双眼单焦点与多焦点人工晶状体混搭植入术后视觉质量评估

目的：比较主视眼植入单焦点人工晶状体(SIOL)、对侧非主视眼植入多焦点人工晶状体(MIOL)和双眼均植入SIOL的临床疗效。

方法：选取2019-01/2021-01于成都爱尔眼科医院行白内障超声乳化联合IOL植入术的年龄相关性白内障患者60例120眼，主视眼均已植入SIOL，根据对侧非主视眼植入IOL的类型分为三组，其中A组患者18例36眼非主视眼植入MIOL(SBL-3)； B组患者19例38眼非主视眼植入MIOL(SN6AD1)； 对照组23例46眼双眼均植入SIOL。术后3mo，评估并比较三组患者双眼视力及视觉质量。

结果：术后3mo，三组患者双眼裸眼和矫正远视力、裸眼中视力及矫正近视力均无差异(P>0.05)，A组和B组患者双眼裸眼近视力和矫正中视力均显著优于对照组(P<0.05)。Catquest 9SF-CN量表评分显示，A组和B组患者(11.11±1.323、11.89±1.883分)视觉质量均优于对照组(14.65±1.722分，均P<0.05)。A组、B组和对照组患者脱镜率分别为88.9%、84.2%、39.1%，A组患者脱镜率显著高于对照组(P<0.0167)。

结论：白内障患者主视眼植入SIOL、对侧非主视眼植入MIOL(SBL-3/SN6AD1)可获得较双眼均植入SIOL更优的全程视力，术后不良视觉症状少，脱镜率及满意度高。

Observation of binocular visual quality after single-focal and multifocal intraocular lens with different types of implantation

AIM: The clinical outcomes of unilateral single-focal intraocular len(SIOL), contralateral implanted multifocal IOL(MIOL)and the SIOL was implanted in binoculus were compared.

METHODS: There were 60 cases with 120 eyes age-related cataract patients in January 2019 to January 2021 underwent phacoemulsification and IOL implantation in Chengdu Aier Eye Hospital. The SIOL has been implanted in the dominant eyes, all patients were divided into three groups according to the types of IOL implanted in the contralateral non-dominant eyes, among them, there were 36 eyes of 18 cases in group A with non-dominant eyes implanted MIOL(SBL-3); 38 eyes of 19 cases in group B were implanted MIOL(SN6AD1)in non-dominant eyes. SIOL was implanted in all 46 eyes of 23 cases of control group. After operation at 3mo,the results of binocular vision and visual quality of the three groups were evaluated and compared.

RESULTS: After operationat 3mo, there was no difference in the uncorrected distance vision and corrected distance vision, uncorrected medium vision and corrected near vision among the three groups(P<0.05).The uncorrected near visual acuity and corrected intermediate visual acuity of both eyes in groups A and B were significantly improved in both groups compared with the control group(P<0.05). The scores of Catquest 9SF-CN scale showed that the quality of life of patients in group A and group B(11.11±1.323, 11.89±1.883 scores)was better than that in the control group(14.65±1.722 scores, both P<0.05). The rate of lens removal in group A, B and control group were 88.9%, 84.2% and 39.1%, respectively, and the rate of lens removal in group A was significantly higher than that in the control group(P<0.0167).

CONCLUSION: Dominant eye implantation of SIOL in patients with cataract and contralateral non-dominant eye implantation of MIOL(SBL-3/SN6AD1)can obtain better full-range visual acuity than binoculus, less postoperative adverse visual symptoms, and higher patient disengagement rate and satisfaction.