旋转非对称折射型多焦点人工晶状体植入术后早期效果

doi:10.3760/cma.j.issn.1674-845X.2019.04.004

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摘要

目的：观察白内障超声乳化联合旋转非对称折射型多焦点人工晶状体（IOL）植入术后患者的早期效果。方法：前瞻性自身前后对照研究。选择2017年1-12月在武汉爱尔眼科医院行白内障超声乳化联合旋转非对称折射型多焦点IOL植入的患者36例（40眼），术后随访3个月。分别观察裸眼远、中、近视力（LogMAR），矫正远视力（LogMAR），术后等效球镜度（SE），离焦曲线，调制传递函数（MTF），眼内高阶像差，并统计患者术后视功能指数量表评分及脱镜率。数据采用配对t检验和非参数Wilcoxon配对秩和检验。结果：术后3个月裸眼远、中、近视力及矫正远视力均较术前增加（P<0.05），72%裸眼远视力优于0.1，98%矫正远视力优于0.1；88%术后SE在±1.0 D以内；离焦曲线在0.0 D及-2.5 D具有峰值，+1.0～-4.0 D屈光范围内视力均优于0.25。术后3 mm瞳孔直径下MTF数值均较术前提高（P<0.05），眼内总像差、垂直彗差及垂直三叶草较术前增加（P<0.05）。患者术后3个月视功能指数量表得分为1.0（0.0，2.0）。92%的患者看远、看近均可完全脱镜。结论：非对称区域折射型多焦点IOL能提供令人满意的远、近视力，亦能保持较大范围的中距离视力，患者术后具有较好的视觉质量及较高的生活质量。

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关键词 ：旋转非对称折射型, 多焦点人工晶状体, 视觉质量, 高阶像差

Abstract：Objective: To observe the early effect of phacoemulsification cataract surgery with the implantation of a refractive rotationally asymmetric multifocal intraocular lens (IOL). Methods: This was a self-controlled, before-after trial in which 36 patients (40 eyes) underwent phacoemulsification cataract surgery combined with the refractive rotationally asymmetric multifocal IOL implantation in Wuhan Aier Eye Hospital from January to December 2017. Uncorrected distance visual acuity (UDVA, LogMAR), uncorrected intermediate visual acuity (UIVA, LogMAR), uncorrected near visual acuity (UNVA, LogMAR) and corrected distance visual acuity (CDVA, LogMAR), postoperative spherical equivalent (SE), defocus curve and modulation transfer function (MTF), intraocular high-order aberrations, visual function index of life quality and the rate of spectacle independence were evaluated 3 months postoperatively. Paired t-tests and non-parameter Wilcoxon pairing rank were used to analyze the data. Results: At 3 months postoperatively, there was a significant improvement in UDVA, CDVA, UIVA and UNVA (P<0.05), 72% of postoperative UDVA was better than 0.1, 98% of postoperative CDVA was better than 0.1; 35 eyes (88%) were within
±1.00 diopter (D) of emmetropia. The defocus curve showed two peaks of maximum visual acuity (0 and -2.5 D of defocus) and the visual acuity of +1.0 D--4.0 D defocus was better than 0.25. With 3 mm pupil diameters, the MTF improved significantly compared to preoperative levels (P<0.05); improvement in total intraocular aberrations, vertical coma and vertical trefoil was observed (P<0.05). The median score of the Chinese version of the visual function index-12 (VF-12-CN) was 1.0 (0.0, 2.0) at 3 months. 92% of the patients were completely independent of spectacles for far and near vision. Conclusions: The refractive rotationally asymmetric multifocal intraocular IOL provides satisfying visual acuity for far and near with a good range of intermediate vision. Patients have good visual quality and high quality of life.

Key words： refractive rotationally asymmetric multifocal intraocular lens (IOL) visual quality high-order aberrations

收稿日期: 2018-08-01

基金资助:爱尔眼科医院集团科研基金（AF1602D2，AM162D08）；武汉市医学科研项目（WX17B22）

通讯作者: 王勇（ORCID：0000-0002-7645-9972），Email：wangyongeye@163.com

引用本文:

王潇1，2 陈碧超1，2 曹丹敏1，2 李雪婷1，2 王勇1，2. 旋转非对称折射型多焦点人工晶状体植入术后早期效果[J]. 中华眼视光学与视觉科学杂志, 2019, 21(4): 259-264. Xiao Wang1, 2, Bichao Chen1, 2, Danmin Cao1, 2, Xueting Li1, 2, Yong Wang1, 2. Surgical Effect after Refractive Rotationally Asymmetric Multifocal Intraocular Lens Implantation. Chinese Journal of Optometry Ophthalmology and Visual science, 2019, 21(4): 259-264. DOI: 10.3760/cma.j.issn.1674-845X.2019.04.004

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http://www.cjoovs.com/CN/ 10.3760/cma.j.issn.1674-845X.2019.04.004 或 http://www.cjoovs.com/CN/Y2019/V21/I4/259

[1]	姚克.我国白内障研究发展方向及面临的问题. 中华眼科杂志, 2015, 51(4): 241-244. DOI: 10.3760/cma.j.issn.0412-4081. 2015.04.001.
[2]	俞阿勇. 屈光性白内障手术的若干挑战. 中华眼视光学与视觉科学杂志, 2017, 19(2): 65-70. DOI: 10.3760/cma.j.issn. 1674-845X.2017.02.001.
[3]	Agresta B, Knorz MC, Kohnen T, et al. Distance and near visual acuity improvement after implantation of multifocal intraocular lenses in cataract patients with presbyopia: A systematic review.J Refract Surg, 2012, 28(6): 426-435. DOI: 10.3928/1081597X-20120518-06.
[4]	de Vries NE, Nuijes RM. Multifocal intraocular lens in cataract surgery: Literature review of benifits and side effects. J Cataract Refract Surg, 2013, 39(2): 268-278. DOI:10.1016/j.jcrs.2012.12.002.
[5]	Portney V. Light distribution in diffractive multifocal optics and its optimization．J Cataract Refract Surg, 2011, 37(11): 2053-2059. DOI: 10.1016/j.jcrs.2011.04.038.
[6]	Dayison JA, Simpson MJ．History and development of the apodized diffractive intraocular lens. J Cataract Refract Surg, 2006, 32(5): 849-858. DOI: 10.1016/j.jcrs.2006.02.006.
[7]	高蓉蓉, 郭燕, 陈海丝, 等. 中国版视功能指数量表的修订及其在白内障患者生活质量评估中的应用. 中华实验眼科杂志, 2016, 34(9): 823-828. DOI: 10.3760/cma.j.issn.2095-0160.2016.
09	011.
[8]	Baykara M, Akova YA, Arslan OS, et al. Visual outcomes at 12 months in patients following implantation of a diffractive multifocal intraocular lens. Ophthalmol Ther, 2015, 4(1): 21-32.DOI: 10.1007/s40123-015-0032-4.
[9]	杨琉舒, 耿宇, 赵剑峰, 等. 老视矫正型人工晶状体原理及临床应用新进展. 国际眼科杂志, 2017, 17(5): 876-880. DOI: 10.3980/j.issn.1672-5123.2017.5.18.
[10]	Venter JA, Barclay D, Pelouskova M, et al. Initial experience with a new refractive rotationally asymmetric multifocal intraocular lens. J Refract Surg, 2014, 30(11): 770-776. DOI:10.3928/1081597X-20141021-09.
[11]	田亚宾, 马忠旭, 黄婉荣, 等. 非对称区域折射型多焦点人工晶状体与可调节型人工晶状体的临床效果研究. 眼科新进展, 2016, 36(12): 1157-1160.
[12]	Alio JL, Plaza-Puche AB, Javaloy J, et al. Comparison of a new refractive multifocal intraocular lens with an inferior segmental near add and a diffractive multifocal intraocular lens.Ophthalmology, 2012, 119(3): 555-563. DOI: 10.1016/j.ophtha.2011.08.036.
[13]	Alió JL, Plaza-Puche AB, Piñero DP, et al. Comparative analysisof the clinical outcomes with 2 multifocal intraocular lens models with rotational asymmetry. J Cataract Refract Surg, 2011, 37(9): 1605-1614. DOI: 10.1016/j.jcrs.2011.03.054.
[14]	Rocha KM, Vabre L, Chateau N, et al. Expanding depth of focus by modifying higher-order aberrations induced by an adaptive optics visual simulator. J Cataract Refract Surg, 2009, 35(11):1885-1892. DOI: 10.1016/j.jcrs.2009.05.059.
[15]	Nanavaty MA, Spalton DJ, Marshall J. Effect of intraocular lens asphericity on vertical coma aberration. J Cataract Refract Surg,2010, 36(2): 215-221. DOI:10.1016/j.jcrs.2009.08.024.
[16]	Nishi T, Nawa Y, Ueda T, et al. Effect of total higher-order aberrations on accommodation in pseudophakic eyes. J CataractRefract Surg, 2006, 32(10): 1643-1649. DOI: 10.1016/j.jcrs.2006.05.020.
[17]	Akondi V, Pérez-Merino P, Martinez-Enriquez E, et al.Evaluation of the True Wavefront Aberrations in Eyes Implanted With a Rotationally Asymmetric Multifocal Intraocular Lens. J
	Refract Surg, 2017, 33(4): 257-265. DOI: 10.3928/1081597X-20161206-03.
[18]	Ramón ML, Piñero DP, Pérez-Cambrodí RJ. Correlation of visual performance with quality of life and intraocular aberrometric profile in patients implanted with rotationally asymmetric multifocal IOLs. J Refract Surg, 2012, 28(2): 93-99. DOI: 10.3928/1081597X-20111213-02.
[19]	Alió JL, Piñero DP, Plaza-Puche AB, et al. Visual outcomes and optical performance of a monofocal intraocular lens and a new-generation multifocal intraocular lens. J Cataract Refract Surg, 2011, 37(2): 241-250. DOI: 10.1016/j.jcrs.2010.08.043.
[20]	Moore JE, McNeely RN, Pazo EE, et al. Rotationally asymmetric multifocal intraocular lenses: Preoperative considerations and postoperative outcomes. Curr Opin Ophthalmol, 2017, 28(1):9-15. DOI: 10.1097/ICU.0000000000000339.