高度近视合并白内障患者三焦点人工晶体植入的临床效果观察

Clinical Effect of Trifocal Diffractive Intraocular Lens Implantation in Patients with High Myopia and Cataract

摘要: 目的：观察高度近视合并白内障患者植入三焦点人工晶状体的临床疗效。方法：回顾性研究。收集2016年11月至2017年10月在我院行人工晶体植入术的白内障患者70例70眼，根据患者术前屈光状态及植入晶体类型分为三组，分析其术后3月的裸眼远、中、近视力及最佳矫正远视力下的中、近视力，客观视觉质量、视觉不良症状、脱镜率及手术满意度。结果：术后3月，A、B组裸眼中、近视力，远矫下的中、近视力差异有统计学意义(P < 0.05)；A、B组裸眼远视力、最佳矫正远视力差异无统计学意义(P > 0.05)；A组MTF cutoff高于B组，SR、OSI、100%、20%、9%OVs低于B组，但差异无统计学意义(P > 0.05)；A、C组裸眼远、中、近视力、MTF cutoff、SR、100%、20%、9%OVs差异无统计学意义(P < 0.05)；A组眩光、光晕的发生率略高于B组；三组患者的脱镜率分别为90%、32%、100%。结论：高度近视合并白内障患者术中植入三焦点人工晶体可以获得较好的全程视力和良好的视觉质量，术后对框架眼镜的依赖显著降低，患者满意度高。

Abstract: PURPOSE: To observe the clinical effect of trifocal diffractive intraocular Lens implantation in pa-tients with high myopia and cataract. METHODS: Retrospective study. 70 patients (70 eyes) with cataract who underwent phacoemulsification and intraocular lens implantation in Department of Ophthalmology, Affiliated Hospital of Qingdao University from November 2016 to October 2017 were selected as the study objects. According to the preoperative refractive status and crystal type, patients were divided into three groups. Monocular distance, intermediate, and near UCVA were measured at 3 months after surgery. Other outcome measurements were MTF cutoff, Strehl ratio, contrast visual acuity and OSI. All patients also completed a subjective questionnaire survey, in-cluding surgical satisfaction, spectacle independence, and perception of photic phenomena. Va-riables were presented as mean ± standard deviation. Visual acuity, OQAS parameter results were compared using Student’s t test. The chi-square test was used to assess differences in categorical variables. In all cases, a p-value <0.05 was considered statistically significant. RESULTS: The results showed a significant difference in the best distance corrected near and intermediate visual acuity in group A and B at 3 months postoperatively (P < 0.05), there was no significant difference in the best corrected distance vision between A and B groups (P > 0.05). The MTF cutoff in group A was higher than that in group B, and the SR, OSI, 100%, 20% and 9% OVs were lower than those in group B, but the difference was not statistically significant (P > 0.05). There were no statistical significances in group A and B after surgery in the following variables: UCDVA, IUCVA, UCNVA, MTF cut off, SR and 100%, 20%, 9% OVs (P > 0.05). The incidence of glare and halo in group A was slightly higher than that in group B. The spectacle independence of the three groups was 90%, 32% and 100%. The vast majority of patients were satisfied with the results of this operation. CONCLUSIONS: For patients with high myopia and cataract, implanted trifocal diffractive intraocular lens can get a better full range vision and good visual quality.