两种非球面衍射多焦点人工晶状体植入术后视觉质量评价

目的:综合评价非球面AcrySof ReSTOR+4D和非球面AcrySof ReSTOR+3D两种多焦点IOL植入术后患者的视觉质量,并探讨其相关影响因素。方法:白内障患者40例80眼,随机分为两组。A组:非球面AcrySof ReSTOR+3D(SN6AD1)IOL植入组;B组:非球面AcrySof ReSTOR+4D(SN6AD3)IOL植入组,其中A组为实验组,B组为对照组。术后1d;1wk;1,3mo行常规检查,并检查术眼裸眼远(UCDVA)、中(UCIVA)、近视力(UCNVA)。术后3mo检查最佳矫正远(BCDVA)、近视力(BCNVA),以及最佳矫正远视力下的近(DCNVA)、中视力(DCIVA);检查对比敏感度及波前像差;绘制离焦曲线,并进行主观问卷调查评分。结果:术后1d;1wk;1,3mo,两组的UCDVA差异均无统计学意义(P>0.05),UCIVA的差异均有统计学意义(P<0.05)。UCNVA在术后第1d,两组间的差异有统计学意义(P<0.05),而在其余时间段,两组间差异无统计学意义(P>0.05)。术后3mo时,两组的BCDVA,BCNVA,DCNVA,DCIVA差异均无统计学意义(P>0.05);两组间总像差、高阶像差、球差间,差异无统计学意义(P>0.05);在各个视角水平有/无眩光下,对比敏感度差异无统计学意义(P>0.05)。离焦曲线显示:B组在+0.0D和-3.0D处形成两个焦点,而A组不仅在+0.0D和-2.5D处形成两个焦点,而且在-2.0～-2.5D之间可形成一个平台期。问卷调查显示:两组患者视远、视近的满意度较高;而视中距离时,A组患者满意度明显高于B组。两组患者术后视觉不良症状发生率,差异无统计学意义(t=-0.87,P>0.05)。结论:非球面AcrySof ReSTOR+3D IOL植入术后,为患者提供了良好的远、中、近全程视力,尤其是中距离视力较非球面AcrySof ReSTOR+4D IOL有了显著的改善,且没有明显的视觉干扰,提高了患者的视觉和生活质量。

Clinical visual quality study after implantation of two kinds of AcrySof ReSTOR aspherical IOL

AIM: To evaluate the clinical visual quality after implantation of two kinds of AcrySof ReSTOR aspherical intraocular lens(IOL), and also to analyze the relative factors.

METHODS: Forty patients with cataract(80 eyes)were divided into two groups: Group A(20 patients, 40 eyes): implanted with AcrySof ReSTOR+3D(SN6AD1); Group B(20 patients, 40 eyes): implanted with AcrySof ReSTOR+4D(SN6AD3). Uncorrected distance visual acuity(UCDVA), uncorrected intermediate visual acuity(UCIVA), uncorrected near visual acuity(UCNVA)were observed at 1 day, 1 week, 1 month, 3 month postoperatively. BCDVA, BCNVA, DCNVA, DCIVA, aberration, contrast sensitivity were examined at 3 month postoperatively. Binocular defocus curve-a full range of vision also were examined at 3 month postoperatively.

RESULTS: All of the eyes had best UCDVA, but, group A showed statistical superiority in UCIVA at 1 day, 1 week, 1 month and 3 month(P<0.05). It showed no statistical difference in UCNVA at 1 week, 1 month and 3 month, but except 1 day after surgery. Both two groups showed no statistical difference in BCDVA, BCNVA, DCNVA, DCIVA, aberration and contrast sensitivity at 3 month postoperatively(P>0.05). Binocular defocus curve-a full range of vision showed that group A had two focuses at +0.0D and -3.0D, but, besides the two focus:+0.0D and -2.5D, group B also had a platform level from -2.0D to -2.5D. Questionnaire showed that both of two groups had no obviously visual disturbance(t=-0.87, P>0.05). But, aspherical AcrySof ReSTOR+3D IOL showed more superior vision performance in intermediate vision.

CONCLUSION: The aspherical AcrySof ReSTOR+3D IOL can provide patients with excellent outcomes in distant, intermediate and near vision. Compared with aspherical AcrySof ReSTOR+4D, it shows more superior vision performance in intermediate vision, reduces the dependence on spectacles and improves the quality-of-life.