连续视程人工晶状体与双焦点、单焦点人工晶状体植入术后患者视力、视觉质量及满意度对比分析

目的 比较连续视程人工晶状体与双焦点、单焦点人工晶状体植入术后患者视力、视觉质量及满意度的差异。方法 选取2020年10月至12月于我院行超声乳化白内障吸除联合人工晶状体植入术的患者61例61眼。依据患者人工晶状体植入情况分为3组，连续视程组16例16眼植入Tecnis Symfony连续视程人工晶状体；双焦点组20例20眼植入Tecnis ZMB00一片式非球面双焦点人工晶状体；单焦点组25例25眼植入Tecnis ZCB00一片式非球面单焦点人工晶状体。术后1个月检测患者裸眼远、近视力，绘制离焦曲线，运用双通道视觉质量分析系统OQASⅡ检测植入不同人工晶状体后，患者单眼客观视觉质量。分析并获得客观散射指数(OSI)、调制传递函数截止频率(MTF_{cut off})、斯特列尔比(SR)、三种对比度(100%、20%、9%)下的模拟对比度视力(OV100%、OV20%、OV9%),通过问卷形式对患者进行满意度调查。结果 术后1个月，三组患者33 cm和40 cm裸眼近视力差异均有统计学意义(均为P<0.01),单焦点组患者33 cm和40 cm裸眼近视力均差于双...

Comparative analysis of visual acuity,visual quality and satisfaction after extended depth,bifocal and monofocal intraocular lens implantation

Objective　To compare the vision, visual quality and satisfaction of patients after extended depth intraocular lens (IOL) implantation, bifocal IOL implantation and monofocal IOL implantation. Methods　Totally 61 eyes of 61 patients who underwent phacoemulsification combined with IOL implantation in our hospital from October 2020 to December 2020 were enrolled. The patients were divided into 3 groups according to their IOL implantation. A total of 16 patients (16 eyes) who were implanted with Tecnis Symfony extended depth IOL were included in the extended depth group, 20 patients (20 eyes) who were implanted with Tecnis ZMB00 one-piece aspherical bifocal IOL were included in the bifocal group, and 25 patients (25 eyes) who were implanted with Tecnis ZCB00 one-piece aspherical monofocal IOL were included in the monofocal group. One month after the operation, the uncorrected distance visual acuity (UCDVA) and uncorrected near visual acuity (UCNVA) of the patients were detected, and the defocus curve was drawn. The dual-channel optical quality analysis system (OQAS II) was used to detect the monocular objective visual quality after the implantation of different IOL. The objective scatter index (OSI), modulation transfer function cut off frequency (MTF_{cut off}), Strehl ratio (SR), and analog contrast visions (OV100%, OV20% and OV9%) under three kinds of contrast (100%, 20% and 9%) were obtained, and satisfaction survey was conducted via questionnaires. Results　One month after the operation, the UCNVA at 33 cm and 40 cm of patients in the three groups were significantly different (all P<0.01); the UCNVA at 33 cm and 40 cm of patients in the monofocal group were lower than those in the bifocal group and extended depth group (all P<0.05); there was no significant difference in the UCNVA at 33 cm and 40 cm between the extended depth group and the bifocal group (both P>0.05). The visual acuity from +1.0 D to -3.5 D of patients in the extended depth group was better than 0. 3 (logMAR), and the visual acuity from +0.5 D to -1.5 D was stable and better than 0.2 (logMAR). In addition, the visual acuity was more stable after the extended depth IOL implantation. The visual quality indexes (OSI, MTF_{cut off}, SR, OV100% and OV20%) in the extended depth group and the bifocal group were better than those in the monofocal group, and the differences were statistically significant (all P<0.05). There was no significant difference in OV9% among the three groups (P>0.05). One month after the operation, the glass removal rate of the extended depth group was 100.0%, and the overall satisfaction was 87.5% with no glasses. In the bifocal group, the glass removal rate was 100.0%, and the overall satisfaction was 80.0% with no glasses. In the monofocal group, the glass removal rate was 60.0%, and the overall satisfaction with no glasses was 60.0%. Conclusion　Patients undergo the extended depth and bifocal IOL implantations show better visual quality and near visual acuity than those receive the monofocal IOL implantation. Patients who are implanted with the extended depth IOL have a more stable full-course visual acuity.