摘要
目的:对双眼植入三焦点人工晶状体(IOL)或双焦点IOL术后早期的视觉质量进行比较研究。方法:前瞻性临床研究。选择武汉爱尔眼科医院2017年4月至2018年5月收治的双眼单纯年龄相关性白内障患者52例(104眼),依据患者选择的IOL进行分组,双眼均植入双焦点IOL26例(52眼)作为双焦点组,双眼均植入三焦点IOL26例(52眼)患者作为三焦点组,术后随访3个月,观察2组间裸眼远视力(UDVA)、裸眼中视力(UIVA)、裸眼近视力(UNVA)、矫正远视力(BCDVA)、矫正远中视力(DCIVA)、矫正远近视力(DCNVA)、离焦曲线、对比敏感度、波前像差、调制传递函数等,并进行VF-14-CN生活质量问卷满意度及脱镜率调查。数据采用独立样本t检验、Mann-WhitneyU检验及χ^2检验进行统计分析。结果:三焦点组UIVA明显优于双焦点组(Z=-2.347,P=0.019),而2组间UDVA、UNVA、BCDVA、DCIVA、DCNVA差异均无统计学意义。三焦点组在-1.0、-3.0、-3.5、-4.0D离焦下视力明显优于双焦点组(Z=-2.619、-2.452、-2.452、-2.147,P=0.009、0.014、0.014、0.032)。2组间明视及明视眩光对比敏感度差异均无统计学意义。3、5mm瞳孔直径时,三焦点组眼内总高阶像差、眼内彗差、眼内三叶草差以及全眼总高阶像差、全眼三叶草差均明显低于双焦点组,差异均有统计学意义(P<0.05)。5mm瞳孔直径时,三焦点组眼内球差明显低于双焦点组(Z=-3.053,P=0.002),余指标组间差异无统计学意义。2组在3、5mm瞳孔直径时的调制传递函数差异均无统计学意义。2组间VF-14-CN得分、日常生活脱镜率以及患者满意度差异均无统计学意义。结论:与双眼植入双焦点IOL相比,双眼植入三焦点IOL能够为患者带来更好的中间距离视力,但二者在远近视力、视觉质量以及术后生活质量方面相近。
Objective:To compare visual performance after bilateral implantation of a bifocal (ReSTOR +3.0 D) or trifocal (AT Lisa tri.839MP) intraocular lens (IOL).Methods:This prospective clinical study involved patients who had cataract surgery that included the bilateral implantation of a bifocal or trifocal IOL from April 2017 to May 2018 at Wuhan Aier Eye Hospital.Fifty-two eyes (26 patients) were implanted with a trifocal IOL (AT Lisa tri.839MP) as trifocal group and fifty-two eyes (26 patients) with a bifocal IOL (ReSTOR +3.0 D) as bifocal IOL group.The follow-up was 3 months.Near,intermediate,and distance visual acuities, defocus curve,optical quality,including modulation transfer functions and intraocular aberrations,ocular aberrations with 3 mm and 5 mm pupil diameters,National Eye Institute Visual Functioning Questionnaire-14 for Chinese people (VF-14-CN),spectacle independence and patient satisfaction were assessed in all patients. Data were assessed with a Student's t test,Mann-Whitney U test,and Chi-square test.Results:No statistically significant difference was found in distance,near,best corrected distance,distance-corrected intermediate, or distance-corrected near visual acuity between the two groups.Uncorrected intermediate visual acuity was significantly better in the trifocal IOL group (Z=-2.347,P=0.019).In the binocular defocus curve,visual acuity was also significantly better for defocus at -1.0,-3.0,3.5 and 4.0 diopters (Z=-2.619,-2.452,-2.452,-2.147;P=0.009,0.014,0.014,0.032).No significant difference was found between the two groups for mean postoperative contrast sensitivity function under photopic conditions with or without glare.With a 3 mm or 5 mm pupil diameter,intraocular higher-order aberrations,coma,trefoil and total higher-order aberrations,and trefoil aberrations were significantly lower in the trifocal IOL group (P<0.05).With a 5 mm pupil diameter, intraocular spherical aberrations were significantly lower in the trifocal IOL group (Z=-3.053,P=0.002), but no statistically significant difference was found in modulation transfer function at 3 mm and 5 mm pupil diameters between the two groups.The level of overall satisfaction was similarly high for both groups. Conclusions:Trifocal IOLs can provide significantly better intermediate vision and equivalent distance and near visual performance compared to bifocal IOLs and have the same level of overall satisfaction.
作者
陈碧超
谭倩
王潇
李雪婷
曹丹敏
王勇
Bichao Chen;Qian Tan;Xiao Wang;Xueting Li;Danmin Cao;Yong Wang(Aier School of Ophthalmology,Central South University,Changsha 410000,China;Wuhan Aier Eye Hospital,Aier Eye Hospital Group,Wuhan 430000,China;Changsha Aier Eye Hospital,Aier Eye Hospital Group,Changsha 410000,China)
出处
《中华眼视光学与视觉科学杂志》
CAS
CSCD
2019年第6期451-459,共9页
Chinese Journal Of Optometry Ophthalmology And Visual Science
基金
湖北省卫生计生委面上项目(WJ2017M2015)
爱尔集团科研项目(AM148D17).
关键词
三焦点人工晶状体
离焦曲线
对比敏感度
像差
视觉质量
生活质量
trifocal intraocular lens
defocus curve
contrast sensitivity
aberration
visual quality
opticalquality
