非球面衍射型多焦点人工晶状体植入术后患者视觉质量评价  

Quality of vision in patients with aspherical diffractive multifocal intraocular lens implantation

作　　者：何永奇[1] 张春芳[1] 王开杰[1] 朱思泉[1] 

机构地区：[1]首都医科大学附属北京同仁医院眼科中心,100730

出　　处：《中华医学杂志》2009年第31期2175-2178,共4页National Medical Journal of China

基　　金：基金项目：“十一五”国家科技支撑计划基金：高效智能化微创白内障治疗系统研制（2006BA103A09）

摘　　要：目的评价非球面衍射型多焦点人工晶状体（MIOL）植入术后的视觉质量。方法前瞻性非随机对照研究。114例（114眼）老年性白内障患者行超声乳化白内障吸除联合人工晶状体植入术，分为多焦点TecnisZM900人工晶状体植入组（多焦组）和单焦点TecnisZA9003人工晶状体植入组（单焦组），各57例（57眼）。术后3个月检查并比较裸眼及矫正的远、近视力、最佳矫正远视力下的近视力、人工晶状体像差、调制传递函数、对比度视力、拟调节力，并对主观评价进行问卷调查。结果术后3个月，多焦组裸眼近视力和最佳矫正远视力下的近视力均高于单焦组（t=-7．62，-9．89，P〈0．05）；调节幅度多焦组为（4．74±1．05）D，单焦组为（1．65±0．68）D，两者差异具有统计学意义（t=8．31，P〈0．01）；瞳孔直径3mm和5mm时，两组各高阶像差差异均无统计学意义；40、63cm对比度视力多焦组高于单焦组，差异具有统计学意义；各空间频率下两组调制传递函数值差异无统计学意义；两组术后脱镜率分别为85．9％和24．6％，差异有统计学意义（X2=43．46，P〈0．05）。结论与非球面单焦点人工晶状体相比，非球面衍射型MIOL不仅具有一定的拟调节力，可获得良好的远近视力，且提供较高的视觉质量，适应于迫切要求脱镜的白内障患者。Objective To evaluate the visual performance of patients with Tecnis ZM900 aspherical diffractive multifocal intraocular lens （MIOL） as compared with aspherical monofocal intraocular lens （IOL）. Methods A prospective nonrandomized controlled study was conducted. Consecutively 114 senile cataract patients （114 eyes） received phacoemulsification and IOL implantation, 57 patients （57 eyes） were implanted Tecnis ZM900 MIOL （multifocal group） and 57 patients （57 eyes） were implanted aspherical Tecnis ZAg003 IOL （monofocal group）. All patients were assessed at 3 months postoperatively：uncorrected and best corrected visual acuities for distance and near, distance corrected near visual acuity, higher-order aberrations of IOL, modulation transfer function, contrast visual acuity at different contrast levels and different distance （40 cm, 63 cm and 100 cm） and pseudoaccommodation. Patient satisfaction （spectacle independence, photic phenomena and overall satisfaction） was assessed by a questionnaire. Results At 3 months post-operation, both uncorrected near visual acuity and distance corrected near visual acuity were significantly better in multifocal group than monofocal group （ t = - 7.62, - 9. 89, P 〈 0. 05 ） . The accommodative range was （ 4. 74 ± 1.05 ） D in muhifocal group and （ 1.65± 0. 68 ） D in monofocal group （P 〈0. 01 ）. There was no statistically significantly difference between the two groups in IOL higher-order aberration with different pupil sizes （ 3 mm vs 5 mm）. At the distance of 40 cm and 63 cm, visual acuity scores were higher in multifocal group than in monofocal group （ P 〈 0. 01 ）. Modulation transfer function was similar in the two groups and there was no statistically significantly difference. The spectacle independence was 85.9% in multifocal group versus 24.6% in the monofocal group （X2 = 43.46, P〈0.05）. Conclusion Compared with aspherical monofocal IOL, the Tecnis ZM900 aspherical diffractive MIOL not only provided certa

关 键 词：晶体 人工 多焦点 非球面 视觉质量 

分 类 号：R686[医药卫生—骨科学]