摘要
目的 对比分析单眼植入两种三焦点人工晶状体(IOL)术后早期的效果.方法 回顾性队列研究.纳入 2019 年 3 月至 2023 年 12 月在嘉兴爱尔眼科医院和湖州爱尔眼科医院行白内障超声乳化联合IOL植入术 35 例(35 眼).根据植入IOL不同分为A、B两组.A组 16 例(16 眼)植入AcrySof IQ PanOptix三焦点IOL;B组 19 例(19 眼)植入AT LISA Tri 839MP三焦点IOL.记录术前及术后 3 个月裸眼远视力(UDVA)、裸眼中视力(UIVA)及裸眼近视力(UNVA),术后 3 个月离焦曲线、视觉干扰现象及脱镜率.结果 A组术前UDVA、UIVA、UNVA(logMAR)分别为 0.61±0.15、0.61±0.17、0.74±0.35,术后 3 个月分别为 0.03±0.07、0.11±0.08、0.09±0.08;B 组术前 UDVA、UIVA、UNVA分别 0.59±0.20、0.58±0.15、0.69±0.26,术后 3 个月分别为 0.04±0.08、0.08±0.09、0.12±0.08.术后 3 个月,两组间UDVA、UIVA、UNVA差异均无统计学意义(t=-0.22,P=0.824;t=0.77,P=0.447;t=-0.85,P=0.404),A组术后3 个月UDVA、UIVA、UNVA均比术前有明显改善(t=18.22、9.84、7.42,均 P<0.001),B 组术后 3 个月 UDVA、UIVA、UNVA 均比术前有明显改善(t=10.39、10.57、9.08,均P<0.001).离焦曲线显示:附加度数为-1.00 D时,B组视力(0.11±0.06)优于A组(0.18±0.08)(t=2.95,P=0.006);附加度数为-1.50 D和-2.00 D时,A组视力(0.13±0.08,0.11±0.08)优于B组(0.19±0.04,0.17±0.07)(t=-3.25,P=0.004;t=-2.24,P=0.032).A组眩光或光晕的发生率为 31.25%(5/16),B组为 36.84%(7/19),两组间差异无统计学意义(P=1.000).A组双眼相互干扰的发生率为 37.50%(6/16),B组为 31.58%(6/19),两组间差异无统计学意义(P=0.736).A组脱镜率为 81.25%(13/16),B 组为 73.68%(14/19),两组间差异无统计学意义(P=0.700).结论 AcrySof IQ PanOptix与AT LISA tri 839MP三焦点IOL均能为患者提供较好的远中近视力、较高的脱镜率;单眼植入三焦点IOL的视觉干扰不严重.
Abstract
Objective To compare and analyze the short-term effects after monocular implantation of two trifocal IOLs.Methods This was a retrospective cohort study.Total 35 cases(35 eyes)who underwent phacoemulsification combined with IOL implantation in Jiaxing Aier Eye Hospital and Huzhou Aier Eye Hospital from Mar.2019 to Dec.2023 were collected and all cases were divided into two groups based on the different types of IOL.In group A 16 cases(16 eyes)were implanted with AcrySof IQ PanOptix trifocal IOLs;19 cases(19 eyes)in group B were implanted with AT LISA Tri 839MP trifocal IOLs.Uncorrected distant visual acuity(UDVA),intermediate visual acuity(UIVA)and near visual acuity(UNVA)were recorded before and at 3 months after surgery.Moreover,defocus curves,visual disturbance phenomena and spectacle independence rates were recorded at 3 months postoperatively.Results In group A,preoperative UDVA(logMAR),UIVA,and UNVA were 0.61±0.15,0.61±0.17 and 0.74±0.35,respectively.At 3 months postoperatively,these values were 0.03±0.07,0.11±0.08 and 0.09±0.08.In group B,preoperative UDVA,UIVA and UNVA were 0.59±0.20,0.58±0.15 and 0.69±0.26,respectively.At 3 months postoperatively,these values were 0.04±0.08,0.08±0.09 and 0.12±0.08.There were no statistically significant differences between the two groups in UDVA,UIVA,and UNVA at 3 months postoperatively(t=0.22,P=0.824;t=0.77,P=0.447;t=0.85,P=0.404).Both groups showed significant improvements in UDVA,UIVA,and UNVA compared to preoperative values(Group A:t=18.22,9.84,7.42;all P<0.001;Group B:t=10.39,10.57,9.08;all P<0.001).The defocus curve showed that with an additional power of-1.00D,the visual acuity of group B(0.11±0.06)was better than that of group A(0.18±0.08)(t=2.96,P=0.006).When the additional power were-1.50 D and-2.00 D,the visual acuity of group A(0.13±0.08,0.11±0.08)were better than that of group B(0.19±0.04,0.17±0.07)(t=-3.25,P=0.004;t=-2.24,P=0.032).The incidence of glare or halo in group A was 31.25%(5/16),which was 36.84%(7/19)in group B,and the difference was not statistically significant between the two groups(P=1.000).The incidence of binocular interference was 37.50%(6/16)in Group A,and 31.58%(6/19)in Group B.There was no statistically significant difference between the two groups(P=0.736).The spectacle independence rates was 81.25%(13/16)in group A,and 73.68%(14/19)in group B,with no statistically significant difference between the two groups.Conclusion Both AcrySof IQ PanOptix and AT LISA Tri 839MP Trifocal IOLs can provide good distant,intermediate and near visual acuity,as well as high spectacle independence rates.The visual disturbance phenomena of monocular implantation with trifocal IOLs are not severe.
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