“微单视”方案植入连续视程人工晶体对老年性白内障患者视觉质量的影响

Impact of the"micro-monovision"approach with extended depth of focus intraocular lenses implantation on visual quality in elderly patients with senile cataracts

目的探讨“微单视”方案植入连续视程(EDOF)人工晶体对老年性白内障患者视觉质量的影响。方法回顾性分析2020年1月—2023年12月收治的老年性白内障患者的临床资料。随机选取46例植入三焦点人工晶状体的患者纳入三焦点组,选取53例行“微单视”方案植入EDOF人工晶体治疗的患者纳入EDOF组。记录术前及术后3个月2组的双眼视力[裸眼远距离视力(UCDVA)、裸眼中距离视力(UCIVA)、裸眼近距离视力(UCNVA)]、视觉质量[视功能指数量表(VF-14)]。记录术后3个月2组的离焦情况、对比敏感度值(CS)、脱镜情况。结果术后3个月,2组患者UCDVA、UCIVA、UCNVA、VF-14评分高于术前,且EDOF组UCIVA、UCNV和VF-14评分高于三焦点组,差异有统计学意义(P<0.05)。术后3个月,2组患者在屈光度-4.00~2.00 D的视力均高于0.35,EDOF组在-1.50~1.50 D的视力均高于0.9,-2.50~-1.50 D的视力高于0.8;在0.50~2.00 D屈光度内,EDOF组视力高于三焦点组,且在-2.00~1.00 D区间内EDOF组视力较为平稳。在明视、暗视环境下,于不同空间频率(3、6、12、18周/度)时,EDOF组CS高于三焦点组,差异有统计学意义(P<0.05)。结论在老年性白内障患者中,“微单视”方案植入EDOF人工晶状体相较于三焦点人工晶状体,在视觉质量和中、近视力方面表现更优。

Objective To investigate the impact of the"micro-monovision"approach with extended depth of focus(EDOF)intraocular lens on visual quality in elderly patients with senile cataracts.Methods A retrospective analysis was conducted on the clinical data of elderly patients with senile cataracts treated from January 2020 to December 2023.Forty-six patients who received trifocal intraocular lens were randomly selected and included in trifocal group,while 53 patients who underwent the"micro-monovision"approach with EDOF intraocular lens were included in EDOF group.Preoperative and 3-month postoperative uncorrected distance visual acuity(UCDVA),uncorrected intermediate visual acuity(UCIVA),uncorrected near visual acuity(UCNVA)and visual function index(VF-14)scores were recorded for both groups.Defocus,contrast sensitivity(CS)and spectacle independence were also evaluated at 3 months postoperatively.Results At 3 months postoperatively,both groups showed significantly higher UCDVA,UCIVA,UCNVA and VF-14 scores compared to preoperative levels;the UCIVA,UCNVA and VF-14 scores in the EDOF group were significantly higher than those in the trifocal group(P<0.05).At 3 months postoperatively,both groups achieved visual acuity greater than 0.35 at refractive errors from-4.0 D to+2.0 D.The EDOF group achieved visual acuity greater than 0.9 at refractive errors from-1.5 D to+1.5 D,and greater than 0.8 at refractive errors from-2.5 D to-1.5 D.Within the refractive range of 0.5 D to+2.0 D,the EDOF group had better visual acuity than the trifocal group,with more stable visual acuityin the range of-2.0 D to 1.0 D.Under photopic and mesopic conditions,the EDOF group demonstrated significantly higher CS values at different spatial frequencies(3,6,12,18 degree per week)compared to the trifocal group(P<0.05).Conclusion In elderly patients with senile cataracts,the"micro-monovision"approach with EDOF intraocular lens implantation provides superior visual quality andintermediate and near vision compared to trifocal intraocular lens.