目的:比较白内障超声乳化联合植入非球面AcrySofReSTOR+3D与非球面AcrySof ReSTOR+4D术后人工晶状体眼的视功能状态及患者的主观满意度,评价非球面AcrySof ReSTOR+3D人工晶状体的临床效果及应用价值。方法:收集我院超声乳化联合非球面+3D植入56例60眼为实验组,非球面+4D58例60眼为对照组。术后3mo行裸眼远、中、近视力及最佳矫正远、近视力,角膜散光度,对比敏感度检查及问卷调查(视觉干扰、满意度及脱镜率),并对数据进行统计学分析。结果:两组术后裸眼远、近视力及最佳矫正远、近视力无明显差异(P>0.05),中距离视力实验组(0.68±0.13)明显优于对照组(0.55±0.08),差异显著(P<0.05);术前散光0.75±0.13D,单切口术后角膜散光0.41±0.15D;术前散光1.25±0.18D,双切口术后角膜散光0.72±0.21D,术前术后比较差异有统计学意义(P<0.05)。各空间频率对比敏感度组间无明显差异(P>0.05)。两组术后均无明显夜视力下降、眩光、光晕等视觉干扰现象(P>0.05),在满意度评价上,视远及视近方面两组患者满意度无明显差异(P>0.05),中距离实验组满意度明显高于对照组(P<0.05),实验组脱镜率明显高于对照组(P<0.05)。结论:非球面AcrySof ReSTOR+3D人工晶状体为患者提供良好的远、中、近全程视力和视觉质量,尤其中距离视力比+4D有明显改善,实现了患者高度满意率和脱镜率。因此我们认为非球面AcrySof ReSTOR+3D有良好的临床效果及广泛的临床应用价值。

AIM:To compare visual function and subjective patient satisfaction after phacoemulsification with implantation of AcrySof ReSTOR Aspheric multifocal intraocular lens(IOL) with a +3.0 diopter addition power or +4.0 diopter addition power.METHODS:After small-incision phacoemulsification,+3D IOL were implanted in 56 subjects(60 eyes,experimental group),+4D IOL were implanted in 58 subjects(60 eyes,control group).Three months following bilateral implantation,uncorrected distance visual acuity(UCDVA),uncorrected Intermediate visual acuity(UCIVA),uncorrected near visual acuity(UCNVA),best-corrected distance visual acuity(BCDVA),best-corrected near visual acuity(BCNVA),corneal astigmatism and contrast sensitivity were compared between two groups.A subjective outcome questionnaire was also completed by the subjects,including visual disturbances,patient satisfaction with their vision and spectacle independence.RESULTS:Three months after phacoemulsification,UCDVA and BCDVA,UCNVA and BCNVA in the +3D group were not statistically differences from +4D group(P>0.05).Intermediate visual acuity was statistically better in the +3D group(0.68±0.13)than that in the +4D group(0.55±0.08)(P<0.05).Corneal astigmatism after phacoemulsification can be significantly reduced,astigmatism was 0.75±0.13D preoperatively and 0.41±0.15D postoperatively in the group of single-incision,and in the group of bilateral-incision was 1.25±0.18D and 0.72±0.21D respectively.In both groups,there was significant difference between preoperative and postoperative(P<0.05).There was no significant difference in contrast sensitivity postoperatively(P>0.05).There was a low incidence in visual disturbances postoperatively,including problems with night vision,glare and halos in both groups(P>0.05).+3D group provided better intermediate visual acuity and more spectacle independence than +4D group.CONCLUSION:AcrySof ReSTOR Aspheric +3D IOLs may provide excellent overall quality of vision.Especially,intermediate vision in +3D was better than + 4D.Patients reported high rate of satisfaction and spectacle independence.So,we conclude that Acrysof ReSTOR Aspheric +3.0D IOL has excellent clinical effectiveness and value.

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