匹配植入多焦点人工晶体远期视觉功能的比较研究

发布时间：2019-05-10 02:35

【摘要】：目的探讨超声乳化白内障摘除联合匹配植入折射型与衍射型多焦点人工晶状体(MIOL)术后远期的视觉功能及满意度。 方法选择2008年7月至2009年12月在广东省惠州市中心人民医院接受白内障超声乳化联合人工晶状体植入术的患者，筛选61例(122眼)，按植入人工晶体的不同分为三组，其中匹配组双眼匹配植入ReZoom（主视眼）和Tecnis ZM900（对侧眼）25例(50眼)，ZM900组双眼植入衍射型多焦点人工晶体（AMO，Tecnis ZM900）16例(32眼)，ReZoom组双眼植入折射型多焦点人工晶体（AMO，ReZoom NXGl MIOL）20例(40眼)。所有患者随访时间均超过12个月（12-23月，平均15.70±3.01月），，末次随访中观察患者术后不同光照条件下双眼裸眼远（500cm）、中（40cm、63cm、100cm）、近视力（30cm）、近立体视锐度，并进行双盲问卷调查了解患者的眼镜依赖程度、视觉干扰症状及满意度。结果采用spss13.0统计软件进行析因设计的方差分析及卡方检验，两两比较采用LSD检验。 结果术后12个月以上随访发现，在20lux、400lux光照度下，三组患者均可获得满意的双眼裸眼远视力；400lux时，匹配组在30cm、40cm、63cm、100cm的双眼裸眼视力均在0.6以上，匹配组在30cm视力优于ReZoom组（P=0．007），匹配组在63cm的高、低对比度视力均明显优于ZM900组，差异均有统计学意义(p=0.000,p=0.010)；20lux时，匹配组在100cm的高、低对比度视力均明显优于ZM900组，差异均有统计学意义(p=0.000,p=0.000)。非矫正近视力下近立体视锐度,匹配组≤60s者达84.0%。眼镜依赖程度调查，视近时，匹配组明显优于ReZoom组，差异有统计学意义（p=0.008）；视中时，匹配组明显优于ZM900组，差异有统计学意义（p=0.000）。满意度调查，匹配组明显优于ZM900组及ReZoom组，差异有统计学意义（p=0.009，p=0.008）。 结论初步研究表明双眼匹配植入MIOL能提供良好的术后远期裸眼远、中、近全程视力及近立体视觉,并能明显减少眼镜依赖度及术后眩光，明显提高患者满意度。
[Abstract]:Objective to investigate the long-term visual function and satisfaction of phacoemulsification combined with matching implantation of refractive and diffractive multifocal intraocular lens (MIOL). Methods from July 2008 to December 2009, 61 patients (122 eyes) underwent cataract phacoemulsification combined with intraocular lens implantation in Huizhou Central people's Hospital of Guangdong Province. They were divided into three groups according to the different intraocular lens implantation. In the matching group, there were 25 cases (50 eyes) of ReZoom and Tecnis ZM900 (contralateral eyes), 16 cases (32 eyes) of diffractive multifocal intraocular lens (AMO,Tecnis ZM900) were implanted into the binocular matched group, and 16 cases (32 eyes) of diffractive multifocal intraocular lens (AMO,Tecnis ZM900) were implanted into the binocular matched eyes of the matched group. In ReZoom group, refractive multifocal intraocular lens (AMO,ReZoom NXGl MIOL) was implanted in 20 cases (40 eyes). All patients were followed up for more than 12 months (12-23 months, with an average of 15.70 卤3.01 months). At the last follow-up, the patients were observed at different light conditions (500cm), medium (40 cm, 63 cm, 100 cm), near visual acuity (30cm). The near stereoscopic visual acuity was investigated by double blind questionnaire to investigate the degree of glasses dependence, visual disturbance symptoms and satisfaction. Results spss13.0 statistical software was used for variance analysis and chi-square test of factorial design, and LSD test was used for pairwise comparison. Results after more than 12 months follow-up, it was found that under the light intensity of 20 luxu and 400 luxu, all the patients in the three groups could obtain satisfactory uncorrected far vision. At 400lux, the visual acuity of the matching group was 30 cm, 40 cm, 63 cm, and the uncorrected visual acuity of 100 cm was above 0.6. The visual acuity of the matching group was better than that of the ReZoom group (P 鈮

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