三焦点人工晶状体与双焦点人工晶状体植入术后视力及视觉质量的对比

目的:比较三焦点人工晶状体(IOL) (Zeiss 839)及双焦点IOL(Zeiss 809)植入术后视力及视觉质量。方法:回顾性研究。选取2017年8月至2019年1月中国中医科学院眼科医院行白内障手术患者54例(83眼)。其中植入三焦点Zeiss 839 IOL(839组)28例(42眼),植入双焦点Zeiss 809 IOL(809组)26例(41眼)。对比2组术后1周、1个月、3个月裸眼视力,客观视觉质量分析仪分析客观散射指数(OSI)、传递函数截止频率(MTF cutoff)、斯特列尔比值(SR)、模拟对比度视力(PVA100%、PVA20%、PVA9%),术后3个月离焦曲线及进行问卷调查。数据采用配对样本 t检验及重复测量方差分析。 结果:术后1、3个月839组裸眼远视力优于809组,术后各观察时间中距离视力优于809组,差异均有统计学意义( P<0.05),术后裸眼近视力2组差异无统计学意义。术后2组OSI、MTF cutoff、SR、PVA100%、PVA20%、PVA9%差异均无统计学意义。离焦曲线示839组波形较平稳且在-3^-1 D范围内居于高位。术后3个月839组与809组眩光发生率、明暗视觉适应力、脱镜率、满意度分别为2%和7%、93%和88%、98%和78%、90%和85%。 结论:Zeiss 839 IOL和Zeiss 809 IOL均具有较好的远、近视力及视觉质量,Zeiss 839具有出色的中距离视力、高脱镜率及更佳的满意度。

Comparison of Visual Acuity and Visual Quality between Trifocal Intraocular Lens and Bifocal Intraocular Lens Implantation

Objective: To analyze visual acuity and visual quality after implantation of Zeiss 839 and Zeiss 809. Methods: In this retrospective study, a total of 54 patients (83 eyes) who underwent phacoemulsification were reviewed from August 2017 to January 2019. Twenty-eight patients (42 eyes) were implanted with Zeiss 839 trifocal lenses (839 group), and 26 patients (41 eyes) were implanted with Zeiss 809 bifocal lenses (809 group). Uncorrected visual acuity as well as visual quality were analyzed by the OQAS at 1 week, 1 month and 3 months postoperatively, and the defocus curve and the results of the questionnaire survey at 3 months postoperatively were compared between the two groups. A Paired-sample t test and repeated measures analysis of variance were used to analyze the data. Results: The 839 group had better distance uncorrected visual acuity (UCVA) 1 month and 3 months postoperatively, and better intermediate UIVA at each observation time point than the 809 group (both P<0.05). The OSI, MTF cutoff, SR, PVA100%, PVA20% and PVA9% were not significantly different between the 839 group and 809 group postoperatively. The defocus curve showed that the wave form of the 839 group was more stable and higher in the range of -3 to -1 D. The incidence of glare, light and dark visual adaptation, independent spectacle ratio and satisfaction in the 839 group and 809 group were 2% vs. 7%, 93% vs. 88%, 98% vs. 78%, 90% vs. 85%, respectively. Conclusions: The trifocal IOL and bifocal IOL have excellent uncorrected near and distance vision and superior visual quality. Zeiss 839 has excellent middle distance vision, a higher independent spectacle ratio and better satisfaction.