区域折射多焦点人工晶状体植入术后视觉质量分析
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摘要
目的:观察区域折射多焦点人工晶状体(IOL)植入术后的视觉质量。方法:选取2016-06/2017-02在我院行白内障超声乳化吸除联合IOL植入术的白内障患者50例83眼,按植入的IOL类型不同分为观察组(22例37眼,植入多焦点IOL)和对照组(28例46眼,植入单焦点IOL)。术后3mo,观察裸眼视力,使用OQASⅡ客观视觉质量分析系统评估视觉质量,并采用问卷调查术后视觉干扰症状、脱镜率及满意度。结果:术后3mo,观察组和对照组裸眼远视力(0.095±0.031 vs 0.078±0.025)无差异(P=0.273),但观察组患者裸眼中、近视力均优于对照组(0.146±0.043 vs 0.537±0.102,0.165±0.048 vs 0.754±0.150,均P<0.05);两组患者MTF cut-off和对比度视力无差异,但OSI(2.64±0.68 vs 1.52±0.47)和客观调节幅度(2.91±0.71D vs 1.32±0.41D)均有明显差异(P<0.01);观察组脱镜率明显高于对照组(91%vs 7%,P<0.05),但两组术后视学干扰症状发生率和满意度无明显差异(均P>0.05)。结论:区域折射多焦点IOL可提供良好的全程视力和视觉质量,提高了患者的脱镜率,且满意度高。
AIM: To observe the visual quality after segmental Refractive multifocal intraocular lens(IOL) implantation.METHODS: Totally 50 cases(83 eyes) of cataract patients who receiving phacoemulsification and IOL implantation in our hospital from June 2016 to February 2017 were selected as the study object. Based on the IOL types, the patients were divided into two groups: 22 cases(37 eyes) in observation group implanted segmental refractive multifocal IOL, 28 cases(46 eyes) in control group implanted monofocal IOL. Three months after surgery, the uncorrected visual acuity was recorded. A double-pass optical quality analysis system(OQAS II) was used to evaluate the visual quality. The near spectacle independence, satisfaction, and symptoms of visual disturbance were assessed by a questionnaire.RESULTS: Three months after surgery, there were no statistical differences in uncorrected distance visual acuity(UCDVA) between the observation group and control group(P=0.273). The uncorrected intermediate visual acuity(UCIVA) and uncorrected near acuity(UCNVA) of observation group was better than control group(P<0.05). There were no statistical differences in MTF cutoff; contrast visual acuity between the groups. The OSI in the observation and control groups was 2.64±0.68 and 1.52±0.47, respectively; objective amplitude of accommodation was(2.91±0.71)D and(1.32±0.41)D, respectively; near spectacle independence was 91% and 7%, respectively. There were statistical differences between the groups(P<0.05). There were no statistical differences between the groups for visual disturbances(glare, ghosting) and satisfaction(P>0.05).CONCLUSION: Segmental refractive multifocal intraocular lens provides wider objective amplitude of accommodation and good overall visual acuity, reduces spectacle dependency and provides high patient satisfaction.
AIM: To observe the visual quality after segmental Refractive multifocal intraocular lens(IOL) implantation.METHODS: Totally 50 cases(83 eyes) of cataract patients who receiving phacoemulsification and IOL implantation in our hospital from June 2016 to February 2017 were selected as the study object. Based on the IOL types, the patients were divided into two groups: 22 cases(37 eyes) in observation group implanted segmental refractive multifocal IOL, 28 cases(46 eyes) in control group implanted monofocal IOL. Three months after surgery, the uncorrected visual acuity was recorded. A double-pass optical quality analysis system(OQAS II) was used to evaluate the visual quality. The near spectacle independence, satisfaction, and symptoms of visual disturbance were assessed by a questionnaire.RESULTS: Three months after surgery, there were no statistical differences in uncorrected distance visual acuity(UCDVA) between the observation group and control group(P=0.273). The uncorrected intermediate visual acuity(UCIVA) and uncorrected near acuity(UCNVA) of observation group was better than control group(P<0.05). There were no statistical differences in MTF cutoff; contrast visual acuity between the groups. The OSI in the observation and control groups was 2.64±0.68 and 1.52±0.47, respectively; objective amplitude of accommodation was(2.91±0.71)D and(1.32±0.41)D, respectively; near spectacle independence was 91% and 7%, respectively. There were statistical differences between the groups(P<0.05). There were no statistical differences between the groups for visual disturbances(glare, ghosting) and satisfaction(P>0.05).CONCLUSION: Segmental refractive multifocal intraocular lens provides wider objective amplitude of accommodation and good overall visual acuity, reduces spectacle dependency and provides high patient satisfaction.
引文
1郭别川,柯敏,田朕,等.多焦点人工晶状体和单焦点非球面人工晶状体植入术后患者视功能及生存质量比较.眼科新进展 2014;34(11):1052-1054
2俞阿勇.双通道客观视觉质量分析的临床实践.北京:人民卫生出版社 2017:28-43
3 de Vries NE, Nuijts RM. Multifocal intraocular lenses in cataract surgery:literature review of benefits and side effects. J Cataract Refract Surg 2013;39(2):268-278
4 Cochener B,Lafuma A,Khoshnood B,et al. Comparison of outcomes with multifocal intraocular lenses:a meta-analysis. Clin Ophthalmol 2011;5:45-56
5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
6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
7 Alió JL,Piňero DP,Plaza-Puche AB,et al. Visual outcomes and optical performance of a monofocal intraocular lens and a new-generation multifocal intraocular lens. J Cataract Refract Surg 2011;37(2):241-250
8 McAlinden C,Moore JE. Multifocal intraocular lens with a surface-embedded near section: Short-term clinical outcomes. J Cataract Refract Surg 2011;37(3):441-445
9 Lin JC,Yang MC. Cost-effectiveness comparison between monofocal and multifocal intraocular lens implantation for cataract patients in Taiwan. Clin Ther 2014;36(10):1422-1430
10陈琛,屈思萌,林珊,等.区域折射多焦点人工晶状体SBL-3的临床应用.国际眼科杂志 2018;18(3):446-450
11林志博,黄芳潘,安鹏,等.区域折射型多焦点人工晶状体植入术后视觉质量的临床研究.中华眼视光学与视觉科学杂志 2017;19(8):482-487
12 Shah S,Peris-Martinez C,Reinhard T,et al. Visual Outcomes After Cataract Surgery:Multifocal Versus Monofocal Intraocular Lenses. J Refract Surg 2015;31(10):658-666
13 Calladine D,Evans JR,Shah S,et al. Multifocal versus monofocal intraocular lenses after cataract extraction. Cochrane Database Syst Rev 2012;9:CD003169
14 Greenstein S,Pineda R 2nd. The Quest for Spectacle Independence:A Comparison of Multifocal Intraocular Lens Implants and Pseudophakic Monovision for Patients with Presbyopia. Semin Ophthalmol 2017;32(1):111-115
2俞阿勇.双通道客观视觉质量分析的临床实践.北京:人民卫生出版社 2017:28-43
3 de Vries NE, Nuijts RM. Multifocal intraocular lenses in cataract surgery:literature review of benefits and side effects. J Cataract Refract Surg 2013;39(2):268-278
4 Cochener B,Lafuma A,Khoshnood B,et al. Comparison of outcomes with multifocal intraocular lenses:a meta-analysis. Clin Ophthalmol 2011;5:45-56
5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
6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
7 Alió JL,Piňero DP,Plaza-Puche AB,et al. Visual outcomes and optical performance of a monofocal intraocular lens and a new-generation multifocal intraocular lens. J Cataract Refract Surg 2011;37(2):241-250
8 McAlinden C,Moore JE. Multifocal intraocular lens with a surface-embedded near section: Short-term clinical outcomes. J Cataract Refract Surg 2011;37(3):441-445
9 Lin JC,Yang MC. Cost-effectiveness comparison between monofocal and multifocal intraocular lens implantation for cataract patients in Taiwan. Clin Ther 2014;36(10):1422-1430
10陈琛,屈思萌,林珊,等.区域折射多焦点人工晶状体SBL-3的临床应用.国际眼科杂志 2018;18(3):446-450
11林志博,黄芳潘,安鹏,等.区域折射型多焦点人工晶状体植入术后视觉质量的临床研究.中华眼视光学与视觉科学杂志 2017;19(8):482-487
12 Shah S,Peris-Martinez C,Reinhard T,et al. Visual Outcomes After Cataract Surgery:Multifocal Versus Monofocal Intraocular Lenses. J Refract Surg 2015;31(10):658-666
13 Calladine D,Evans JR,Shah S,et al. Multifocal versus monofocal intraocular lenses after cataract extraction. Cochrane Database Syst Rev 2012;9:CD003169
14 Greenstein S,Pineda R 2nd. The Quest for Spectacle Independence:A Comparison of Multifocal Intraocular Lens Implants and Pseudophakic Monovision for Patients with Presbyopia. Semin Ophthalmol 2017;32(1):111-115