| 非球面多焦点散光矫正型人工晶状体植入术后患者的视觉质量 |
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| 引用本文： | 谭亮章,张红,田芳,穆劲卫. 非球面多焦点散光矫正型人工晶状体植入术后患者的视觉质量[J]. 眼科新进展, 2015, 0(9): 861-865. DOI: 10.13389/j.cnki.rao.2015.0235 |
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| 作者姓名： | 谭亮章 张红 田芳 穆劲卫 |
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| 作者单位： | 300384 天津市，天津医科大学眼科医院 |
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| 摘 要： | 目的 评价非球面多焦点散光矫正型人工晶状体植入术后患者的视觉质量。方法 前瞻性对照研究。选取２０１３年１月至２０１３年１２月在天津医科大学眼科医院行超声乳化白内障吸出术的单纯年龄相关性白内障患者１３０例（１５０眼）分为三组，每组５０眼。其中，术前规则角膜散光０．５～２．５Ｄ患者植入非球面多焦点散光矫正型人工晶状体为试验组（ＡＲＴ组）；术前顺规角膜散光＜１Ｄ，逆规角膜散光＜０．７５Ｄ患者植入非球面多焦点人工晶状体为对照组１（Ｒｅｓｔｏｒ组）；术前规则角膜散光１．０～３．０Ｄ患者植入非球面散光矫正型人工晶状体为对照组２（Ｔｏｒｉｃ组）。术后１ｄ、１周、１个月、３个月用ＯＱＡＳ视觉质量分析仪检查三组患者的ＯＱＡＳ参数、对比敏感度、裸眼远视力、最佳矫正远视力，并进行脱镜率和患者满意度调查，绘制三组患者的离焦曲线；检查ＡＲＴ组和Ｒｅｓｔｏｒ组的最佳近视力、６０ｃｍ中距离视力；检查ＡＲＴ组和Ｔｏｒｉｃ组的轴位旋转度。结果 三组裸眼远视力及最佳矫正远视力差异无统计学意义（Ｆ＝０．６６１，Ｐ＝０．５１８；Ｆ＝０．０１３，Ｐ＝０．９８７）；ＡＲＴ组与Ｒｅｓｔｏｒ组中距离视力及最佳近视力差异均无统计学意义（ｔ＝－０．７９６，Ｐ＝０．４２８；ｔ＝－０．８８５，Ｐ＝０．３７８）；ＯＱＡＳ参数检查发现:三组的客观散射指数、调制传递函数截止频率值、ＯＶ１００％、ＯＶ２０％、ＯＶ９％差异均无统计学意义（均为Ｐ＞０．０５）；三组的斯特列尔比值、对比敏感度结果比较，差异均有统计学意义（均为Ｐ＜０．０５），其中ＡＲＴ组与Ｒｅｓｔｏｒ组差异均无统计学意义（均为Ｐ＞０．０５）；术后３个月轴位旋转度，ＡＲＴ组与Ｔｏｒｉｃ组差异无统计学意义（ｔ＝１．０３６，Ｐ＝０．３０３）；ＡＲＴ组与Ｒｅｓｔｏｒ组脱镜率分别为９０％和８８％，高于Ｔｏｒ-ｉｃ组的１２％，三组均未发现明显视觉干扰现象。结论 非球面多焦点散光矫正型人工晶状体在有效矫正角膜散光的基础上，可以提供一个良好的全程视力，提高了患者脱镜率。
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| 关 键 词： | 人工晶状体 视觉质量 对比敏感度 脱镜率 |
Clinical study of optical quality after aspheric multifocal toric intraocular lens implantation |
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| TAN Liang-Zhang,ZHANG Hong,TIAN Fang,MU Jin-Wei. Clinical study of optical quality after aspheric multifocal toric intraocular lens implantation[J]. Recent Advances in Ophthalmology, 2015, 0(9): 861-865. DOI: 10.13389/j.cnki.rao.2015.0235 |
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| Authors: | TAN Liang-Zhang ZHANG Hong TIAN Fang MU Jin-Wei |
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| Affiliation: | Tianjin Medical University Eye Hospital, Tianjin 300384 , China |
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| Abstract: | Objective To observe the optical quality after aspheric multifocal toric intraocular lens ( IOL) implantation. Methods It was a case-control study. One hundred and fifty eyes of 130 patients underwent phacoemulsification in Tianjin Medical University Eye Hospital from January 2013 to December 2013 were enrolled and divided into three groups , one was of ART IOL with 0. 5 - 2. 5 D corneal regular astigmatism , one was of Restor IOL with below l. 0 D astigmatism with the rule or below 0. 75D astigmatism against the rule , the other was of Toric IOL with l. 0 - 3. 0 D corneal regular astigmatism. The main measurements included optical scattering index ( OSI) , modulation transfer function cutoff ( MTF cutoff) . Strehl ratio , optical quality analysis system values ( OV) .contrast sensitivity , uncorrected distance visual acuity ( UDVA ) . corrected distance visual acuity ( CDVA) , distance corrected near visual acuity ,intermediate visual acuity (60 cm) at postoperative I day,l week,l month.3 months. IOL rotation,defocus measurement and spectacle independence survey were also detected after surgery at postoperative I day , I week, I month , 3 months. Results There was no statistically significant difference in both UDVA and CDVA among groups ( F = 0. 661 ,P = 0. 5 18 ;F = 0. 013 .P = 0. 987 ) . There was no statistically significant difference in the near vision and intermediate visual acuity between ART group and Restor group ( t = - 0. 796 ,P = 0. 428 ; t = - 0. 885 , P = 0. 378 ) . No statistically sigruficant difference was noted among three groups in OSI,MTF cutoff , OVIOO% , OV20% .OVg% ( all P > 0. 05 ) . There were significant differences in Strehl ratio and contrast sensitivity among three groups ( all P < 0. 05 ) .but no statistical sigruficant difference was noted between ART group and Restor group ( all P > 0. 05 ) . There was no significant difference in IOL rotation ART group and Toric group ( t = 1. 036 .P = 0. 303 ) . The percentages of spectacle independence were 90% and 88% in ART group and Restor group , respectively. No significant visual interference problems was noted among three groups. Conclusion On the basis of the effective correction corneal astigmatism,the aspheric multifocal toric IOL implantation can provide a good vision, improve the rate of spectacle independence. |
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| Keywords: | intraocular lens optical quality contrast sensitivity spectacle independence |
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