CAJ | 학술논문

目的评价全光学面衍射型非球面多焦点人工晶状体(multifocal intraocular lens,MIOL)植入术后的视觉质量.方法将56例(82只眼)行白内障超声乳化联合人工晶状体植入的患者分为两组:多焦点组(MIOL组):26例(36只眼)植入衍射型非球面多焦点人工晶状体TecnisZMA00;单焦点组(SIOL组):30例(46只眼)植入非球面单焦点人工晶状体Tecnis ZA9003.术后随访3月,测量裸眼远、中、近视力、最佳矫正远视力及最佳矫正远视力下中、近视力、术后并发症、对比敏感度、焦点深度并进行问卷调查比较脱镜率、满意度及视觉不良症状.结果 (1)术后3月,MIOL组裸眼近视力及最佳矫正远视力下近视力优于SIOL组,差异有统计学意义(P＜0.01).两组裸眼远视力、最佳矫正远视力、裸眼中间视力及矫正远视力下中间视力差异无统计学意义(P＞0.05).(2)术后3月,MIOL组对比敏感度在暗光条件空间频率3 cpd低于SIOL组,差异有统计学意义外(P＜0.01),余差异均无统计学意义(P ≥0.05).(3) MIOL组和SIOL组焦点深度范围分别为(+1.5～-3.5)D和(+1.0～1.5)D,差异有统计学意义(P＜0.05).(4) MIOL组脱镜率为88.9％,而SI-OL组为27.8％,两组差异有统计学意义(P＜0.01).全程视力满意度,MIOL组80.6％ (29/36)与SI-OL组19.6％ (9/46)相比,差异有统计学意义(P＜0.01).少数患者诉轻度光晕、眩光现象,MIOL和SIOL组分别为27.8％ (10/36)和23.9％ (11/46),差异无统计学意义(P＞0.05).患者诉这种现象对日常生活无明显影响.结论 Tecnis ZMA00多焦点人工晶状体可提供良好的全程视力、尤其是近视力,具有较高的拟调节力及脱镜率,有效地提高了白内障患者术后的视觉质量.
목적 평개전광학면연사형비구면다초점인공정상체(multifocal intraocular lens,MIOL)식입술후적시각질량.방법 장56례(82지안)행백내장초성유화연합인공정상체식입적환자분위량조:다초점조(MIOL조):26례(36지안)식입연사형비구면다초점인공정상체TecnisZMA00;단초점조(SIOL조):30례(46지안)식입비구면단초점인공정상체Tecnis ZA9003.술후수방3월,측량라안원、중、근시력、최가교정원시력급최가교정원시력하중、근시력、술후병발증、대비민감도、초점심도병진행문권조사비교탈경솔、만의도급시각불량증상.결과 (1)술후3월,MIOL조라안근시력급최가교정원시력하근시력우우SIOL조,차이유통계학의의(P＜0.01).량조라안원시력、최가교정원시력、라안중간시력급교정원시력하중간시력차이무통계학의의(P＞0.05).(2)술후3월,MIOL조대비민감도재암광조건공간빈솔3 cpd저우SIOL조,차이유통계학의의외(P＜0.01),여차이균무통계학의의(P ≥0.05).(3) MIOL조화SIOL조초점심도범위분별위(+1.5～-3.5)D화(+1.0～1.5)D,차이유통계학의의(P＜0.05).(4) MIOL조탈경솔위88.9％,이SI-OL조위27.8％,량조차이유통계학의의(P＜0.01).전정시력만의도,MIOL조80.6％ (29/36)여SI-OL조19.6％ (9/46)상비,차이유통계학의의(P＜0.01).소수환자소경도광훈、현광현상,MIOL화SIOL조분별위27.8％ (10/36)화23.9％ (11/46),차이무통계학의의(P＞0.05).환자소저충현상대일상생활무명현영향.결론 Tecnis ZMA00다초점인공정상체가제공량호적전정시력、우기시근시력,구유교고적의조절력급탈경솔,유효지제고료백내장환자술후적시각질량.
Objective To evaluate the visual quality of patients after implantation of the diffractive aspherical multifocal intraocular lens.Methods In the clinical research,56 patients (82 eyes)who underwent phaocoemulsification were divided into two groups,26 cases (36 eyes) who received the diffractive aspherical multifocal IOL (Tecnis ZMA00) were divided into multifocal group (MIOL group),30 patients (46 eyes) who received the single focus aspherical IOL (Tecnis ZA9003) were divided into single focus group (SIOL group).Three months after surgery,uncorrected and best corrected distance visual acuity (UCDVA and BCDVA),uncorrected intermediate and near visual acuity (UCIVA and UCNVA),distance corrected intermediate and near visual acuity (DCIVA and DCNVA),postoperative complications,contrast sensitivity,pseudoaccommodation were recorded.The patient's degree of satisfaction,spectacle independence,severity of symptoms (night glare or halo) through a questionnaire was assessed.Results Three months after surgery,average uncorrected and distance corrected near visual acuity of MIOL group were better than those of SIOL group,the differences were statistically significant (P ＜0.05).The uncorrected and best corrected distance visual acuity,uncorrected and distance corrected intermediate visual acuity were similar to SIOL group' s,no statistical differences were found in them (P ＞0.05).Contrast sensitivity of MIOL group were lower than those of SIOL group,but no statistical differences were found between them in all contrast sensitivities except at the 3 cpd in dark condition.The depth of focal of MIOL group was better than SIOL group's (+1.5 ～-3.5D versus +l.0～-1.5D),there was statistical difference between them.The spectacle independence in MIOL and SIOL groups were 88.9％ and 27.8％ (P ＜0.05).The degrees of satisfaction about MIOL and SIOL group were 80.6％ and 19.6％ (P ＜0.01).No statistical differences were found in night glare or halo phenomena between MIOL group 27.8％ and SIOL group 23.9％ (P ＞0.05).Conclusions The diffractive aspherical multifocal lens (Tecnis ZMA00) can provide good full range visual acuity,especially near visual acuity and higher spectacle independence and depth of focus,so it can improve the quality of life for patients after surgery.