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“微单视”方案植入连续视程人工晶体对老年性白内障患者视觉质量的影响

Impact of the "micro-monovision" approach with extended depth of focus intraocular lenses implantation on visual quality in elderly patients with senile cataracts

    摘要
  • 摘要:
    目的 探讨“微单视”方案植入连续视程(EDOF)人工晶体对老年性白内障患者视觉质量的影响。
    方法 回顾性分析2020年1月—2023年12月收治的老年性白内障患者的临床资料。随机选取46例植入三焦点人工晶状体的患者纳入三焦点组，选取53例行“微单视”方案植入EDOF人工晶体治疗的患者纳入EDOF组。记录术前及术后3个月2组的双眼视力裸眼远距离视力(UCDVA)、裸眼中距离视力(UCIVA)、裸眼近距离视力(UCNVA)、视觉质量视功能指数量表(VF-14)。记录术后3个月2组的离焦情况、对比敏感度值(CS)、脱镜情况。
    结果 术后3个月, 2组患者UCDVA、UCIVA、UCNVA、VF-14评分高于术前，且EDOF组UCIVA、UCNV和VF-14评分高于三焦点组，差异有统计学意义(P < 0.05)。术后3个月, 2组患者在屈光度-4.00~2.00 D的视力均高于0.35, EDOF组在-1.50~1.50 D的视力均高于0.9, -2.50~-1.50 D的视力高于0.8; 在0.50~2.00 D屈光度内, EDOF组视力高于三焦点组，且在-2.00~1.00 D区间内EDOF组视力较为平稳。在明视、暗视环境下，于不同空间频率(3、6、12、18周/度)时, EDOF组CS高于三焦点组，差异有统计学意义(P < 0.05)。
    结论 在老年性白内障患者中，“微单视”方案植入EDOF人工晶状体相较于三焦点人工晶状体，在视觉质量和中、近视力方面表现更优。

     

    Abstract:
    Objective To investigate the impact of the "micro-monovision" approach with extended depth of focus (EDOF) intraocular lens on visual quality in elderly patients with senile cataracts.
    Methods A retrospective analysis was conducted on the clinical data of elderly patients with senile cataracts treated from January 2020 to December 2023. Forty-six patients who received trifocal intraocular lens were randomly selected and included in trifocal group, while 53 patients who underwent the "micro-monovision" approach with EDOF intraocular lens were included in EDOF group. Preoperative and 3-month postoperative uncorrected distance visual acuity (UCDVA), uncorrected intermediate visual acuity (UCIVA), uncorrected near visual acuity (UCNVA) and visual function index (VF-14) scores were recorded for both groups. Defocus, contrast sensitivity (CS) and spectacle independence were also evaluated at 3 months postoperatively.
    Results At 3 months postoperatively, both groups showed significantly higher UCDVA, UCIVA, UCNVA and VF-14 scores compared to preoperative levels; the UCIVA, UCNVA and VF-14 scores in the EDOF group were significantly higher than those in the trifocal group (P < 0.05). At 3 months postoperatively, both groups achieved visual acuity greater than 0.35 at refractive errors from -4.0 D to +2.0 D. The EDOF group achieved visual acuity greater than 0.9 at refractive errors from -1.5 D to +1.5 D, and greater than 0.8 at refractive errors from -2.5 D to -1.5 D. Within the refractive range of 0.5 D to +2.0 D, the EDOF group had better visual acuity than the trifocal group, with more stable visual acuityin the range of -2.0 D to 1.0 D. Under photopic and mesopic conditions, the EDOF group demonstrated significantly higher CS values at different spatial frequencies (3, 6, 12, 18 degree per week) compared to the trifocal group (P < 0.05).
    Conclusion In elderly patients with senile cataracts, the "micro-monovision" approach with EDOF intraocular lens implantation provides superior visual quality andintermediate and near vision compared to trifocal intraocular lens.

     

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