连续视程与三焦点人工晶状体植入术后视觉质量的比较

Comparison of visual quality between extended depth and trifocal intraocular lens implantation

摘要:

目的：比较Tecnis Symfony连续视程人工晶状体与Zeiss三焦点人工晶状体(At Lisa tri 839MP)植入术后患者视觉质量的差异。

方法：选取2019-01/2020-12于我院行白内障超声乳化吸除联合人工晶状体植入术的患者42例53眼，其中A组22例29眼植入Tecnis Symfony连续视程人工晶状体，B组20例24眼植入Zeiss三焦点人工晶状体。观察两组患者术后3mo时远中近视力，绘制离焦曲线，并评估生活质量，记录并发症发生情况。

结果：术后3mo，两组患者视力均明显改善，两组患者裸眼远(5m)、中(80cm)距离视力及最佳矫正远距离视力(5m)无差异(均P>0.05)，但B组患者裸眼中(60cm)、近(40cm)距离视力优于A组(均P<0.05)。术后3mo绘制离焦曲线示A组在+1.0～-2.0D段跨度平稳形成平台期； B组在0、-2.5D处形成两个波峰； 0D处两组远视力无显著差异(P>0.05)，-2.5、-3.5D处B组近视力显著优于A组(均P<0.01)。两组患者术后脱镜率均在90%以上，均出现不同程度眩光、光晕等光学现象，但生活质量总体满意度较高，A组阅读速度明显高于B组，且夜间视物满意度较高(均P<0.05)。

结论：两种类型人工晶状体植入术后脱镜率均在90%以上，可为患者提供兼顾远、中、近的全程视力，Symfony连续视程人工晶状体植入术后流畅阅读及夜间视物满意度较高； Zeiss三焦点人工晶状体植入术后近距离视力更好，更适合近距离工作者。

Abstract:

AIM: To evaluate the visual quality between the Tecnis Symfony extended depth of focus intraocular lens(IOL)and Zeiss trifocal IOL(At Lisa tri 839 MP)implantation.

METHODS: Forty-two patients(53 eyes)who underwent cataract phacomulsification with IOL implantation from Jan. 2019 to Dec. 2020 were randomly divided into group A and group B according to the type of implanted IOL. The group A with 22 patients(29 eyes)implanted the Tecnis Symfony extended depth of focus IOL, the group B with 20 patients(24 eyes)implanted Zeiss trifocal IOL. The uncorrected distance visual acuity(UDVA), uncorrected intermediate distance visual acuity(UIVA), uncorrected near distance visual acuity(UNVA), and best corrected distance visual acuity(BCVA)were measured after 3mo of surgery. The defocus curve, the quality of life and the occurrence of complications were also observed.

RESULTS: The visual acuity was significantly improved in both groups after 3mo of surgery. There were no significant differences in the UDVA(5m), UIVA(80cm)and BCVA(5m)between the two groups(P>0.05). In group B, the UIVA(60cm)and UNVA(40cm)were better than in group A(all P<0.05). The defocus curve analysis revealed that the group A tended to be stable between +1.0D to -2.0D, and to form a platform, while the group B had double peaks(0D, -2.5D). The distance visual acuity at 0D were no significantly differences between the two groups(P>0.05), but the near visual acuity at -2.5D and -3.5D in group B were significantly higher than in group A(all P<0.01). In both groups over 90% patients were spectacle independent. Patients in the two groups showed different degrees of halo, glare and other optical phenomena, but the overall satisfaction were higher. The scores of satisfactions for reading speed and night vision were significantly better in group A than in group B(all P<0.05).

CONCLUSION: In both groups over 90% patients were spectacle independent, they can obtain good near,intermediate and far distance visual acuity. Symfony extended depth IOL has better continuous intermediate distance visual acuity, patients can also obtain higher satisfaction and have better night vision. The Zeiss trifocal IOL implantation is associated with significantly better near visual acuity, and it is more suitable for near vision.