中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2010年
7期
625-630
,共6页
叶盼盼%姚克%李霞%吴炜%黄晓丹%俞一波
葉盼盼%姚剋%李霞%吳煒%黃曉丹%俞一波
협반반%요극%리하%오위%황효단%유일파
晶体,人工%对比敏感度%深度知觉
晶體,人工%對比敏感度%深度知覺
정체,인공%대비민감도%심도지각
Lenses,intraocular%Contrast sensitivity%Depth perception
目的 比较双眼植入Tecnis多焦点人工晶状体(IOL)与传统球面单焦点IOL对视觉功能的影响.方法 前瞻性临床研究.对100例(200只眼)患者实施超声乳化白内障吸除联合IOL植入术,采用随机数字表法随机植入前表面非球面和后表面衍射环的多焦点IOL(美国AMO公司Tecnis ZM900型;多焦点非球面组)与传统球面单焦点IOL(美国Bausch&Lomb公司Akreos Adapt型;单焦点球面组).随访3个月,检测两组IOL眼的5 m、1 m、63 cm、40 cm和30 cm各距离的裸眼视力和最佳远视力矫正下的近视力、调节幅度、全眼球差、对比敏感度、眩光敏感度以及近立体视锐度,并进行患者视功能和满意度问卷调查.对计量资料中两组数据进行正态性检验分析,满足正态分布的行t检验,不满足的行Mann-Whitney U检验,对计数资料行x2检验.结果 随访3个月后观察发现,30 cm和40cm距离多焦点非球面组的双眼远视力矫正下视力(logMAR视力)为0.24±0.12和0.22±0.11,明显优于单焦点球面组(Z=-8.261,P=0.000;Z=-5.508,P=0.000),其余各距离无明显差异;较之单焦点球面组,多焦点非球面组患者提高2.3～2.8 D的调节幅度(单眼Z=-10.655,P=0.000;双眼Z=-2.709,P=0.007);无论5 mm或3 mm瞳孔直径时多焦点非球面组的全眼球差[(0.027±0.160)μm,(0.006±0.083)μm]均小于单焦点球面组[(0.269±0.161)μm,(0.037±0.205)μm](Z=-8.815,P=0.000,Z=-2.791,P=0.005);两组的对比敏感度无明显差别,但单焦点球面组的眩光敏感度明显高于多焦点非球面组(P=0.0000);多焦点非球面组的裸眼近立体视锐度为(72.4±29.9)",优于单焦点球面组的(92.8±35.7)"(Z=-3.089,P=0.0002),近矫后近立体视锐度两组无统计学差异.结论 Tecnis多焦点非球面IOL较单焦点球面IOL可提供较好的近视力及调节幅度,提高近立体视锐度,非球面设计减少全眼球差,在一定程度上改善对比敏感度.
目的 比較雙眼植入Tecnis多焦點人工晶狀體(IOL)與傳統毬麵單焦點IOL對視覺功能的影響.方法 前瞻性臨床研究.對100例(200隻眼)患者實施超聲乳化白內障吸除聯閤IOL植入術,採用隨機數字錶法隨機植入前錶麵非毬麵和後錶麵衍射環的多焦點IOL(美國AMO公司Tecnis ZM900型;多焦點非毬麵組)與傳統毬麵單焦點IOL(美國Bausch&Lomb公司Akreos Adapt型;單焦點毬麵組).隨訪3箇月,檢測兩組IOL眼的5 m、1 m、63 cm、40 cm和30 cm各距離的裸眼視力和最佳遠視力矯正下的近視力、調節幅度、全眼毬差、對比敏感度、眩光敏感度以及近立體視銳度,併進行患者視功能和滿意度問捲調查.對計量資料中兩組數據進行正態性檢驗分析,滿足正態分佈的行t檢驗,不滿足的行Mann-Whitney U檢驗,對計數資料行x2檢驗.結果 隨訪3箇月後觀察髮現,30 cm和40cm距離多焦點非毬麵組的雙眼遠視力矯正下視力(logMAR視力)為0.24±0.12和0.22±0.11,明顯優于單焦點毬麵組(Z=-8.261,P=0.000;Z=-5.508,P=0.000),其餘各距離無明顯差異;較之單焦點毬麵組,多焦點非毬麵組患者提高2.3～2.8 D的調節幅度(單眼Z=-10.655,P=0.000;雙眼Z=-2.709,P=0.007);無論5 mm或3 mm瞳孔直徑時多焦點非毬麵組的全眼毬差[(0.027±0.160)μm,(0.006±0.083)μm]均小于單焦點毬麵組[(0.269±0.161)μm,(0.037±0.205)μm](Z=-8.815,P=0.000,Z=-2.791,P=0.005);兩組的對比敏感度無明顯差彆,但單焦點毬麵組的眩光敏感度明顯高于多焦點非毬麵組(P=0.0000);多焦點非毬麵組的裸眼近立體視銳度為(72.4±29.9)",優于單焦點毬麵組的(92.8±35.7)"(Z=-3.089,P=0.0002),近矯後近立體視銳度兩組無統計學差異.結論 Tecnis多焦點非毬麵IOL較單焦點毬麵IOL可提供較好的近視力及調節幅度,提高近立體視銳度,非毬麵設計減少全眼毬差,在一定程度上改善對比敏感度.
목적 비교쌍안식입Tecnis다초점인공정상체(IOL)여전통구면단초점IOL대시각공능적영향.방법 전첨성림상연구.대100례(200지안)환자실시초성유화백내장흡제연합IOL식입술,채용수궤수자표법수궤식입전표면비구면화후표면연사배적다초점IOL(미국AMO공사Tecnis ZM900형;다초점비구면조)여전통구면단초점IOL(미국Bausch&Lomb공사Akreos Adapt형;단초점구면조).수방3개월,검측량조IOL안적5 m、1 m、63 cm、40 cm화30 cm각거리적라안시력화최가원시력교정하적근시력、조절폭도、전안구차、대비민감도、현광민감도이급근입체시예도,병진행환자시공능화만의도문권조사.대계량자료중량조수거진행정태성검험분석,만족정태분포적행t검험,불만족적행Mann-Whitney U검험,대계수자료행x2검험.결과 수방3개월후관찰발현,30 cm화40cm거리다초점비구면조적쌍안원시력교정하시력(logMAR시력)위0.24±0.12화0.22±0.11,명현우우단초점구면조(Z=-8.261,P=0.000;Z=-5.508,P=0.000),기여각거리무명현차이;교지단초점구면조,다초점비구면조환자제고2.3～2.8 D적조절폭도(단안Z=-10.655,P=0.000;쌍안Z=-2.709,P=0.007);무론5 mm혹3 mm동공직경시다초점비구면조적전안구차[(0.027±0.160)μm,(0.006±0.083)μm]균소우단초점구면조[(0.269±0.161)μm,(0.037±0.205)μm](Z=-8.815,P=0.000,Z=-2.791,P=0.005);량조적대비민감도무명현차별,단단초점구면조적현광민감도명현고우다초점비구면조(P=0.0000);다초점비구면조적라안근입체시예도위(72.4±29.9)",우우단초점구면조적(92.8±35.7)"(Z=-3.089,P=0.0002),근교후근입체시예도량조무통계학차이.결론 Tecnis다초점비구면IOL교단초점구면IOL가제공교호적근시력급조절폭도,제고근입체시예도,비구면설계감소전안구차,재일정정도상개선대비민감도.
Purpose To compare visual function in pseudophakic patients with bilateral implantation of Tecnis multifocal aspheric and conventional monofocal spherical intraocular lenses (IOL). Methods A prospective study of 100 consecutive cases (200 eyes) was conducted. All cataract patients underwent phaocoemulsification were randomized to receive multifocal aspheric IOL ( Tecnis ZM900, AMO, multifocal aspheric group) or conventional spherical IOL ( Akreos Adapt, Bausch&Lomb, monofocal spherical group) . The following investigations were performed to assess the uncorrected and distance-corrected visual acuity of distance, intermediate and near distances, accommodative amplitude, spherical aberrations of total eye, contrast sensitivity, glare sensitivity and near stereoacuity. Patients were surveyed for visual disturbances and lifestyle visual quality. The independent-samples t test waa used to compare the measure data which met normal distribution and the Mann-Whitney U test was used to compare the measure data which didn' t meet. The chi-square test was applied to compare categorical variables. Results The uncorrected and distance-corrected bilateral visual acuity of multifocal aspheric group at 30 cm and 40 cm were 0. 24 ± 0. 12 and 0. 22 ± 0. 11 (logMAR) , better than monofocal spherical group ( Z = - 8. 261, P = 0. 000;Z = -5. 508, P =0.000), but the visual acuity at other distances had no statistical difference between two groups. Patients with multifocal aspheric IOL had significantly higher accommodative amplitude than those with monofcal spherical IOL, improved about 2. 3 - 2. 8 D ( Z= -10. 655, P = 0. 000; Z =- 2. 709, P = 0. 007). Mean spherical aberration of multifocal aspheric group was ( 0. 027 ±0. 160) μm and (0. 006 ±0. 083)μm, significantly lower than that of monofocal spherical group (0. 269 ±0. 161) μm, (0.037 ±0.205) μm at 5 mm and 3 mm pupil diameter(Z= - 8. 815, P = 0. 000; Z = -2. 791, P = 0. 005) . The difference of contrast sensitivity was not significant, but glare sensitivity was higher for monofocal spherical group than for multifocal aspheric group. Multifocal aspheric group showed statistically better uncorrected stereoacuity (72.4 ± 29. 9 ) " than monofocal spherical group (92. 8 ± 35. 7)" ( Z =-3. 089,P = 0.002) . Conclusions The present clinical results demonstrated that Tecnis multifocal aspheric group had better near visual acuity, accommodative amplitude and near stereoacuity as compared to conventional monofocal spherical group. The aspheric design reduced spherical aberration of total eye and improved contrast sensitivity in some way.
