多焦点人工晶体植入术后双眼离焦曲线对视觉功能的评价

Evaluation of visual function after multifocal intraocular lens implantation through defocus curves assessment

目的利用离焦曲线评价观察多焦点人工晶体植入术后患者的真实生活视力。方法回顾性分析2017年5月至2018年5月间收治的老年性白内障患者60例(120眼),按植入晶体不同分为两组,各30例(60眼)。其中植入ZEISS AT LISA 809M晶体者30例(60眼)设为多焦非球面组(观察组),植入HOYA-PY60AD晶体者30例(60眼)设为单焦非球面组(对照组),术后3个月观察术眼的屈光状态、双眼离焦曲线、脱镜率并问卷调查视觉质量。结果术前两组患者远视力及最佳矫正近视力情况差异无统计学意义(P> 0.05),术后观察组的裸眼近视力(UCNVA)明显优于对照组(P <0.01);离焦曲线测量显示:观察组曲线下面积大于对照组,近距离曲线呈平滑趋势,而对照组的近距离曲线呈明显下降趋势,在-1.5 D(66 cm)、-3.5 D(33 cm)两点处两组视力表现差异有统计学意义(P <0.01)。结论两种晶体均可为患者提供良好的裸眼远视力;真实生活中多焦点非球面人工晶状体裸眼近视力效果更佳,脱镜率更高、视觉效果满意度更高,可为白内障患者术后提供更好的视觉质量。

Objective To observe the visual quality after phacoemulsification combined with ZEISS AT LISA 809M or HOYA PY60AD implementation by defocus curve testing. Methods This is a retrospective controlled study. 60 patients( 120 eyes) with bilateral cataract were observed. 30 patients( 60 eyes) in the test group were implanted bilaterally with ZEISS AT LISA 809M IOL,and 30 patients( 60 eyes) in the control group were im planted bilaterally with HOYA-PY60AD-IOL. The follow up period was 3 months. Overall visual acuity,defocus curve testing,patient reported outcomes were assessed. Results Binocular uncorrected near visual acuity(UCNVA) was statistically significantly better in the test group than that in the control group(P < 0.01);there was no difference in corrected near or distance visual acuity(P > 0.05). The defocus curve testing shows that the area of the defocus curve in the test group is bigger than that in the control group;the first peak position of the two groups is at 0 D to -1 D;the curve between -1.5 D and -3.0 D was smooth;and visual acuity at -1.5 D( 66 cm) and -3.5 D (33 cm) were statistically significantly better in the test group. In the questionnaire,the rate of satisfaction of near-distance and off-glass in the test group were higher than that in the control group(P < 0.01). Conclusion Both intraocular lens(IOL) can obtain good near and far visual acuity. The AT LISA tri 839 MP IOL can obtain better intermediate visual acuity and higher patient satisfaction,and has better full time visual acuity.