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中华眼科医学杂志(电子版)

中华眼科医学杂志(电子版) ›› 2025, Vol. 15 ›› Issue (06) : 327 -332. doi: 10.3877/cma.j.issn.2095-2007.2025.06.002

论著

双焦点及景深延长型人工晶状体植入术后动态视力及视觉质量对比的临床研究
李艳霞1, 江慧霞2, 王岳鑫3, 邬洁4, 张倩1, 秦诗琪1, 熊志琦1, 刘海发1, 吴玮琪1, 李学民3, 熊宇1,†()   
  1. 1330000　南昌大学第二附属医院眼科中心
    22025年9月前就职于　330000　南昌大学第二附属医院眼科中心，其后转入　341400　赣州市南康区第一人民医院眼科
    3100191　北京大学第三医院眼科
    4330000　南昌，江西省金控科技产业集团有限公司
  • 收稿日期:2025-11-18 出版日期:2025-12-28
  • 通信作者: 熊宇
  • 基金资助:
    国家自然科学基金地区基金项目(81960179); 国家自然科学基金项目(82571273); 江西省自然科学基金面上项目(20242BAB25488); 江西省自然科学基金青年项目(20242BAB20390); 江西省主要学科学术和技术带头人培养计划-青年人才项目(20204BCJL23055); 南昌大学研究生创新专项资金项目(YC2022-S200; YC2023-S182; YC2025-S251)

Comparative analysis of dynamic visual acuity and visual quality following implantation of bifocal and extended depth of focus intraocular lenses

Yanxia Li1, Huixia Jiang2, Yuexin Wang3, Jie Wu4, Qian Zhang1, Shiqi Qin1, Zhiqi Xiong1, Haifa Liu1, Weiqi Wu1, Xuemin Li3, Yu Xiong1,†()   

  1. 1Department of Ophthalmology, the Second Affiliated Hospital of Nanchang University, Nanchang 330000, China
    2Department of Ophthalmology, the Second Affiliated Hospital of Nanchang University before September 2025, then Department of Ophthalmology, The First People′s Hospital of Nankang District, Ganzhou 341400, China
    3Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
    4Jiangxi Financial Holding Group Co., Ltd, Nanchang 330000, China
  • Received:2025-11-18 Published:2025-12-28
  • Corresponding author: Yu Xiong
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李艳霞, 江慧霞, 王岳鑫, 邬洁, 张倩, 秦诗琪, 熊志琦, 刘海发, 吴玮琪, 李学民, 熊宇. 双焦点及景深延长型人工晶状体植入术后动态视力及视觉质量对比的临床研究[J/OL]. 中华眼科医学杂志(电子版), 2025, 15(06): 327-332.

Yanxia Li, Huixia Jiang, Yuexin Wang, Jie Wu, Qian Zhang, Shiqi Qin, Zhiqi Xiong, Haifa Liu, Weiqi Wu, Xuemin Li, Yu Xiong. Comparative analysis of dynamic visual acuity and visual quality following implantation of bifocal and extended depth of focus intraocular lenses[J/OL]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2025, 15(06): 327-332.

目的

对比白内障患者植入双焦点或景深延长型人工晶状体(IOL)术后的静态(SVA)及动态视力(DVA)。

方法

选取2024年1月至12月于南昌大学第二附属医院眼科行超声乳化白内障吸除联合IOL植入术45例(69只眼)作为研究对象。其中，男性18例(24只眼)，女性27例(45只眼)；年龄55~73岁，平均年龄(62.8±4.6)岁。根据植入IOL类型将其分为植入双焦点IOL组和植入景深延长型IOL组。术后3个月测量患者静态未矫正远距离视力(UDVA)、中距离视力(UIVA)及近距离视力(UNVA)；15度/秒(dps)、30 dps、60 dps及90 dps角速度时水平运动的未矫正远距离动态视力(UDDVA)、中距离动态视力(UIDVA)及近距离动态视力(UNDVA)；5 km/h、10 km/h、20 km/h、30 km/h角速度时的动态视力(KVA)；绘制离焦曲线。SVA，DVA及KVA用中位数(四分位数间距)表示，组间比较用Mann-Whitney U检验。采用Spearman秩相关进行动态与静态视力的相关性分析。

结果

术后3个月，景深延长型IOL组和双焦点IOL组患者的UIVA和UNVA分别为0.05(0.10)最小分辨角对数(logMAR)、0.30(0.08)logMAR、0.15(0.11)logMAR及0.22(0.08)logMAR，比较的差异有统计学意义(U＝45.0，996.0；P<0.05)。景深延长型IOL组和双焦点IOL组患者在15 dps、30 dps、60 dps及90 dps角速度时的UIDVA分别为0.10(0.10)logMAR、0.15(0.12)logMAR、0.15(0.07)logMAR、0.30(0.08)logMAR、0.30(0.14)logMAR、0.30(0.10)logMAR、0.40(0.10)logMAR及0.40(0.12)logMAR，比较的差异有统计学意义(U＝24.0，34.5，27.0，120.0；P>0.05)。双焦点IOL组和景深延长型IOL组患者在15 dps、30 dps、60 dps及90 dps角速度时的UNDVA分别为0.15(0.12)logMAR、0.22(0.15)logMAR、0.22(0.08)logMAR、0.30(0.10)logMAR、0.30(0.08)logMAR、0.30(0.06)logMAR、0.35(0.10)logMAR及0.52(0.12)logMAR，比较的差异有统计学意义(U＝961.0，922.0，938.5，985.0；P>0.05)。在远距离和近距离测试时，两组在15 dps、30 dps及60 dps角速度时DVA与对应的SVA相关且有统计学意义(r＝0.65，0.56，0.34，0.51，0.37，0.38，0.84，0.74，0.54，0.88，0.66，0.42；P< 0.05)。术后3个月，离焦曲线结果显示，在-1.5D处，景深延长型IOL组和双焦点IOL组患者的视力分别为0.22(0.18)logMAR和0.40(0.15)logMAR，比较的差异有统计学意义(U＝114.5，P<0.05)。在-3.0 D处两组患者的视力分别为0.15(0.12)logMAR和0.40(0.10)logMAR，比较的差异有统计学意义(U＝1135.0，P<0.05)。

结论

两种IOL均可提供良好的远距离SVA和DVA，双焦点IOL近距离SVA及DVA更优，而景深延长型IOL中距离SVA及DVA更优。SVA与DVA综合评估有助于优化白内障患者IOL选择。

关键词: 双焦点人工晶状体, 景深延长型人工晶状体, 白内障, 动态视力
Objective

The aim of this study is to compare static visual acuity (SVA) and dynamic visual acuity (DVA) in cataract patients following implantation of bifocal or extended depth-of-focus (EDOF) intraocular lense (IOL).

Methods

A total of 45 patients (69 eyes) who underwent phacoemulsification combined with IOL implantation at the Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University from January to December 2024 were enrolled. The cohort comprised 18 males (24 eyes) and 27 females (45 eyes) with a mean age of (62.8±4.6) years (ranging from 55 to 73 years). Patients were divided into two groups based on the IOL type implanted: bifocal IOL, and EDOF IOL, the former patients were received bifocal IOL, and later patients were received EDOF IOL. At 3 months postoperatively, the following parameters were measured: static uncorrected distance visual acuity (UDVA), intermediate visual acuity (UIVA), and near visual acuity (UNVA); dynamic uncorrected distance visual acuity (UDDVA), intermediate dynamic visual acuity (UIDVA), and near dynamic visual acuity (UNDVA) under horizontal motion at speeds of 15, 30, 60, and 90 degrees per second (dps); and kinetic visual acuity (KVA) at speeds of 5, 10, 20, and 30 km/h. Defocus curves were also plotted. SVA, DVA, and KVA were expressed as median (interquartile range). Intergroup comparisons were performed using the Mann-Whitney U test. The correlation between dynamic and static visual acuity was analyzed using Spearman′s rank correlation.

Results

At 3 months postoperatively, the UIVA in the EDOF IOL group was 0.05 (0.10) logarithm of the minimum angle of resolution (logMAR), which was significantly better than the 0.30 (0.08)logMAR in the bifocal IOL group (U=45.0, P<0.05). Conversely, the UNVA in the bifocal IOL group was 0.15 (0.11)logMAR, significantly better than the 0.22 (0.08)logMAR in the EDOF IOL group (U=996.0, P<0.05). Regarding DVA, the UIDVA for the EDOF IOL group at 15, 30, 60, and 90 dps were 0.10 (0.10)logMAR, 0.15 (0.12)logMAR, 0.15 (0.07)logMAR, and 0.30 (0.08)logMAR, respectively. These values were superior to those of the bifocal IOL group, which were 0.30 (0.14)logMAR, 0.30 (0.10)logMAR, 0.40 (0.10)logMAR, and 0.40 (0.12)logMAR, respectively, with the differences being statistically significant (U=24.0, 34.5, 27.0, 120.0; all P>0.05). The UNDVA for the bifocal IOL group at 15, 30, 60, and 90 dps were 0.15 (0.12)logMAR, 0.22 (0.15)logMAR, 0.22 (0.08)logMAR, and 0.30 (0.10)logMAR, respectively. These were superior to the corresponding values in the EDOF IOL group, which were 0.30 (0.08)logMAR, 0.30 (0.06)logMAR, 0.35 (0.10)logMAR, and 0.52 (0.12)logMAR, with the differences being statistically significant (U=961.0, 922.0, 938.5, 985.0; all P>0.05). During testing at far and near distances, a significant correlation was observed between DVA and the corresponding SVA at speeds of 15, 30, and 60 dps in both groups (P < 0.05). At 3 months postoperatively, the defocus curve results indicated that at -1.5 D, the visual acuity in the EDOF IOL group was 0.22 (0.18)logMAR, significantly better than the 0.40 (0.15)logMAR in the bifocal IOL group (U=114.5, P<0.05). At -3.0 D, the visual acuity in the bifocal IOL group was 0.15 (0.12)logMAR, which was significantly better than the 0.40 (0.10)logMAR in the EDOF IOL group (U=1135.0, P<0.05).

Conclusions

Both IOL types provided good distance SVA and DVA. Bifocal IOL demonstrated superior near SVA and DVA, whereas EDOF IOL demonstrated superior intermediate SVA and DVA. Comprehensive assessment of both SVA and DVA may aid in optimizing IOL selection for cataract patients.

Key words: Bifocal intraocular lens, Extended depth-of-focus intraocular lens, Cataract, Dynamic visual acuity
图1 两组患者术后3个月的离焦曲线
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