目的：观察不同类型人工晶状体植入术对白内障患者视觉质量的影响。

方法：回顾性研究。选取2020-06/2023-12期间我院收治的超声乳化联合人工晶状体植入术治疗的白内障患者85例113眼，根据植入晶状体不同分为单焦点组42例55眼和双焦点组43例58眼。术后随访3 mo，比较两组患者手术前后裸眼近视力(UNVA)、裸眼中视力(UIVA)、裸眼远视力(UDVA)、最佳矫正近视力(BCNVA)、最佳矫正中视力(BCIVA)、最佳矫正远视力(BCDVA)、对比敏感度(CS)、客观视觉质量、视觉相关生存质量量表(NEI-VFQ-25)评分及并发症情况。

结果：术后3 mo，双焦点组UNVA(LogMAR)优于单焦点组(0.24±0.06 vs 0.53±0.13，P<0.001)，两组UIVA、UDVA、BCNVA、BCIVA、BCDVA比较均无差异(均P>0.05)； 双焦点组暗视条件下18 c/d空间频率CS低于单焦点组(0.84±0.17 vs 0.92±0.22，P<0.05)，其余CS比较均无差异(均P>0.05)； 双焦点组OSI高于单焦点组(P<0.05)，OV 20%、OV 9%低于单焦点组(均P<0.05)，MTF_{cut off}、SR、OV 100%组间比较均无差异(均P>0.05)； 双焦点组总体视力、近视力活动评分高于单焦点组(均P<0.001)，两组总体健康、远视力活动、周边视力、色觉、依赖程度、社交功能、社会角色、精神健康各维度得分比较均无差异(均P>0.05)。两组患者并发症发生率比较无差异(P>0.05)

结论：超声乳化联合双焦点人工晶状体植入术能够为白内障患者提供更理想的近视力及视觉相关生存质量，但其客观视觉质量较差。单焦点、双焦点人工晶状体植入术各有优缺点，临床尚需结合患者实际需求以选择合适的人工晶状体。

METHODS: Retrospective study. Totally 85 patients(113 eyes)with cataract who received phacoemulsification combined with intraocular lens implantation in the hospital June 2020 to December 2023 were selected. According to the different implanted lenses, they were divided into monofocal group(42 cases, 55 eyes)and bifocal group(43 cases, 58 eyes). The uncorrected near visual acuity(UNVA), uncorrected intermediate visual acuity(UIVA), uncorrected distance visual acuity(UDVA), best corrected near visual acuity(BCNVA), best corrected intermediate visual acuity(BCIVA), best corrected distance visual acuity(BCDVA), contrast sensitivity(CS), objective visual quality, National Eye Institute 25-item Visual Function Questionnaire(NEI-VFQ-25)scores and complications were compared between both groups of patients at 3 mo after surgery.

RESULTS:At 3 mo after surgery, the UNVA(LogMAR)of the bifocal group was significantly better than that of the monofocal group(0.24±0.06 vs 0.53±0.13, P<0.001), but there were no statistical differences in UIVA, UDVA, BCNVA, BCIVA and BCDVA between the two groups(all P>0.05). The 18 c/d spatial frequency scotopic CS in the bifocal group at 3 mo after surgery was significantly lower than that in the monofocal group(0.84±0.17 vs 0.92±0.22, P<0.05), while the CS in other frequency was not statistically significant(all P>0.05); the objective scatter index(OSI)was higher in the bifocal group than that in the monofocal group(P<0.05), while OV 20% and OV 9% were lower than those in monofocal group(all P<0.05), but there were no statistically significant differences in modulation transfer function cut off(MTF_{cut off}), Strehl ratio(SR)and OV 100% between the two groups(all P>0.05). The scores of overall visual acuity and near visual activity in the bifocal group at 3 mo after surgery were higher than those in the monofocal group(all P<0.001), but there were no statistical differences in the scores of dimensions of overall health, distance visual activity, peripheral visual acuity, color vision, dependence degree, social function, social role and mental health between the two groups(all P>0.05). Furthermore, there were no statistical significance in the incidence of complications in the two groups(P>0.05).

CONCLUSION: Phacoemulsification combined with bifocal intraocular lens implantation can provide more ideal near visual acuity and visual-related quality of life for patients with cataract, but its objective visual quality is worse, The two types of intraocular lenses have their own advantages and disadvantages, and it is still necessary to choose the appropriate intraocular lens according to the actual needs of patients.