Ye Pan-pan, Yao Ke, Li Xia, Wu Wei, Huang Xiao-dan, Yu Yi-bo
Eye Center, Affiliated Second Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Zhonghua Yan Ke Za Zhi. 2010 Jul;46(7):625-30.
To compare visual function in pseudophakic patients with bilateral implantation of Tecnis multifocal aspheric and conventional monofocal spherical intraocular lenses (IOL).
A prospective study of 100 consecutive cases (200 eyes) was conducted. All cataract patients underwent phacoemulsification were randomized to receive multifocal aspheric IOL (Tecnis ZM900, AMO, multifocal aspheric group) or conventional spherical IOL (Akreos Adapt, Bausch & Lomb, monofocal spherical group). The following investigations were performed to assess the uncorrected and distance-corrected visual acuity of distance, intermediate and near distances, accommodative amplitude, spherical aberrations of total eye, contrast sensitivity, glare sensitivity and near stereoacuity. Patients were surveyed for visual disturbances and lifestyle visual quality. The independent-samples t test was used to compare the measure data which met normal distribution and the Mann-Whitney U test was used to compare the measure data which didn't meet. The chi-square test was applied to compare categorical variables.
The uncorrected and distance-corrected bilateral visual acuity of multifocal aspheric group at 30 cm and 40 cm were 0.24 ± 0.12 and 0.22 ± 0.11 (logMAR), better than monofocal spherical group (Z = -8.261, P = 0.000; Z = -5.508, P = 0.000), but the visual acuity at other distances had no statistical difference between two groups. Patients with multifocal aspheric IOL had significantly higher accommodative amplitude than those with monofocal spherical IOL, improved about 2.3 ∼ 2.8 D (Z = -10.655, P = 0.000; Z = -2.709, P = 0.007). Mean spherical aberration of multifocal aspheric group was (0.027 ± 0.160) µm and (0.006 ± 0.083) µm, significantly lower than that of monofocal spherical group (0.269 ± 0.161) µm, (0.037 ± 0.205) µm at 5 mm and 3 mm pupil diameter (Z = -8.815, P = 0.000; Z = -2.791, P = 0.005). The difference of contrast sensitivity was not significant, but glare sensitivity was higher for monofocal spherical group than for multifocal aspheric group. Multifocal aspheric group showed statistically better uncorrected stereoacuity (72.4 ± 29.9)″ than monofocal spherical group (92.8 ± 35.7)″ (Z = -3.089, P = 0.002).
The present clinical results demonstrated that Tecnis multifocal aspheric group had better near visual acuity, accommodative amplitude and near stereoacuity as compared to conventional monofocal spherical group. The aspheric design reduced spherical aberration of total eye and improved contrast sensitivity in some way.
比较植入Tecnis多焦点非球面人工晶状体和传统单焦点球面人工晶状体的双眼假晶状体患者的视觉功能。
对100例连续病例（200只眼）进行前瞻性研究。所有接受白内障超声乳化手术的患者被随机分为接受多焦点非球面人工晶状体（Tecnis ZM900，AMO，多焦点非球面组）或传统球面人工晶状体（Akreos Adapt，博士伦，单焦点球面组）。进行以下检查以评估远、中、近距离的未矫正视力和距离矫正视力、调节幅度、全眼的球差、对比敏感度、眩光敏感度和近立体视锐度。对患者进行视觉干扰和生活方式视觉质量的调查。采用独立样本t检验比较符合正态分布的测量数据，采用Mann-Whitney U检验比较不符合正态分布的测量数据。应用卡方检验比较分类变量。
多焦点非球面组在30 cm和40 cm处的双眼未矫正视力和距离矫正视力分别为0.24±0.12和0.22±0.11（logMAR），优于单焦点球面组（Z = -8.261，P = 0.000；Z = -5.508，P = 0.000），但两组在其他距离的视力无统计学差异。植入多焦点非球面人工晶状体的患者调节幅度明显高于植入单焦点球面人工晶状体的患者，提高了约2.3～2.8 D（Z = -10.655，P = 0.000；Z = -2.709，P = 0.007）。多焦点非球面组在5 mm和3 mm瞳孔直径时的平均球差分别为(0.027±0.160)µm和(0.006±0.083)µm，明显低于单焦点球面组的(0.269±0.161)µm，(0.037±0.205)µm（Z = -8.815，P = 0.000；Z = -2.791，P = 0.005）。对比敏感度差异不显著，但单焦点球面组的眩光敏感度高于多焦点非球面组。多焦点非球面组的未矫正立体视锐度（72.4±29.9）″在统计学上优于单焦点球面组（92.8±35.7）″（Z = -3.089，P = 0.002）。
目前的临床结果表明，与传统单焦点球面组相比，Tecnis多焦点非球面组具有更好的近视力、调节幅度和近立体视锐度。非球面设计降低了全眼的球差，并在一定程度上提高了对比敏感度。
