非球面衍射型多焦点人工晶状体植入术后视觉质量评价

目的 评价非球面多焦点人工晶状体(AcrySof IQ ReSTOR IOL SN6AD3)植入术后的视觉质量.方法 对植入非球面多焦点人工晶状体的老年性白内障患者30例(35只眼)(试验组)与植入球面多焦点人工晶状体(AcrySof ReSTOR 10L SN60D3)患者40例(56只眼)(对照组)进行对比研究.观察患者的术后视力(远视力,70 cm中距视力,近视力)、焦点深度、高阶像差、对比敏感度和眩光敏感度,问卷形式调查视觉不良症状及满意度.结果 术后3个月裸眼近、远、中间视力≥0.5者,试验组分别为80%(20/35)、82.9%(29/35)、45.7%(16/35),对照组分别为76.8%(43/56)、80.4%(45/56)、39.3%(22/56),两组比较差异无统计学意义(P＞0.05);术后3个月最佳矫正远视力下近、远、中间视力≥0.5者,试验组分别为88.6%(31/35)、91.4%(32/35)、54.3%(19/35),对照组分别为81.5%(49/56)、91.1%(51/56)、42.9%(24/56),两组比较差异无统计学意义(P＜0.05).术后3个月试验组各频段对比敏感度和眩光敏感度高于对照组,差异有统计学意义(P＜0.05).在+1.00～-1.00D,-1.50D和-2.50～-3.50D调节范围内,视力≥0.5者试验组分别为94.3%(33/35)、97.1%(34/35)、85.7%(30/35),对照组分别92.9%(52/56)、94.6%(53/56)、83.9%(47/56),两组比较差异无统计学意义(P＞0.05).高阶像差Zemike常数项中两组的Z(4,0)、Z(4,2)、S3+S4和S总系数差异有统计学意义(P＜0.05),其余的Zernike常数项、三阶像差和四阶像差各指标间两组比较差异无统计学意义(P＞0.05).两组均无严重眩光症状,对照组有3眼诉有光晕症状,试验组仅有1眼诉有光晕症状,满意程度较高.结论 AcrySof IQ ReSTOR非球面多焦点人工晶状体可为患者提供良好的近、中、远全程视力,该人工晶状体具有产生负球差的非球面设计,可平衡角膜的正球差,从而降低了术后总体像差,提高了术眼对比敏感度和眩光敏感度,全面改善患者的视觉质量.

Evaluating visual quality of an aspheric multifocal intraocular lens

Objective To evaluate visual quality of patients implanted with the AcrySof IQ ReSTOR~(R) muhifocal aspheric intraocular lens.Method Retrospective study of patients who had implantation of an AcrySof IQ ReSTOR SN6AD3 IOL(Group test)or an AcrySof ReSTOR SN60D3 IOL(Group control).Group test comprised 30 patients(35 eyes)and Group control,40 patients(56 eyes).Three months postoperatively,uncorrected and best corrected distance visual acuity,uncorrected and best corrected near visual acuity,best corrected intermediate visual acuity,the focus depth,higher order aberration,contrast sensitivity and glare sensitivity were measured in both IOL groups.Patients were orally administered a visual function questionnaire including questions about glare,halos,and other visual discomfort.Results The percentage of patients with uncorrected near,far and intermediate visual acuity ≥0.5 in test group was 80% (20/35),82.9%(29/35)and 45.7%(16/35)respectively,and that of the control group was 76.8%(43/56),80.4%(45/56)and 39.3%(22/56)respectively.There was no statistical difference of uncorrected visual acuity between two groups(P ＞ 0.05).When compare the best distance corrected near,far and intermediate visual acuity between two groups,we can get the same results(P ＞ 0.05).The contrast sensitivity and glare sensitivity in all frequency sect of group test have been more obviously improved postoperatively than that of group control(P ＜0.05).The Z(4,0),Z(4,2),S3+S4 and total S of Zemike coefficients was statistically different(P ＜0.05).The other Zemike coefficients and higher order aberration did not differ significantly between the two groups(P ＞ 0.05).There were no statistical difference between two groups in focus depth(P ＞ 0.05).Both groups had no serious glare.Though three eyes felt discomfort of halos in group control,only one eye felt the same phenomenon in group test.Conclusion AcrySof IQ ReSTOR SN6AD3 intraocular lens has negative spherical aberration by an aspherieal design in front surface,which makes it could counteract the positive spherical aberration of cornea.Consequently,IQ ReSTOR IOL gave good high-contrast visual acuity at distance,near and intermediate visual acuity.