三焦点人工晶状体与区域折射人工晶状体植入术视觉质量对比

Comparison of visual quality between implantations of trifocal intraocular lens and regional refractive intraocular lens

目的比较三焦点人工晶状体(IOL)与区域折射IOL植入术的视觉质量。方法回顾性分析郑州大学第一附属医院2018年9月至2020年11月超声乳化术56例(62只眼)的临床资料。患者分为两组:A组植入区域折射IOL 29例(32只眼);B组植入三焦点IOL 27例(30只眼)。随访3个月,比较两组视力、球差、彗差及视功能质量评分。结果术后2周、1个月及3个月:80 cm中距离裸眼视力(logMAR)B组依次为0.00(0.00,0.10)、0.00(-0.03,0.10)及0.00(-0.03,0.10),优于A组的0.20(0.00,0.25)、0.10(0.00,0.25)及0.10(0.00,0.24)(Z=-2.478、-2.332、-2.248,P=0.013、0.020、0.025),两组裸眼远视力、矫正远视力及裸眼近视力差异均无统计学意义(均P>0.05);暗室条件下A组球差大于B组(Z=-2.424、-2.620、-2.550,P=0.015、0.009、0.011),彗差A组大于B组(Z=-2.184、-2.376、-2.325,P=0.029、0.018、0.020)。术后3个月,两组患者问卷调查评分视远、视近、使用电脑、夜间开车、日常生活活动及总分差异均无统计学意义(均P>0.05)。结论与区域折射IOL相比三焦点IOL能提供更好的中距离视力,具有更小的球差和彗差。

Objective To compare the visual quality between implantations of trifocal intraocular lens(IOL)and regional refractive IOL.Methods The clinical data of 62 eyes of 56 cases of phacoemulsification and IOL implantation from Sep.2018 to Nov.2020 in the First Affiliated Hospital of Zhengzhou University were analyzed retrospectively.The patients were divided into two groups:in group A 32 eyes of 29 cases were implanted with regional refractive IOL;in group B 30 eyes of 27 patients were implanted with trifocal IOL.The follow-up time was 3 months after surgery.The visual acuity,spherical aberrations,coma and the visual quality questionnaire scores between the two groups were compared.Results At 2 weeks,1 month and 3 months after surgery,the median of uncorrected intermediate visual acuity(logMAR)at 80cm in group B were 0.00(0.00,0.10),0.00(-0.03,0.10)and 0.00(-0.03,0.10),which were greater than the 0.20(0.00,0.25),0.10(0.00,0.25)and 0.10(0.00,0.24)in group A(Z=-2.478,-2.332,-2.248;P=0.013,0.020,0.025).There was no statistically significant difference in uncorrected distance vision,best corrected distance vision,and uncorrected near vision between the two groups(all P>0.05).The spherical aberrations under dark room conditions of group A were higher than that of group B(Z=-2.424,-2.620,-2.550;P=0.015,0.009,0.011).The coma of group A were higher than that of group B(Z=-2.184,-2.376,-2.325;P=0.029,0.018,0.020).At 3 months after surgery,there was no statistical significance in the questionnaire scores between the two groups in terms of distant visual acuity,near visual acuity,computer use,night driving,daily living activities and total scores(all P>0.05).Conclusion Compared with regional refractive IOL,trifocal IOL can provide better middle distance vision,with smaller spherical aberration and coma.