNVA、DCNVA、DCIVA均优于全光面衍射型组,差异有统计学意义;除暗光18 c/d、暗光眩光18 c/d空间频率外,区域折射型组明光、暗光、明光眩光、暗光眩光其他频率下对比敏感度均优于全光面衍射型组,差异有统计学意义(P <0.05)。术后3个月,区域折射型组离焦曲线在+1.0 D～-3.0 D范围内平稳,-3.0 D后开始缓慢下滑;全光面衍射型组仅于±0.5 D间出现波峰,两端均快速下滑。两组患者术后3个月视觉质量均较术前改善,区域折射型组术后3个月客观散射指数(OSI)低于全光面衍射型组,其调制传递函数截止频率(MTFcutoff)、斯特列尔比(SR)高于全光面衍射型组;区域折射型组眼镜视觉质量满意度优于全光面衍射型组,差异有统计学意义(P <0.05)。结论区域折射型MIOL能够有效改善白内障患者视觉质量,其临床应用价值优于全光面衍射型MIOL。

Objective To compare the effects of regional refraction and full-light diffraction multifocal intraocular lens(MIOL)on visual quality of cataract patients.To analyze the clinical value of regional refraction MIOL SBL-3.Methods 86 patients with monocular cataract admitted in 2017.10~2018.04 were enrolled in this prospective controlled study.Patients were divided into two groups:regional refraction group(group I)and all-optical diffraction group(group II).All patients were treated with phacoemulsification.Group I implantation synchronous regional refraction MIOL SBL-3,Group II implantation MIOL Tecnis ZMB00.Visual acuity,contrast sensitivity,defocus curve and visual quality were compared between the two groups.Summary the clinical application of SBL-3.Results The incidence of postoperative complications of the I and II group were 9.3%and 4.65%,showed no significant difference.three months later,the UIVA、UNVA、DCNVA、DCIVA of group I were better than that of group II.Except for dark light 18 c/d,dark glare 18 c/d space frequency,the contrast sensitivity at other frequencies of bright,dark light,glare,dark glare were better than that in group II.The difference were statistically significant(P<0.05);The curve of group I was stable in the range of+1.0 D^-3.0 D,and began to decline slowly after-3.0 D;The peaks of group II appeard between+0.5 D,and both ends slide rapidly.The visual quality of the two groups improved after three months,but OSI of group I was lower than group II,and MTFcutoff、SR were higher than group II,the difference were statistically significant(P<0.05).Conclusion Regional refractive MIOL can effectively improve the visual quality of cataract patients,and its clinical value is better than full-light diffraction MIOL.