连续视程IOL植入术后患者主观视觉质量及阅读能力的临床观察

Subjective visual quality, reading fluency and patient satisfaction with the extended depth of focus IOL

摘要:

目的：比较双眼及单眼植入Tecnis Symfony连续视程人工晶状体(IOL)术后患者主观视觉质量、阅读流畅性及术后满意度的差异。

方法：对我院48例71眼行白内障超声乳化吸除联合IOL植入术的患者进行回顾性分析，根据植入IOL类型不同分为2组，其中23例46眼双眼植入Symfony IOL为双眼组，25例25眼一眼植入Symfony IOL，另一眼植入非球面单焦点IOL为单眼组。收集两组患者术后3、6mo远、中、近距离视力数据、对比敏感度、术后阅读流畅性、阅读速度及患者满意度调查，并对结果进行统计学分析。

结果：术后3mo，单眼组植入Symfony IOL眼的裸眼远距离视力(UDVA)、最佳矫正视力(BCVA)与植入单焦点IOL眼比较无差异(P>0.05)。术后6mo时单眼及双眼植入Symfony IOL患者UDVA均较术前显著提高，平均视力达到0.1以下(LogMAR视力)，两组间无差异(P>0.05)。组间比较UDVA、BCVA、裸眼中距离视力(UIVA)、裸眼近距离视力(UNVA)均无差异(P>0.05)。术后6mo两组患者在明视、暗视及暗视眩光状态下各空间频率对比敏感度比较均无差异(P>0.05)。两组患者术后6mo远中近距离视物满意度较高； 双眼组中近距离流畅阅读满意度高于单眼组(P<0.05)； 双眼组阅读速度略高于单眼组，但组间比较无差异(P>0.05)。

结论：双眼及单眼植入Symfony连续视程IOL均可为患者提供兼顾远、中、近的全程视力，术后脱镜率均在90%以上，包容性及可预测性好，术后中距离流畅阅读及满意度较高，更适合中距离工作的患者。

Abstract:

AIM: To investigate the subjective visual quality, reading fluency and patient satisfaction after a unilateral or bilateral implantation of the Tecnis Symfony extended depth of focus intraocular lens(IOL)with cataract.

METHODS: The retrospective analysis on the 48 patients(71 eyes)with cataract phacomulsification surgery in our hospital, which were randomly divided into two groups. The bilateral group with 23 patients(46 eyes)bilateral implanted the Symfony extended depth of focus IOL, the unilateral group with 25 patients(25 eyes)implanted the Symfony IOL in one eye and an aspherical monofocal IOL in the other eye. 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 3, 6mo after surgery. The contrast sensitivity, reading fluency, reading speed, patient satisfaction and the occurrence of complications were also observed.

RESULTS: In the unilateral group, there were no significant differences in the UDVA and BCVA between an eye with the Symfony IOL and an eye with monofocal IOL 3mo after surgery(P>0.05). After 6mo of surgery, UDVA were significantly better than pre-operation in two groups, average visual acuity of LogMAR was under 0.1. There were no significant differences in UDVA, BCVA, UIVA and UNVA between two groups(P>0.05). The patients'far, intermediate, and near distances satisfaction were higher after 3mo of surgery. There were no statistically significant differences in spatial frequency contrast sensitivity between the two groups under photopic/mesopic conditions and mesopic with glare 6mo after surgery. The scores of satisfactions for reading fluency were better in the bilateral group than in the unilateral group(P>0.05). After 6mo, the reading speed of binocular group was slightly higher than the unilateral group(P<0.05), but there was no significant difference between two groups(P >0.05).

CONCLUSION:The Symfony extended depth of focus IOL provides good far, intermediate, and near visual acuity in the bilateral group and the unilateral group, while maintaining the same level of visual quality. In both groups over 90% patients were spectacle independent. Symfony IOL has widely adaptability and highly predictability, patients can obtain better satisfactions for reading fluency and reading speed. It is more suitable for intermediate vision.