Tecnis ZM900和Rezoom多焦点人工晶状体植入术后视功能比较

摘要

目的 比较Tecnis ZM900和Rezoom多焦点人工晶状体(MIOL)植入术后的视功能情况.方法 前瞻性对照研究.拟行白内障超声乳化吸除术患者36例(40眼),年龄55～83岁.按照患者植入人工晶状体的不同分为两组:Tecnis组22例(25眼),植入TecnisZM900 MIOL;Rezoom组14例(15眼),植入Rezoom MIOL.术后3个月,随访观察两组的屈光状态及最佳矫正远视力,远、中、近距离裸眼视力,并检查明、暗光条件下对比敏感度和球差.采用两样本t检验对结果进行分析.结果 术后3个月,两组最佳矫正远视力、裸眼远视力、100 cm中距离视力比较,Rezoom组优于Tecnis组(t=0.85、2.50、2.15,P＜0.05).两组63 cm中距离视力和40 cm近视力比较,差异无统计学意义(t=1.55、0.45,P＞0.05).33 cm近视力比较,Tecnis组优于Rezoom组(t=5.52,P＜0.05).暗光条件下低频(3、6 c/d)对比敏感度比较,Tecnis组优于Rezoom组(t=2.15、3.01,P＜0.05);而两组暗光下高频和明光下各空间频率对比敏感度比较,差异均无统计学意义(P＞0.05).在3、4、5 mm瞳孔直径下,Tecnis组全眼球差均低于Rezoom组,差异有统计学意义(t=2.16、2.28、4.00,P＜0.05).结论 Rezoom MIOL能提供较好的远、中距离视力,近视力相对较差;Tecnis ZM900 MIOL能提供较好的远、近视力,中距离视力相对较差.相对于Rezoom MIOL,Tecnis ZM900 MIOL的非球面设计降低了全眼球差,改善了暗光大瞳孔下的低频区对比敏感度.%Objective To evaluate visual performance after implantation of either the Tecnis ZM900 multifocal intraocular lens (MIOL) or the Rezoom MIOL. Methods This was a prospective comparative clinical study that included 25 eyes of 22 patients implanted with Tecnis ZM900 MIOL and 15 eyes of 14 patients implanted with Rezoom MIOL. The following parameters were assessed 3 months after surgery: refraction and best corrected distance visual acuity, uncorrected distance,intermediate and near visual acuities, photopic and mesopic contrast sensitivity at different spatial frequencies, and spherical aberrations at different pupil diameters. The data were analyzed with independent samples t test. Results Both groups achieved good distance visual acuity. For intermediate visual acuity at 100 cm, the best corrected and uncorrected visual acuity for eyes implanted with Rezoom MIOL were better than those with Tecnis ZM900 MIOL (t=0.85, 2.50, 2.15,P＜0.05). There were no statistically significant differences between the two groups for visual acuities at 63 cm and 40 cm (t=1.55, 0.45, P＞0.05). However, eyes implanted with Tecnis ZM900 MIOL had better near visual acuity at 33 cm than those with Rezoom MIOL (t=5.52, P＜0.05). There were statistically significant differences in mesopic contrast sensitivity at low spatial frequencies (3, 6 c/d)between the two groups (t=2.15, 3.01, P＜0.05). The root mean square of spherical aberrations was lower in eyes with Tecnis ZM900 MIOL than those with Rezoom MIOL for 3, 4, and 5 mm pupil diameters (t=2.16, 2.28, 4.00, P＜0.05). There were no statistically significant differences in photopic contrast sensitivity between the two groups (t=1.94, 1.00, 0.60, 0.67, P＞0.05). Conclusion The RezoomMIOL provide better distance and intermediate visual acuity. The Tecnis ZM900 MIOL provide good distance and near visual acuity. The Tecnis ZM900 MIOL provide better contrast sensitivity at low spatial frequencies due to a significant reduction in spherical aberrations under mesopic conditions.