摘要
目的比较三焦点衍射型人工晶状体(IOL)和双焦点折射型IOL植入后患者的术后视觉质量差异。方法回顾性队列研究。收集2019年3月至2020年7月于北京大学第三医院眼科行超声乳化白内障吸除联合后房型IOL植入的52例(104只眼)患者。其中,男性17例(34只眼),女性35例(70只眼);年龄36~87岁,平均年龄(69.3±11.2)岁。根据患者植入IOL种类分为区域折射组和衍射三焦组。区域折射组植入Lenstec SBL-3型IOL;衍射三焦组植入AT LISA tri 839MP型三焦点IOL。比较患者术后3个月裸眼近视力(UNVA)、裸眼中视力(UIVA)及裸眼远视力(UDVA),最佳矫正视力(BCVA)、离焦曲线、客观视觉质量、脱镜率、不良视觉现象及满意度。两组患者视功能相关生活质量问卷评分以(±s)表示;UNVA、UIVA、UDVA、BCVA、调制传递函数截止频率(MTF cut-off)、斯特列尔比(SR)、客观散射指数(OSI)、对比度视力(VA)及患者满意度以中位数和四分位数表示,组间比较采用Mann-Whitney U检验。等效球镜屈光度(SE)的分布、脱镜率及不良视觉率以百分比表示,组间比较采用χ^(2)检验。Spearman相关性分析患者术后客观视觉质量与BCVA的关系。结果衍射三焦组术后最小分辨角度对数视力(logMAR)UNVA、UIVA、UDVA及BCVA分别为0.10(0.05,0.10)、0.10(0.00,0.20)、0.10(0.10,0.20)及0.00(0.00,0.05);区域折射组分别为0.05(0.00,0.10)、0.10(0.00,0.20)、0.10(0.00,0.20)及0.00(0.00,0.05),UNVA比较的差异有统计学意义(Z=-2.596,P<0.05)。衍射三焦组SE在±0.25 D、±0.50 D、±0.75 D及±1.00 D处,分布分别占34.6%、65.4%、90.4%及100.0%;区域折射组SE在±0.25 D、±0.50 D、±0.75 D及±1.00 D处,分别占57.7%、71.2%、78.9%及92.4%。两组SE整体分布比较的差异有统计学意义(χ^(2)=27.083,P<0.05)。两组平均SE分别为(-0.38±0.43)D和(-0.25±0.49)D,差异无统计学意义(t=0.667,P>0.05)。离焦曲线分析显示,球镜屈光度为2.00 D、-2.00 D及-2.50 D时两组患者的
Objective To compare the visual quality of patients implanted the trifocal diffractive intraocular lens(IOL)and the segmented refractive bifocal IOL after cataract surgery.Methods Retrospective cohort study.From March 2019 to July 2020,52 patients(104 eyes)with cataract phacoemulsification and IOL implantation in the Department of Ophthalmology of Peking University Third Hospital were collected.There were 17 males(34 eyes)and 35 females(70 eyes)with the average age of(69.3±11.2)years-old(ranged from 36 to 87 years-old).The patients were divided into segmented refractive group and trifocal diffractive group according to the type of IOL implanted.Lenstec SBL-3 IOL was implanted in segmented refractive group;AT LISA tri 839MP triple focus IOL was implanted in the trifocal diffractive group.The uncorrected distance visual acuity(UDVA),uncorrected intermediate visual acuity(UIVA),uncorrected near visual acuity(UNVA),best corrected distance visual acuity(BCVA),spherical equivalent(SE),defocus curve,objective visual quality,off-glasses rate,poor visual events,life quality and satisfaction were evaluated after surgery for 3 months.The questionnaire scores of two groups were expressed by(±s),independent sample t test was used for comparison between groups;UNVA,UIVA,UDVA,BCVA,modulation transfer function cut-off(MTF cut off),strehl ratio(SR),objective scatter index(OSI),contrast visual acuity(VA)and patient satisfaction were expressed by median and quartile intervals,compared by Mann-Whitney U test between groups.The distribution of SE,off-glasses rate and poor visual events were expressed in percentage,and chi-square test was used for comparison between groups.Spearman correlation analysis was used to analyze the correlation between objective visual quality and BCVA.Results The postoperative logMAR UNVA,UIVA,UDVA and BCVA of the trifocal diffractive group were 0.10(0.05,0.10),0.10(0.00,0.20),0.10(0.10,0.20)and 0.00(0.00,0.05),and those of segmented refractive group were 0.05(0.00,0.10),0.10(0.00,0.20),0.10(0.00,0.20)and
作者
王晓宇
李亚新
刘一昀
耿嘉懿
秦锐
李炎城
敖明昕
刘德海
齐虹
Xiaoyu Wang;Yaxin Li;Yiyun Liu;Jiayi Geng;Rui Qin;Yancheng Li;Mingxin Ao;Dehai Liu;Hong Qi(Department of Ophthalmology,Peking University Third Hospital,Beijing 100191,China;Department of Ophthalmology,The First Hospital of Fangshan District,Beijing 102400,China)
出处
《中华眼科医学杂志（电子版）》
2022年第4期210-215,共6页
Chinese Journal of Ophthalmologic Medicine(Electronic Edition)
基金
国家自然科学基金面上项目(81600760,81974128,82171022)
首都卫生发展科研专项自主创新项目(2020-2-4097)。
关键词
白内障
人工晶状体
视觉质量
脱镜率
Cataract
Intraocular lens
Visual quality
Spectacle independence
