非球面多焦点人工晶状体眼的波前像差及拟调节力研究

目的评价白内障超声乳化摘出联合非球面衍射型多焦点人工晶状体（MIOL）植入术后患者的波前像差及拟调节力。方法将进行白内障超声乳化联合人工晶状体植入术且年龄45～70岁的36例50眼患者随机分为2组,MIOL组患者17例25眼植入AcrysofReSTORMIOL,单焦点人工晶状体（SIOL）组患者19例25眼植入AcrysofSIOL。术后3个月检查裸眼及矫正远近视力,最佳矫正远视力下的近视力（DCNVA）、波前像差、调制传递函数（MTF）、拟调节力,并比较脱近用镜率。结果术后3个月,2组患者术后裸眼远视力和最佳矫正远视力差异均无统计学意义（P〉0.05）;MIOL组术后裸眼近视力和DCNVA明显优于SIOL组（P〈0.05）;球面像差ZernikeC12、4阶高阶像差及总体高阶像差比较MIOL组与SIOL组间差异均无统计学意义（P〉0.05）;MTF值在各空间频率2组间差异均无统计学意义（P〉0.05）。视近拟调节力：MIOL组为（0.925±0.549）D,SIOL组为（0.390±0.235）,差异有统计学意义（P〈0.05）。脱近用镜率：MIOL组（80%）优于SIOL组（24%）（P=0.000）。结论 ReSTOR衍射型MIOL眼能提供良好的远近视力,拟调节幅度较SIOL大,能有效改善白内障患者术后的视觉质量。

Wavefront aberration and accommodation power in eyes with aspheric multifocal intraocular lens implantation

Background The implantation of multifocal intraocular lenses （MIOLs） after cataract extraction can improved the distance and near vision simultaneously.Recently,the research on MIOLs maily focus at the visual quality after implantation of MIOLs.Objective Present study was to evaluate the visual quality and pseudoaccommodation power in the patients with the implantation of an apodized diffractive mutifocal intraocular lens （MIOL）.Methods Fifty eyes（25 patients age 60-70）received phacoemulsification＋intraocular lens （IOL） implantation were included in this study.The patients were randomly divided into apodized diffractive multifocal IOL group and aspherical monofocal IOL group.Acrysoft MIOL and Acrysoft SIOL were used respectively in these two groups.The wavefront aberrations of crystalline,modulation transfer function,uncorrected distanced visual acuity （UCDVA）,uncorrected near visual acuity （UCNVA）,best-corrected distance visual acuity （BCDVA）,best-corrected near visual acuity （BCNVA）,distance corrected near visual acuity （DCNVA）,pseudoaccommodation and the rate of off-near glasses were studied in 3 months following phacoemulsification＋intraocular lens （IOL） implantation.Written informed consent was obtained from each patient prior to any medical procedure.Results UCDVA and BCDVA in the Acrysoft MIOL group were not statistically significant different from those of Acrysoft SIOL group （P0.05）,however,the UCNVA and DCNVA were significantly increased in Acrysoft MIOL group compared to Acrysoft SIOL group （P0.05）.No statistical differences were found in spherical aberration,4th order high aberration and whole high-order aberrations between Acrysoft MIOL group and Acrysoft SIOL group （P0.05）.There was no statistically dignificant difference in the MTF in the spacial frequencies of 5,10,15,20,25 and 30 cycle/degree between two groups（P0.05）.The accommodative range was 0.925±0.549 D in Acrysoft MIOL group and 0.390±0.235 D in Acrysoft SIOL group,showing a considerably difference between them（t=4.476,P=0.000）.The rate of off-near glass in Acrysoft MIOL group was higher than in Acrysoft SIOL group （P=0.000）.Conclusion The Acrysof ReSTOR apodized diffractive MIOL can offer excellent distance and near visual acuity,better accommodation and improved quality of life for the patients after phacoemulsification.