中文摘要：

目的评价衍射型多焦点人工晶状体（MIOL）植入术后患者的视觉质量。方法非随机化对照研究。65例（80只眼）行超声乳化白内障吸除联合人工晶状体植入术的患者，分为MIOL植入组（多焦组）41例（50只眼）和单焦点人上品状体（SIOL）植入组（单焦组）24例（30只眼）。术后3个月观察记录裸眼远、中、近视力，最佳矫正远、中、近视力，远视力最佳矫正后中间视力及近视力；对比敏感度；波前像差；并对术后患者主观视觉质量进行问卷调查。对分类变量资料进行x^2检验，对计量资料进行独立样本t检验。结果多焦组与单焦组在术后裸眼远（t=0．79，P=0．44）、中视力（t=1．49，P=0．15），最佳矫正远（t=0．19，P=0．85）、中（t=1．77，P=0．09）、近视力（t=0．01，P=0．99）及远视力最佳矫正后中间视力（t=1．57，P=0．13）比较，差异无统计学意义；多焦组裸眼近视力、远视力最佳矫正后近视力优于单焦组，分别为0．82±0．20、0．33±0．14（t=8．99，P=0．00）；0．83±0．17、0．32±0．11（t=9．83，P=0．00）；多焦组在明适应高空间频率（18e／d）（明亮有眩光，t=2．33，P=0．03；明亮无眩光，t=2．80，P=0．01）、暗适应有眩光中空间频率（6c／d）对比敏感度下降差异有统计学意义（t=3．14，P=0．01）；多焦组总像芹与球差均小于单焦组（t=3．74，P=0．00；t=3．56，P=0．00）；多焦、单焦组术后脱镜率分别为70．73％（29／41）和8．33％（2／24）（x^2=23．63，P=0．00）；两组均存在轻中度的眩光和光晕感（x^2=0．50，P=0．78）：中度视觉干扰现象在多焦组为24％（12／50），单焦组为26．67％（8／30），两组尢患者存在严重的眩光与光晕感。结论与SIOL相比，除了对比敏感度有所下降，MIOL能提供令人满意的术后功能性远、近视力，患者能获得较高的视觉质量。

英文摘要：

Objective To evaluate and compare the visual performance between the patients with the diffractive multifocal and monofoeal intraocular lens （IOL）. Methods It was a prospective nonrandomized controlled study. Sixty-five patients （80 eyes ） received phacoemulsification and IOL implantation were divided into two groups, 41 patients （50 eyes） in the multifocal group, and 24 patients （30 eyes） in the monofocal group. Three months or longer after surgery, the results of the uncorrected distance, intermediate and near vision; the best-corrected distance, intermediate and near vision; the intermediate and near vision after the distance vision corrected; the contrast sensitivity and the wave-front aberrations were recorded. The subjective visual performance after surgery was evaluated by the questionnaire. The chi-square test was applied to compare categorical variables, and the independentsamples t test was used to compare the measure data. Results The difference of the uncorrected distance, intermediate vision; the best-corrected distance, intermediate and near vision; intermediate vision after the distance vision corrected between the multifocal and monofocal groups was no statistical significance. The uncorrected near vision （0. 82 ±0. 20 vs 0. 33 ± 0. 14, t = 8.99, P = 0. 000） and the near vision after the distance vision corrected （0. 83 ± 0. 17 vs 0. 32 ±0. 11, t = 9. 83, P = 0. 000） were statistically better in the muhifocal group than the monofocal group. Photopic contrast sensitivity at high spatial frequency （18 c/d） and mesopic sensitivity with glare at medium frequency （6 c/d）was statistically lower in the multifocal group （P 〈 0. 05 ） . The total aberration and spherical aberration of the multifocal group were smaller than the monofocal group （t = 3.74,P = 0. 00;t = 3.56, P = 0. 00）. The spectacle independent rate of multifocal and monofocal group were 70. 73 % （29/41）and 8. 33 % （2/24） respectively （x^2 = 23.63, P = 0. 00 ）. The mild and moderate gl