区域折射型多焦点人工晶状体SBL-3的疗效观察

Clinical observation of regional refractive multifocal intraocular lens SBL-3

摘要:

目的：观察区域折射型多焦点人工晶状体SBL-3的临床疗效和安全性。

方法：选取在我院行白内障超声乳化吸除联合人工晶状体植入术的年龄相关性白内障患者85例130眼，按植入人工晶状体的不同分为2组：植入区域折射型多焦点人工晶状体(MIOL)的患者42例65眼作为观察组，植入单焦点非球面人工晶状体的患者43例65眼作为对照组。术后3mo，观察裸眼远视力(UCDVA)、裸眼中距离视力(UCIVA)、裸眼近视力(UCNVA)、等效球镜度数(SE)、裸眼离焦曲线情况，并对患者主观视觉质量进行问卷调查，包括视近脱镜率、视觉干扰症状及满意度。

结果：术后3mo，两组患者UCDVA均较术前显著改善，差异均有统计学意义(P<0.01)，但两组间比较，差异无统计学意义(P>0.05)，而观察组患者UCIVA、UCNVA均明显优于对照组，差异均有统计学意义(P<0.01)。术后3mo，两组患者电脑验光等效球镜度(SE)比较，差异有统计学意义(P<0.01)。术后3mo，观察组患者裸眼离焦曲线在+0.50～-3.00D范围内平稳，LogMAR视力均在0.301以下，-3.50D后开始缓慢上升； 对照组在±0.5D之间出现波谷，两端均快速上升。术后3mo，观察组患者出现视觉干扰症状者的比例(4/42)与对照组(2/43)比较，差异无统计学意义(P=0.433)； 观察组患者视近脱镜率达97.6%(41/42)，对照组为18.6%(8/43)，差异有统计学意义(χ²=4.318，P=0.038)； 观察组患者单眼视远满意度为92.3%，对照组为93.8%，差异无统计学意义(P=1.000)； 观察组患者单眼视近满意度为98.5%(64/65)，对照组为16.9%(11/65)，差异有统计学意义(χ²=88.526，P<0.01)。

结论：区域折射型MIOL可提供良好的远中近全程裸眼视力，能够满足患者日常工作和生活中远、中、近距离用眼需求，术后不良视觉症状少，患者满意度高。

Abstract:

AIM: To observe the clinical efficacy and safety of regional refractive multifocal intraocular lens SBL-3.

METHODS: Eighty-five senile cataract patients(130 eyes)who underwent phacoemulsification and intraocular lens implantation in our hospital were divided into two groups according to the difference of implanted intraocular lens: patients with regional refractive multifocal intraocular lens(MIOL)42 example(65 eyes)as an observation group, 43 patients(65 eyes)of a single-focus aspheric intraocular lens were used as a control group. Three months after operation, the indicators were: uncorrected distance visual acuity(UCDVA), uncorrected intermediate visual acuity(UCIVA), uncorrected near visual acuity(UCNVA), and spherical equivalent power(SE). The naked eye defocus curve was measured and the patient's subjective visual quality was investigated by questionnaire, including the rate glasses removal, visual interference symptoms and satisfaction.

RESULTS: At 3mo after operation, UCDVA was significantly improved in both groups compared with preoperative, and the difference was statistically significant(P<0.01). However, there was no significant difference between the two groups(P>0.05), while UCIVA and UCNVA in the observation group were significantly better than the control group, the difference was statistically significant(P<0.01). At 3mo after operation, the difference of computerized optometry spherical equivalent power(SE)of the two groups was statistically significant(P<0.01). At 3mo after operation, the naked eye defocus curve of the observation group was stable in the range of +0.50 to -3.00D, the LogMAR visual acuity was below 0.301, and the curve began to rise slowly after -3.50D; the control group showed trough between ±0.5D, both ends are rising rapidly. At 3mo postoperatively, the proportion of patients with visual interference symptoms in the observation group(4/42)was not significantly different from that in the control group(2/43)(P=0.433). The glasses removal rate of the observation group was 97.6%(41/42), control group was 18.6%(8/43), the difference was statistically significant(χ²=4.318, P=0.038). In the observation group, the single eye distance satisfaction was 92.3%, and the control group was 93.8%. The difference was not statistically significant(P=1.000). The observation group had a single eye near fullness of 98.5%(64/65)and the control group was 16.9%(11/65), the difference was statistically significant(χ²=88.526, P<0.01).

CONCLUSION: The regional refraction MIOL can provide good near-intermediate-distance and full-distance uncorrected visual acuity. It can meet the needs of the patients at daily, distance-middle distance-near use. Postoperative visual interference symptoms were fewer and patient satisfaction was higher.