阶梯渐进衍射型（ReSTOR）与折射型（ReZoom）两种多焦点人工晶体的临床比较研究

发布时间：2018-12-16 10:01

【摘要】： 目的：本研究通过比较年龄相关性白内障患者，行超声乳化分别联合应用阶梯渐进衍射型多焦点人工晶体（Acrysof ReSTOR MIOL）与折射型多焦点人工晶体（AMO ReZoom MIOL）植入术后的近期全程视力（包括远、中、近距离视力）及主观感觉等情况，评价临床上两种多焦点人工晶体植入术后的临床效果及应用价值。方法：方法为非随机对照临床试验。收集在惠州市中心人民医院行超声乳化白内障吸除联合多焦点人工晶体植入的患者33例（45眼），按植入多焦点人工晶体种类的不同分为ReSTOR组（15例23眼）和ReZoom组（18例22眼），术后3个月用标准对数视力表测量患者裸眼远视力，应用标准近视力表测量裸眼近视力，应用Colenbrander MIXEDCONTRAST CARD SET测量患者裸眼中程视力（40、63、100cm），观察两组患者在不同照明条件下（20、400lux）的单眼裸眼远、中距离（40、63、100cm高低对比度）、近视力，术前存在影响视力的其他疾病或者术中发生并发症等患者均排除于本研究。问卷调查项目包括日常生活视物舒适度(远、中、近距离)，读书看报是否需要近用镜，不同照明条件对视物有无影响及其它视觉症状。结果采用spss15.0统计软件进行t检验和χ2检验。结果：术后3个月，两组患者术中术后均无严重并发症，散瞳后行裂隙灯检查未发现晶体偏心、移位，无后发性白内障发生。术后3个月，20lux和400lux照明条件下ReSTOR组和ReZoom组患者均可获得良好的裸眼远视力,分别为0.34±0.20，0.36±0.14（20lux）及0.71±0.20，0.77±0.21（400lux），差异无显著统计学意义；20lux照明条件下，两组裸眼近视力分别为0.20±0.07，0.20±0.08（p0.05），400lux照明条件下0.33±0.10，0.27±0.10（400lux），ReSTOR组近视力优于ReZoom组（p0.05）；ReZoom组在40cm、63cm、100cm的裸眼高低对比度视力均明显优于ReSTOR组（p0.05）。不同照明条件下，两组患者裸眼远中近视力均随着照明条件的改善而有所提高。术后问卷调查显示ReSTOR组患者术后脱镜率高于ReZoom组（p0.01)，但术后眩光等不适两组无明显差异。在患者的满意度评价上，在看远上，两组患者满意度无统计学差异，在近视力满意度上ReSTOR多焦组明显高于ReZoom多焦组，而视中距离满意度上，，ReZoom多焦组则优于ReSTOR组。结论：初步应用表明两种多焦点人工晶体术后近期均能提供较好的远视力，但ReSTOR MIOL近视力较好，术后脱镜率较高；ReZoom MIOL则能提供良好的中程视力。故临床上应根据患者的不同需求而选择植入相应的人工晶体。
[Abstract]:Objective: to compare age-related cataract patients. Phacoemulsification was performed in combination with stepwise progressive diffraction intraocular lens (Acrysof ReSTOR MIOL) and refraction multifocus intraocular lens (AMO ReZoom MIOL) implantation. The clinical effect and application value of two kinds of multi-focus intraocular lens implantation were evaluated. Methods: non-randomized controlled clinical trial. Thirty-three patients (45 eyes) with phacoemulsification combined with multi-focus intraocular lens implantation in Huizhou Central people's Hospital were collected. According to the type of multi-focus intraocular lens implanted, the patients were divided into ReSTOR group (15 cases, 23 eyes) and ReZoom group (18 cases, 22 eyes). The median naked visual acuity (40 ~ 63100cm) was measured by Colenbrander MIXEDCONTRAST CARD SET. The distance of uncorrected eyes (20400lux), middle distance (400.63100cm high contrast) and near visual acuity (NVA) were observed in two groups under different illumination conditions (20400lux). Patients with preoperative vision-related diseases or intraoperative complications were excluded from the study. The items of the questionnaire included the comfort of visual objects in daily life (far, middle and close distance), the need of reading and newspaper reading, the influence of different lighting conditions on the visual objects and other visual symptoms. Results t test and 蠂 2 test were performed by spss15.0 software. Results: three months after operation, there were no serious complications in both groups. No eccentricity, displacement and no posterior cataract were found after pupil dilation by slit lamp examination. 3 months after operation, the patients in ReSTOR group and ReZoom group under 20lux and 400lux illumination could obtain good naked far visual acuity (20lux) 0.34 卤0.20 卤0.36 卤0.14 (20lux) and 0.71 卤0.20 卤0.77 卤0.21 (400lux), respectively. There was no significant difference between the two groups. Under 20lux illumination, the near-visual acuity of the two groups was 0.20 卤0.07 卤0.08 (p0.05) and 0.33 卤0.10 卤0.27 卤0.10 under 400lux illumination respectively. The near visual acuity of 400lux), ReSTOR group was better than that of ReZoom group (p0.05). The visual acuity of high and low contrast in ReZoom group was better than that in ReSTOR group at 40 cm, 63 cm or 100 cm (p0.05). Under different illumination conditions, the open eye distant near visual acuity of the two groups improved with the improvement of lighting conditions. Post-operative questionnaire survey showed that the rate of postoperative removal of endoscopy in ReSTOR group was higher than that in ReZoom group (p0.01), but there was no significant difference in postoperative glare and discomfort between the two groups. In the evaluation of patients' satisfaction, there was no statistical difference in satisfaction between the two groups. The ReSTOR multi-focus group was significantly higher than the ReZoom multi-focal group in the near vision satisfaction, while the ReZoom multi-focus group was superior to the ReSTOR group. Conclusion: the preliminary application shows that the two kinds of multi-focus intraocular lens can provide better distant visual acuity in the short term, but the near visual acuity of ReSTOR MIOL is better, and the higher rate of removal of endoscopy after operation,; ReZoom MIOL can provide good intermediate visual acuity. Therefore, we should choose to implant intraocular lens according to the different needs of patients.
【学位授予单位】：汕头大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R779.66

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