三焦点与双焦点人工晶体植入术后视觉质量的1年随访研究

Clinical outcomes of bifocal and trifocal intraocular lens during a 1-year follow-up

目的:对比分析三焦点人工晶体(intraocular lens,IOL)植入与双焦点IOL植入术后12个月患者视觉相关生活质量。方法:回顾性收集2019年1月—2021年11月在宜兴市人民医院行白内障超声乳化摘除联合IOL植入的患者40例40眼,按植入不同IOL分为两组,其中植入AT LISA tri 839MP IOL的20例20眼纳入观察组;植入AT LISA 809M IOL的20例20眼纳入对照组。术后12个月检测两组患者远、中、近视力情况,绘制IOL离焦曲线,测试不同空间频率下的对比敏感度,问卷调查眼镜依赖程度和视觉满意度,并通过美国国家眼科学会视功能问卷(National Eye Institute Visual Function Questionnaire 25,NEI-VFQ-25量表)评价视觉相关生活质量。结果:术后12个月,两组患者裸眼远视力、矫正远视力、裸眼近视力、矫正远视力下近视力和对比敏感度差异均无统计学意义(均P>0.05);观察组裸眼中视力、矫正远视力下中视力明显优于对照组(P<0.05),且离焦曲线中间焦段下降平缓;观察组视中活动区眼镜依赖程度、满意度及NEI-VFQ-25量表评分均优于对照组(均P<0.05)。结论:双焦点及三焦点IOL可以为患者长期提供良好稳定的全程视力康复。三焦点IOL植入患者中距离视力更佳,术后视觉相关生活质量更高。

Objective:To evaluate and compare the clinical outcomes of bifocal and trifocal intraocular lens(IOL)in patients at 12 months after implantation.Methods:Retrospective collection of 40 cataract patients(40 eyes)who were treated in Yixing People′s Hospital from January 2019 to November 2021 were divided into two groups according to different types of IOL,20 patients(20 eyes)in the observation group were treated with AT LISA tri 839MP IOL implantation,20 patients(20 eyes)in the control group were treated with AT LISA 809M IOL implantation.Examinations including distance,intermediate and near visual acuity,defocus curves,contrast sensitivity values for different spatial frequencies,spectacle independence,overall satisfaction and National Eye Institute Visual Function Questionnaire 25(NEI-VFQ-25)were measured at 12 months postoperatively.Results:No statistically significant differences between groups were found in uncorrected distant visual acuity,corrected distance visual acuity,uncorrected near visual acuity,distance corrected near visual acuity and contrast sensitivity values(all P>0.05);uncorrected intermediate visual acuity and distance corrected intermediate visual acuity in observation group was significantly higher than that in control group(P<0.05),and the middle focal segment of the defocus curve declined more gently;the observation group was better than the control group in the degree of spectacle independence,overall satisfaction and NEI-VFQ-25 score(P<0.05).Conclusions:Bifocal and trifocal IOLs are able to provide effective and stable visual restoration after cataract surgery in the long term,while the trifocal IOL can achieve improved intermediate visual acuity and vision-related quality of life.