Akreos AO人工晶状体与Tecnis Z9000人工晶状体植入眼后患者视功能对比研究

目的对比植入Akreos AO人工晶状体(intraocular lens,IOL)与Tecnis Z9000 IOL后的波前像差及视功能等指标。方法 82例(100眼)行超声乳化白内障吸出联合IOL植入术的患者,50眼植入Akreos AO IOL(Akreos AO组),50眼植入Tecnis Z9000IOL(Tecnis Z9000组),于术后3个月观察裸眼视力及最佳矫正视力、对比敏感度、波前像差并进行主观问卷调查。结果术后3个月Akreos AO组及Tecnis Z9000组的裸眼视力及最佳矫正视力差异均无统计学意义(均为P>0.05)。Tecnis Z9000组在瞳孔直径为4.0mm、5.0mm、6.0mm下的总体高阶像差及球面像差Z(4,0)均明显低于Akreos AO组(均为P<0.001)。两组在瞳孔直径为4.0mm、5.0mm、6.0mm下的总体三阶像差均方根值差异均无统计学意义(均为P>0.05)。术后3个月,Akreos AO组与Tecnis Z9000组在明视、暗视、明视眩光、暗视眩光下各个空间频率的对比敏感度差异均无统计学意义(均为P>0.05)。术后Akreos AO组患者满意度为95.9%,高于Tecnis Z9000组的81.3%,两组差异有统计学意义(χ2=5.189,P=0.023),术后眩光、光晕及暗处功能视力的不满意率两组差异没有统计学意义。结论虽然Akreos AO IOL与Tecnis Z9000IOL相比保留了患眼的部分球面像差,但植入Akreos AO IOL的患眼仍能够获得满意的术后客观、主观视功能及很高的患者满意度。

Comparison of visual function between eyes with Akeros AO and Tecnis Z9000 intraocular lens implantation

Objective To compare the wavefront aberration and visual function in eyes with Akreos Advanced Optics(AO) and Tecnis Z9000 intraocular lens(IOL) implantation.Methods In 82 patients(100 eyes) with cataract underwent phacoemulsification combined with IOL implantation,50 eyes was implanted with Akreos AO IOL(Akreos group),50 eyes with Tecnis Z9000 IOL(Tecnis Z9000 group).At postoperative 3 months,the uncorrected visual acuity,best corrected visual acuity,contrast sensitivities and wavefront aberration were observed,and a questionnaire on the subjective quality of vision was performed.Results The postoperative average uncorrected visual acuity and best corrected visual acuity were similar in two groups(all P>0.05).Under pupil diameter with 4.0 mm,5.0 mm and 6.0 mm,The values of total high order aberration and spherical aberration Z(4,0) in Tecnis Z9000 group were lower than that in Akreos AO group(all P<0.001),but there was no statistical difference in RMS3 between Tecnis Z9000 group and Akreos AO group(all P>0.05).The postoperative contrast sensitivity at each spatial frequency under photopia,mesopia,photopic glare and mesopic glare had no statistical difference between two groups(all P>0.05).Patient postoperative satisfaction in Akreos AO group(95.9%) was higher than that in Tecnis Z9000 group(81.3%)(χ2=5.189,P=0.023),the postoperative dissatisfaction rate in visual acuity under glare,halation and dark condition had no statistical difference between two groups.Conclusion Although the Akreos AO IOL remains partial spherical aberrations,it produces excellent subjective and objective visual quality and high patient satisfaction.