| 双眼植入多焦点人工晶状体和采用“微单视”方案植入新型连续视程人工晶状体后年龄相关性白内障患者视功能的差异 |
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| 引用本文： | 麦圣龙,邢健强,黄雄高. 双眼植入多焦点人工晶状体和采用“微单视”方案植入新型连续视程人工晶状体后年龄相关性白内障患者视功能的差异[J]. 眼科新进展, 2021, 0(8): 737-740. DOI: 10.13389/j.cnki.rao.2021.0153 |
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| 作者姓名： | 麦圣龙 邢健强 黄雄高 |
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| 作者单位： | 570000 海南省海口市，海南爱尔新希望眼科医院眼科（麦圣龙，邢健强）；570102 海南省海口市，海南医学院第一附属医院眼科（黄雄高） |
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| 摘 要： | 目的 对比分析双眼植入多焦点人工晶状体（MIOL）和采用“微单视”方案植入新型连续视程（EDOF）人工晶状体后年龄相关性白内障患者的视功能差异。方法 该研究为随机对照试验。选取2020年1月至9月于海南爱尔新希望眼科医院就诊的年龄相关性白内障患者100例（200眼）作为研究对象，均接受双眼人工晶状体植入术。采用随机数字表法，将患者随机分入两组:MIOL组和EDOF组，每组各50例（100眼）。MIOL组患者双眼植入衍射型三焦点人工晶状体，EDOF组患者采用“微单视”方案双眼植入EDOF 人工晶状体。术后3个月，复查并对比两组患者的视力（以logMAR表示）、对比敏感度、脱镜率、波前像差、不良视觉现象（跳视感、光晕、眩光、星芒）发生情况。其中视力检查包括单眼及双眼的远视力（5 m）、中视力（60 cm）、近视力（33 cm）。结果 EDOF组患者非主视眼裸眼远视力较其他各眼（EDOF组患者主视眼，MIOL组患者非主视眼、主视眼）高（均为P<0.05）；并且EDOF组主视眼裸眼近视力较其他各眼（EDOF组患者非主视眼，MIOL组患者非主视眼、主视眼）也高（均为P<0.05）。术后3个月，MIOL组实现完全脱镜的患者有46例，脱镜率为92%；EDOF 组完全脱镜的患者有45例，脱镜率为90%，两组患者脱镜率差异无统计学意义（χ2=1.512，P=0.137）。术后3个月，在明视条件下两组患者在各空间频率的对比敏感度差异均无统计学意义（均为P>0.05）；而在暗视条件下，EDOF组患者在各空间频率的对比敏感度均优于MIOL组，差异均有统计学意义（均为P<0.05）。术后3个月，MIOL组患者总高阶像差、彗差、三叶草像差均高于EDOF组，差异均有统计学意义（均为P<0.05）。术后3个月，EDOF组患者各不良视觉现象的发生率均低于MIOL组，差异均有统计学意义（均为P<0.05）。结论 采用“微单视”方案植入EDOF 人工晶状体，可有效解决以往EDOF 人工晶状体植入后年龄相关性白内障患者近视力欠佳的问题。植入EDOF 人工晶状体眼高阶像差和暗视条件下的对比敏感度优于植入MIOL眼，且不良视觉现象发生少于植入MIOL眼。
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| 关 键 词： | 多焦点人工晶状体 新型连续视程人工晶状体 白内障 视功能 |
Comparison between the visual functions of age-related cataract patients after implantation of multifocal intraocular lens and extended depth-of-focus intraocular lens |
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| MAI Shenglong1,XING Jianqiang1,HUANG Xionggao2. Comparison between the visual functions of age-related cataract patients after implantation of multifocal intraocular lens and extended depth-of-focus intraocular lens[J]. Recent Advances in Ophthalmology, 2021, 0(8): 737-740. DOI: 10.13389/j.cnki.rao.2021.0153 |
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| Authors: | MAI Shenglong1 XING Jianqiang1 HUANG Xionggao2 |
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| Affiliation: | 1.Department of Ophthalmology, Hainan New Hope & Aier Ophthalmic Hospital, Haikou 570000, Hainan Province, China2.Department of Ophthalmology, the First Affiliated Hospital of Hainan Medical University, Haikou 570102, Hainan Province, China |
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| Abstract: | Objective To compare the visual function of age-related cataract patients after implantation of multifocal intraocular lens (MIOL) and extended depth-of-focus (EDOF) intraocular lens.Methods This study was a randomized controlled trial. A total of 100 age-related cataract patients (200 eyes) treated in Hainan Aier New Hope Eye Hospital from January to September 2020 were recruited as the research subjects, and all patients had received binocular intraocular lens implantation. The patients were randomly divided into the MIOL group and EDOF group, with 50 patients (100 eyes) in each group. Diffractive trifocal intraocular lenses (IOLs) were implanted in the MIOL group, while EDOF IOLs were implanted in the EDOF group through a micro-monovision surgery. Three months after surgery, the visual acuity (expressed by logMAR), contrast sensitivity, glasses-independent rate, wavefront aberration, and visual complications (saccade, halation, glare, asterism) of patients in the two groups were reexamined and compared. The visual acuity examination included distant visual acuity (5 m), middle visual acuity (60 cm) and near visual acuity (33 cm) of either and both eyes.Results The uncorrected distance visual acuity (UCDVA) of non-dominant eyes in the EDOF group was higher than that of the other eyes (including dominant eyes in the EDOF group, non-dominant eyes and dominant eyes in the MIOL group) (all P<0.05); the uncorrected near visual acuity (UCNVA) of dominant eyes in the EDOF group was higher than that of the other eyes (including non-dominant eyes in the EDOF group, non-dominant eyes and dominant eyes in the MIOL group) (all P<0.05). Three months after surgery, 46 patients in the MIOL group were completely glasses-independent, accounting for 92%, and 45 patients in the EDOF group were completely glasses-independent, accounting for 90%. There was no statistically significant difference in the glasses-independent rate between the two groups (χ2=1.512， P=0.137). Three months after surgery, the contrast sensitivity of the two groups in any spatial frequency under optical conditions showed no statistically significant difference (all P>0.05). However, under scotopic conditions, the contrast sensitivity of the EDOF group was better than that of the MIOL group in all spatial frequencies, with statistical significance (all P<0.05). Three months after surgery, the total high-order aberration (HOA), coma and trefoil aberration in the MIOL group were higher than those in the EDOF group, and the differences were statistically significant (all P<0.05). Three months after surgery, the incidence of adverse visual phenomena in the EDOF group was lower than that in the MIOL group, with the differences being statistically significant (all P<0.05).Conclusion The implantation of EDOF IOLs through the “micro-monovision” surgery can effectively solve the poor near vision of age-related cataract patients caused by the EDOF IOLs. The eyes implanted with EDOF IOLs have lower HOAs, better scotopic contrast sensitivity and fewer adverse visual phenomena than those implanted with MIOLs. |
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| Keywords: | multifocal intraocular lens extended depth-of-focus intraocular lens cataract visual function |
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