【摘要】：目的:不同照明條件對漸進衍射型人工晶體全程視力及對比敏感度的影響。方法:回顧性分析了自2010年1月~2012年12月在膠南市開發(fā)區(qū)醫(yī)院眼科中心行白內障超聲乳化吸出聯(lián)合植入Alcon Restore+3D多焦點人工晶體(Monofocal intraocular lens,MIOL)植入的白內障病例45例(45眼)作為Restore組。選取行白內障超聲乳化吸出聯(lián)合植入單焦人工晶體植入的白內障患者32例(32眼)作為單焦點組,在術后3個月在弱(50Lux)、中(250Lux)、強(500Lux)三種照明條件下,四種不同對比度(100%,25%,10%和5%)下,對視遠狀態(tài)(5m)、視近狀態(tài)(33cm)和中程視力表下,記錄兩組患者的單眼裸眼近視力、單眼裸眼遠視力及單眼最佳矯正遠視力。同時分別在術后1個月和3個月時對兩組患者進行視覺質量調查問卷,記錄得分。結果:術后1個月單焦點組和ReStore組視功能生存質量調查總評分平均值分別為49.12±2.86和51.32±3.12,差異具有統(tǒng)計學意義(p=0.032);隨著時間的推移,Re Store組患者的視功能生存質量有著一定程度的改善。術后1個月和3個月時Re Store組在遠脫鏡、看近脫鏡以及中距離脫鏡和滿意度上均優(yōu)于單焦點組(p0.05),且發(fā)現(xiàn)在Re Store組中有5位患者顯示在術后3個月時的在眩光及光暈主觀感覺上比術后1個月時有明顯改善。spearman秩相關分析結果顯示提示隨著背景亮度的下降及對比度的下降,白內障患者術后的全程視力,無論裸眼近視力、裸眼遠視力還是最佳矯正遠視力、中程視力均是逐漸下降,裸眼近視力、裸眼遠視力及最佳矯正遠視力與背景光強度及對比度成正相關(r0,p0.05)。無論在弱、中、強照明條件下,其CS均值均低于單焦點組,只是在弱照明條件下兩組CS值差異并沒有統(tǒng)計學差異;在中和強照明條件下,Restore組患者在1.5cpd,3 cpd,6 cpd,12 cpd下CS均值均低于單焦點組,均屬于正常的CS范圍內,兩組間無統(tǒng)計學差異(p0.05)。而只有在高空間頻率18cpd下,Restore組患者的CS值顯著性低于單焦點組(p0.05)。結論:DMIOL可以獲得良好的全程視力及視覺質量滿意度。裸眼遠視力、最佳矯正遠視力和裸眼近視力與光照強度和對比度成正相關。DMIOL在各個空間頻率下的CS值會有所下降,尤其在高空間頻率DMIOL的CS下降更為顯著。
[Abstract]:Objective: to study the effects of different illumination conditions on the whole visual acuity and contrast sensitivity of progressive diffractive intraocular lens. Methods: from January 2010 to December 2012, 45 cases (45 eyes) of cataract were treated with phacoemulsification combined with Alcon Restore 3D multi-focus intraocular lens (Monofocal intraocular lens,MIOL) implantation in ophthalmology center of Jiaonan Development Zone Hospital as Restore group. Thirty-two patients (32 eyes) with cataract received phacoemulsification combined with single-focus intraocular lens implantation were selected as the single focus group. Under three illumination conditions (50Lux, 250Lux and 500Lux), there were four different contrast rates (10% and 5%). The distance visual acuity (5m), the proximal visual acuity (33cm) and the median visual acuity of the two groups were recorded. Visual quality questionnaire was conducted at 1 month and 3 months after operation to record scores. Results: the average scores of visual function quality of life in single focus group and ReStore group were 49.12 鹵2.86 and 51.32 鹵3.12 respectively at one month after operation, the difference was statistically significant (p0.032), and the visual function quality of life of patients in re Store group improved to a certain extent with the passage of time. At 1 month and 3 months after operation, the Re Store group was treated with distal detonate. It was found that in the Re Store group, 5 patients showed significant improvement in glare and halo subjective sensation at 3 months after operation than at 1 month after surgery (p0.05). The results of Spearman rank correlation analysis showed that with the decrease of background brightness and contrast, The whole visual acuity of cataract patients was decreased gradually, regardless of the open eye near visual acuity, the open eye distance vision or the best corrected distance vision, the middle range visual acuity was decreased gradually, the naked eye near vision, The distance visual acuity and the best corrected far visual acuity were positively correlated with the intensity and contrast of background light (r0. 05). The mean CS value of the two groups was lower than that of the single focus group under weak, moderate and strong illumination conditions, but there was no statistical difference between the two groups in the weak illumination condition. The mean value of CS in the restore group was lower than that in the monocentric group at 1.5cpdt3 cpd,6 cpd,12 cpd, which belonged to the normal range of CS, and there was no statistical difference between the two groups (p0.05). The CS value of restore group was significantly lower than that of monocentric group only at high spatial frequency 18cpd (p0.05). Conclusion: DMIOL can obtain satisfactory visual acuity and visual quality satisfaction. The uncorrected far visual acuity, the best corrected far visual acuity and the uncorrected near visual acuity were positively correlated with the intensity and contrast of light. The CS value of DMIOL decreased at different spatial frequencies, especially in the high spatial frequency DMIOL.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R779.66

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