不同多焦点人工晶状体临床视觉质量的研究

目的:比较植入REZOOM、Acri.Lisa366D和Tecnis ZMA00三种不同特性多焦点人工晶状体的术后视觉质量。方法:选取2008年9月～2010年3月期间,在天津市眼科医院白内障中心行白内障超声乳化术联合多焦点人工晶状体植入术患者,分别植入REZOOM、Acri.Lis、Tecnis ZMA00。术后随诊复查,进行问卷调查视觉质量,以Colenbrander Mixed Contrast Card Set视力测试卡分别测量高/低对比度条件下,最佳矫正远视力下的中、近视力。以iTrace视觉功能分析仪检查得出5、10、15、20、25、以及30cpd空间频率的调制传递函数(MTF)、眼内像差及瞳孔直径。以iTrace3.12软件分析3种人工晶状体眼在4mm瞳孔直径下的MTF。结果:三组最佳矫正远视力比较,差异无统计学意义(P>0.05)。最佳矫正远视力下的中视力,三组在高对比度条件下比较,差异有统计学意义(P<0.05),REZOOM低于另2组;低对比度条件下比较,3组差异无统计学意义(P>0.05)。最佳矫正远视力下的中视力3组在高/低对比度条件下比较,差异无统计学意义(P>0.05)。3组调制传递函数在4mm瞳孔直径下比较,在5cpd、10cpd、15cpd、20cpd间频率下的差异有统计学意义(P>0.05)。眼内像差三组间差异有统计学意义(P<0.05)。结论:三种多焦点人工晶状体术后在远视力方面表现优秀且差异不大,在中距离视力和近视力方面也都有良好表现,但同时也体现出了一定的差异。而术后的视觉症状如眩光、光晕等三种人工晶状体没有出现对生活的影响。对于调制函传递数的表现,作为非球面多焦点人工晶状体的Acri.Lisa366D和Tecnis ZMA00表现优于球面设计的REZOOM。

Visual quality of different multifocal intraocular lens

Objective Comparison of postoperative visual function of 3 different multifocal intraocular lens： REZOOM,Acri.Lisa 366D and Tecnis ZMA00 implanted.Method Patients selected from cataract center in Tianjin Eye Hospital,who underwent cataract phacoemulsification,and multifocal intraocular lens（REZOOM,Acri.Lisa 366D,Tecnis ZMA00） implantation during September 2008 to March 2010.Patients were followed up for review,distance vision were measured,intermediate distance and near vision under high / low contrast conditions were measured.Then iTrace visual function analyzer checks was used to drawn 5,10,15,20,25,and 30 cpd for modulation transfer function （MTF） and measure the intraocular aberrations as well as pupil diameter.MTF of three kinds of intraocular lens was analyzed by iTrace3.12 software in the pupil diameter of 4 mm.Results There was no statistically significance among these three groups about distance visual acuity.No statistically significant difference was founded in the best corrected intermediate visual acuity among 3 group in the low/ low contrast conditions.No statistically significant difference was founded in the best corrected near visual acuity among 3 group in the low contrast conditions,but in high-contrast conditions,statistically significant were founded.Modulation transfer function of group 5 in comparison 4 mm pupil diameters in 5 /10 /15 /20 cpd,the difference was statistically significant.Conclusion 3 multifocal intraocular lens in the far visual acuity after surgery are very well and the difference is not outstanding,in the middle distance vision and near vision also have better performance,but also reflects a significant difference.In concern of modulation transfer function of intraocular lens,aspheric multifocal intraocular lens Acri.Lisa 366D and Tecnis ZMA00 outperformed the spherical design of the REZOOM.