三焦点人工晶状体术后早期临床观察

目的：比较三焦点人工晶状体（IOL）与单焦点IOL植入术后早期的视力情况、视觉质量及患者满意度。方法：前瞻性临床研究。选取2016年4-7月就诊于中国医科大学附属第四医院眼科确诊为白内障欲行手术治疗的患者44例（50眼），植入三焦点IOL为实验组（22例，25眼），植入单焦点IOL为对照组（22例，25眼）。随访至术后3个月，测试单眼裸眼远中近视力（LogMAR）、离焦曲线、主观散射光、客观散射指数（OSI）、调制传递函数截止频率（MTF cutoff）、斯特列尔比（SR）、像差，并 发放调查问卷统计患者满意度、脱镜率以及光晕发生率。采用配对t检验、Wilcoxon符号秩检验及χ 2 检验进行数据分析。结果：术后3个月，2组间远视力差异无统计学意义，中、近视力方面，实验组（0.12±0.11、0.17±0.11）优于对照组（0.28±0.08、0.47±0.16） （t=-5.912、-8.504，均P < 0.001）；实验组（2.02±0.93）的OSI高于对照组（1.13±0.31） （t=-3.311，P=0.001）；2组间MTFcutoff、SR、主观散射光以及像差的差异均无统计学意义；实验组在满意度和脱镜率方面优于对照组（ χ 2 =4.50，P=0.034； χ 2 =30.65，P < 0.001），光晕发生率在2组间差异无统计学意义。结论：三焦点IOL植入术后，患者拥有良好的远、中、近全程视力及视觉质量。

Preliminary Clinical Observation of Trifocal Intraocular Lens Implantation

Objective: To compare preliminary outcomes of visual acuity (VA), visual quality, and patient satisfaction with trifocal intraocular lens (TIOL) implantation. Methods: This prospective clinical trial enrolling 50 eyes of 44 patients undergoing cataract surgery with implantation of a TIOL (25 eyes of 22 patients) or a monofocal intraocular lens (MIOL) 25 eyes of 22 patients from April 2016 to July 2016 at the Forth Hospital of China Medical University. VA and visual quality were evaluated during a 3-month follow-up and included the uncorrected VA, defocus curve, subjective scattered light, objective scatter index (OSI),modulation transfer function (MTF) cutoff, Sterhl Ratio (SR), and wavefront aberration. A questionnaire was used to evaluate patient satisfaction, independence of glasses, and halo occurrence. Data was assessed by paired t-tests, Wilcoxon signed ranks tests, and chi-square tests. Results: Three months after surgery,there was no significant difference between the TIOL and MIOL in distance VA. The intermediate and near VA in the TIOL group were 0.12 ± 0.11 and 0.17 ± 0.11, respectively, and in the MIOL group, 0.28 ± 0.08 and 0.47 ± 0.16, respectively (t=-5.912, P < 0.001, t=-8.504, P < 0.001). OSI for the MIOL was 1.13 ± 0.31 and 2.02 ± 0.93 for the TIOL (t=-3.311, P=0.001). There were no significant differences between the lensesin MTF cutoff, SR, subjective scattered light, or wavefront aberration. The questionnaire showed that the overall rate of satisfaction and independence of glasses for the TIOL group was higher than for the MIOL group ( χ 2 =4.50, P=0.034; χ 2 =30.65, P < 0.001). The rate of halo occurrence was not significantly different between the two groups. Conclusions: After implantation of TIOL, patients could obtain high visual quality for far, intermediate, and near vision.