渐进衍射型多焦点IOL植入术后视功能和视觉质量的研究

目的：评价渐进衍射型多焦点人工晶状体(multifocal intraocular lens，MIOL)植入术后的临床效果。

方法：采取随机对照临床试验研究方法，将年龄相关性白内障患者72例分为两组，32例32眼植入渐进衍射型MIOL，40例40眼植入单焦点人工晶状体(monofocal intraocular lens， MoIOL)。术后3mo进行裸眼远视力、中间视力、近视力及矫正远、近、中视力及对比敏感度检查，并进行视功能和生存质量问卷调查。

结果：术后3mo，多焦点组裸眼近视力高于单焦点组(P<0.05)，中间距离视力(40，60，80cm)均高于单焦点组(P<0.05)，两组裸眼远视力、矫正远视力、矫正近视力及最佳矫正远视力下近视力差异无统计学意义(P>0.05)。术后3mo两组对比敏感度相比差异无统计学意义(P>0.05)。术后多焦点组脱镜率高于单焦点组(P<0.05)，视近满意度多焦点组好于单焦点组(P<0.05)，术后不良视觉症状及视远满意度两组相比差异无统计学意义(P>0.05)。

结论：渐进衍射型MIOL能提供良好的全程视力和视觉质量，有效降低术后脱镜率，提高患者术后的生活质量。

Visual function and quality after the apodized diffractive multifocal intraocular lens implantation

AIM:To evaluate clinical effects of the apodized diffractive multifocal intraocular lens(MIOL)implantation.

METHODS: Seventy-two patients(72 eyes)with age-related cataract were divided into two groups by randomized controlled clinical trials, 32 eyes of 32 cases received the apodized diffractive MIOL, 40 eyes of 40 cases received monofocal intraocular lens(MoIOL). Three months after surgery, uncorrected distance visual acuity(UCDVA), intermediate visual acuity(IVA), near vision, correct near and far vision were observed. Visual function and quality of life questionnaire was measured.

RESULTS:Three months after surgery, the uncorrected near visual acuity(UCNVA)and IVA(40, 60, 80cm)in MIOL group were significantly higher than that in MoIOL group(P<0.05). The UCDVA, best corrected distant visual acuity(BCDVA), best corrected near visual acuity(BCNVA)and distant corrected visual acuity(DCNVA)had no statistically significant difference between two groups(P>0.05). Contrast sensitivity values had no statistically significant difference between two groups at 3mo postoperatively(P>0.05). The spectacle independence in MIOL group was significantly higher than that in MoIOL group(P<0.05)and near vision satisfaction in MIOL group was higher than that in MoIOL group(P<0.05). Compared with those adverse visual symptoms and distant vision satisfaction, there were no statistically significant difference between two groups(P>0.05).

CONCLUSION: The apodized diffractive MIOL can provide excellent full range of vision and visual quality, effectively decrease the dependence of glasses and improve the life quality after sugery.