两种不同附加度数的多焦点人工晶状体植入术后视觉质量对比研究

目的评价两种具有不同附加度数的AcrySof ReSTOR人工晶状体(SN60D3和SN6AD1)植入术后的视觉质量。方法收集2009年4月至2010年3月在北京同仁医院就诊的白内障患者共69例(80眼),随机植入多焦点人工晶状体AcrySofRe-STORSN60D3(+4D组)35例(40眼)和SN6AD1(+3D组)34例(40眼)。入选患者分别在超声乳化术后植入AcrySofRe-STOR多焦点人工晶状体SN60D3或SN6AD1,观察术后1个月和3个月裸眼远视力(5m)、裸眼近视力(33cm)、裸眼中间视力(40cm、63cm、100cm);术后3个月拟调节力、对比敏感度和眩光敏感度;问卷调查患者术后不良视觉症状的发生率和脱镜率。结果 +3D组裸眼中间视力(63cm)在术后1个月时为0.70±0.27、术后3个月时为0.72±0.15,明显优于+4D组0.43±0.14、0.45±0.14,差异均有统计学意义(均为P<0.05),而术后1个月、3个月裸眼远视力(5m)、裸眼近视力(33cm)、裸眼中间视力(40cm、100cm)差异均无统计学意义(均为P>0.05)。术后3个月+3D组的拟调节力为(5.45±0.56)D,优于+4D组的(4.90±0.38)D,差异有统计学意义(均为P<0.05)。2组视角6.3°、4.0°、2.5°、1.0°、0.7°对比敏感度差异均有统计学意义,+3D组优于+4D组(均为P<0.05)。视角6.3°、4.0°、2.5°、1.6°、0.7°眩光敏感度差异均有统计学意义,+3D组优于+4D组(均为P<0.05)。在调查问卷中两组视觉不良症状的发生率、脱镜率差异均无统计学意义(均为P>0.05)。结论两种不同附加度数的AcrySofReSTOR人工晶状体SN60D3和SN6AD1均可以提供良好的远视力、近视力、较高的术后脱镜率,低度数附加的SN6AD1具有更为理想的全程视力和视觉质量。

Visual quality after two types of multifocal intraocular lens implantation with different additional degrees

Objective To evaluate the visual quality after AcrySof ReSTOR multifocal intraocular lens(IOL,SN60D3 and SN6AD1) implantation with different additional degrees.Methods Sixty-nine patients(80 eyes) with cataract underwent phacoemulsification and IOL implantation in Beijing Tongren Hospital from April 2009 to March 2010 were divided into two groups by their type of IOL at random:SN60D3(+4 D) group(35 cases,40 eyes) and SN6AD1(+3 D) group(34 cases,40 eyes).Phacoemulsification combined with the implantation of IOL SN60D3 or SN6AD1 were performed.The uncorrected distant visual acuity(5 m),uncorrected near visual acuity(33 cm),uncorrected intermediate visual acuity(40 cm,63 cm,100 cm) at 1 month and 3 months after surgery were observed,pseudoaccommodation,contrast sensitivity and glare sensitivity at 3 months after surgery were also observed,rate of visual disturbance and spectacle independence by questionnaire were investigated by questionnaire.Results Uncorrected intermediate visual acuity(63 cm) of +3 D group at 1 month and 3 months after surgery were 0.70±0.27 and 0.72±0.15,significantly better than those of +4 D group(0.43±0.14,0.45±0.14),there were statistical differences(both P<0.05),but there was no statistical difference in uncorrected distant visual acuity(5 m),uncorrected near visual acuity(33 cm),uncorrected intermediate visual acuity(40 cm,100 cm) at 1 month and 3 months after surgery between two groups(both P>0.05).The pseudoaccommodation of +3 D group at 3 months after surgery was(5.45±0.56) D,significantly better than +4 D group(4.90±0.38) D,there was statistical difference(P<0.05).The contrast sensitivity under visual angle of 6.3°,4.0°,2.5°,1.0°,0.7° and glare sensitivity under visual angle of 6.3°,4.0°,2.5°,1.6°,0.7° of +3 D group were better than those of +4 D group,there were statistical differences(both P<0.05).There was no significant difference in rate of visual disturbance and spectacle independence between two groups(both P>0.05).Conclusion Both SN60D3 and SN6AD1 can provide good distant,intermediate,near visual acuity and high rate of spectacle independence.SN6AD1 can provide better whole range visual acuity and quality.