折射型多焦点人工晶状体与衍射型非球面多焦点人工晶状体术后视觉质量的临床分析

摘要

目的 通过分别植入折射型多焦点人工晶状体(Rezoom MIOL)和衍射型非球面多焦点人工晶状体(Tecnis ZM900 MIOL),观察植入术后的视力、对比敏感度、焦点深度及问卷调查,比较植入 Rezoom MIOL和植入Tecnis ZM900 MIOL术后视觉质量.方法 将52例(58只眼)拟行白内障超声乳化吸除术按照患者植入人工晶状体的不同分为两组:Rezoom组25例(28只眼)植入Rezoom MIOL,Tecnis组27例(30只眼)植入Tecnis ZM900 MIOL,术后3个月,随访观察两组裸眼远视力、最佳矫正远视力、裸眼近视力、中间视力;并检查暗光条件下对比敏感度、焦点深度测量及问卷调查;对结果进行分析.结果 术后3个月,两组最佳矫正远视力、裸眼远视力比较,差异无统计学意义(P＞0.05);近视力比较,Tecnis组优于Rezoom组,差异有统计学意义(P＜0.05);63 cm中距离视力比较,Rezoom组优于Tecnis组,差异有统计学意义(P＜0.05);暗光(3 cd/m2)背景光线;1.5、3、6、12、18 c/d五种空间频率对比敏感度比较,Tecnis组优于Rezoom组,差异有统计学意义(P＜0.05).术后3个月Rezoom组的焦点深度为4.56 D,Tecnis组焦点深度为5.10 D;Tecnis组与ReZoom组比较,差异无统计学意义(P>0.05).结论 Rezoom MIOL能提供较好的远、中距离视力;Tecnis ZM900 MIOL能提供较好的远、近视力.个性化的选择人工晶状体才能更好地提高术后视觉质量.%Objective To observe and compare the clinical result of vision quality after implanting Rezoom MIOL and Tecnis ZM900 MIOL by studying the postoperative visual acuity, contrast sensitivity ,focal depth and questionnaires.Method 52 patients( 58eyes ) were observed in this study ,We separated the patients into two groups. The first group consisted of 25 patients ( 28eyes ),which implant Rezoom MIOL and the second group consisted of 27 patients ( 30 eyes ) that impant Tecnis ZM900 MIOL. we recorded and analyzed the parameters such as: UCDVA, BCDVA, UCNVA and intermediate vision, contrast sensitivity, focal depth and results of questionnaire at 3 months postoperatively. Results There were no significant differences between the groups in UCDVA and BCDVA at 3 months postoperatively ( P ＞ 0.05 ). The second goup ( Tecnis ZM900 MIOL ) had better near visual acuity and better intermediate vision of 63 cm, there were significant differences between the groups in UCNVA and intermediate vision of 63cm. Two groups did not show differences in contrast sensitivity under mesopic light conditions( 3 cd/m2 at 1.5、3、6、12、18c/d ) ( P ＞ 0.05 ). At 3 months postoperatively,there were statistically differences between the two groups in focal depth( P ＜ 0.05 ), with 4.46 D in Rezoom MIOL group and 5.35 D in Tecnis ZM900 MIOL group. In patients' questionaire: there were no significant differences between the groups in visual symptoms and satisfaction with distance vision. More patients need glasses in Rezoom MIOL group than Tecnis ZM900 MIOL group, and less satisfaction with near vision in Rezoom MIOL group than Tecnis ZM900 MIOL group.Conclusion The patients with Rezoom MIOL implantation have better distance and intermediate vision, while who of with Tecnis ZM900 MIOL implantation provides better near visual acuity. Personalized options are needed in order to improve visual quality.