区域折射型人工晶状体植入术后角膜残余散光对患者视觉质量的影响  

Effect of residual corneal astigmatism on visual acuity of patients undergoing regional refractive intraocular lens implantation

作　　者：马晓婷 李科军[1] 赵智华[1] 张茵 杜颖华 梁福珍 MA Xiaoting;LI Kejun;ZHAO Zhihua;ZHANG Yin;DU Yinghua;LIANG Fuzhen(Department of Ophthalmology,Hebei Provincial People’s Hospital,Shijiazhuang 050057,Hebei Province,China;Department of Ophthalmology,Beijing Tiantan Hospital,Beijing 100050,China;Hebei Medical University,Shijiazhuang 050011,Hebei Province,China)

机构地区：[1]河北省人民医院眼科,河北省石家庄市050057 [2]北京天坛医院眼科,北京市100050 [3]河北医科大学,河北省石家庄市050011

出　　处：《眼科新进展》2024年第1期43-47,共5页Recent Advances in Ophthalmology

基　　金：河北省医学科学研究课题计划(编号:20190341);河北省科技厅民生专项(编号:19277780D)。

摘　　要：目的探讨区域折射型人工晶状体植入术后角膜残余散光对患者视觉质量的影响。方法回顾性队列研究。收集2020年6月至2022年3月在河北省人民医院眼科行白内障超声乳化摘除联合LENTIS Comfort LS-313 MF15人工晶状体植入术的白内障患者57例(73眼)的病历及随访资料,将其按照术后角膜残余散光进行分组,角膜残余散光>0.75~1.50 D的患者32例40眼作为试验组,角膜残余散光≤0.75 D的患者25例33眼作为对照组。记录两组患者术后6个月的裸眼远距离视力(5 m)、裸眼中距离视力(80 cm)、裸眼近距离视力(40 cm)、离焦曲线、客观视觉质量、主观视觉质量、满意度及脱镜率。结果试验组与对照组患者术后裸眼远距离视力(logMAR)均为0.10(0.00,0.22),裸眼中距离视力(logMAR)均为0.00(0.00,0.10),裸眼近距离视力(logMAR)分别为0.20(0.10,0.30)、0.20(0.10,0.20),两组患者间比较差异均无统计学意义(均为P>0.05)。术后离焦曲线显示,附加球镜度数从+2.00 D至-4.00 D的不同屈光度数上的远距离视力两组患者间相比差异均无统计学意义(均为P>0.05)。两组患者术后客观视觉质量中总像差、彗差、调制传递函数及斯特列尔比值相比差异均有统计学意义(均为P<0.05),总高阶像差、球差及三叶草差两组患者间相比差异均无统计学意义(均为P>0.05)。两组患者间主观视觉质量、满意度及脱镜率相比差异均无统计学意义(均为P>0.05)。结论LENTIS Comfort LS-313 MF15人工晶状体植入术后0.75~1.50 D的角膜残余散光对患者主观视觉质量及客观视觉质量中总高阶像差、球差及三叶草差没有影响,对客观视觉质量中总像差、彗差、调制传递函数及斯特列尔比值有影响。Objective To investigate the effect of residual corneal astigmatism on visual acuity after regional refractive intraocular lens(IOL)implantation.Methods A retrospective cohort study was conducted.The medical records and follow-up data of 73 eyes of 57 cataract patients who underwent ultrasound emulsification cataract extraction combined with LENTIS Comfort LS-313 MF15 IOL implantation in the Ophthalmology Department of the Hebei General Hospital from June 2020 to March 2022 were collected.These patients were grouped according to postoperative residual corneal astigmatism:32 patients(40 eyes)with a residual corneal astigmatism of 0.75(exclusive)-1.50 D were taken as the experimental group,and 25 patients(33 eyes)with a residual corneal astigmatism≤0.75 D were taken as the control group.The uncorrected distance visual acuity(5 m),uncorrected intermediate visual acuity(80 cm),uncorrected near visual acuity(40 cm),out-of-focus curve,objective visual quality,subjective visual quality,satisfaction degree and lens removal rate of patients in the two groups were recorded 6 months postoperatively.Results The postoperative uncorrected distance visual acuity(logMAR)was 0.10(0.00,0.22),the uncorrected intermediate visual acuity(logMAR)was 0.00(0.00,0.10),and the uncorrected near visual acuity(logMAR)was 0.20(0.10,0.30)and 0.20(0.10,0.20)in the experimental and control groups,with no statistically significant differences(all P>0.05).The postoperative out-of-focus curves showed that the distance visual acuity of patients with additional spherical equivalent refraction ranged from+2.00 D to-4.00 D in the two groups had no statistically significant difference(all P>0.05).There were statistically significant differences in total aberration,coma aberration,modulation transfer function and Strehl ratio in the objective visual quality of patients after surgery(all P<0.05),and there was no statistically significant difference in the total higher-order aberration,spherical aberration and cloverleaf aberration(all P>0.05).There was n

关 键 词：散光 视觉质量 区域折射型人工晶状体 

分 类 号：R776.1[医药卫生—眼科]