目的：评估改良非球面平衡曲线(ABC)设计的非球面人工晶状体(IOL)植入术后的视觉质量，同时进行临床IOL选择的影响因素分析，指导患者的IOL选择方案。

方法：前瞻性病例对照研究。选取拟行白内障超声乳化联合折叠式IOL植入术的单纯性白内障患者67例74眼，其中观察组植入改良设计IOL 23眼(HOYA Vivinex XY1组)，对照组植入传统设计IOL 51眼(Tecnis ZCB00组27眼，IQ SN60WF组24眼)，术后1wk，1mo测量裸眼视力及最佳矫正视力、不同瞳孔直径下(3、4、5、6mm)全眼球差及彗差、不同瞳孔直径(3、4、5mm)下的调制传递函数(MTF)曲线、客观散射指数(OSI)、眼内散射光值Log(s)及对比敏感度。对所得的数据进行统计学分析。

结果：三组术后1wk，1mo裸眼视力及最佳矫正视力均较术前显著提高，组间均无差异(P>0.05)。术后全眼球差值比较，术后1wk，5、6mm瞳孔直径下三组存在差异(P=0.045、0.037)，术后1mo 6mm瞳孔直径下三组存在差异(P=0.042)。全眼彗差值比较，术后1wk，1mo 5、6mm瞳孔直径下三组均存在差异(P<0.05)。术后1wk，1mo，随瞳孔直径增加，Vivinex XY1组的全眼球差值增高程度小于其他两组，HOYA Vivinex XY1组在各个空间频率下的MTF值高于对照组，组间无差异(P>0.05)； 客观散射指数、眼内散射光值Log(s)及对比敏感度三组组间均无差异(P>0.05)。

结论：改良设计的Vivinex IOL能够降低全眼球差及彗差，提高客观视觉质量，为改良式非球面IOL的选择提供了新的方案。

AIM: To evaluate the visual quality of patients after modified design aspheric balance curve(ABC)with intraocular lens(IOL)implantation, and to analyze the influencing factors of clinical IOL selection and guide the patient's IOL selection plan.

METHODS: A prospective case-control study was conducted in 67 patients(74 eyes)with simple cataract underwent phacoemulsification and foldable aspheric IOL implantation, and 23 eyes in the observation group were implanted with modified design IOL(HOYA Vivinex XY1 group), the control group was implanted with 51 eyes of traditional design IOL(Tecnis ZCB00 group with 27 eyes, IQ SN60WF group with 24 eyes). The uncorrected visual acuity, the best corrected visual acuity, total ocular spherical aberration(SA)and coma under different pupil diameters(3, 4, 5, 6mm), and different pupil diameters(3, 4, 5mm)were measured 1wk and 1mo after operation, the modulation transfer function(MTF)curve, objective scattering index(OSI), intraocular scattered light value Log(s)and contrast sensitivity were obtained. Statistical analysis was performed on the obtained data.

RESULTS: The uncorrected visual acuity and best corrected visual acuity at 1wk and 1mo after operation in the three groups were significantly improved compared with those before operation, there was no significant difference among groups(P>0.05). The difference of total ocular spherical aberration was statistically significant among the three groups with 5 and 6mm pupil diameter 1wk after operation(P=0.045, 0.037)and there were differences among three groups in pupil diameter of 6mm at 1mo after operation(P=0.042). Comparing the total ocular coma aberration, there were differences among the three groups at 1wk and 1mo after the operation at the pupil diameter of 5 and 6 mm(P<0.05). With the increase of pupil diameter at 1wk and 1mo after operation, the total ocular spherical aberration in the HOYA Vivinex XY1 group was lower than that in the other two groups. The MTF values of the Vivinex XY1 group were higher than those that of the control group at each spatial frequency, there was no significant difference among groups(P>0.05), and there were no statistical differences in objective scattering index, intraocular scattered light value Log(s)and contrast sensitivity among the three groups(P>0.05).

CONCLUSION:The improved design of the modified Vivinex IOL can reduce the total ocular spherical aberration and coma, improve the visual quality, and provide a new method for the selection of aspheric IOL.

国家自然科学基金(No.81870644); 沈阳市科技计划项目公共卫生研发专项(No.21-173-9-12); 沈阳市中青年科技创新人才支持计划(No.RC210388)