多焦点人工晶状体与非球面人工晶状体植入术后视觉质量的临床研究

目的客观与主观检测结合评价非球面设计的多焦点与单焦点人工晶状体植入术后的视觉质量。方法132例（207只眼）白内障患者分别植入非球面的多焦点人工晶状体AcrySof IQ ReSTOR IOL和单焦点人工晶状体AcrySof IQ IOL。记录患者手术后的裸眼远、近视力，矫正远、近视力。术后3个月检测患者明视、暗视和暗视眩光状态的对比敏感度。采用VF-14（Visual function-14）视功能和生存质量调查问卷评价患者主观的视觉质量。结果术后两组裸眼远视力（t=0．61，P〉0．05）最佳矫正近视力（t=1．877，P〉0．05）差异无统计学意义。非矫正近视力多焦点组优于单焦点组（t=11．38，P〈0．001），单焦点组在明光、暗光、暗光眩光条件下各空间频率对比敏感度均高于多焦点组，明光条件下3cpd和6cpd空间频率差异有统计学意义（P〈0．05），暗光眩光条件下中高频率差异有统计学意义（P〈0．05），两组无患者存在严重的视觉干扰现象。两组术后视远时脱镜率均大于98％，视近时脱镜率多焦点组为78．9％，单焦点组为10．9％。结论与单焦点人工晶状体相比，除了对比敏感度下降，多焦点人工晶状体能提供令人满意的术后视功能和生活质量，患者能获得较高的视觉质量。

Clinical study of visual quality in patients with implantation of multifocal aspheric and monofocal aspheric intraocular lenses

Objective To evaluate the visual quality in patients implantd with aspheric diffractive multifocal and aspheric monofocal intraocular lenses.Methods Prospecive nonrandomized controlled study,207 cataract eyes in 132 patients were included,Patients received AcrySof IQ ReSTOR IOL(SN6AD3) or AcrySof IQ IOL(SN60WF) implantation,The follow up period was 3 months.The mean of uncorrected distance visual acuity(UCDVA),uncorrected near visual acuity(UCNVA),best corrected distance visual acuity(BCDVA),best distance-correct near visual acuity(BCNVA) in patients with SN6AD3 and SN60WF was compared postoperatively in all patients.Photopic and mesopic contrast sensitivity function with and without glare were tested at 3 months after operation.Subjective outcomes were assessed by VF-14 questionnaire.Results Postoperatively,there were no significant differences between groups in UCDVA(t=0.61,P﹥0.05) or BCNVA(t=1.877,P﹥0.05),UCNVA improved remarkably after the implantation of MIOL(t=11.38,P﹤0.001).Contract sensitivity in monoforal group was better at all spatial frequencies under photopic,mesopic and mesopic with glare conditions.Contrast sensitivity was statistically different at median spatial frequenciesunder photopic conditions and at median and high spatial frequencies under mesopic with glare conditions(P﹤0.05),No srious visual disturbances were reported.The spectacle independent rate of multifocal and monofocal group were 78.9% and 10.9%.Conclusion Compared with the monofocal intraocular lens,the diffractive multifocal intraocular lens could provide a safisfactory recovery of vision function and good quality of life except the slight decrease of the contrast sensitivity.