【摘要】： 目的：本研究通過比較年齡相關性白內障患者，行超聲乳化分別聯(lián)合應用階梯漸進衍射型多焦點人工晶體（Acrysof ReSTOR MIOL）與折射型多焦點人工晶體（AMO ReZoom MIOL）植入術后的近期全程視力（包括遠、中、近距離視力）及主觀感覺等情況，評價臨床上兩種多焦點人工晶體植入術后的臨床效果及應用價值。 方法：方法為非隨機對照臨床試驗。收集在惠州市中心人民醫(yī)院行超聲乳化白內障吸除聯(lián)合多焦點人工晶體植入的患者33例（45眼），按植入多焦點人工晶體種類的不同分為ReSTOR組（15例23眼）和ReZoom組（18例22眼），術后3個月用標準對數(shù)視力表測量患者裸眼遠視力，應用標準近視力表測量裸眼近視力，應用Colenbrander MIXEDCONTRAST CARD SET測量患者裸眼中程視力（40、63、100cm），觀察兩組患者在不同照明條件下（20、400lux）的單眼裸眼遠、中距離（40、63、100cm高低對比度）、近視力，術前存在影響視力的其他疾病或者術中發(fā)生并發(fā)癥等患者均排除于本研究。問卷調查項目包括日常生活視物舒適度(遠、中、近距離)，讀書看報是否需要近用鏡，不同照明條件對視物有無影響及其它視覺癥狀。結果采用spss15.0統(tǒng)計軟件進行t檢驗和χ2檢驗。 結果：術后3個月，兩組患者術中術后均無嚴重并發(fā)癥，散瞳后行裂隙燈檢查未發(fā)現(xiàn)晶體偏心、移位，無后發(fā)性白內障發(fā)生。術后3個月，20lux和400lux照明條件下ReSTOR組和ReZoom組患者均可獲得良好的裸眼遠視力,分別為0.34±0.20，0.36±0.14（20lux）及0.71±0.20，0.77±0.21（400lux），差異無顯著統(tǒng)計學意義；20lux照明條件下，兩組裸眼近視力分別為0.20±0.07，0.20±0.08（p0.05），400lux照明條件下0.33±0.10，0.27±0.10（400lux），ReSTOR組近視力優(yōu)于ReZoom組（p0.05）；ReZoom組在40cm、63cm、100cm的裸眼高低對比度視力均明顯優(yōu)于ReSTOR組（p0.05）。不同照明條件下，兩組患者裸眼遠中近視力均隨著照明條件的改善而有所提高。術后問卷調查顯示ReSTOR組患者術后脫鏡率高于ReZoom組（p0.01)，但術后眩光等不適兩組無明顯差異。在患者的滿意度評價上，在看遠上，兩組患者滿意度無統(tǒng)計學差異，在近視力滿意度上ReSTOR多焦組明顯高于ReZoom多焦組，而視中距離滿意度上，，ReZoom多焦組則優(yōu)于ReSTOR組。 結論：初步應用表明兩種多焦點人工晶體術后近期均能提供較好的遠視力，但ReSTOR MIOL近視力較好，術后脫鏡率較高；ReZoom MIOL則能提供良好的中程視力。故臨床上應根據(jù)患者的不同需求而選擇植入相應的人工晶體。
[Abstract]:Objective: to compare age-related cataract patients. Phacoemulsification was performed in combination with stepwise progressive diffraction intraocular lens (Acrysof ReSTOR MIOL) and refraction multifocus intraocular lens (AMO ReZoom MIOL) implantation. The clinical effect and application value of two kinds of multi-focus intraocular lens implantation were evaluated. Methods: non-randomized controlled clinical trial. Thirty-three patients (45 eyes) with phacoemulsification combined with multi-focus intraocular lens implantation in Huizhou Central people's Hospital were collected. According to the type of multi-focus intraocular lens implanted, the patients were divided into ReSTOR group (15 cases, 23 eyes) and ReZoom group (18 cases, 22 eyes). The median naked visual acuity (40 ~ 63100cm) was measured by Colenbrander MIXEDCONTRAST CARD SET. The distance of uncorrected eyes (20400lux), middle distance (400.63100cm high contrast) and near visual acuity (NVA) were observed in two groups under different illumination conditions (20400lux). Patients with preoperative vision-related diseases or intraoperative complications were excluded from the study. The items of the questionnaire included the comfort of visual objects in daily life (far, middle and close distance), the need of reading and newspaper reading, the influence of different lighting conditions on the visual objects and other visual symptoms. Results t test and 蠂 2 test were performed by spss15.0 software. Results: three months after operation, there were no serious complications in both groups. No eccentricity, displacement and no posterior cataract were found after pupil dilation by slit lamp examination. 3 months after operation, the patients in ReSTOR group and ReZoom group under 20lux and 400lux illumination could obtain good naked far visual acuity (20lux) 0.34 鹵0.20 鹵0.36 鹵0.14 (20lux) and 0.71 鹵0.20 鹵0.77 鹵0.21 (400lux), respectively. There was no significant difference between the two groups. Under 20lux illumination, the near-visual acuity of the two groups was 0.20 鹵0.07 鹵0.08 (p0.05) and 0.33 鹵0.10 鹵0.27 鹵0.10 under 400lux illumination respectively. The near visual acuity of 400lux), ReSTOR group was better than that of ReZoom group (p0.05). The visual acuity of high and low contrast in ReZoom group was better than that in ReSTOR group at 40 cm, 63 cm or 100 cm (p0.05). Under different illumination conditions, the open eye distant near visual acuity of the two groups improved with the improvement of lighting conditions. Post-operative questionnaire survey showed that the rate of postoperative removal of endoscopy in ReSTOR group was higher than that in ReZoom group (p0.01), but there was no significant difference in postoperative glare and discomfort between the two groups. In the evaluation of patients' satisfaction, there was no statistical difference in satisfaction between the two groups. The ReSTOR multi-focus group was significantly higher than the ReZoom multi-focal group in the near vision satisfaction, while the ReZoom multi-focus group was superior to the ReSTOR group. Conclusion: the preliminary application shows that the two kinds of multi-focus intraocular lens can provide better distant visual acuity in the short term, but the near visual acuity of ReSTOR MIOL is better, and the higher rate of removal of endoscopy after operation,; ReZoom MIOL can provide good intermediate visual acuity. Therefore, we should choose to implant intraocular lens according to the different needs of patients.
【學位授予單位】：汕頭大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R779.66

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