非球面变色人工晶状体植入术后3个月不同照明条件下视觉效果的临床观察
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摘要
目的比较在不同光线条件下非球面变色人工晶状体(intraocular lens, IOL)、非球面黄色IOL和球面变色IOL在白内障患者植入术后的视觉效果。设计回顾性比较性病例系列。研究对象白内障超声乳化联合IOL植入治疗后的患者300例。方法按植入IOL的类型患者被分为三组,分别为非球面变色IOL组100眼,非球面黄色IOL组100眼和球面变色IOL组100眼。术后3个月,检查患者裸眼视力(UDVA)、最佳矫正视力(CDVA)、对比度视力(400 lux, 30 lux)及色觉辨别力(FM-100 hue,400 lux, 30 lux)。主要指标视力、对比度视力、色觉辨别力。结果三组患者术后3个月裸眼视力和矫正远视力无显著差异(P=0.935和P=0.681),在暗光线(30 lux,对比度5%)下,对比度视力非球面变色IOL组(LogMAR 0.301±0.17)高于其他两组(LogMAR 0.472±0.22和0.327±0.23),三组间比较差异有统计学意义(P<0.001)。FM100色棋测试中,在400 lux照度下三组间总错误评分无显著差异(P=0.163),在暗光线下(30 lux)三组患者的辨色力错误总评分均明显增高,并且三组间具有明显的统计学差异(P<0.001),非球面变色IOL组(36.45±14.89)低于比其他两组(46.72±20.67和38.31±15.82)。结论非球面变色IOL、非球面黄色IOL和球面变色IOL在强光下对比度视力无明显差别,非球面变色IOL在弱光下能够具有更好的对比度视力和更强的色彩辨别能力。(眼科,2019, 28:104-108)
Objective To analyze and compare the differences of contrast vision and color vision of three kinds of intraocular lens(IOL) in different illumination conditions in cataract patients. Design Retrospective case series. Participants 300 cases with phacoemulsification and IOL implantation. Methods We chronologically collected 300 patients undergone cataract extraction and implanted with different IOL, 100 eyes in group 1(implanted with aspheric photochromic IOL), 100 eyes in group 2(implanted with aspheric yellow IOL) and 100 eyes in group 3(implanted with spheric photochromic IOL). All eyes were reviewed at 3 months postoperatively. Visual acuity, intraocular pressure(IOP), slit lamp examination, fundus, contrast vision and color vision were recorded. Main Outcome Measures Visual acuity, contrast vision and color vision. Results There is no significant difference in postoperative uncorrected and corrected visual acuity among the three groups(P=0.935, P=0.681). The aspheric photochromic IOL group had better contrast vision than the other two groups at 30 lux, 5% contrast conditions(LogMAR 0.301 ± 0.17 vs LogMAR 0.472 ± 0.22 and 0.327 ± 0.23, both P<0.001). The total error scores of FM 100 test were not significantly different among the three groups at 400 lux conditions(P=0.163),but the total error scores of the aspheric photochromic IOL group was significantly lower than that the other two groups(36.45±14.89 vs46.72 ±20.67 and 38.31±15.82) at the mesopic conditions(30 lux)(both P<0.001). Conclusion There was no significant difference of contrast vision among eyes implanted with aspheric photochromic IOL, aspheric yellow IOL and spheric photochromic IOL under photopic conditions, but the aspheric photochromic IOL group had better contrast vision and color vision under mesopic conditions.(Ophthalmol CHN, 2019, 28: 104-108)
Objective To analyze and compare the differences of contrast vision and color vision of three kinds of intraocular lens(IOL) in different illumination conditions in cataract patients. Design Retrospective case series. Participants 300 cases with phacoemulsification and IOL implantation. Methods We chronologically collected 300 patients undergone cataract extraction and implanted with different IOL, 100 eyes in group 1(implanted with aspheric photochromic IOL), 100 eyes in group 2(implanted with aspheric yellow IOL) and 100 eyes in group 3(implanted with spheric photochromic IOL). All eyes were reviewed at 3 months postoperatively. Visual acuity, intraocular pressure(IOP), slit lamp examination, fundus, contrast vision and color vision were recorded. Main Outcome Measures Visual acuity, contrast vision and color vision. Results There is no significant difference in postoperative uncorrected and corrected visual acuity among the three groups(P=0.935, P=0.681). The aspheric photochromic IOL group had better contrast vision than the other two groups at 30 lux, 5% contrast conditions(LogMAR 0.301 ± 0.17 vs LogMAR 0.472 ± 0.22 and 0.327 ± 0.23, both P<0.001). The total error scores of FM 100 test were not significantly different among the three groups at 400 lux conditions(P=0.163),but the total error scores of the aspheric photochromic IOL group was significantly lower than that the other two groups(36.45±14.89 vs46.72 ±20.67 and 38.31±15.82) at the mesopic conditions(30 lux)(both P<0.001). Conclusion There was no significant difference of contrast vision among eyes implanted with aspheric photochromic IOL, aspheric yellow IOL and spheric photochromic IOL under photopic conditions, but the aspheric photochromic IOL group had better contrast vision and color vision under mesopic conditions.(Ophthalmol CHN, 2019, 28: 104-108)
引文
[1]孙政基,王勤美.非球面人工晶状体理论与技术的研究进展.中华眼视光学与视觉科学杂志,2007, 9(1):66-69.
[2] Cruickshanks KJ, Klein R, Klein BE, et al. Sunlight and the 5-year incidence of early age-related maculopathy:the beaver dam eye study. Arch Ophthalmol, 2001, 119(2):246-250.
[3] Sparrow JR, Miller AS, Zhou J. Blue light-absorbing intraocular lens and retinal pigment epithelium protection in vitro. J Cataract Refract Surg, 2004, 30(4):873-878.
[4] Kernt M, Walch A, Neubauer AS, et al. Filtering blue light reduces light-induced oxidative stress, senescence and accumulation of extracellular matrix proteins in human retinal pigment epithelium cells. Clin Exp Ophthalmol, 2012, 40(1):e87-e97.
[5] Wirtitsch MG, Schmidinger G, Prskavec M, et al. Influence of blue-light-filtering intraocular lenses on color perception and contrast acuity. Ophthalmology, 2009, 116(1):39-45.
[6] Wang H, Wang J, Fan W, et al. Comparison of photochromic, yellow, and clear intraocular lenses in human eyes under photopic and mesopic lighting conditions. J Cataract Refract Surg, 2010, 36(12):2080-2086.
[7] Ao M, Chen X, Huang C, et al. Color discrimination by patients with different types of light-filtering intraocular lenses. J Cataract Refract Surg, 2010, 36(3):389-395.
[8] Mester U, Holz F, Kohnen T, et al. Intraindividual comparison of a blue-light filter on visual function:AF-1(UY)versus AF-1(UV)intraocular lens. J Cataract Refract Surg, 2008, 34(4):608-615.
[9] Bandyopadhyay S, Saha M, Chakrabarti A, et al. Effect on contrast sensitivity after clear, yellow and orange intraocular lens implantation. Int Ophthalmol, 2016, 36(3):313-318.
[10] Werner L, Mamalis N, Romaniv N, et al. New photochromic foldable intraocular lens:preliminary study of feasibility and biocompatibility. J Cataract Refract Surg, 2006, 32(7):1214-1221.
[11] Werner L, Abdel-Aziz S, Cutler PC, et al. Accelerated 20-year sunlight exposure simulation of a photochromic foldable intraocular lens in a rabbit model. J Cataract Refract Surg, 2011, 37(2):378-385.
[12] Nochez Y, Majzoub S, Pisella PJ. Effect of residual ocular spherical aberration on objective and subjective quality of vision in pseudophakic eyes. J Cataract Refract Surg, 2011, 37(6):1076-1081.
[13] Xu ZQ, Song XH, Li WZ, et al. Clinical study inpatient-reported outcomes after binocular implantation of aspheric intraocular lensof different negative spherical aberrations. Asian Pac J Trop Med,2017, 10(7):710-713.
[14] Chen Y, Wang X, Zhou CD, et al. Evaluation of visual quality of spherical and aspherical intraocular lenses by Optical Quality Analysis System. Int J Ophthalmol, 2017, 10(6):914-918.
[15] Santhiago MR, Netto MV, Barreto JJ, et al. Optical quality in eyes implanted with aspheric and spherical intraocular lenses assessed by NIDEK OPD-Scan:a randomized, bilateral, clinical trial. J Refract Surg, 2011, 27(4):287-292.
[16] Schweitzer C, Colin J. Patient-reported difference following implantation of a blue light-filtering aspheric intraocular lens and a UV-filtering aspheric intraocular lens. Case Rep Ophthalmol,2013, 4(3):248-251
[17]张景尚,王进达,熊瑛,等.儿童白内障手术中应用非球面变色人工晶状体的疗效观察.眼科,2016, 25(3):199-201.
[2] Cruickshanks KJ, Klein R, Klein BE, et al. Sunlight and the 5-year incidence of early age-related maculopathy:the beaver dam eye study. Arch Ophthalmol, 2001, 119(2):246-250.
[3] Sparrow JR, Miller AS, Zhou J. Blue light-absorbing intraocular lens and retinal pigment epithelium protection in vitro. J Cataract Refract Surg, 2004, 30(4):873-878.
[4] Kernt M, Walch A, Neubauer AS, et al. Filtering blue light reduces light-induced oxidative stress, senescence and accumulation of extracellular matrix proteins in human retinal pigment epithelium cells. Clin Exp Ophthalmol, 2012, 40(1):e87-e97.
[5] Wirtitsch MG, Schmidinger G, Prskavec M, et al. Influence of blue-light-filtering intraocular lenses on color perception and contrast acuity. Ophthalmology, 2009, 116(1):39-45.
[6] Wang H, Wang J, Fan W, et al. Comparison of photochromic, yellow, and clear intraocular lenses in human eyes under photopic and mesopic lighting conditions. J Cataract Refract Surg, 2010, 36(12):2080-2086.
[7] Ao M, Chen X, Huang C, et al. Color discrimination by patients with different types of light-filtering intraocular lenses. J Cataract Refract Surg, 2010, 36(3):389-395.
[8] Mester U, Holz F, Kohnen T, et al. Intraindividual comparison of a blue-light filter on visual function:AF-1(UY)versus AF-1(UV)intraocular lens. J Cataract Refract Surg, 2008, 34(4):608-615.
[9] Bandyopadhyay S, Saha M, Chakrabarti A, et al. Effect on contrast sensitivity after clear, yellow and orange intraocular lens implantation. Int Ophthalmol, 2016, 36(3):313-318.
[10] Werner L, Mamalis N, Romaniv N, et al. New photochromic foldable intraocular lens:preliminary study of feasibility and biocompatibility. J Cataract Refract Surg, 2006, 32(7):1214-1221.
[11] Werner L, Abdel-Aziz S, Cutler PC, et al. Accelerated 20-year sunlight exposure simulation of a photochromic foldable intraocular lens in a rabbit model. J Cataract Refract Surg, 2011, 37(2):378-385.
[12] Nochez Y, Majzoub S, Pisella PJ. Effect of residual ocular spherical aberration on objective and subjective quality of vision in pseudophakic eyes. J Cataract Refract Surg, 2011, 37(6):1076-1081.
[13] Xu ZQ, Song XH, Li WZ, et al. Clinical study inpatient-reported outcomes after binocular implantation of aspheric intraocular lensof different negative spherical aberrations. Asian Pac J Trop Med,2017, 10(7):710-713.
[14] Chen Y, Wang X, Zhou CD, et al. Evaluation of visual quality of spherical and aspherical intraocular lenses by Optical Quality Analysis System. Int J Ophthalmol, 2017, 10(6):914-918.
[15] Santhiago MR, Netto MV, Barreto JJ, et al. Optical quality in eyes implanted with aspheric and spherical intraocular lenses assessed by NIDEK OPD-Scan:a randomized, bilateral, clinical trial. J Refract Surg, 2011, 27(4):287-292.
[16] Schweitzer C, Colin J. Patient-reported difference following implantation of a blue light-filtering aspheric intraocular lens and a UV-filtering aspheric intraocular lens. Case Rep Ophthalmol,2013, 4(3):248-251
[17]张景尚,王进达,熊瑛,等.儿童白内障手术中应用非球面变色人工晶状体的疗效观察.眼科,2016, 25(3):199-201.