非球面散光矫正型多焦点人工晶状体在白内障中的临床观察

目的:通过对非球面矫正型多焦点人工晶状体与非球面人工晶状体的比较,探讨白内障超声乳化联合非球面散光矫正型人工晶状体植入术后患者的远近视力、剩余散光、视远脱镜率、视近脱镜率、视觉质量和患者满意度等情况.方法:选取2014-02/2016-06在我院确诊为年龄相关性白内障的患者46例48眼,实行白内障超声乳化摘除联合人工晶状体植入术,分别植入AcrySof IQ ReSTOR Toric人工晶状体23例24眼作为试验组;AcrySof IQ 人工晶状体23例24眼作为对照组.术后随访6mo,观察两组患者术后裸眼远视力(UCDVA)、最佳矫正远视力(BCDVA)、裸眼近视力(UCNVA)、最佳矫正近视力(BCNVA)、剩余散光和术后患者视远脱镜率、视近脱镜率、患者对手术疗效的满意度.结果:术后1、3、6mo两组患者最佳矫正远视力和最佳矫正近视力无统计学差异(P>0.05),而裸眼远视力、裸眼近视力均有统计学差异(P<0.05).两组患者术后1wk,1、3、6mo的剩余散光差异有统计学意义(P<0.05),术后6mo时两组患者对疗效满意度差异有统计学意义(P<0.05);术后6mo视近视远脱镜率,试验组明显高于对照组,差异有统计学意义(P<0.05).结论:非球面散光矫正型人工晶状体具有良好的近附加和散光矫正,可为患者提高良好的裸眼远视力和裸眼近视力,明显提高患者术后的脱镜率和对疗效的满意度,是白内障术后患者尤其是散光伴有明显视近阅读需求患者的福音.

Clinical observation of multifocal intraocular lens with aspheric astigmatism in cataract surgery

AIM: By comparing the aspheric and multifocal Toric intraocular lens and the aspheric intraocular lens in cataract patients, to observe the patients'' visual quality, to evaluate the patients'' distance visual acuity, near visual acuity, Pseudo-accommodative power, residual astigmatism, the rotational stability of AcrySof IQ Toric Restor intraocular lens(IOLs), contrast the rate of off-distance glass, the rate of off-near glass and patient satisfaction after the implantation of AcrySof IQ Toric Restor IOL in the cataract patients with preexisting corneal astigmatism.

METHODS:Carried out in 46 patients(48 eyes)with age-rated cataract who receiving phacoemulsification and implantation of artificial lens in our department during February 2014 to June 2016. All the cases were randomly divided into 2 groups: experimental group: 23 cases(24 eyes), AcrySof IQ ReSTOR Toric IOL was implanted after phacoemulsification; control group: 23 cases(24 eyes), AcrySof IQ was implanted. Uncorrected distance visual acuity(UCDVA)and best corrected distance visual acuity(BCDVA), uncorrected near visual acuity(UCNVA)and best-corrected near visual acuity(BCNVA), Pseudo-accommodative power, residual astigmatism, preoperative and postoperative corneal astigmatism, the rate of off-distance glass, the rate of off-near glass and patient satisfaction were measured at 6mo postoperatively follow-up.

RESULTS: BCDVA and BCNVA were not statistically different between the two groups(P<0.05). At 1wk, 1, 3 and 6mo postoperatively of UCDVA the experimental group were statistically better than the control group(P<0.05). UCNVA were also statistically better than the control group(P<0.05). The mean residual astigmatisms 1wk, 1, 3 and 6mo postoperatively were statistically differences between the control group and experimental group(P<0.05). At 6mo postoperatively, patients satisfaction of experimental group were significantly better than control group(P<0.05). Spectacles independence for near vision achieved 83% and 17% in experimental group and control group, experimental group were statistically better than control group(P<0.05). Spectacles independence for distance vision achieved 92% and 67% in experimental group and control group, experimental group were statistically better than control group(P<0.05).

CONCLUSION:The results indicate that AcrySof IQ ReSTOR Toric IOLs may provide a better uncorrected distance visual acuity and uncorrected near visual acuity, which can significantly reduce preexisting corneal astigmatism in cataract surgery, improve spectacles independence for distance vision and spectacles independence for near vision, have a high patient satisfaction.