不同多焦点人工晶状体植入术后视觉效果的比较
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摘要
目的:比较不同多焦点人工晶状体(MIOL)植入治疗白内障术后患者的视觉质量。方法:选取2016-02/2017-06于本院行白内障超声乳化摘除联合MIOL植入手术的年龄相关性白内障患者78例78眼。根据植入MIOL的不同分为A、B、C组,各26例26眼。A组植入区域折射型MIOL SBL-3,B组植入阶梯渐进衍射型MIOL SN6AD1,C组植入全光学面衍射型MIOL Tecnis ZMB00。比较三组患者术后3mo的视力恢复情况、对比敏感度、离焦曲线、对比度视力以及视觉质量满意度。结果:三组患者术后不良反应发生情况比较,差异无统计学意义(P>0.05);三组患者裸眼中视力、裸眼近视力、矫正远视力下的中视力、矫正远视力下的近视力的比较,差异均有统计学意义(P<0.05),且A、B组均显著优于C组(P<0.05)。三组患者术后在明光、明光眩光下4种空间频率(3、6、12、18c/d)以及暗光、暗光眩光下3种空间频率(3、6、12c/d)的对比敏感度比较,差异均有统计学意义(P<0.05),且A组患者均显著优于B、C组患者(P<0.05)。三组患者术后离焦曲线表明A、B组患者在-1.5、-2.0、-2.5D处视力高于C组患者(P<0.05)。三组患者术后对比度为20%、9%的对比度视力比较,差异均有统计学意义(P<0.05),且A组显著优于B、C组患者(P<0.05)。三组患者术后视觉质量满意度比较,差异有统计学意义(P<0.05),且A组显著优于B、C组(P<0.05)。结论:区域折射型MIOL SBL-3不仅可提供较理想的远、近、中视力,还可提供更佳的对比敏感度及对比度视力,从而提高了患者对视觉质量的满意度。
AIM:To compare the visual quality after different multifocal lens(MIOL) implantation in cataract patients. METHODS:Totally 78 cases(78 eyes) of cataract patients who receiving phacoemulsification and implantation of different MIOL were enrolled from February 2016 to June 2017 in our hospital.According to the different type of implanted MIOL,the 78 cases(78 eyes) were divided Group A,B and C,each group was 26 cases(26 eyes).Patients in the Group A were implanted regional refraction MIOL SBL-3;patients in the Group B implanted step progressive diffraction MIOL SN6 AD1;patients in the Group C implanted all-optical plane diffraction MIOL Tecnis ZMB00.The visual acuity,contrast sensitivity,defocus testing,contrast visual acuity and satisfaction of visual quality were compared in 3 groups at postoperative 3 mo. RESULTS:There was no statistically significant difference in postoperative adverse reactions between the three groups(P>0.05).There was statistical difference in uncorrected intermediate visual acuity,uncorrected near visual acuity,distance-corrected intermediate visual acuity and distance-corrected near visual acuity in 3groups(P < 0.05),and those in the Group C were significantly worse than those of Group A and B(P <0.05).There was statistical difference in contrast sensitivity at four spatial frequencies(3,6,12,18 c/d) in light and light glare and three spatial frequencies(3,6,12 c/d) in dark and dark glare in 3 groups(P<0.05),and those in the Group A were significantly better than those of Group B and C(P<0.05).According to the defocus testing of 3 groups,the visual acuity at-1.5 D,-2.0 D and-2.5 D in Group A and B was significantly higher than Group C(P < 0.05).There was statistical difference in contrast visual acuity at 20% and 9% of contrast ratio in 3 groups(P<0.05),and those in Group A were significantly better than Group B and C(P<0.05).There was statistical difference in visual quality satisfaction in 3 groups(P <0.05),and that in the Group A was significantly better than that of Group B and C(P<0.05).CONCLUSION:The region refraction MIOL SBL-3 not only could provide better distant,intermediate and near visual acuity,but also could provide better contrast sensitivity and contrast visual acuity,thereby greatly increase visual quality satisfaction.
AIM:To compare the visual quality after different multifocal lens(MIOL) implantation in cataract patients. METHODS:Totally 78 cases(78 eyes) of cataract patients who receiving phacoemulsification and implantation of different MIOL were enrolled from February 2016 to June 2017 in our hospital.According to the different type of implanted MIOL,the 78 cases(78 eyes) were divided Group A,B and C,each group was 26 cases(26 eyes).Patients in the Group A were implanted regional refraction MIOL SBL-3;patients in the Group B implanted step progressive diffraction MIOL SN6 AD1;patients in the Group C implanted all-optical plane diffraction MIOL Tecnis ZMB00.The visual acuity,contrast sensitivity,defocus testing,contrast visual acuity and satisfaction of visual quality were compared in 3 groups at postoperative 3 mo. RESULTS:There was no statistically significant difference in postoperative adverse reactions between the three groups(P>0.05).There was statistical difference in uncorrected intermediate visual acuity,uncorrected near visual acuity,distance-corrected intermediate visual acuity and distance-corrected near visual acuity in 3groups(P < 0.05),and those in the Group C were significantly worse than those of Group A and B(P <0.05).There was statistical difference in contrast sensitivity at four spatial frequencies(3,6,12,18 c/d) in light and light glare and three spatial frequencies(3,6,12 c/d) in dark and dark glare in 3 groups(P<0.05),and those in the Group A were significantly better than those of Group B and C(P<0.05).According to the defocus testing of 3 groups,the visual acuity at-1.5 D,-2.0 D and-2.5 D in Group A and B was significantly higher than Group C(P < 0.05).There was statistical difference in contrast visual acuity at 20% and 9% of contrast ratio in 3 groups(P<0.05),and those in Group A were significantly better than Group B and C(P<0.05).There was statistical difference in visual quality satisfaction in 3 groups(P <0.05),and that in the Group A was significantly better than that of Group B and C(P<0.05).CONCLUSION:The region refraction MIOL SBL-3 not only could provide better distant,intermediate and near visual acuity,but also could provide better contrast sensitivity and contrast visual acuity,thereby greatly increase visual quality satisfaction.
引文
1蔡德栋,余汉霞.白内障摘除联合非球面散光矫正型多焦点人工晶状体植入术的疗效.国际眼科杂志2016;16(10):1862-1864
2 Yoshino M,Minami K,Hirasawa M,et al.Clinical Results of Diffractive Multifocal Intraocular Lens Implantation after Laser In Situ Keratomileusis.Nippon Ganka Gakkai Zasshi 2015;119(9):613-618
3张玲玲,贾义军,郑广瑛.非球面散光矫正型多焦点人工晶状体植入术对白内障患者视力和对比敏感度的影响.国际眼科杂志2016;16(7):1302-1305
4 Chen T,Yu F,Lin H,et al.Objective and subjective visual quality after implantation of all optic zone diffractive multifocal intraocular lenses:a prospective,case-control observational study.Br J Ophthalmol 2016;100(11):1530-1535
5 Labuz G,Reus NJ,Berg TJ.Comparison of ocular straylight after implantation of multifocal intraocular lenses.J Cataract Refract Surg2016;42(4):618-625
6 Velika V,Hejsek L,Raiskup F.Clinical Results of the Implantation of Two Types of Multifocal Rotational Asymmetric Intraocular Lenses.Cesk Slov Oftalmol 2017;73(1):3-12
7 Lee H,Lee K,Ahn JM,et al.Evaluation of optical quality parameters and ocular aberrations in multifocal intraocular lens implanted eyes.Yonsei Med J 2014;55(5):1413-1420
8 Kamiya K,Hayashi K,Shimizu K,et al.Multifocal intraocular lens explantation:a case series of 50 eyes.Am J Ophthalmol 2014;158(2):215-220
9彭璟,邓应平,李爽乐,等.高度近视患者LASIK矫正术后行白内障手术并植入区域折射型多焦点人工晶体1例.四川医学2017;38(4):487-488
10吴杰,朱磊.多焦点人工晶状体植入术后早期全程视力和拟调节力的临床观察.眼科新进展2017;37(6):572-575
11王宏伟,孙鹏.AcrySof ReSTOR多焦点人工晶状体应用的临床研究.齐齐哈尔医学院学报2016;37(30):3772-3773
12王晓峰,杨卫华.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.国际眼科杂志2017;17(8):1497-1500
13 Lehmann R,Modi S,Fisher B,et al.Bilateral implantation of+3.0Dmultifocal toric intraocular lenses:results of a US Food and Drug Administration clinical trial.Clin Ophthalmol 2017;11:1321-1331
14张利科,王晓冰,陈正伟.两衍射多焦点人工晶状体的光学性能与视觉质量对比研究.眼科新进展2017;37(5):445-449
15田亚宾,马忠旭,黄婉荣,等.非对称区域折射型多焦点人工晶状体与可调节型人工晶状体的临床效果研究.眼科新进展2016;36(12):1157-1160
2 Yoshino M,Minami K,Hirasawa M,et al.Clinical Results of Diffractive Multifocal Intraocular Lens Implantation after Laser In Situ Keratomileusis.Nippon Ganka Gakkai Zasshi 2015;119(9):613-618
3张玲玲,贾义军,郑广瑛.非球面散光矫正型多焦点人工晶状体植入术对白内障患者视力和对比敏感度的影响.国际眼科杂志2016;16(7):1302-1305
4 Chen T,Yu F,Lin H,et al.Objective and subjective visual quality after implantation of all optic zone diffractive multifocal intraocular lenses:a prospective,case-control observational study.Br J Ophthalmol 2016;100(11):1530-1535
5 Labuz G,Reus NJ,Berg TJ.Comparison of ocular straylight after implantation of multifocal intraocular lenses.J Cataract Refract Surg2016;42(4):618-625
6 Velika V,Hejsek L,Raiskup F.Clinical Results of the Implantation of Two Types of Multifocal Rotational Asymmetric Intraocular Lenses.Cesk Slov Oftalmol 2017;73(1):3-12
7 Lee H,Lee K,Ahn JM,et al.Evaluation of optical quality parameters and ocular aberrations in multifocal intraocular lens implanted eyes.Yonsei Med J 2014;55(5):1413-1420
8 Kamiya K,Hayashi K,Shimizu K,et al.Multifocal intraocular lens explantation:a case series of 50 eyes.Am J Ophthalmol 2014;158(2):215-220
9彭璟,邓应平,李爽乐,等.高度近视患者LASIK矫正术后行白内障手术并植入区域折射型多焦点人工晶体1例.四川医学2017;38(4):487-488
10吴杰,朱磊.多焦点人工晶状体植入术后早期全程视力和拟调节力的临床观察.眼科新进展2017;37(6):572-575
11王宏伟,孙鹏.AcrySof ReSTOR多焦点人工晶状体应用的临床研究.齐齐哈尔医学院学报2016;37(30):3772-3773
12王晓峰,杨卫华.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.国际眼科杂志2017;17(8):1497-1500
13 Lehmann R,Modi S,Fisher B,et al.Bilateral implantation of+3.0Dmultifocal toric intraocular lenses:results of a US Food and Drug Administration clinical trial.Clin Ophthalmol 2017;11:1321-1331
14张利科,王晓冰,陈正伟.两衍射多焦点人工晶状体的光学性能与视觉质量对比研究.眼科新进展2017;37(5):445-449
15田亚宾,马忠旭,黄婉荣,等.非对称区域折射型多焦点人工晶状体与可调节型人工晶状体的临床效果研究.眼科新进展2016;36(12):1157-1160