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

摘要

目的 比较白内障手术患者植入Tecnis ZMB00及AcrySof ReSTOR SN6AD1多焦点人工晶状体(multifocal intraocular lens,MIOL)后光学性能与视觉质量.方法 选取2012年3月至2015年7月于我院眼科择期进行白内障手术治疗的患者120例(130眼).所有患者均采用MIOL植入,并根据MIOL类型分为A组(Tecnis ZMB00组)、B组(AcrySof ReSTOR SN6AD1组),测定患者手术前后裸眼远视力(uncorrect distant visual acuity,UCDVA)、裸眼近视力(uncorrect near visual acuity,UCNVA)、裸眼中距离视力(uncorrecta intermediate vision,UCIVA)、最佳矫正远视力(best correct distant visual acuity,BCDVA)、最佳矫正近视力(best correct near visual acuity,BCNVA),均绘制离焦曲线,作对比敏感度分析,并采用术后视功能与生存质量调查表(VF-14)评定患者术后视觉质量.结果 术后1周、1个月、3个月A组UCNVA、UCIVA、BCNVA恢复情况均优于B组(均为P＜0.05),术后1周、3个月A组UCDVA恢复情况均优于B组,术后3个月等效球镜屈光度低于B组(P＜0.05).A组暗视、明视炫光、暗视炫光不同频率下对比敏感度均高于B组(均为P ＜0.05);A组术后3个月VF-14评分低于B组(P＜0.05);A组在0.0D与-2.5D形成2个波峰,-2.0～-2.5 D形成平台期,B组仅在0.0D与-3.0D形成2个波峰.结论 白内障手术患者植入Tecnis ZMB00 MIOL可改善患者术眼裸眼视力,提升对比敏感度,改善患者术后视功能及生活质量.%Objective To compare the optical properties and visual quality between Tecnis ZMB00 and AcrySof ReSTOR SN6AD1 multifocal intraocular lens (MIOL) in patients undergoing cataract surgery.Methods A total of 120 patients (130 eyes) who umderwent elective cataract surgery in our hospital from March 2012 to July 2015 were selected prospectively.All patients were treated with diffractive MIOL,and divided into group A (Tecnis ZMB00 group) and group B (AcrySof ReSTOR SN6AD1 group).The uncorrected distance visual acuity (UCDVA),uncorrected near visual acuity (UCNVA),uncorrected medium distance visual acuity (UCIVA),best corrected distance visual acuity (BCDVA) and best corrected near visual acuity (BCNVA) were measured before and after surgery.The defocusing curve was drawn for analysis of the contrast sensitivity,and the postoperative visual function and survival quality questionnaire (VF-14) was used to evaluate the postoperative visual quality.Results At 1 week,1 month and 3 months after surgery,recovery of UCNVA,UCIVA and BCNVA in group A was better than that in group B (all P ＜ 0.05).At 1 week and 3 months after surgery,the recovery of UCDVA in group A was better than that in group B (all P ＜ 0.05).At 3 months after surgery,the spherical equivalent was lower in group A than group B (P ＜ 0.05).The contrast sensitivities under scotopia,photopic glare and scotopic glare of different frequencies in group A were higher than those in group B (all P＜0.05).The VF-14 score in group A at 3 months after surgery was lower than that in group B (P＜0.05).In group A,0.0 D and-2.5 D formed 2 peaks,and from-2.0 D to-2.5 D formed the platform stage,while in group B,only 0.0 D and-3.0 D formed 2 peaks.Conclusion The implantation of Tecnis ZMB00 MIOL after cataract surgery can improve the uncorrected visual acuity of treated eye,contrast sensitivities,postoperative visual function and quality of life of patients.