不同种类人工晶状体植入术后患者的客观视觉质量及视觉相关生活质量的对比研究

Comparison of objective visual quality and vision-related living quality after the implantation of different kinds of intraocular lenses

目的比较不同种类的人工晶状体(IOL)植入术后患者的客观视觉质量及视觉相关生活质量。方法采用非随机对照研究设计,收集2020年7月至2021年12月在天津市眼科医院进行超声乳化白内障吸除联合IOL植入术的年龄相关性白内障患者85例(136眼),其中,双焦点IOL组23例(34眼),景深延长型IOL组21例(33眼),三焦点IOL组17例(30眼),单焦点IOL组24例(39眼)。测量四组患者术后1 d、1周、1个月和3个月裸眼远、中、近视力及矫正远、中、近视力,并绘制四组患者IOL离焦曲线,同时问卷调查四组患者的视觉满意度及脱镜率。结果同一时间点,四组患者术后裸眼远视力及术后矫正远视力差异均无统计学意义(均为P>0.05)。同一时间点,四组患者术后裸眼中视力、裸眼近视力差异均有统计学意义(均为P<0.05)景深延长型IOL组和三焦点IOL组患者术后裸眼中视力均优于双焦点IOL组和单焦点IOL组(均为P<0.05),单焦点IOL组与双焦点、三焦点以及景深延长型IOL组患者术后裸眼近视力差异均有统计学意义(均为P<0.05);景深延长型IOL组与双焦点和三焦点IOL组患者术后裸眼近视力差异均有统计学意义(均为P<0.05)。单焦点和景深延长型IOL组患者术后视觉干扰情况少于双焦点和三焦点IOL组,双焦点和三焦点IOL组患者术后眼部不适症状均少于单焦点和景深延长型IOL组,景深延长型IOL组患者术后眼部不适症状少于单焦点IOL组,双焦点、三焦点和景深延长型IOL组患者术后视力主观感受优于、配戴老视眼镜情况均少于单焦点IOL组,差异均有统计学意义(均为P<0.05)。结论植入双焦点、三焦点、景深延长型IOL均能有效地提高患者术后的全程视力,植入三焦点IOL和双焦点IOL术后部分患者存在轻度视觉不良现象。

Objective To evaluate the objective visual quality and vision-related living quality after the implantation of different kinds of intraocular lenses(IOL)in patients.Methods This non-randomized controlled study enrolled 85 age-related cataract patients(136 eyes)undergoing phacoemulsification combined with IOL implantation in Tianjin Eye Hospital from July 2020 to December 2021.Among them,23 patients(34 eyes)were implanted with bifocal IOL,21 patients(33 eyes)with extended depth-of-focus(EDOF)IOL,17 patients(30 eyes)with trifocal IOL,and 24 patients(39 eyes)with monofocal IOL.Their uncorrected visual acuity(UCVA)and best corrected visual acuity(BCVA)at far,intermediate and near distances were measured at one day,one week,one month,and three months postoperatively.IOL defocus curves of four groups were drawn.A questionnaire was made to survey patients’visual satisfaction and off-glass rate.Results There were no statistically significant differences in postoperative UCVA and BCVA at far distances among the four groups at the same time point(all P>0.05),but there were statistically significant differences in postoperative UCVA at intermediate and near distances among the four groups at the same time point(all P<0.05).Postoperative UCVA at intermediate distances of patients with EDOF and trifocal IOL was better than that of patients with bifocal and monofocal IOL(all P<0.05).There were statistically significant differences in postoperative UCVA at near distances between patients with monofocal and bifocal IOL,monofocal and trifocal IOL,monofocal and EDOF IOL(all P<0.05).There were also statistically significant differences in postoperative UCVA at near distances between patients with EDOF and bifocal IOL,EDOF and trifocal IOL(both P<0.05).The postoperative visual interference in patients with monofocal and EDOF IOL was less than that in patients with bifocal and trifocal IOL(P<0.05).The postoperative eye symptoms in patients with bifocal and trifocal IOL were less than those in patients with monofocal and EDOF IOL,and meanwhile,the postoperative eye symptoms in patients with EDOF IOL were less than those in patients with monofocal IOL(all P<0.05).The postoperative vision and off-glass rate of patients with bifocal,trifocal and EDOF IOL were better than those of patients with monofocal IOL(all P<0.05).Conclusion Implantation of bifocal,trifocal and EDOF IOL can effectively improve the postoperative visual acuity of patients,except that mild visual discomfort may occur in some patients with trifocal and bifocal IOL.