正常瞳孔下多焦点非球面人工晶体眼视觉质量的研究

摘要

目的 通过分析计算不同晶体消除球面相差的差值,研究白内障患者行白内障超声乳化联合多焦点非球面人工晶状体的临床疗效.方法 临床纳入2016年01月至2016年05月间收治的老年性白内障患者180例(180只眼),按入院顺序分为3组,各60例.其中植入ReSTOR-SN60D3晶体者60例设为多焦非球面组(SN60D3组),植入SN60AT晶体者60例设为单焦球面组(SN60AT组),植入SN60WF晶体者60例设为单焦非球面组(SN60WF组).术后3个月观察术眼的屈光状态、焦点深度、调制解调函数值MTF,测量高阶像差,并问卷调查视觉质量.结果 术前3组患者视力情况无明显差异(P>0.05),术后SN60D3组的UCNVA明显优于SN60AT组和SN60WF组(P<0.05);在3 mm瞳孔直径下,术后SN60D3组与SN60WF组的球差Z(4,0)均小于SN60AT组(P<0.05),术后SN60D3组与SN60WF组仅在5cpd空间频率下MTF(HOA)值优于SN60AT组(P<0.05);术后SN60D3组患者在近视力、对矫正视力的依赖、活动是否受限等方面得分均高于其他两组(P<0.05),在视觉清晰度方面及白天视力波动情况好于单焦球面组(P<0.05).结论 多焦点非球面人工晶状体全眼总的球差及高阶像差更小,裸眼近视力效果更佳,其余视力稳定,可为白内障患者术后提供良好的视觉质量.%Objective To study the clinical effect of the combination of cataract ultrasonic emulsification and multifocal aspherical intraocular lens in cataract patients through evaluating different intraocular lenses elimi-nating spherical aberration. Methods 180 patients(180 eyes)with senile cataract were included between,2001 and 2005.The patients were divided into three group (n = 60 each),based on the admition time. Implantion of ReSTOR-SN60D3 is multifocal aspherical intraocular lens(SN60D3),implantion of SN60AT lens is single spheri-cal intraocular lens (SN60AT),and implantion of SN60WF lens is single aspherical intraocular lens (SN60WF group). Three months after operation,the refractive state,focus depth,modulation transfer function(MTF),and higher-order aberrations were measured ,and the visual quality were investigated. Results There was no signifi-cant difference in vision in three groups before operation(P > 0.05). After operation,the UCNVA of SN60D3 group was significantly better than the SN60AT group and SN60WF group(P < 0.05). Under 3 mm pupil diame-ter,spherical aberration of SN60D3 group and SN60WF Z(4,0)were less than SN60AT group(P < 0.05), SN60D3 group and SN60WF only under 5 CPD spatial frequency MTF(HOA)value was superior to the SN60AT group(P<0.05);The score of near vision,reliance on vision correction and limitation of operation of patients in SN60D3 group were higher than other two groups(P<0.05). Visual clarity and day vision fluctuations of patients in SN60D3 group is better than single focal sphere group(P<0.05). Conclusion In multifocal aspherical intra-ocular lens,general spherical aberrations and higher-order aberrations is smaller,effect of naked near vision is bet-ter and the rest of the vision is stable ,which can bring good visual quality for cataract patients after operation.