Li L, Zheng G Y, Zhao Y T, Li Y
Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Zhonghua Yan Ke Za Zhi. 2017 Aug 11;53(8):599-609. doi: 10.3760/cma.j.issn.0412-4081.2017.08.008.
To observe the clinical effect of long term visual quality after the implantation of the aspheric diffractive multifocal intraocular lens. This was a retrospective cohort study.One hundred and thirty cases of age-related cataract (170 eyes) after phacoemulsification cataract extraction combined with IOL implantation were collected from September of 2009 to January of 2011 in the First Affiliated Hospital of Zhengzhou University.There were 42 patients (57 eyes) with aspheric multifocal group, 43 patients (57 eyes) in the aspheric group and 45 patients (56 eyes) in the spherical group according to the different types of IOL implanted.At 1 year, 3 years and 5 years after operation, the following parameters were assessed: uncorrected and best corrected distance, medium and near vision acuity, contrast sensitivity, wavefront aberrations, modulation transfer functions (MTF), stereopsis, visual function and quality of life (VF/QOL) questionnaire survey. At 1 year, 3 years and 5 years after operation, the uncorrected medium visual acuity in aspheric diffractive multifocal IOL group(0.30(0.10, 0.50), 0.30(0.10, 1.00), 0.30(0.10, 0.50)) was better than that of eyes in aspheric IOL group(0.40 (0.10, 0.0), 0.40 (0.20, 1.00), 0.40 (0.20, 0.50)) ((1)-3.32,-1.73,-3.01, (1)0.00, 0.01, 0.00) and spherical IOL group (0.40(0.30, 1.00), 0.40(0.20, 1.00), 0.40(0.20, 1.00)) ((2)-5.77,-3.19,-4.49, (2)0.00, 0.00, 0.00).And the near vision in aspheric diffractive multifocal IOL group(0.25(0.00, 1.00), 0.30(0.00, 1.00), 0.30(0.00, 1.00)) was also obviously better than that of eyes in aspheric IOL group (0.50(0.18, 1.00), 0.50(0.18, 1.00), 0.50(0.18, 1.00)) ((1)-5.57,-5.37,-4.93, (1)0.00, 0.00, 0.00) and spherical IOL group(0.60(0.18, 1.00), 0.60(0.18, 1.00), 0.60(0.18, 1.00)) ((2)-7.00,-6.91,-6.53, (2)0.00, 0.00, 0.00). At 5 years after operation, the mean higher-order aberration for 3.0mm and 5.0mm optical zone in aspheric diffractive multifocal IOL group (0.21(0.03, 0.46), 0.37(0.12, 2.01)) were significantly lower than that in spherical IOL group (0.43(0.10, 1.91), 0.46 (0.10, 1.91) ) ((2)-4.81,-1.97, (2)0.00, 0.01).But there was no statistical difference between the aspheric diffractive multifocal and aspheric IOL group (0.21(0.03, 1.17), 0.34(0.06, 1.74)) ((1)-0.10,-1.81, (1)0.92, 0.07).The mean spherical aberration for 3.0mm and 5.0mm optical zone in aspheric diffractive multifocal IOL group (0.01(-0.01, 0.20), 0.03(-0.10, 0.20)) were significantly lower than that in spherical IOL group (0.29(0.10, 0.99), 0.32(0.10, 0.99)) ((2)-8.48,-8.54, (2)0.00, 0.01).But there was no statistical differences between the aspheric diffractive multifocal and aspheric IOL group (0.02(-0.09, 0.37), 0.04(-0.09, 0.37)) ((1)-0.60,-0.73, (1)0.55, 0.46).About 86% of patients in aspheric diffractive multifocal IOL group do not need to wear glasses, it was better than the other two groups (χ(2)=17.83, 24.45, 0.00, 0.00).The incidence of night glare and halo in aspheric diffractive multifocal IOL group 16/50(32%) was higher than that of aspherical IOL group 5/50(10%) and spherical IOL group 3/50(6%), and the difference was statistically significant (χ(2)=7.29, 10.98, 0.00, 0.00).The overall satisfaction in aspheric diffractive multifocal IOL group was 45/50 (90%), better than that of aspherical IOL group 29/50(58%) and spherical IOL group 20/50(40%), and the difference was statistically significant (χ(2)=13.31, 27.47, 0.00, 0.00). The aspheric diffractive multifocal IOL can provide patients with good and stable far, medium and near vision, to meet the needs of patients without glasses.At the same time, it can effectively reduce the high order aberrations and spherical aberration, improve visual quality.But due to night glare and glow, it does not apply to professional drivers and nighttime drivers. -.
观察非球面衍射多焦点人工晶状体植入术后长期的视觉质量临床效果。这是一项回顾性队列研究。2009年9月至2011年1月期间，在郑州大学第一附属医院收集了130例年龄相关性白内障患者（170只眼），这些患者均接受了超声乳化白内障摘除联合人工晶状体植入术。根据植入的人工晶状体类型不同，分为非球面多焦点组42例（57只眼）、非球面组43例（57只眼）和球面组45例（56只眼）。在术后1年、3年和5年，评估以下参数：未矫正和最佳矫正远、中、近视力、对比敏感度、波前像差、调制传递函数（MTF）、立体视、视觉功能及生活质量（VF/QOL）问卷调查。术后1年、3年和5年时，非球面衍射多焦点人工晶状体组的未矫正中视力（0.30(0.10, 0.50)，0.30(0.10, 1.00)，0.30(0.10, 0.50)）优于非球面人工晶状体组（0.40 (0.10, 0.0)，0.40 (0.20, 1.00)，0.40 (0.20, 0.50)）（(1)-3.32,-1.73,-3.01，(1)0.00, 0.01, 0.00）和球面人工晶状体组（0.40(0.30, 1.00)，0.40(0.20, 1.00)，0.40(0.20, 1.00)）（(2)-5.77,-3.19,-4.49，(2)0.00, 0.00, 0.00）。并且非球面衍射多焦点人工晶状体组的近视力（0.25(0.00, 1.00)，0.30(0.00, 1.00)，0.30(0.00, 1.00)）也明显优于非球面人工晶状体组（0.50(0.18, 1.00)，0.50(0.18, 1.00)，0.50(0.18, 1.00)）（(1)-5.57,-5.37,-4.93，(1)0.00, 0.00, 0.00）和球面人工晶状体组（0.60(0.18, 1.00)，0.60(0.18, 1.00)，0.60(0.18, 1.00)）（(2)-7.00,-6.91,-6.53，(2)0.00, 0.00, 0.00）。术后5年时，非球面衍射多焦点人工晶状体组3.0mm和5.0mm光学区的平均高阶像差（0.21(0.03, 0.46)，0.37(0.12, 2.01)）显著低于球面人工晶状体组（0.43(0.10, 1.91)，0.46 (0.10, 1.91) ）（(2)-4.81,-1.97，(2)0.00, 0.01）。但非球面衍射多焦点人工晶状体组与非球面人工晶状体组之间无统计学差异（0.21(0.03, 1.17)，0.34(0.06, 1.74)）（(1)-0.10,-1.81，(1)0.92, 0.07）。非球面衍射多焦点人工晶状体组3.0mm和5.0mm光学区的平均球差（0.01(-0.01, 0.20)，0.03(-0.10, 0.20)）显著低于球面人工晶状体组（0.29(0.10, 0.99)，0.32(0.10, 0.99)）（(2)-8.48,-8.54，(2)0.00, 0.01）。但非球面衍射多焦点人工晶状体组与非球面人工晶状体组之间无统计学差异（0.02(-0.09, 0.37)，0.04(-0.09, 0.37)）（(1)-0.60,-0.73，(1)0.55, 0.46）。非球面衍射多焦点人工晶状体组约86%的患者无需佩戴眼镜，优于其他两组（χ(2)=17.83, 24.45, 0.00, 0.00）。非球面衍射多焦点人工晶状体组的夜间眩光和光晕发生率为16/50(32%)，高于非球面人工晶状体组的5/50(10%)和球面人工晶状体组的3/50(6%)，差异有统计学意义（χ(2)=7.29, 10.98, 0.00, 0.00）。非球面衍射多焦点人工晶状体组的总体满意度为45/50 (90%)，优于非球面人工晶状体组的29/50(58%)和球面人工晶状体组的20/50(40%)，差异有统计学意义（χ(2)=13.31, 27.47, 0.00, 0.00）。非球面衍射多焦点人工晶状体可为患者提供良好且稳定的远、中、近视力，满足患者不戴眼镜的需求。同时，它能有效降低高阶像差和球差，提高视觉质量。但由于夜间眩光和光晕问题，它不适用于职业驾驶员和夜间驾驶者。
