目的：比较超声乳化联合衍射型多焦点人工晶状体(IOL)与单焦点IOL植入术治疗白内障的疗效。

方法：将2015-01/2019-02在本院接受超声乳化术联合IOL植入术的99例145眼白内障患者按非随机临床试验及患者自愿原则分为观察组(51例75眼)、对照组(48例70眼)。两组均行超声乳化术，观察组联合衍射型多焦点IOL植入术、对照组联合单焦点IOL植入术； 比较两组视力、角膜内皮细胞计数及角膜内皮细胞丢失率、角膜地形图检查结果及昼、昼眩光及夜、夜眩光状态下的对比敏感度(CS)； 并统计并发症及脱镜率。

结果：两组术后1wk，1、3mo时的最佳矫正远视力(BCDVA)、最佳矫正近视力(BCNVA)均无差异(P>0.05)，但观察组术后1wk，1mo时的裸眼远视力(UCDVA)，术后1wk，1、3mo时的裸眼近视力(UCNVA)及最佳矫正远视力下的近视力(DCNVA)均显著低于对照组(P<0.05)； 两组术后角膜内皮细胞数、散光较术前均显著下降，但术后角膜内皮细胞数、角膜内皮细胞丢失率及散光组间比较均无差异(P>0.05)； 观察组昼状态下1.5c/d频段及昼眩光状态下1.5、3、6c/d频段CS显著低于对照组，但昼状态下12c/d频段的CS显著高于对照组； 且观察组夜状态下3、18c/d频段的CS及夜眩光状态下3、6、18c/d频段的CS显著低于对照组； 两组并发症发生率无差异(P<0.05)，但观察组脱镜率显著高于对照组(P<0.05)。

结论：超声乳化联合滤过衍射型多焦点IOL植入术可获得良好的全程视力，脱镜率高，但术后CS相对更低。

METHODS: A total of 99 cataract patients(145 eyes)who underwent phacoemulsification combined with IOL implantation in the hospital from January 2015 to February 2019 were divided into observation group(n=51, 75 eyes)and control group(n=48, 70 eyes)according to the non-randomized clinical trial and patient voluntary principles. The observation group was treated with diffractive multifocal IOL implantation, while the control group was treated with monofocal IOL implantation. The visual acuity, corneal endothelial cell count, loss rate of corneal endothelial cells, results of corneal topography, and contrast sensitivity(CS)in daytime, day glare time, nighttime and night glare time were compared between two groups. The complications and spectacles-independent rate were counted.

RESULTS: At 1wk, 1mo and 3mo, there were no significant differences in the best corrected distance visual acuity(BCDVA)and best corrected near visual acuity(BCNVA)between two groups(P>0.05). However, the uncorrected distance visual acuity(UCDVA)at 1wk and 1mo, the uncorrected near visual acuity(UCNVA)and the distance corrected near visual acuity(DCNVA)at 1wk, 1mo and 3mo of the observation group were significantly lower than those of the control group(P<0.05). After surgery, corneal endothelial cell counts and astigmatism of two groups decreased significantly. No significant differences were found in corneal endothelial cell count, loss rate of corneal cells and astigmatism between two groups(P>0.05). CS in daytime of 1.5c/d frequency band, in day glare time of 1.5c/d, 3c/d and 6c/d frequency bands, in nighttime of 3c/d and 18c/d frequency bands, in night glare time of 3c/d, 6c/d and 18 c/d frequency bands were significantly lower, while CS in daytime of 12c/d frequency band was significantly higher in the observation group than in the control group. There was no significant difference in the incidence of complications between two groups(P<0.05), but the spectacles-independent rate was significantly higher in the observation group than in the control group(P<0.05).

CONCLUSION: Phacoemulsification combined with diffractive multifocal IOL implantation can obtain good total range visual acuity, with a higher spectacles-independent rate and relatively low CS after surgery.