摘要目的 比较植入REZOOM[折射型多焦点人工晶状体(MIOL)]、Tecnis ZMA00(全光学面衍射型MIOL)和Acri.Lisa 366D(折射-衍射混合型MIOL)三种不同特性MIOL的术后全程视力及视觉质量.方法 前瞻性病例对照研究.选取2008年9月至2010年3月期间,在天津市眼科医院白内障中心行白内障超声乳化联合MIOL植入术患者29例(40眼),分为三组,分别植入ReZoom MIOL 15眼；Tecnis ZMA00 MIOL 12眼;Acri.Lisa 366D MIOL 13眼.术后3个月随访,以Colenbrander Mixed Contrast视力测试卡分别测量最佳矫正远视力下的中(66 cm)、近视力(40 cm).以iTrace视觉功能分析仪测量调制传递函数(MTF)、眼内像差及瞳孔直径.数据的比较采用单因素方差分析.结果 术后3个月,三组间最佳矫正远视力、中视力及近视力差异无统计学意义.REZOOM、ZMA00、Acri.Lisa 366D三组所有患者术后最佳矫正远视力均≥0.8；中视力≥0.8的眼数分别为7眼(47％)、5眼(42％)和7眼(54％)；近视力≥0.8的眼数分别为2眼(13％)、6眼(50％)和4眼(31％)；REZOOM组近视力明显低于ZMA00组和Acfi.Lisa组,但差异无统计学意义.将三组MIOL与传统球面人工晶状体(AR40e)和机械调节型人工晶状体(Tetraflex)进行比较.在5 mm瞳孔直径下,除三叶草外,各组人工晶状体眼各成分眼内像差差异均有统计学意义(P＜0.01).除5 c/d外,三种MIOL在其他空间频率下的MTF值差异均无统计学意义.结论 三种MIOL植入术后在远视力方面表现优秀且差异不大,在中距离视力和近视力方面也都有良好表现,但同时也体现出了一定的差异.非球面设计的Tecnis ZMA00和Acri.Lisa366D眼内像差及MTF值优于球面设计的REZOOM.

abstractsObjective To compare postoperative visual function and quality after 3 different multifocal intraocular lenses (MIOLs) were implanted:REZOOM (refractive MIOL),Tecnis ZMA00 (all optical diffractive MIOL) and Acri.Lisa 366D (refractive diffractive MIOL).Methods This was a prospective case-control study.Forty eyes of 29 patients who underwent cataract phacoemulsification and MIOL implantation in Tianjin Eye Hospital cataract center were selected from September 2008 to March 2010.Fifteen eyes were implanted with REZOOM,12 eyes with Tecnis ZMAO0,and 13 eyes with Acri.Lisa 366D.Patients were reviewed after 3 months or more following surgery.Colenbrander Mixed Contrast Card Set vision test cards were used to measure intermediate and near visual acuity under the best corrected distance visual acuity.Then iTrace visual function analyzer checks were used to plot 5,10,15,20,25,and 30 c/d for modulation transfer function (MTF) and to measure intraocular aberrations as well as pupil diameter.Data were analyzed using a one-way ANOVA.Results The differences in best corrected distance,intermediate,near visual acuity among the 3 groups were not statistically significant.Three months or more after MIOL implantation,all examined patients from the 3 groups had best corrected distance visual acuity with 20/25 or better visual acuity.Forty-seven percent,42％ and 54％ patients in REZOOM,ZMA00 and Acri.Lisa 366D groups had intermediate visual acuities with 20/25 or better under the best corrected distance visual acuity.In corresponding group,13％,31％ and 50％ with 20/25 or better best corrected near visual acuity.Exccept for trefoil,There were statistically significant differences among the 3 groups in spherical and coma aberrations compared with the spherical intraocular lens (IOL) (Ar40e) and Tetraflex IOL.There were no statistically significant differences in MTF among the 3 groups except at 5 c/d.Conclusion The differences among the 3 MIOLs for far visual acuity after surgery are not substantial.Performance for middle distance vision and near vision is good.The aspheric MIOLs,Tecnis ZMA00 and Acri.Lisa 366D,perform better with fewer aberrations and better MTF than the spherical design of the REZOOM.