客观视觉质量分析系统评估不同人工晶状体植入术后视觉质量

Evaluation of visual quality in implanted cases with different types of intraocular lenses by optical quality analysis system

目的应用双通道客观视觉质量分析系统(OQAS II)评价由同一平台生产的单焦点非球面人工晶状体(ZEISS CT ASPHINA 509M)及衍射折射型多焦点非球面人工晶状体(ZEISS AT LISA 809M)植入术后患者的视觉质量。方法收集年龄相关性白内障患者62例(99只眼),根据植入人工晶状体(IOL)的不同分为多焦点组及单焦点组。术前、术后1周、1个月、3个月采用OQAS II对两组患者的视觉质量进行检测。结果 (1)视力:经术后三次随访,两组的UCNVA、UCDVA、BCDVA及BCNVA均明显高于术前(均P=0.000),多焦点组术后的UCNVA优于单焦点组(FUCNVA=105.557,PUCNVA=0.000);(2)客观视觉质量:多焦点组术后OV20%、OV9%均低于单焦点组(FOV20%=8.096,POV20%=0.005;FOV9%=16.738,POV9%=0.000);两组SR、OSI术后3个月均优于术后1周(P=0.022;P=0.002;P=0.039;P=0.032),单焦点组MTF cut off术后3个月优于术后1周(P=0.013)。(3)NEI-VFQ-25问卷:术后3个月,多焦点组在总体视觉(t=-3.475,P=0.001)及近距离活动评分方面(t=-9.419,P=0.000)优于单焦点组;(4)不良反应:多焦点组1例(2眼)患者出现夜间眩光、光晕,单焦点组无特殊视觉症状。结论单焦点非球面人工晶状体与衍射折射型两焦点非球面人工晶状体的植入均能有效改善年龄相关性白内障患者术后的客观视觉质量。

OBJECTIVE To measure the optical quality after implantation of ZEISS CT ASPHINA 509 M and ZEISS AT LISA 809 M in patients by optical quality analysis system(OQAS II).METHODS A total of 62 patients(99 eyes) with age-related cataract were divided into multifocal intraocular lens group(MIOL group), and monofocal intraocular lens group(SIOL group) according to the intraocular lens implanted. Follow-up at 1 week, 1 month, and 3 months after surgery. The Optical Quality Analysis System(OQAS II) was used to evaluate objective visual quality. RESULTS(1) vision acuity: three follow-ups were performed after surgery, UCDVA, BCDVA, UCNVA and BCNVA were significantly improved in both MIOL and SIOL groups(all P =0.000).The MIOL group had a better UCNVA than SIOL group(FUCNVA=105.557,PUCNVA=0.000);(2)Analysis of objective visual quality:MIOL group had a lower OV20%= and OV9% than SIOL group(FOV20%==8.096,POV20%==0.005;FOV9%=16.738,POV9%=0.000).Three months after surgery, SR and OSI in both groups was better than the result 1 week after surgery(P=0.022;P=0.002;P=0.039;P=0.032).Three months after cut off, MTF in SIOL group was better than it of 1 week after surgery(P=0.013);(3)NEI-VFQ-25 questionnaire: The MIOL group was superior to the SIOL group in terms of overall visual and close-motion scores at 3 months after operation(t=-3.475,P=0.001;t=-9.419,P=0.000);(4)Adverse effects: One case(2 eyes)in the MIOL group had night glare and halo, but there was no special visual symptom in the single focus group. No significant difference showed between the two groups. CONCLUSIONS Implantation of single-focus aspheric intraocular lens and diffractive refractive bifocal aspheric intraocular lens could effectively improve the objective visual quality of patients with age-related cataract.