Alpha角对多焦点人工晶状体植入术后视觉质量影响

研究不同Alpha角对多焦点人工晶状体（MIOL）植入术后视觉质量的影响，指导功能性IOL的应用。方法：前瞻性临床研究。选取2016年12至2018年10月就诊于潍坊眼科医院行白内障超声乳化吸除联合MIOL植入术患者56例（74眼），根据Alpha角大小（角膜上视轴与光轴的距离α）分为3组： A组12眼（0 mm<α≤0.2 mm），B组38眼（0.2 mm<α≤0.4 mm），C组24眼（α>0.4 mm）。术后随访3个月，记录裸眼远、中、近视力以及调制传递函数、眩光、光晕等情况。数据采用卡方检验、方差分析进行统计。结果：B组和C组光晕和眩光发生率高于A组，差异有统计学意义（χ2 =38.372，P=0.01）； 3组间术后3个月远、中、近视力比较差异无统计学意义（均P>0.05）；3组间MTF值在0～30 c/d范围差异无统计学意义（P>0.05）；夜间远视、重影、混合焦点、星芒的发生率差异均无统计学意义（均 P>0.05）。结论：当Alpha角大于0.4 mm时，植入MIOL会增加眩光和光晕的发生，所以Alpha角>0.4 需谨慎考虑使用MIOL。

Effect of Angle Alpha on Visual Quality after Multifocal Intraocular Lens Implantation

To evaluate the visual quality of patients with different angle alpha sizes after a multifocal intraocular lens (MIOL) implantation. Methods: This was a prospective case series study. Fifty-six patients (74 eyes) who had phacoemulsification with MIOL implantation were enrolled in the study from December 2016 to October 2018. The patients were divided into 3 groups based on the size of the preoperative angle alpha. There were 12 eyes in group A (0 mm<α≤0.2 mm), 38 eyes in group B (0.2 mm<α≤0.40 mm) and 24 eyes in group C (α>0.4 mm). Monocular far, intermediate, and near uncorrected visual acuities were measured during a 3-month follow-up. Other outcome measurements taken were the modulation transfer function (MTF) cutoff, the incidence of glare, and halo. The data were analyzed with an independent χ2 test or a ANOVA test. Results: The incidence of halo and glare in groups B and C was higher than that in group A (χ2 =38.372, P=0.01). There were no significant differences in the far, intermediate, or near vision between the three groups (P>0.05). Angle alpha had no significant effect on the MTF, night hyperopia, double vision, mixed focus or starburst (P>0.05). Conclusions: When angle alpha is greater than 0.4 mm, the incidence of glare and halo increases. In clinical work, for patients with a larger angle alpha, the choiceto implant MIOLs should be carefully evaluated.