多焦点与单焦点人工晶状体植入术后视觉质量的临床研究

Clinical investigation on visual quality after apodized diffractive multifocal intraocular lens and monofocal intraocular lens implantation

目的:评价多焦点人工晶状体与单焦点人工晶状体植入术后患者的视觉质量。方法:前瞻性研究2018年11月至2019年10月在山西省眼科医院就诊的年龄相关性白内障62例(102只眼),患者随机分为两组:多焦点组,40例(66只眼),植入SN6AD1阶梯渐进性衍射非球面多焦点人工晶状体;单焦点组,22例(36只眼),植入SN60WF非球面单焦点人工晶状体。术后随访3个月,观察两组视力及视觉质量。结果:术后1周、1个月及3个月多焦点组裸眼近视力均显著优于单焦点组( t=9.302,11.886,11.494;P均<0.05);单焦点组客观视觉质量参数目标散射指数显著低于多焦点组,调制传递函数截止频率、Strehl比值、9%对比度下的视力均显著高于多焦点组,差异有统计学意义( P<0.05)。 结论:阶梯渐进性多焦点IOL能够为患者提供更好的裸眼近视力,而非球面单焦点IOL在术后视觉质量方面表现出较早的稳定性及更好的优越性。

Objective To evaluate the postoperative visual quality after aspheric apodized diffractive multifocal intraocular lens and aspheric monofocal intraocular lens implantation.Methods In this prospective study,a total of 102 eyes of 62 patients with age-related cataract who underwent phacoemulsification in Shanxi Eye Hospital from Nov.2018 to Oct.2019 were included.All cases were randomly divided into two groups:66 eyes of 40 patients implanted with SN6AD1 in multifocal intraocular lens group and 36 eyes of 22 patients implanted with SN60WF in aspheric monofocal intraocular lens group.The visual acuity and indexes of visual quality of the two groups were observed.The follow-up time was 3 months after cataract surgery.Results The uncorrected near visual acuity of the SN6AD1 group were significantly better at 1 week,1 month and 3 months postoperatively than those of the SN60WF group at the same time points(t=9.302,11.886,11.494;all P<0.01).The objective scatter index(OSI)in the SN6AD1 group was higher than that in the SN60WF group at each observation time points.And the modulation transfer function cutoff frequency(MTF cutoff),Strehl ratio(SR),objective vision at contrasts 9%(OV9%)were lower in the SN6AD1 group.Conclusion Apodized diffractive multifocal IOL can provide better near visual acuity,but aspheric monofocal IOL shows early stability and better superiority in postoperative objective visual quality.