Symfony连续视程人工晶状体与Tecnis ZMBOO多焦点人工晶状体视觉质量比较

A Comparative Study of the Visual Quality of the Symfony Extended Range of Vision Intraocular Lens and Tecnis ZMBOO Multifocal Intraocular Lens

目的:对Symfony连续视程人工晶状体(IOL)与Tecnis ZMBOO多焦点IOL视觉质量进行对比,为临床推广应用提供理论依据。方法:回顾性病例对照研究。收集2016年1月至2018年2月在大庆油田总医院白内障中心行白内障超声乳化吸除联合IOL植入术的白内障患者113例(113眼),根据植入IOL不同分为2组:63例(63眼)植入Symfony连续视程IOL为Symfony组,50例(50眼)植入Tecnis ZMBOO(+4D)多焦点IOL为ZMBOO组,观察2组患者术后3个月远、中、近距离视力,对比敏感度,双离焦曲线,波前像差及问卷调查,2组数据采用t检验进行统计分析。结果:术后3个月时2组患者远视力(5 m)比较差异无统计学意义;近距离视力(33 cm)ZMBOO组优于Symfony组,差异有统计学意义(t=6.641,P=0.002);中距离视力(60、80 cm)Symfony组优于ZMBOO组,差异有统计学意义(t=3.942,P=0.020;t=4.247;P=0.011)。术后3个月,2组患者的离焦曲线显示:Symfony组在-2.5^+0.5 D区间趋于平稳,视力均在0.3 LogMAR以上,形成平台期,优于ZMBOO组;ZMBOO组离焦曲线呈双峰,峰值在0 D和-3.5 D,近距离视力优于Symfony。术后3个月,2组患者在明视及明视加眩光状态下各空间频率对比敏感度比较差异均无统计学意义;在暗视状态下,Symfony组在3.0、6.0、12.0 c/d空间频率的对比敏感度要优于ZMBOO组,差异有统计学意义(t=8.246,P=0.013;t=10.831,P=0.006;t=6.246,P=0.027)。术后3个月,Symfony组总像差、高阶像差、彗差、三叶草均低于ZMBOO组,差异有统计学意义(t=3.302,P=0.035;t=9.495,P=0.010;t=5.310,P=0.018;t=4.259,P=0.024),总低阶像差、球差、二阶散光2组差异无统计学意义。结论:Symfony连续视程IOL可提供优质的视觉质量,且在中距离视力具有优势,而Tecnis ZMBOO多焦点IOL更适合视近。

Objective: To compare the visual quality of the Symfony extended range of vision intraocular lensand the Tecnis ZMBOO multifocal intraocular lens, which can provide a theoretical basis for clinical promotion and application. Method: This was a retrospective case control analysis. One hundred thirteen patients (113 eyes) with cataract, who underwent phacoemulsification and IOL implantation, were divided into two groups: 63 patients (63 eyes) who were prescribed Symfony extended range of vision intraocular lenses and 50 patients (50 eyes) who were prescribed Tecnis ZMBOO multifocal intraocular lenses. Far, intermediate, and near distance vision were tested at postoperative 3 months. A binocular defocus curve was plotted, contrast sensitivity wave front aberrations were measured and patients answered a questionnaire. Data from the two groups were statistically analyzed by t test. Results: There was no significant difference invisual acuity between the two groups at 3 months postoperatively. Near vision (33 cm) in the ZMBOO group was superior to the Symfony group, and the difference was statistically significant (t=6.641, P=0.002). The intermediate-distance visual acuity (60 cm, 80 cm) of the Symfony group was superior to that of the ZMBOO group, and the difference was statistically significant (t=3.942, P=0.020;t=4.247;P=0.011). Three months after surgery, the defocus curve of the two groups showed that the Symfony group tended to be stable between +0.5 D and -2.5 D, and vision was above 0.3 LogMAR, forming a platform stage, and was more consistently superior to that of the ZMBOO group. The ZMBOO group showed a double peak, with a peak value of 0 D and -3.5 D. There were no statistically significant differences in spatial frequency contrast sensitivity between the two groups under visual acuity conditionsand visual acuity with glare three months after surgery. Under dark conditions, the contrast sensitivities for the spatial frequencies of the Symfony group were better than that of ZMBOO group at 3.0 c·d-1, 6.0 c·d-1, and 12.0 c·d-1, and the differences were statistically significant (t=8.246, P=0.013;t=10.831, P=0.006;t=6.246, P=0.027). Three months after surgery, the total aberrations, higher-order aberrations, and coma aberrations of the Symfony group were lower than that of the ZMBOO group, and the differences were statistically significant (t=3.302, P=0.035;t=9.495, P=0.010;t=5.310, P=0.018;t=4.259, P=0.024). There was no significant difference in total lower order aberrations, spherical aberrations and second-order astigmatism in the two groups. Conclusion: Symfony extended range of vision intraocular lenses can provide patients with good visual quality and continuous range of vision, while Tecnis ZMBOO multi-focus IOL is more suitable for near vision.