旋转非对称折射型多焦点人工晶状体植入术后早期效果

目的:观察白内障超声乳化联合旋转非对称折射型多焦点人工晶状体(IOL)植入术后患者的早期效果。方法:前瞻性自身前后对照研究。选择2017年1-12月在武汉爱尔眼科医院行白内障超声乳化联合旋转非对称折射型多焦点IOL植入的患者36例(40眼),术后随访3个月。分别观察裸眼远、中、近视力(LogMAR),矫正远视力(LogMAR),术后等效球镜度(SE),离焦曲线,调制传递函数(MTF),眼内高阶像差,并统计患者术后视功能指数量表评分及脱镜率。数据采用配对t检验和非参数Wilcoxon配对秩和检验。结果:术后3个月裸眼远、中、近视力及矫正远视力均较术前增加(P<0.05),72%裸眼远视力优于0.1,98%矫正远视力优于0.1;88%术后SE在±1.0D以内;离焦曲线在0.0D及-2.5D具有峰值,+1.0^-4.0D屈光范围内视力均优于0.25。术后3mm瞳孔直径下MTF数值均较术前提高(P<0.05),眼内总像差、垂直彗差及垂直三叶草较术前增加(P<0.05)。患者术后3个月视功能指数量表得分为1.0(0.0,2.0)。92%的患者看远、看近均可完全脱镜。结论:非对称区域折射型多焦点IOL能提供令人满意的远、近视力,亦能保持较大范围的中距离视力,患者术后具有较好的视觉质量及较高的生活质量。

Surgical Effect after Refractive Rotationally Asymmetric Multifocal Intraocular Lens Implantation

Objective: To observe the early effect of phacoemulsification cataract surgery with the implantation of a refractive rotationally asymmetric multifocal intraocular lens (IOL). Methods: This was a self-controlled, before-after trial in which 36 patients (40 eyes) underwent phacoemulsification cataract surgery combined with the refractive rotationally asymmetric multifocal IOL implantation in Wuhan Aier Eye Hospital from January to December 2017. Uncorrected distance visual acuity (UDVA, LogMAR), uncorrected intermediate visual acuity (UIVA, LogMAR), uncorrected near visual acuity (UNVA, LogMAR) and corrected distance visual acuity (CDVA, LogMAR), postoperative spherical equivalent (SE), defocus curve and modulation transfer function (MTF), intraocular high-order aberrations, visual function index of lifequality and the rate of spectacle independence were evaluated 3 months postoperatively. Paired t-tests and non-parameter Wilcoxon pairing rank were used to analyze the data. Results: At 3 months postoperatively, there was a significant improvement in UDVA, CDVA, UIVA and UNVA (P<0.05), 72% of postoperative UDVA was better than 0.1, 98% of postoperative CDVA was better than 0.1; 35 eyes (88%) were within ±1.00 diopter (D) of emmetropia. The defocus curve showed two peaks of maximum visual acuity (0 and -2.5 D of defocus) and the visual acuity of +1.0 D--4.0 D defocus was better than 0.25. With 3 mm pupil diameters, the MTF improved significantly compared to preoperative levels (P<0.05); improvement in total intraocular aberrations, vertical coma and vertical trefoil was observed (P<0.05). The median score of the Chinese version of the visual function index-12 (VF-12-CN) was 1.0 (0.0, 2.0) at 3 months. 92% of the patients were completely independent of spectacles for far and near vision. Conclusions: The refractive rotationally asymmetric multifocal intraocular IOL provides satisfying visual acuity for far and near with a good range of intermediate vision. Patients have good visual quality and high quality of life.