TECNIS symfnoy连续视程人工晶体在白内障手术中的应用

Application of Continuous Vision Intraocular Lens TECNIS Symfnoy in Cataract Surgery

目的:通过比较植入不同人工晶体的白内障患者术前与术后视觉质量的差异,探究TECNIS symfnoy连续视程人工晶体在白内障手术中的应用前景。方法:选择2018年1月—2020年1月黑龙江省眼科医院收治的90例单纯老年性白内障患者作为研究对象,30例患者植入强生公司的TECNIS symfnoy连续视程人工晶体,30例患者植入眼力健公司的ZMB00衍射双焦点人工晶体,30例患者植入眼力健公司的ZCB00单焦非球面人工晶体,于术后1周、1个月和3个月分别记录三组患者的裸眼远、近视力,最佳矫正远、近视力。术后3个月时采用KR-1W视觉质量分析仪观察三组患者3 mm及5 mm瞳孔在最佳矫正视力下的5、10、15、20、25、30 c/d 6种空间频率下的调制传递函数(MTF)。测量三组患者在明光、暗光、炫光状态下的对比敏感度(CS)。对数据进行单因素方差分析及多重比较。结果:各组术后早期远视力未见明显差异,但是在术后早期近视力比较中,TECNIS symfnoy组及ZMB00组明显优于ZCB00组,差异有统计学意义(P<0.05);在3 mm瞳孔和5 mm瞳孔时各空间频率MTF显示,ZMB00组低于TECNIS symfnoy组及ZCB00组,差异有统计学意义(P<0.05),5mm瞳孔时高空间频率TECNIS symfnoy组低于ZCB00组,差异有统计学意义(P<0.05);昼视及夜视状态下,各空间频率的CS比较中,ZMB00组明显低于TECNIS symfnoy组及ZCB00组,差异有统计学意义(P<0.05),虽然TECNIS symfnoy组稍低于ZCB00组,差异无统计学意义(P>0.05)。结论:TECNIS symfnoy连续视程人工晶体能够提供令人满意的近视力及远视力,并且具有较好的视觉质量,能提供令人满意的术后视功能和生活质量;ZMB00双焦人工晶体可提供较好的远视力及近视力,但是视觉质量不如单焦非球面晶体;ZCB00单焦非球面晶体术后视觉质量明显高于多焦人工晶体,但是无法满足患者视近需求。

Objective: By comparing the preoperative and postoperative visual quality of cataract patients implanted with different IOL, to explore the application prospect of continuous range intraocular lens(TECNIS Symfnoy) in cataract surgery. Methods:90 patients with simple senile cataract were selected as the research objects. 30 cases were implanted with Johnson & Johnson’s TECNIS symfnoy continuous vision intraocular lens, 30 cases were implanted with Allergan’s ZMB00 diffractive bifocal intraocular lens, and 30 cases were implanted with Allergan’s ZCB00 monofocal aspheric intraocular lens. The uncorrected distance and near visual acuity and the best corrected distance and near visual acuity of the three groups of patients were recorded at 1 week, 1month, and 3 months after the operation. 3 months after operation, KR-1W visual quality analyzer was used to observe the modulation transmission function(MTF) of 3 mm and 5 mm pupils in the two groups under the best corrected visual acuity at 5, 10, 15,20, 25, 30 c/d spatial frequencies. The contrast sensitivity(CS) of the three groups of patients under bright light, dark light and glare was measured. One-way ANOVA and multiple comparisons were performed on the data. Results: There was no significant difference in early postoperative distance vision between the groups, but in the comparison of early postoperative near visual acuity,the TECNIS symfnoy group and the ZMB00 group were significantly better than the ZCB00 group, and the difference was statistically significant(P<0.05). The MTF of each spatial frequency at 3 mm pupil and 5 mm pupil showed that the ZMB00 group was lower than the TECNIS symfnoy group and the ZCB00 group, and the difference was statistically significant(P<0.05). At 5 mm pupil,the high spatial frequency TECNIS symfnoy group was lower than the ZCB00 group, and the difference was statistically significant(P<0.05). Under the condition of day vision and night vision, in the CS comparison of each spatial frequency, the ZMB00 group was significantly lower than the TECNIS symfnoy group and the ZCB00 group, and the difference was statistically significant(P<0.05). The TECNIS symfnoy group was slightly lower than the ZCB00 group, but the difference was not statistically significant(P>0.05). Conclusion: TECNIS Symfnoy can provide satisfactory near and far vision, and has good visual quality, can provide satisfactory visual function and quality of life. ZMB00 can provide better far and near visual acuity, but the visual quality is inferior to that of single focal aspheric lens. The visual quality of ZCB00 is significantly higher than that of other IOL, but it cannot meet the needs of near visual acuity.