【作者】 王雅茹；

【导师】 张辉；

【作者基本信息】 吉林大学 ， 临床医学硕士（专业学位）， 2025， 硕士

【摘要】 目的:研究植入不同预留度数的MF15的患者在术后的屈光状态、视觉质量以及主观视觉满意度之间的区别。方法:本研究为回顾性。两组均进行常规护理和心理疏导及健康宣教等基础治疗。在2022年2月至2023年2月期间,本医疗组内进行了白内障超声乳化吸除术与区域折射型多焦点人工晶状体(Oculentis,荷兰,LS-313 MF15)的植入手术。参与手术的患者年龄范围是50岁至70岁,平均年龄为61.34±9.01岁,总计53例(68眼),根据手术前的预留度数,这些患者被分为2组:A组包括预留度数为0±0.2D的26例30眼患者,B组则包括为预留度数为-0.2 D～-0.5 D的27例38眼患者。本研究采用多维度评估体系,对两组患者术后3个月的视觉功能恢复情况进行系统性观察。评估指标包括:客观视觉功能指标(远视力、中视力、近视力)、光学质量参数(高阶像差,HOAs)、主观视觉功能评分(VF-14量表)、功能性视力范围(离焦曲线)、屈光矫正效果(摘镜率)以及视觉干扰症状(不良光学现象),以评估他们术后的生活质量。结果:1.经过手术后,两组患者的裸眼远视力均相较术前有了明显的提升,有统计学意义(P<0.001)。2.在裸眼远视力方面,A组明显优于B组,这种差异在统计学是有意义的(P<0.05);而在裸眼近视力方面,B组患者的表现得更为出色,这种差异在统计上是有意义的(P<0.05);在裸眼视力方面,两组患者之间没有统计上的显著差异(P>0.05)。3.手术后3个月,离焦曲线的绘制结果表明,在1D至-0.5D的范围内,A组的视力明显优于B组,而在-1.5D至-4.0D的范围内,B组的视力明显优于A组;然而,在0D和-2.5D的情况下,两组的视力才在统计上是意义的(P<0.05)。4.根据VF-14问卷调查结果,B组在总分上表现得更为出色,其近距离视力和脱镜率都明显超过了A组(P<0.05),然而,B组的裸眼远视力稍微低于A组(P<0.05),而中距离视力和不良光学干扰的发生率在两组之间并没有统计学上的显著差异(P>0.05)。5.两组在各种高阶像差方面的差异并没有统计学上的显著性(P>0.05)。结论:1.经过植入MF15人工晶状体的白内障手术后,患者的裸眼远视力有了明显的提升。2.在手术后的第三个月,两组病人在手术后都展现出了良好的裸眼中、远视能力,但B组的患者相较于A组患者展现出更为出色的裸眼近视力。3.在手术后的三个月内,B组患者相较于A组展现出更优秀的脱镜率和满意度。4.对于那些选择植入MF15的白内障病人,我们可以根据他们的不同需求,为他们预留不同的度数,从而增加他们的满意度。那些预留度数范围在-0.2 D至-0.5 D之间的患者,手术后在远、中视力得到满足的同时,也拥有了相对较好的近视力。更多还原

【Abstract】 PURPOSE:The aim is to assess the differences in visual sharpness,quality,and satisfaction of patient after the implantation of MF15 intraocular lens(IOL)at various levels of preloading.METHODS:This study is retrospective.Both groups received routine care,psychological counseling,and health education as basic treatments.Between February 2022 and February 2023,cataract phacoemulsification surgery and the surgical implantation of a regional refractive multifocal intraocular lens(Oculentis,Netherlands,LS-313MF15)were performed by our medical team.The patients involved in the surgery were aged between 50 and 70 years,with an average age of 61.34±9.01 years,totaling53 cases(68 eyes).Based on the pre-surgery refraction degree,the patients were divided into two groups:Group A included 26 cases(30 eyes)with a refraction degree of 0±0.2D,and Group B included 27 cases(38 eyes)with a refraction degree ranging from-0.2D to-0.5D.We observed the distance vision,intermediate vision,near vision,higher-order aberrations(HOAs),visual function score(VF-14),defocus curve,spectacle-free rate,and adverse optical disturbances of both groups three months after surgery,in order to assess their post-operative quality of life.RESULTS:1.After the surgery,both groups of patients showed a significant improvement in uncorrected distance vision compared to pre-surgery levels,with statistical significance(P<0.001).2.Regarding uncorrected distance visual acuity(UDVA),Group A demonstrated significantly better outcomes than Group B,with this difference being statistically significant(P<0.05).Comparative analysis of visual outcomes revealed distinct performance patterns between the groups.Group B demonstrated statistically superior uncorrected near visual acuity(UNVA)compared to Group A(P<0.05),indicating better functional near vision.In contrast,the evaluation of uncorrected intermediate visual acuity(UIVA)showed comparable results between the two groups,with the observed variations failing to reach statistical significance.3.Three months after the surgery,the results of the defocus curve indicate that within the range of 1D to-0.5D,the vision of Group A is significantly better than that of Group B,whereas within the range of-1.5D to-4.0D,Group B’s vision is significantly better than Group A.However,at 0D and-2.5D,the vision of both groups is statistically significant(P<0.05).4.According to the VF-14 questionnaire results,Group B demonstrated superior overall performance,with significantly better near visual acuity and spectacle independence rates compared to Group A(P<0.05).Nevertheless,Group B exhibited marginally inferior uncorrected distance visual acuity compared to Group A,with this difference reaching statistical significance(P<0.05).The comparative analysis revealed no statistically significant intergroup disparities in intermediate visual acuity outcomes or the prevalence of postoperative optical disturbances(P>0.05).5.No statistically significant differences were observed between the two groups in various higher-order aberrations(P>0.05).Conclusion:1.Following cataract surgery with MF15 intraocular lens implantation,patients demonstrated significant improvement in uncorrected distance visual acuity.2.At the three-month postoperative follow-up,both groups exhibited satisfactory uncorrected intermediate and distance visual acuity.However,Group B patients showed superior uncorrected near visual acuity compared to their Group A counterparts.3.Within the three months after the surgery,patients in Group B demonstrated a significantly higher rate of mirror removal and satisfaction levels relative to their counterparts in Group A.4.For patients diagnosed with age-related cataracts who choose to implant the MF15,we can reserve different diopters based on their individual needs,thereby increasing their satisfaction.Patients whose diopters range from-0.2 D to-0.5 D will not only achieve satisfactory distance and intermediate vision post-surgery,but will also have relatively good near vision.更多还原