三种IOL对年龄相关性白内障患者视力和视觉质量的影响

目的:分析植入AT LISA tri 839MP三焦点人工晶状体(IOL)、Lenstec SBL-3区域折射型非球面IOL、CT SPHERIS 209M单焦点IOL对年龄相关性白内障(ARC)患者视力水平及视觉质量的影响。方法:前瞻性临床研究。选择2018-10/2019-04本院拟行手术治疗的ARC患者114例114眼,以随机数字表法分为LISA tri组、SBL组、单焦点组,各38例38眼,分别植入AT LISA tri 839MP三焦点IOL、Lenstec SBL-3区域折射型非球面IOL、CT SPHERIS 209M单焦点IOL。比较术前、术后3mo角膜内皮镜、视力检查及视觉质量。结果:术后3mo三组患者角膜内皮细胞密度(ECD)、中央角膜厚度(CCT)及六角形细胞比例较术前均无差异(P>0.05)。术后3mo三组患者裸眼远视力(UCDVA)、裸眼中距离视力(UCIVA)、裸眼近视力(UCNVA)较术前均显著改善(P<0.001),LISA tri组UCDVA、UCIVA、UCNVA(LogMAR)分别为0.11±0.03、0.17±0.05、0.09±0.02,SBL组为0.12±0.02、0.19±0.05、0.08±0.02,均优于单焦点组(0.21±0.04、0.24±0.07、0.15±0.03)(P<0.05)。术后3mo LISA tri组视近脱镜率、视觉满意度为92%、97%,SBL组为95%、92%,均显著高于单焦点组的66%、68%(P<0.017)。术后3mo三组患者美国国立眼科研究开发的视功能与生存质量(VF-QOL)各类评分较术前均明显升高(P<0.001),LISA tri组、SBL组VF-QOL各类评分均显著高于单焦点组(P<0.05)。结论:ARC患者应用AT LISA tri 839MP三焦点IOL和区域折射型非球面多焦点IOL(SBL-3)植入的治疗效果均优于单焦点IOL,可有效改善视力水平、提高视觉质量。

Influence of three kinds of intraocular lens on vision and visual quality of patients with age-related cataract

AIM: To analyze the influence of trifocal lens(AT LISA tri 839MP), Lenstec SBL-3 intraocular lens(IOL)and T SPHERIS 209M monofocal IOL implantation on vision and visual quality of patients with age-related cataract(ARC).

METHODS: Totally 114 patients(114 eyes)with ARC undergoing elective surgical treatment in the hospital between October 2018 and April 2019 were enrolled in the prospective clinical study. They were divided into LISA tri group, SBL group and monofocal group with 38 cases(38 eyes)in each group. They were treated with trifocal IOL(AT LISA tri 839MP), Lenstec SBL-3 IOL and CT SPHERIS 209M monofocal IOL, respectively. The corneal endothelium, vision and visual quality before operation and 3mo after operation were compared.

RESULTS:Three months after operation, no significant changes in corneal endothelial cell density(ECD), central corneal thickness(CCT)and the proportion of hexagonal cells in the three groups compared with preoperation(P>0.05), while the uncorrected distance visual acuity(UCDVA), uncorrected intermediate visual acuity(UCIVA)and uncorrected near visual acuity(UCNVA)were significantly improved(P<0.001). UCDVA, UCIVA and UCNVA of LISA tri group were(0.11±0.03)LogMAR,(0.17±0.05)and(0.09±0.02), which of SBL group were(0.12±0.02, 0.19±0.05, 0.08±0.02), all significantly better than(0.21±0.04, 0.24±0.07, 0.15±0.03)in monofocal group(P<0.05). 3mo after operation, the near off-glasses rate and visual satisfaction in LISA tri group were 92% and 97%, which in SBL group were 95% and 92%, all significantly higher than 66% and 68% in monofocal group(P<0.017). Compared with preoperation, the visual function and quality of life(VF-QOL)scores of the three groups significantly increased(P<0.001), which were significantly higher in LISA tri group and SBL group than in monofocal group(P<0.05).

CONCLUSION: Trifocal IOL(AT LISA tri-839MP)and Lenstec SBL-3 multifocal IOL implantation is superior to monofocal IOL in the treatment of patients with ARC, which can effectively improve vision and visual quality.