[1]巫雷,王文惠.三焦点人工晶状体植入术后中期立体视功能及视觉质量研究[J].眼科新进展,2019,39(10):956-960.[doi:10.13389/j.cnki.rao.2019.0218]
　WU Lei,WANG Wen-Hui.Mid-term stereopsis vision and visual quality after implantation of trifocal intraocular lenses[J].Recent Advances in Ophthalmology,2019,39(10):956-960.[doi:10.13389/j.cnki.rao.2019.0218]
点击复制

三焦点人工晶状体植入术后中期立体视功能及视觉质量研究/HTML
分享到：

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
39卷
期数:
2019年10期
页码:
956-960
栏目:
应用研究
出版日期:
2019-10-05

文章信息/Info

Title:
Mid-term stereopsis vision and visual quality after implantation of trifocal intraocular lenses
作者:
巫雷; 王文惠
610000　四川省成都市，成都爱尔眼科医院
Author(s):
WU Lei; WANG Wen-Hui
Aier Eye Hospital of Chengdu，Chengdu 610000，Sichuan Province，China
关键词:
立体视; 三焦点人工晶状体; 双通道技术; 视觉质量
Keywords:
stereopsis vision; trifocal intraocular lens; double-pass optical quality analysis system; visual quality
分类号:
R776
DOI:
10.13389/j.cnki.rao.2019.0218
文献标志码:
A
摘要:
目的　评价三焦点非球面衍射型人工晶状体植入术后的双眼立体视功能及视觉质量。方法　非随机同期对照临床研究。对38例76眼单纯性白内障患者行超声乳化吸出联合人工晶状体植入术，依据植入人工晶状体类型不同分为2组：双眼均植入三焦点人工晶状体组18例36眼为三焦组，双眼均植入单焦点人工晶状体组20例40眼为单焦组。随访记录2组患者术后双眼近立体视功能、视力［单眼及双眼裸眼远距离视力（uncorrected distance visual acuity，UDVA）、裸眼中距离视力（uncorrected intermediate visual acuity，UIVA）、裸眼近距离视力（uncorrected near visual acuity，UNVA）、矫正远距离视力（corrected distance visual acuity，CDVA）、矫正远视力基础上的中距离视力（distance-corrected intermediate visual acuity，DCIVA）、矫正远视力基础上的近距离视力（distance-corrected near visual acuity，DCNVA）］和等效球镜度。利用VF-14-CN量表行主观问卷调查，对夜间光晕及老视眼镜依赖与否行问卷并记录；利用双通道视觉质量分析系统测量客观散射指数、调制传递函数截止频率（modulation transfer function，MTF-cutoff）、斯特列尔比值（strehl ratio，SR）及100%、20%、9%对比度视力（contrast visual acuity，CVA）等指标。结果　三焦组术后近立体视功能明显优于单焦组（P=0.001）。三焦组和单焦组所有术眼术后单眼UDVA较术前均明显提高（均为P<0.05）。三焦组单眼UDVA、UIVA、UNVA均明显优于单焦组（均为P<0.05）；三焦组单眼DCDVA与单焦组差异无统计学意义（P>0.05），但DCIVA和DCNVA均明显优于单焦组（均为P<0.01）。三焦组双眼UDVA、UIVA、UNVA均明显优于单焦组（均为P<0.01）；三焦组双眼DCDVA与单焦组比较差异无统计学意义（P>0.05），但DCIVA和DCNVA均明显优于单焦组（均为P<0.01）。两组等效球镜度差异无统计学意义（P=0.437）。VF-14量表评分单焦组明显低于三焦组（P=0.000）。90.0%单焦组患者依赖老视眼镜，5.6%三焦组患者依赖老视眼镜，差异有统计学意义（P=0.000）；两组眩光发生率差异无统计学意义（P=0.437）；两组夜间光晕发生率（单焦组2/20，三焦组7/18）差异有统计学意义（P=0.027）。三焦组和单焦组客观散射指数、斯特列尔比值、调制传递函数截止频率差异均无统计学意义（均为P>0.05）。三焦组100%CVA、20%CVA均好于单焦组（均为P<0.01）；9%CVA两组差异无统计学意义（P>0.05）。结论　双眼植入三焦点人工晶状体患者可获得良好的立体视功能和视觉质量，术后满意度高。
Abstract:
Objective　To evaluate the mid-term stereopsis vision and visual quality after implantation of a trifocal diffractive intraocular lens.Methods　Non-randomized concurrent controlled clinical trial.Totally 38 patients of 76 eyes with simple cataract underwent phacoemulsification combined with intraocular lens implantation.According to the type of implanted intraocular lens,the patients were divided into two groups:18 patients of 36 eyes receiving a trifocal diffractive intraocular lens (trifocal group) and 20 patients of 40 eyes being implanted with monofocal intraocular lens (monofocal group).The stereopsis vision,monocular and binocular uncorrected distance visual acuity (UDVA),uncorrected intermediate visual acuity （UIVA），uncorrected near visual acuity (UNVA),corrected distance visual acuity (CDVA),distance-corrected intermediate visual acuity (DCIVA),distance-corrected near visual acuity (DCNVA) and spherical equivalent (SE) were measured for all patients.The VF-14-CN scale was used to conduct subjective questionnaire surveys for recording nighttime glow and presbyopic glasses.Double-pass visual quality analysis system was used to evaluate the visual quality,including the objective scatter index (OSI),modulation transfer function (MTF-cutoff),strehl ratio (SR),100%,20%,9% contrast visual acuity (CVA).Results　Trifocal group had a better stereopsis vision than monofocal group（P=0.001）.Postoperative single-eye UDVA of all patients in both groups were improved dramatically (all P<0.05).UDVA,UIVA and UNVA of trifocal group was better than those in the monofocal group in both single and binocular eyes (all P＜0.05).No significant statistical difference in DCDVA was found between trifocal group and monofocal group no matter single and binocular eyes (all P＞0.05),but DCIVA and DCNVA were significantly better than those in the monofocal group for both single and binocular eyes (all P<0.01).There was no significance in SE between the two groups (P=0.437).In terms of VF-14 scale score,the trifocal group was significantly higher than that of the monofocal group (P=0.000).Moreover,90.0% of patients in the monofocal group were dependent on presbyopic glasses,and 5.6% in the trifocal group were dependent on presbyopic glasses,and the difference was statistically significant (P=0.000);there was no significant difference in the incidence of glare between the two groups (P=0.437).The incidence of nocturnal halos in the two groups (2/20 in the monofocal group and 7/18 in the trifocal group) was statistically significant (P=0.027).There were no significant differences in OSI,SR and MTF-cutoff between the trifocal and monofocal groups (all P>0.05).100% CVA and 20% CVA in the trifocal group were better than those in the monofocal group (both P<0.01),but there was no significant difference in 9% CVA between the two groups (P>0.05).Conclusion　Compare to the traditional mono-focal intraocular lens,the trifocal diffractive intraocular lens can provide a better full range of clear vision and visual quality,which may help to achieve good postoperative satisfaction.

参考文献/References:

［1］　KELMAN C D.Phacoemulsification and aspiratio：a new technique of cataract removal.A preliminary report［J］.Am J Ophthalmol，1967，64（1）：23-35.
［2］　LIU Y Z.Debate on the advantages and disadvantages of multifocal and monofocal intraocular lens［J］.Chin J Ophthalmol，2013，49（5）：389-391.
刘奕志.人工晶状体多焦点与单焦点优劣之争［J］.中华眼科杂志，2013，49（5）：389-391.
［3］　OSHER R H，GOLNIK K C，BARRETT G，SHIMIZU K.Intentional extreme anisometropic pseudophakic monovision：new approach to the cataract patient with longstanding diplopia［J］.J Cataract Refract Surg，2012，38（8）：1346-1351.
［4］　PLAZA-PUCHE A B，ALIO J L.Analysis of defocus curves of different modern multifocal intraocular lenses［J］.Eur J Ophthalmol，2016，26（5）：412-417.
［5］　KRETZ F T，CHOI C Y，MüLLER M，GERL M，GERL R H，AUFFARTH G U.Visual outcomes，patient satisfaction and spectacle independence with a trifocal diffractive intraocular lens［J］.Korean J Ophthalmol，2016，30（3）：180-191.
［6］　PLAZA-PUCHE A B，ALIO J L，SALA E，MOJZIS P.Impact of low mesopic contrast sensitivity outcomes in different types of modern multifocal intraocular lenses［J］.Eur J Ophthalmol，2016，26（6）：612-617.
［7］　Chinese Medical Association Ophthalmological Society Cataract and Intraocular Lens group.Expert advice on standardized prevention of perioperative infection in cataract surgery［J］.Chin J Ophthalmol，2013，49（1）：76-78.
中华医学会眼科学分会白内障和人工晶状体学组.关于白内障围手术期预防感染措施规范化的专家建议（2013年）［J］.中华眼科杂志，2013，49（1）：76-78.
［8］　STEINBERG E P，TIELSCH J M，SCHEIN O D，JAVITT J C，SHARKEY P，CASSARD S D，et al.The VF-14.An index of functional impairment in patients with cataracts［J］.Arch Ophthalmol，1994，112（5）：630-638.
［9］　YE P P，YAO K，LI X，WU W，HUANG X D，YU Y B，et al.Binocular clinical comparison study of Tecnis multifocal aspheric and monofocal spherical intraocular lenses［J］.Chin J Ophthalmol，2010，46（7）：625-630.
叶盼盼，姚克，李霞，吴炜，黄晓丹，俞一波，等.双眼植入Tecnis多焦点和单焦点球面人工晶状体的临床比较研究［J］.中华眼科杂志，2010，46（7）：625-630.
［10］　YANG L，HU C T，LIU M M，XIAGN K，SA C L，FANG Y C，et al.Research progress of stereopsis vision ［J］.Med Recapitul，2014，20（11）：1965-1967.
杨亮，胡础图，刘密密，项凯，萨楚拉，芳原草.立体视觉的研究进展［J］.医学综述，2014，20（11）：1965-1967.
［11］　FAWCETT S L，WANG Y Z，BIRCH E E.The critical period for susceptibility of human stereopsis［J］.Invest Ophthalmol Vis Sci，2005，46（2）：521-525.
［12］　MU J，CHEN H，LI Y Z.Comparison study of visual function and satisfaction in patients with monovision and patients with bilateral multifocal intraocular lenses［J］.Chin J Ophthalmol，2014，50（2）：95-99.
穆晶，陈晖，李一壮.双眼植入多焦点人工晶状体与单眼视设计术后视功能及满意度的比较［J］.中华眼科杂志，2014，50（2）：95-99.
［13］　ALFONSO J F，FERNNDEZ-VEGA CUETO L，BELDA-SALM-ERN L，MONTS-MIC R，FERNNDEZ-VEGA L.Visual function after implantation of a diffractive aspheric trifocal intraocular lens［J］.Eur J Ophthalmol，2016，26（5）：405-411.
［14］　BRAGA-MELE R，CHANG D，DEWEY S，FOSTER G，HENDERSON B A，HILL W，et al.Multifocal intraocular lenses：Relative indications and contraindications for implantation［J］.J Cataract Refract Surg，2014，40（2）：313-322.
［15］　KOHNEN T，TITKE C，BHM M.Trifocal intraocular lens implantation to treat visual demands in various distances following lens removal［J］.Am J Ophthalmol，2016，161（1）：71-77.
［16］　WATT R J.An outline of the primal sketch in human vision［J］.Pattern Rec Lett，1987，5（2）：139-150.
［17］　WU J，ZHU L.Full range of vision and pseudoaccommodation in early stage after multifocal intraocular lens implantation［J］.Rec Adv Ophthalmol，2017，37（6）：572-575.
吴杰，朱磊.多焦点人工晶状体植入术后早期全程视力和拟调节力的临床观 察 ［J］.眼科新进展，2017，37（6）：572-575.
［18］　XING X J，SONG H，TANG X.Repeatability of measurements with a double-pass OQAS system after three IOLs implantations［J］.Chin J Pract Ophthalmol，2014，32（10）：1163-1168.
邢晓杰，宋慧，汤欣.应用OQAS双通道系统对人工晶状体眼视觉质量评估可重复性研究［J］.中国实用眼科杂志，2014，32（10）：1163-1168.
［19］　DAZ-DOUTN F，BENITO A，PUJOL J，ARJONA M，GELL J L，ARTAL P.Comparison of the retinal image quality with a Hartmann-Shack wavefront sensor and a double-pass instrument［J］.Invest Opthalmol Vis Sci，2006，47（4）：1710-1716.
［20］　LIAN H F，TANG X，WANG J.The influences on modulation transfer function as a function of age and pupil in adult emmetropic eyes［J］.Chin J Ophthalmol，2010，46（3）：227-232.
连慧芳，汤欣，王娟.年龄及瞳孔直径对成人正视眼调制传递函数的影响［J］.中华眼科杂志，2010，46（3）：227-232.

相似文献/References:

[1]李梦迪,王雁,赵新恒,等.双目视力仪在立体视筛查中的应用[J].眼科新进展,2020,40(4):336.[doi:10.13389/j.cnki.rao.2020.0077]
　LI Mengdi,WANG Yan,ZHAO Xinheng,et al.Application of binoptometer in stereoscopic screening[J].Recent Advances in Ophthalmology,2020,40(10):336.[doi:10.13389/j.cnki.rao.2020.0077]

更新日期/Last Update: 2019-10-12