目的：评估改良囊膜抛光对飞秒激光辅助白内障超声乳化手术(FLACS)并植入多焦点人工晶状体(MIOL)患者视力和视觉质量的影响。

方法：研究纳入37例患者74眼，其中男17例，女20例，平均年龄为51.74±7.80岁。使用抛硬币法，随机选取每位患者的一眼进行改良囊膜抛光，另一眼则接受常规的灌注/抽吸(I/A)抛光，抛光组包含37眼，其中右眼21只，左眼16只，对照组则为抛光组同一患者的对侧眼。评估术前以及术后1 wk、1、6、12 mo患者的视力和视觉质量。采用OPD-Scan III评估高阶像差，利用光学质量分析系统(OQAS)评估调制传递函数(MTF cutoff)、斯特列尔比(SR)和客观散射指数(OSI)评估视觉质量。运用配对t检验和重复测量方差分析(ANOVA)对结果进行比较，并采用SNK-q事后检验确定差异是否显著。

结果：抛光组患者术后1 wk的裸眼远视力(UDVA)和裸眼近视力(UNVA)较对照组表现更优(均P<0.05)。术后12 mo时，抛光组的UDVA、UNVA和最佳矫正远视力(CDVA)均优于对照组(P<0.05)。术后12 mo时，与对照组相比，抛光组的MTF cutoff、SR、OSI和高阶像差均有改善(P<0.05)。

结论：改良囊膜抛光对FLACS并植入MIOL的患者1 a内维持视力和视觉质量有益。

METHODS: This study included 74 eyes from 37 patients, comprising 17 males and 20 females, with a mean age of 51.74±7.80 years. Using a coin toss method, one eye per patient was randomly selected for improved anterior capsular polishing, while the other eye received standard irrigation/aspiration(I/A)polishing. The polishing group consisted of 37 eyes, including 21 right and 16 left eyes, while the control group comprised the contralateral fellow eyes of the same individuals in the polishing group. Visual acuity and quality of the patients were evaluated before surgery and at 1 wk, 1, 6, and 12 mo after surgery. The OPD-Scan III was utilized to assess high-order aberrations, while the optical quality analysis system(OQAS)was employed to evaluate modulation transfer function(MTF cutoff), Strehl ratio(SR), and objective scatter index(OSI)for the purpose of visual quality assessment. Paired t-tests and repeated measures analysis of variance(ANOVA)were utilized to compare the results, and the SNK-q post hoc test was applied to identify significant differences.

RESULTS:The polishing group's uncorrected distant visual acuity(UDVA)and uncorrected near visual acuity(UNVA)significantly improved 1-week post-surgery(all P<0.05). At 12-months, UDVA, UNVA, and corrected distant visual acuity(CDVA)were better than the control group(P<0.05). The MTF cutoff, SR, OSI, and high-order aberrations in the polishing group also showed significant improvements compared to the control group at 12 mo(P<0.05).

CONCLUSION:The improved capsular polishing method has been demonstrated to effectively maintain visual acuity and visual quality in patients with MIOL after FLACS within 1 a.