高级检索
中华实验眼科杂志
期刊首页
过刊列表
高级检索
稿件发表
• 临床研究 •
ENGLISH ABSTRACT
三焦点与单焦点人工晶状体植入术后1年视觉质量比较
秦勤
刘军
陈晖
李一壮
鲍连云
何自芳
解正高
作者及单位信息
·
DOI： 10.3760/cma.j.cn115989-20200211-00060
Comparison of one-year postoperative visual quality between trifocal and monofocal intraocular lens implantation
Qin Qin
Liu Jun
Chen Hui
Li Yizhuang
Bao Lianyun
He Zifang
Xie Zhenggao
Authors Info & Affiliations
Qin Qin
Department of Ophthalmology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
Liu Jun
Department of Ophthalmology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
Chen Hui
Department of Ophthalmology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
Li Yizhuang
Department of Ophthalmology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
Bao Lianyun
Department of Ophthalmology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
He Zifang
Department of Ophthalmology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
Xie Zhenggao
Department of Ophthalmology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
·
DOI： 10.3760/cma.j.cn115989-20200211-00060
1195
112
0
0
4
1
PDF下载
APP内阅读
摘要

目的比较三焦点与单焦点人工晶状体(IOL)植入术后1年视觉质量。

方法采用队列研究设计，纳入2017年5月至2018年6月在南京大学医学院附属鼓楼医院行超声乳化白内障摘出联合IOL植入术的年龄相关性白内障患者41例41眼，根据患者意愿将其分为三焦点IOL组20例20眼和单焦点IOL组21例21眼，分别植入AT LISA tri 839MP三焦点IOL和603P单焦点IOL。术后随访1年，检测2个组患者术后1年裸眼远距离视力(UCDVA)、裸眼中距离视力(UCIVA)、裸眼近距离视力(UCNVA)、最佳矫正远视力(BCDVA)、远视力矫正下的中距离视力(DCIVA)和远视力矫正下的近距离视力(DCNVA)；采用OQAS Ⅱ检测患者点扩散函数(PSF)、调制传递函数(MTF)截止频率、斯特尔比率(SR)，以及对比度分别为100%、20%、9%时的OQAS Ⅱ值(OV 100%、OV 20%、OV 9%)及客观散射指数(OSI)；采用iTrace视功能分析仪评估患者的波前像差，包括全眼总像差(TA)、总高阶像差(tHOAs)、球差、彗差、三叶草像差、总低阶像差(tLOAs)、离焦、散光，所有像差值用均方根表示；采用综合验光仪检测2个组患者术眼不同调节范围内的视力，并以高于0.5 LogMAR视力绘制离焦曲线图；采用裂隙灯显微镜观察并以Sellman法量化分析2个组患者IOL区域内后囊膜混浊(PCO)发生程度；采用视功能指数量表(VF-14)对视功能进行评分。

结果术后1年，三焦点IOL组患者UCIVA、UCNVA、DCIVA和DCNVA明显优于单焦点IOL组，差异均有统计学意义(均 P<0.001)。OQAS Ⅱ视觉质量指标显示，三焦点IOL组患者MTF截止频率、SR、OV 100%及OSI值明显高于单焦点IOL组，差异均有统计学意义(均 P<0.001)。2个组患者各波前像差比较，差异均无统计学意义(均 P>0.05)。离焦曲线显示，单焦点IOL组组患者在-1.0、-1.5、-2.0、-2.5、-3.0、-3.5 D时(即相当于1 m、66 cm、50 cm、40 cm、33 cm、29 cm)的LogMAR视力明显高于三焦点IOL组，差异均有统计学意义(均 P<0.05)。三焦点IOL组PCO例数多于单焦点IOL组，差异有统计学意义( χ 2 ＝41.0， P<0.001)。三焦点IOL组的VF-14评分为87.99±1.09，明显高于单焦点IOL组的81.49±1.67，差异有统计学意义( t＝10.301， P<0.001)。

结论三焦点IOL植入术后1年患者全程视力及主观视觉质量、客观视觉质量均优于单焦点IOL。

白内障;手术;人工晶状体，三焦点;人工晶状体，单焦点;视觉质量
ABSTRACT

ObjectiveTo compare the one-year postoperative visual quality after trifocal intraocular lens (IOL) implantation and monofocal IOL implantation.

MethodsA cohort study was conducted.Forty-one eyes from 41 age-related cataract patients who underwent phacoemulsification extraction combined with IOL implantation in Nanjing Drum Tower Hospital from May 2017 to June 2018 were enrolled.The patients were divided into trifocal IOL group (20 eyes) receiving ZEISS AT LISA tri 839MP trifocal IOL implantation and monofocal IOL group (21 eyes) receiving ZEISS 603P monofocal IOL implantation according to their willingness.One year after surgery, uncorrected distant visual acuity (UCDVA), uncorrected intermediate visual acuity (UCIVA), uncorrected near visual acuity (UCNVA), best corrected distance visual acuity (BCDVA), distance corrected intermediate visual acuity (DCIVA) and distance corrected near visual acuity (DCNVA) were detected in both groups.The patient point spread function (PSF), modulation transfer function (MTF) cutoff frequency, Strehl ratio (SR), OQAS Ⅱ values at 100%, 20%, and 9% contrast (OV 100%, OV 20%, OV 9%) and objective scattering index (OSI) were measured by OQAS Ⅱ.Wavefront aberrations including total aberration (TA), total high order aberrations (tHOAs), spherical aberration, coma, trefoil aberration, total low order aberrations (tLOAs), defocus, and astigmatism were evaluated with the iTrace visual function analyzer.All aberrations were represented by root mean square.The visual acuity of operative eyes was measured with a phoropter, and defocus curves were drawn with visual acuity better than 0.5 LogMAR.The incidence of posterior capsular opacification (PCO) in the IOL region was quantitatively analyzed by Sellman method.Visual function was scored by visual function index (VF-14). This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School (No.2018-219-01). Written informed consent was obtained from each subject prior to any medical examination.

ResultsOne year after the operation, UCIVA, UCNVA, DCIVA, and DCNVA of trifocal IOL group were significantly better than those of monofocal IOL group, and the differences were statistically significant (all at P<0.001). OQAS Ⅱ visual quality indicators showed that the MTF cutoff frequency, SR, OV 100%, and OSI values of trifocal IOL group were significantly higher than those of monofocal IOL group, showing statistically significant differences (all at P<0.001). No significant difference in wavefront aberrations was found between the two groups (all at P>0.05). Defocus curve showed that the LogMAR visual acuity of patients at -1.0 D, -1.5 D, -2.0 D, -2.5 D, -3.0 D, and -3.5 D (namely, 1 m, 66 cm, 50 cm, 40 cm, 33 cm, and 29 cm) in monofocal IOL group were significantly better than those in trifocal IOL group (all at P<0.05). There was a higher incidence of PCO in trifocal IOL group than monofocal IOL group, with a statistically significant difference ( χ 2 =41.0, P<0.001). The VF-14 score of trifocal IOL group was 87.99±1.09, which was significantly higher than 81.49±1.67 of monofocal IOL group ( t=10.301, P<0.001).

ConclusionsOne year after trifocal IOL implantation, the full range of vision, subjective and objective visual quality of eyes are better than eyes implanted with monofocal IOL.

Cataract;Surgery;Lenses, intraocular, trifocal;Lenses, intraocular, monofocal;Visual quality
Xie Zhenggao, Email: mocdef.3ab61eixoaggnehz
Copyright by Chinese Medical Association
No content published by the journals of Chinese Medical Association may be reproduced or abridged without authorization. Please do not use or copy the layout and design of the journals without permission.
All articles published represent the opinions of the authors, and do not reflect the official policy of the Chinese Medical Association or the Editorial Board, unless this is clearly specified.
引用本文

秦勤,刘军,陈晖,等. 三焦点与单焦点人工晶状体植入术后1年视觉质量比较[J]. 中华实验眼科杂志,2022,40(05)：454-460.

DOI:10.3760/cma.j.cn115989-20200211-00060

PERMISSIONS

Request permissions for this article from CCC.

评价本文
*以上评分为匿名评价

版权归中华医学会所有。

未经授权，不得转载、摘编本刊文章，不得使用本刊的版式设计。

除非特别声明，本刊刊出的所有文章不代表中华医学会和本刊编委会的观点。

白内障是老年人群主要的致盲眼病之一，严重影响老年人的生活质量。随着经济社会的不断发展和人们知识水平的不断提高，患者对于白内障术后拥有清晰的全程视力要求越来越高，白内障手术从复明手术逐渐过渡到拥有更好视觉质量的屈光性手术。因此，为让患者拥有更佳远、中、近全程视力和更好视觉质量，三焦点和区域折射等新型人工晶状体(intraocular lens，IOL)应运而生，弥补了以往双焦点IOL无法提供清晰中距离视力的缺陷 [ 1 , 2 , 3 ]。大量研究显示三焦点IOL可以提供优良的屈光效果 [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ]；然而，也有研究者认为由于光线通过三焦点IOL时能量分散于不同焦点，各焦点光能量有不同程度的减弱，使成像于视网膜的物像对比度降低，影响视觉质量 [ 13 , 14 ]。目前，我国三焦点IOL上市时间较短，国内研究尚缺少对其长期临床效果观察研究。本研究拟比较三焦点IOL与单焦点IOL植入术后1年的视觉质量，以期为患者选择最佳治疗方案及合适的IOL提供参考。
试读结束，您可以通过登录机构账户或个人账户后获取全文阅读权限。
参考文献
[1]
Mojzis P , Kukuckova L , Majerova K ，et al. Postoperative visual performance with a bifocal and trifocal diffractive intraocular lens during a 1-year follow-up[J]．Int J Ophthalmol， 2017，10(10):1528-1533. DOI： 10.18240/ijo.2017.10.08 .
返回引文位置Google Scholar
百度学术
万方数据
[2]
Shen Z , Lin Y , Zhu Y ，et al. Clinical comparison of patient outcomes following implantation of trifocal or bifocal intraocular lenses：a systematic review and meta-analysis[J/OL]．Sci Rep， 2017，7:45337[2021-06-20]．http://www.ncbi.nlm.nih.gov/pubmed/28422087. DOI： 10.1038/srep45337 .
返回引文位置Google Scholar
百度学术
万方数据
[3]
Yoon CH , Shin IS , Kim MK . Trifocal versus bifocal diffractive intraocular lens implantation after cataract surgery or refractive lens exchange：a meta-analysis[J/OL]．J Korean Med Sci， 2018，33(44):e275[2021-06-20]．http://www.ncbi.nlm.nih.gov/pubmed/30369857. DOI： 10.3346/jkms.2018.33.e275 .
返回引文位置Google Scholar
百度学术
万方数据
[4]
Bilbao-Calabuig R , Llovet-Rausell A , <x>Ortega-Us</x> <x>obiaga</x> J ，et al. Visual outcomes following bilateral lmplantation of two diffractive trifocal intraocular lenses in 10 084 eyes[J]．Am J Ophthalmol， 2017，179:55-66. DOI： 10.1016/j.ajo.2017.04.013 .
返回引文位置Google Scholar
百度学术
万方数据
[5]
Cochener B ．Prospective clinical comparison of patient outcomes following implantation of trifocal or bifocal intraocular lenses[J]．J Refract Surg， 2016，32(3):146-151. DOI： 10.3928/1081597X-20160114-01 .
返回引文位置Google Scholar
百度学术
万方数据
[6]
Mendicute J , Kapp A , Lévy P ，et al. Evaluation of visual outcomes and patient satisfaction after implantation of a diffractive trifocal intraocular lens[J]．J Cataract Refract Surg， 2016，42(2):203-210. DOI： 10.1016/j.jcrs.2015.11.037 .
返回引文位置Google Scholar
百度学术
万方数据
[7]
Alfonso JF , Fernández-Vega Cueto L , Belda-Salmerón L ，et al. Visual function after implantation of a diffractive aspheric trifocal intraocular lens[J]．Eur J Ophthalmol， 2016，26(5):405-411. DOI： 10.5301/ejo.5000741 .
返回引文位置Google Scholar
百度学术
万方数据
[8]
Kohnen T , Titke C , Böhm M ．Trifocal intraocular lens implantation to treat visual demands in various distances following lens removal[J]．Am J Ophthalmol， 2016，161:71-77. DOI： 10.1016/j.ajo.2015.09.030 .
返回引文位置Google Scholar
百度学术
万方数据
[9]
Gerl M , Breyer D , Hagen P ，et al. Clinical comparison of a trifocal and a trifocal-toric intraocular lens based on the same diffractive platform[J]．Klin Monbl Augenheilkd， 2017，234(10):1276-1282. DOI： 10.1055/s-0043-102573 .
返回引文位置Google Scholar
百度学术
万方数据
[10]
Ortiz C , Esteve-Taboada JJ , Belda-Salmerón L ，et al. Effect of decentration on the optical quality of two intraocular lenses[J]．Optom Vis Sci， 2016，93(12):1552-1559. DOI： 10.1097/OPX.0000000000001004 .
返回引文位置Google Scholar
百度学术
万方数据
[11]
Carson D , Xu Z , Alexander E ，et al. Optical bench performance of 3 trifocal intraocular lenses[J]．J Cataract Refract Surg， 2016，42(9):1361-1367. DOI： 10.1016/j.jcrs.2016.06.036 .
返回引文位置Google Scholar
百度学术
万方数据
[12]
Almulhim AK , Alarfaj KM , Altaisan AA ，et al. Visual outcomes and patient satisfaction after bilateral implantation of a new trifocal diffractive intraocular lens[J]．Saudi J Ophthalmol， 2018，32(4):310-317. DOI： 10.1016/j.sjopt.2018.08.004 .
返回引文位置Google Scholar
百度学术
万方数据
[13]
Tetz M , Koerber N , Shingleton BJ ，et al. Phacoemulsification and intraocular lens implantation before，during，or after canaloplasty in eyes with open-angle glaucoma：3-year results[J]．J Glaucoma， 2015，24(3):187-194. DOI： 10.1097/IJG.0b013e318285ff13 .
返回引文位置Google Scholar
百度学术
万方数据
[14]
de Silva SR , Evans JR , Kirthi V ，et al. Multifocal versus monofocal intraocular lenses after cataract extraction[J/OL]．Cochrane Database Syst Rev， 2016，12:CD003169[2021-06-26]．http://www.ncbi.nlm.nih.gov/pubmed/27943250. DOI： 10.1002/14651858.CD003169.pub4 .
返回引文位置Google Scholar
百度学术
万方数据
[15]
Wan Y , Zhao L , Huang C ，et al. Validation and comparison of the National Eye Inst itute Visual Functioning Questionnaire-25 (NEI VFQ-25) and the Visual Function Index-14 (VF-14) in patients with cataracts：a multicentre study [J/OL]．Acta Ophthalmol， 2021，99(4):e480-e488[2022-04-09]．http://www.ncbi.nlm.nih.gov/pubmed/32940410. DOI： 10.1111/aos.14606 .
返回引文位置Google Scholar
百度学术
万方数据
[16]
Farideh D , Azad S , Feizollah N ，et al. Clinical outcomes of new toric trifocal diffractive intraocular lens in patients with cataract and stable keratoconus：six months follow-up[J/OL]．Medicine (Baltimore)， 2017，96(12):e6340[2021-07-10]．http://www.ncbi.nlm.nih.gov/pubmed/28328814. DOI： 10.1097/MD.0000000000006340 .
返回引文位置Google Scholar
百度学术
万方数据
[17]
Javitt JC , Steinert RF . Cataract extraction with multifocal intraocular lens implantation：a multinational clinical trial evaluating clinical，functional，and quality-of-life outcomes[J]．Ophthalmology， 2000，107(11):2040-2048. DOI： 10.1016/s0161-6420(00)00368-7 .
返回引文位置Google Scholar
百度学术
万方数据
[18]
de Vries NE , Webers CA , Touwslager WR ，et al. Dissatisfaction after implantation of multifocal intraocular lenses[J]．J Cataract Refract Surg， 2011，37(5):859-865. DOI： 10.1016/j.jcrs.2010.11.032 .
返回引文位置Google Scholar
百度学术
万方数据
[19]
Mojzis P , Majerova K , Plaza-Puche AB ，et al. Visual outcomes of a new toric trifocal diffractive intraocular lens[J]． J Cataract Refract Su rg ， 2015，41(12):2695-2706. DOI： 10.1016/j.jcrs.2015.07.033 .
返回引文位置Google Scholar
百度学术
万方数据
[20]
Bilbao-Calabuig R , Llovet-Osuna F , González-López F ，et al. Nd：YAG capsulotomy rates with two trifocal intraocular lenses[J]．J Refract Surg， 2016，32(11):748-752. DOI： 10.3928/1081597X-20160803-02 .
返回引文位置Google Scholar
百度学术
万方数据
[21]
Almulhim AK , Alarfaj KM , Altaisan AA ，et al. Visual outcomes and patient satisfaction after bilateral implantation of a new trifocal diffractive intraocular lens[J]．Saudi J Ophthalmol， 2018，32(4):310-317. DOI： 10.1016/j.sjopt.2018.08.004 .
返回引文位置Google Scholar
百度学术
万方数据
[22]
Kim BH , Hyon JY , Kim MK . Effects of bifocal versus trifocal diffractive intraocular lens implantation on visual quality after cataract surgery[J]．Korean J Ophthalmol， 2019，33(4):333-342. DOI： 10.3341/kjo.2019.0001 .
返回引文位置Google Scholar
百度学术
万方数据
[23]
Artal P , Guirao A , Berrio E ，et al. Compensation of corneal aberrations by the internal optics in the human eye[J]．J Vis， 2001，1(1):1-8. DOI： 10.1167/1.1.1 .
返回引文位置Google Scholar
百度学术
万方数据
[24]
Theiss MB , Santhiago MR , Moraes HV Jr，et al. Prevalence of corneal astigmatism in cataract surgery candidates at a public hospital in Brazil[J]．Arq Bras Oftalmol， 2019，82(5):377-380. DOI： 10.5935/0004-2749.20190071 .
返回引文位置Google Scholar
百度学术
万方数据
[25]
Hao J , Tan LZ , Li L ，et al. Comparison of visual quality in cataract patients with low astigmatism after ART2 or ReSTOR intraocular lens implantation[J]．Int J Ophthalmol， 2019，12(3):424-428. DOI： 10.18240/ijo.2019.03.12 .
返回引文位置Google Scholar
百度学术
万方数据
[26]
Prasher P , Sandhu JS . Prevalence of corneal astigmatism before cataract surgery in Indian population[J]．Int Ophthalmol， 2017，37(3):683-689. DOI： 10.1007/s10792-016-0327-z .
返回引文位置Google Scholar
百度学术
万方数据
[27]
Akman A , Asena L , Ozturk C ，et al. Evaluation of quality of life after implantation of a new trifocal intraocular lens[J]．J Cataract Refract Surg， 2019，45(2):130-134. DOI： 10.1016/j.jcrs.2018.12.003 .
返回引文位置Google Scholar
百度学术
万方数据
[28]
Ozturkmen C , Kesim C , Gunel Karadeniz P ，et al. Comparative analysis of a new hybrid EDOF-multifocal diffractive intraocular lens with a trifocal diffractive intraocular lens[J/OL]．Eur J Ophthalmol， 2021:11206721211067643[2022-04-09]．http://www.ncbi.nlm.nih.gov/pubmed/34905987. DOI： 10.1177/11206721211067643 .
返回引文位置Google Scholar
百度学术
万方数据
备注信息
A
解正高，Email： mocdef.3ab61eixoaggnehz
B

秦勤：设计试验、实施研究、采集数据、统计分析、文章撰写；刘军：实施研究、采集数据、统计分析；陈晖、李一壮、鲍连云：实施研究；何自芳：实施研究、采集分析数据；解正高：设计试验、指导研究、对文章的知识性内容作批评性审阅

C
所有作者均声明不存在利益冲突
D
南京鼓楼医院临床研究专项资金项目 (2021-LCYJ-PY-25)
南京市医学科技发展项目 (YKK17078)
评论 （0条）
注册
登录
时间排序
暂无评论，发表第一条评论抢沙发
最新推荐
更多
不同暗瞳直径屈光不正患者ICL植入术后视觉质量比较
尹娜 等
中华眼视光学与视觉科学杂志 2024,26(05)
连续视程人工晶状体植入术后残余散光对视觉质量的影响
胡晓昕 等
中华眼科杂志 2022,58(05)
三焦点人工晶状体与双焦点人工晶状体植入术后视力及视觉质量的对比
钟慧 等
中华眼视光学与视觉科学杂志 2020,22(04)
双眼三焦点人工晶状体和双焦点人工晶状体植入术后早期视觉质量比较
陈碧超 等
中华眼视光学与视觉科学杂志 2019,21(06)
MedAI助手（体验版）
文档即答
智问智答
机器翻译
回答内容由人工智能生成，我社无法保证其准确性和完整性，该生成内容不代表我们的态度或观点，仅供参考。
生成快照
文献快照

你好，我可以帮助您更好的了解本文，请向我提问您关注的问题。

0/2000

《中华医学会杂志社用户协议》 | 《隐私政策》

《SparkDesk 用户协议》 | 《SparkDesk 隐私政策》

网信算备340104764864601230055号 | 网信算备340104726288401230013号

技术支持：

历史对话
本文全部
还没有聊天记录
设置
模式
纯净模式沉浸模式
字号
小中大