Subjektive und objektive Ergebnisse nach Implantation der apodisiert diffraktiven AcrySof ReSTOR

Background

Our purpose in this study was to assess the postoperative subjective and objective results after implantation of the Acrysof ReSTOR lens and to evaluate the advantages and limitations of the apodized diffractive optic design of this new multifocal intraocular lens (MIOL).

Methods

Phakoemulsification and implantation of an Acrysof ReSTOR was performed in 55 eyes of 32 patients. All patients were examined after a mean period of 7.9±1.9 months. The accuracy of lens calculation was evaluated for the Haigis, Holladay I, and SRK-T formulas. Uncorrected and corrected visual acuity for distance and for intermediate and near vision were assessed, as was stereoacuity. In addition, contrast sensitivity was tested under photopic and mesopic conditions, with and without glare. The patients were asked about dysphotic phenomena such as halos, glare or flare, and night vision using a standardized evaluation. The degree to which patients were able to manage without spectacles after the surgery was also documented.

Results

The median monocular uncorrected visual acuity (UCVA) for distance was 20/25 (LogMAR 0.05) while the binocular UCVA was 20/20 (LogMAR 0). The monocular uncorrected acuity for near vision was 20/25 (LogMAR 0.1), the binocular near visual acuitiy was 20/20 (LogMAR 0), while the intermediate monocular visual acuity was 20/50 (LogMAR 0.4) and the binocular, 20/32 (LogMAR 0.2). Contrast sensitivity was within the normal range. Dysphotic phenomena were noted by 66% of patients but were so slight as not to cause any problem at all in 59%. For close work and distance vision 84% of all patients needed no correcting glasses, while 78% did not need to use glasses for intermediate vision.

Conclusion

The Acrysof ReSTOR provides excellent uncorrected visual acuity for distance and near vision and the level of patient satisfaction achieved with it is good.     

KTP激光治疗下泪小管吻合术后泪道阻塞的临床分析

目的：通过对Acrysof ReSTOR SA60D3多焦点人工晶状体植入和Acrysof SN60AT单焦点人工晶状体植入术后3a远近视力及拟调节力的对比研究,探讨Acrysof ReSTOR SA60D3多焦点人工晶状体中期的临床应用效果。

方法：对在同一时期接受白内障超声乳化人工晶状体植入手术的年龄相关性白内障患者68例80眼进行回顾性分析。其中A组40眼植入Acrysof ReSTOR SA60D3多焦点人工晶状体,B组40眼植入Acrysof SN60AT单焦点人工晶状体。术后3a随访观察术眼的屈光状态,裸眼远、近视力,矫正远、近视力, 最佳远矫下近视力,对比敏感度,问卷调查视觉质量和满意度,术后脱镜率及并发症等。

结果：术中术后两组均无严重并发症。两组患者术后均有良好的远视力和最佳矫正近视力,差异无统计学意义; A组患者裸眼近视力明显优于B组,A组脱镜率达82%,B组脱镜率16%; 术后对比敏感度差异无统计学意义,术后视觉症状无明显差异,但是术后满意度A组明显高于B组。

结论：Acrysof ReSTOR SA60D3多焦点人工晶状体植入安全有效,可为患者同时提供良好的远、近视力,值得临床推广应用。     

Visual performance of patients with bilateral vs combination Crystalens, ReZoom, and ReSTOR intraocular lens implants

PURPOSE: To compare the visual performance of patients with bilateral vs combination Crystalens, ReZoom, and ReSTOR intraocular lens (IOLs) implants. DESIGN: Prospective, nonrandomized study. METHODS: Forty-nine patients were implanted with bilateral Crystalens (Eyeonics, Aliso Viejo, California, USA), ReSTOR (Alcon Laboratories, Fort Worth, Texas, USA), and ReZoom (American Medical Optics, Santa Clara, California, USA) or combined Crystalens and ReSTOR or Crystalens and ReZoom IOLs after phacoemulsification. Monocular and binocular testing four to six months after surgery included uncorrected and best-spectacle corrected visual acuity at distance, intermediate, and near vision; mesopic contrast sensitivity function with and without glare; and quality-of-life and vision surveys six months after surgery. RESULTS: Monocular testing showed that eyes with Crystalens accommodating IOL had statistically better best-spectacle corrected distance, uncorrected and distance-corrected intermediate, and best-corrected near vision. Eyes with the ReSTOR multifocal IOL had better uncorrected near vision, required the lowest reading add, and had the lowest uncorrected and distance-corrected intermediate vision. Monocular mesopic contrast sensitivity with and without glare was better with the Crystalens IOL vs either multifocal IOL at specific spatial frequencies. The binocular subjective quality of vision and quality of life questionnaires were favorable for the bilateral Crystalens group. CONCLUSIONS: Any combination of Crystalens in one or both eyes was better for intermediate vision. Any combination of ReSTOR in one or both eyes was better for near vision. The Crystalens and ReSTOR combination had better mean intermediate and near vision overall. A multifocal IOL in one or both eyes was associated with lower contrast sensitivity and more subjective reports of photic phenomena. The accommodating and multifocal IOL combinations elicited less night glare symptoms than in patients with either bilateral multifocal IOL, but more than with bilateral Crystalens implantation.     

衍射型多焦点人工晶状体ReSTOR植入术后远中近视力比较

目的:比较白内障超声乳化联合植入Acrysof ResToR及Acrysof Natural的临床效果。方法:随机化临床试验,选择年龄性白内障患者,ReSTOR组30例36眼,植入ReSTOR SA60D3衍射型多焦点人工晶状体(MIOL),Natural组28例30眼,植入NaturalSN60AT单焦点人工晶状体(SIOL)。观察术后未矫正远视力(UCDVA)、未矫正近视力(UCNVA)、最佳矫正远视力(BCDVA)、最佳矫正近视力(BCNVA)、远矫正下的近视力(DCNVA)。中间距离视力(40,60,80cm)和视觉症状。结果:两组患者UCDVA,BCDVA和BCNVA无显著差异,术后ReSTOR组UCNVA,DCNVA及中间距离视力明显优于Natural组(P<0.05)。ReSTOR组术后4wk UCNVA,UCDVA明显优于1wk。术后12wk,ReSTOR组术后UCNVA优于中间距离视力(40cm),差异有统计学意义。而中间距离视力之间(40与60cm;60与80cm)无统计学差异。ReSTOR组患者术后受眩光和光晕影响较Natural组明显(P<0.05),但均可忍受。ReSTOR组戴镜率低于Natural组,差异有统计学意义(P<0.05)。结论:新型衍射型MIOL ReSTOR能提供良好的全程视力,有效减低患者对老视镜的依赖,提高白内障患者术后的视觉质量。     

Functional vision with bilateral ReZoom and ReSTOR intraocular lenses 6 months after cataract surgery

PURPOSE: To compare the visual outcomes in patients with bilateral implantation of AcrySof ReSTOR multifocal intraocular lenses (IOLs) (Alcon Laboratories) or ReZoom multifocal IOLs (Advanced Medical Optics) 6 months after cataract surgery. SETTING: Orsett and Southend Hospital, Essex, United Kingdom. METHODS: This study comprised patients who had uneventful bilateral cataract extraction with implantation of ReZoom (n = 50) or ReSTOR (n = 50) multifocal IOLs. Parameters analyzed included binocular uncorrected distance, intermediate, and near acuities; spectacle independence; subjective visual symptoms; and patient satisfaction. All parameters were evaluated 6 months after second-eye surgery. RESULTS: All patients had binocular uncorrected distance visual acuity of 20/32 or better; there was no statistically significant difference between the 2 groups. The mean binocular uncorrected near acuity was 20/26 (J1.22) in the ReSTOR group and 20/34 (J2.34) in the ReZoom group (P<.0001). The mean binocular uncorrected intermediate visual acuity was 20/42 and 20/34, respectively (P = .003). Patients in the ReZoom group reported greater satisfaction with intermediate vision (P = .04). No statistically significant difference was found in satisfaction with near vision. Eighty-six percent of ReSTOR patients and 70% of ReZoom patients did not wear glasses for daily activities; the overall satisfaction was not statistically significantly different between groups. There was no significant difference between groups in photic phenomena. CONCLUSIONS: The ReSTOR IOL provided better near vision and the ReZoom IOL better intermediate vision. Both multifocal IOLs gave excellent distance vision. Photic phenomena were comparable and clinically acceptable. ReSTOR patients had greater spectacle independence for near vision and ReZoom patients for intermediate vision. Overall spectacle independence was not statistically significantly different.     

Visual function and change in quality of life after bilateral refractive lens exchange with the ReSTOR multifocal intraocular lens

PURPOSE: To evaluate vision and quality of life and explore the correlation between vision and change of quality of life after bilateral refractive lens exchange of the Acrysof SA60D3 ReSTOR multifocal intraocular lens (IOL) for correction of ametropia in presbyopic populations. METHODS: Pre- and postoperatively, the National Eye Institute Refractive Error Quality of Life Instrument (NEI-RQL) was self-administered by 30 consecutive refractive lens exchange patients, including 19 myopes and 11 hyperopes. The change of NEI-RQL scores was determined for each subscale covering a specific aspect of quality of life. Refraction, visual acuity, and contrast sensitivity function were evaluated 3 and 6 months postoperatively. RESULTS: Postoperatively, all patients achieved binocular uncorrected distance and near visual acuity of 20/30 or better. Photopic contrast sensitivity function decreased significantly at high spatial frequencies (P < .05). Overall scores of expectations, activity limitations, dependence on correction, appearance, and satisfaction were significantly higher postoperatively (P < .05). Greater improvement in near vision and dependence on correction was achieved in hyperopes. However, glare scores were significantly lower postoperatively (P < .001). Lower preoperative uncorrected near visual acuity was associated with higher scores for dependence on correction in myopes (r = 0.51, P = .027), and overall patient satisfaction correlated significantly with postoperative uncorrected distance visual acuity (r = -0.44, P = .015). CONCLUSIONS: Refractive lens exchange with the ReSTOR IOL in presbyopic patients provided good visual function and better patient satisfaction compared with preoperative corrections. Improvement in vision-related quality of life was most evident in hyperopes. A slight reduction in contrast sensitivity function appears to have no influence on quality of life.     

衍射折射型多焦点人工晶状体远期视觉质量观察

目的:测定衍射折射型多焦点人工晶状体眼术后远期的视觉质量。方法:采取随机对照临床试验研究方法,将67例白内障患者分两组,其中30例33眼植入多焦点人工晶状体,37例37眼植入单焦点人工晶状体。术后3mo和1a进行裸眼远视力、中间视力、近视力、矫正远、中、近视力和对比敏感度检查。视功能和生存质量调查问卷评价患者主观的视觉功能。结果:(1)术后多焦点组裸眼近视力优于单焦点组(P<0·05),中间距离视力亦优于单焦点组(P<0.05),两组裸眼和矫正远视力、近视力及最佳矫正远视力下近视力差异无显著性。术后1a和3mo相比,差异无显著性意义。(2)术后两组对比敏感度均低于正常范围,空间分布差异无统计学意义。(3)两组术后多焦点组脱镜率达83%,而单焦点组脱镜率为32%,两组比较差异有显著性(P<0·05)。多焦点组4例有眩光。多焦点组患者对全程视力的满意度高于单焦组患者。结论:多焦点人工晶状体能提供良好的全程视力,但近视力更好,视觉症状轻,脱镜率更高,有效地提高白内障患者术后的视觉质量。     

三种不同IOL植入术后短期的视力和视觉干扰现象及脱镜率的对比

目的：对比分析单眼植入三焦点、多焦点及连续视程人工晶状体(IOL)术后短期的视力、视觉干扰现象及脱镜率。方法：回顾性分析2019-03/2022-12行超声乳化白内障吸除联合IOL植入术的白内障患者67例67眼。35例35眼植入Symfony连续视程IOL； 21例21眼植入AcrySof IQ ReSTOR+3D多焦点IOL； 11例11眼植入AcrySof IQ PanOptix三焦点IOL。记录术前及术后3 mo裸眼远视力(UDVA)、中视力(UIVA)、近视力(UNVA)，术后3 mo离焦曲线、视觉干扰现象及脱镜率。结果：术后3 mo，三组间UDVA无差异(P&#x003E;0.05)； Symfony组及PanOptix组UIVA优于ReSTOR组(均P&#x003C;0.01)； ReSTOR组及PanOptix组UNVA优于Symfony组(均P&#x003C;0.01)。离焦曲线显示，在中视力区间(-1.00--1.50 D)，Symfony组视力优于ReSTOR组(P&#x003C;0.05)； 在近视力区间(-2.50--3.50 D)，ReSTOR组视力优于Symfony组(P&#x003C;0.05)； PanOptix组在近视力区间(-2.00--3.50 D)的视力优于Symfony组(P&#x003C;0.05)，同时在中视力区间(-1.00--2.00 D)的视力优于ReSTOR组(P&#x003C;0.05)。三组间眩光或光晕的发生率及双眼相互干扰现象发生率均无差异(P&#x003E;0.05)。PanOptix组和ReSTOR组脱镜率比Symfony组高(P&#x003C;0.0167)。结论：与Symfony连续视程IOL和ReSTOR多焦点IOL相比，PanOptix三焦点IOL能够兼顾远中近视力，眩光和光晕发生率不高，脱镜率较高； 单眼植入老视矫正型IOL仍需慎重。     

ReSTOR +3D多焦点人工晶状体植入的初步观察

目的:评价ReSTOR +3D渐进衍射型多焦点人工晶状体植入术后临床效果。方法:收集我院2009-06/2009-11老年性白内障行白内障超声乳化联合AcrysofReSTOR +3D人工晶状体植入手术患者32例48眼。术后连续随访3～6(平均4±1.5)mo。观察术后末次随访时裸眼远、中、近视力及最佳矫正远、中,近视力、脱镜率、人工晶状体的位置。结果:术后裸眼远视力为0.85±0.17,术后裸眼中距离视力为0.65±0.15,术后裸眼近视力为0.64±0.13,术后最佳矫正远视力为0.96±0.14,术后最佳矫正中距离视力为0.69±0.17,术后最佳矫正近视力为0.77±0.15。脱镜率为84%。裂隙灯检查见人工晶状体居中,无倾斜。随访期间未发现后发性白内障。结论:ReSTOR+3D衍射型多焦点人工晶状体能为患者提供满意的全程视力。     

Erste Ergebnisse mit einer neuen aberrationskorrigierten intraokularen Bifokallinse

Objective

To investigate the functional results with a new bifocal intraocular lens.

Methods

The *Acri.LISA (*Acri.Tec) was implanted bilaterally in 20 patients after uneventful cataract surgery. The new bifocal IOL has a light distribution of 65% for distance and 35% for the near range. The diffractive optics of the lens are designed to be independent of pupil size. Smooth steps in diffractive structure should reduce glare. An aspheric design of the posterior optic surface is engineered to counteract the asphericity of the cornea (–0.26). Postoperative evaluation included 6 weeks after surgery: uncorrected (UCVA) and best corrected (BCVA) visual acuity for distance (ETDRS charts) and near (C.A.T. charts, Birkhäuser charts) monocular and binocular, defocus curve, contrast sensitivity under photopic and mesopic lighting conditions (F.A.C.T.), and subjective assessment of halos

Results

At the 6-week follow-up mean binocular UCVA and BCVA (LogMAR) were ?0.02±0.10 and ?0.07±0.09, respectively, for distance. Near UCVA (LogMAR) was 0.09±0.16; distance corrected near VA was 0.04±0.13. Visual acuity was significantly superior when tested binocularly compared to monocular testing (p<0.01). The depth of field showed an intermediate decimal VA of 0.6±0.21 at 70 cm and a pseudoaccommodation range of 5.5 D. Of 20 patients, 16 reported slight halos, but no patient was seriously impaired.

Conclusions

The *Acri.LISA showed very good visual performance 6 weeks after bilateral surgery.     

单眼视设计的人工晶状体眼视功能临床研究

目的 探讨应用单眼视原理设计双眼白内障超声乳化联合植入单焦点人工晶状体术后的视功能情况.方法 对双眼年龄相关性白内障患者42例(84只眼),分为常规组21例(42只眼)及单眼视组21例(42只眼).常规行白内障超声乳化联合折叠式人工晶状体植入术.分别记录术前最佳矫正视力及术后1周单眼裸眼远、近视力及双眼裸眼远、近视力.采用SAS8.2统计软件对结果进行统计学分析.结果 (1)术前平均最佳矫正视力常规组4.44,单眼视组4.47(P ＞0.05),患者平均年龄常规组71岁,单眼视组69.5岁(P ＞0.05),差异无统计学意义.(2)术后1周单眼裸眼远视力常规组4.90,单眼视组:优势眼4.94(P ＞0.05),与常规组比较差异无统计学意义;非优势眼4.71(P < 0.05),与常规组比较差异有统计学意义.术后1周单眼近视力常规组4.36,单眼视组:优势眼4.37(P＞0.05),与常规组比较差异无统计学意义;非优势眼4.78(P < 0.05),与常规组比较差异有统计学意义.(3)术后1周双眼裸眼远视力常规组4.91,单眼视组4.91(P ＞0.05),与常规组比较差异无统计学意义;术后1周双眼近视力常规组4.42,单眼视组4.78(P < 0.05),与常规组比较差异有统计学意义.结论 单眼视设计的人工晶状体眼术后双眼远视力与常规设计人工晶状体眼相同,但近视力明显好于常规设计.按照单眼视原理设计人工晶状体可以较好的临床应用.     

散光矫正型多焦点人工晶状体植入术后临床效果

评价白内障超声乳化联合散光矫正型多焦点人工晶状体（MIOL）植入术后患者的长期临床效果。方法：前瞻性自身前后对照研究。选择在大庆油田总医院行白内障超声乳化联合散光矫正型多焦点IOL植入术患者50例（82眼），术后随访1年，分别观察术前，术后3个月、6个月、1年的裸眼远中近视力（LogMAR）、最佳矫正远中近视力（LogMAR）、离焦曲线、对比敏感度（CS）、全眼像差、预计残留散光和IOL轴位偏差分析及脱镜率。对手术前后各参数进行重复测量的方差分析，两两比较采用Bonferroni法及t检验。结果：散光矫正型MIOL植入术后，所有患者术后3个月、6个月、1年时远、中、近距离均可获得优于0.3的较好视力。术后3个月、6个月、1年时各距离视力较术前显著提高（远距离：F=26.39，P<0.001；中距离：F=13.68，P<0.001；近距离：F=12.90，P<0.001）。矫正远距离视力较裸眼视力略有提高，但差异无统计学意义，矫正前后近距离视力差异无统计学意义。术后6个月时，所有患者裸眼远视力接近0.0，且-4.0～+1.2 D离焦下视力均可优于0.3 LogMAR。术后 1年时明视带眩光CS最好，明视、暗视的CS比明视眩光有所下降，暗视眩光分辨率最差，而在高频区（18 c/d），CS随时间推移有显著提高，差异有统计学意义。术后1年全眼总散光（0.24±0.15）D，与术前[（1.56±0.38）D]相比，差异有统计学意义（t=3.31，P=0.023）。术后全眼总散光与术前预计残留散光[（0.15±0.07）D]接近，差异无统计学意义（t=2.31，P=0.102）。术后1年，IOL轴位平均偏离（3.12±1.51）°。术后脱镜率为100%。结论：散光矫正型MIOL能为白内障患者提供满意的全程视力、视觉质量和脱镜率，可预测性好，并有良好的旋转稳定性。     

Visual outcome and optical quality after bilateral implantation of aspheric diffractive multifocal, aspheric monofocal and spherical monofocal intraocular lenses:a prospective comparison

AIM:To evaluate the visual function after bilateral implantation of aspheric diffractive multifocal Tecnis ZMA00, aspheric monofocal ZA9003 versus spherical monofocal Akreos Adapt intraocular lenses (IOLs).METHODS:Tecnis ZMA00, Tecnis ZA9003 or Akreos Adapt IOLs were bilaterally implanted in 180 eyes from 90 patients. The following parameters were assessed 3 months postoperatively:monocular and binocular uncorrected visual acuity (UCVA) and distance-corrected visual acuity (DCVA) for distance, intermediate and near, spherical aberration (SA), contrast and glare sensitivity, near point refractive power, uncorrected and best-corrected near stereoscopic acuity (NSA). Patient satisfaction was assessed by a questionnaire.RESULTS:Three months postoperatively, the monocular and binocular UCVA and DCVA at near of Tecnis ZMA00 were significantly better than other two groups. The mean SA for 5.0mm optical zone in Tecnis ZMA00 and Tecnis ZA9003 was significantly lower than that in Akreos Adapt. Mean contrast sensitivity and glare sensitivity were better for Tecnis ZA9003 group than for other two groups. Patients with Tecnis ZMA00 had higher monocular and binocular near point refractive power and uncorrected NSA than monofocal groups. The patients in Tecnis ZMA00 had higher mean values for halo compared with other two groups.CONCLUSION:Tecnis ZMA00 provided better near VA and uncorrected NSA and higher near point refractive power than monofocal IOLs and patients were spectacle independent. The IOLs with Tecnis aspheric design improved contrast and glare sensitivity. Patients with Tecnis ZMA00 reported more disturbances on visual phenomena of halo.     

衍射型多焦点人工晶状体植入术后视功能的观察

目的:通过观察白内障超声乳化摘除联合ReSTOR衍射型多焦点人工晶状体植入术后患者的视力、受眩光、光晕干扰程度及老视镜脱镜率,评价衍射型多焦点人工晶状体眼的视觉质量。方法:将60例(68眼)年龄相关性白内障患者随机分为2组,分别行白内障超声乳化摘除并植入ReSTOR SA60D3衍射型多焦点人工晶状体(多焦组)和Natural SN60AT单焦点人工晶状体(单焦组),观察术后裸眼及最佳矫正远、近视力,受眩光、光晕干扰程度及阅读时戴镜情况。结果:两组患者术后裸眼远视力、最佳矫正远视力和最佳矫正近视力均无显著性差异(P>0.05)。多焦组术后裸眼近视力和最佳视远矫正时近视力明显优于单焦组(P<0.05),且近距离阅读时不需戴老视镜的患者多焦组22例(73.3%),而单焦组仅4例(13.3%),差异有统计学意义(P<0.05)。多焦组患者术后受眩光、光晕干扰较单焦组明显(P<0.05)。结论:ReSTOR衍射型多焦点人工晶状体能提供良好的远、近视力,有效降低患者对老视镜的依赖,提高了白内障患者术后的视觉质量。     

三焦点人工晶状体植入术后的早期临床效果

目的评价白内障超声乳化联合三焦点人工晶状体（IOL）植入术后的早期临床效果。方法前瞻性自身前后对照研究。选择在大庆油田总医院行白内障超声乳化联合三焦点IOL植入术患者24例（26眼）,术后随访3个月,分别观察术前,术后1周、1个月、3个月的裸眼远视力、裸眼中距离视力和裸眼近视力,以及离焦曲线、对比敏感度（CS）和全眼像差。对手术前后各参数进行重复测量的方差分析。结果三焦点IOL植入术后所有患者1周、1个月、3个月时远、中、近距离均可获得0.3 LogMAR以上的较好视力。术后各距离视力较术前显著提高（P＜0.05）。术后3个月时裸眼远视力接近0 LogMAR,且+1.5~-4.0 D离焦下视力均优于0.3 LogMAR;CS可见术后1周时明视眩光分辨率最好,明视、暗视的分辨率较明视眩光差,暗视眩光分辨率最差,差异有统计学意义（P＜0.05）;术后1周、1个月、3个月时总像差、总低阶像差、离焦深度、散光均较术前明显降低,差异有统计学意义（P＜0.05）。结论三焦点IOL提供了远、中、近兼顾的全程视力,术后视觉质量良好。     

ReSTOR intraocular lens implantation in cataract surgery: quality of vision

PURPOSE: To compare the visual outcome and subjective visual symptoms in patients who had implantation of the AcrySof ReSTOR multifocal intraocular lens (IOL) (Alcon Laboratories) with those in patients who received the AcrySof SA60AT monofocal IOL (Alcon Laboratories) in cataract surgery. SETTING: Southend Hospital, Essex, United Kingdom. METHODS: Eighty eyes of 40 patients received the ReSTOR multifocal IOL after cataract extraction. They were closely paired in age, sex, and ocular findings with patients who had monofocal IOL implantation during the same period. The distance and near visual acuities were compared, and patient satisfaction with their vision, visual symptoms, and spectacle dependence was assessed using a standardized questionnaire. RESULTS: There was no significant difference in the mean uncorrected and best corrected distance visual acuities between the groups. An uncorrected distance visual acuity of 20/30 or better was achieved in 93.8% eyes in the multifocal group and 82.5% in the monofocal group and of 20/20 or better in 57.5% and 40.0%, respectively (P = .18). Uncorrected near visual acuity was 20/30 or better in 75.0% of eyes in the multifocal group and 3.8% in the monofocal group. Reading glasses were required by 2.5% in the multifocal group and by 92.5% in the monofocal group. Satisfactory uncorrected intermediate distance vision was achieved in 75.0% of eyes in the multifocal group and 87.5% in the monofocal group (P = .089); 85.0% of patients in the multifocal group and 7.5% in the monofocal group never had to wear glasses. Moderate glare was reported by 21.3% in the multifocal group and 7.5% in the monofocal group (P = .008); no patient reported severe glare. In the multifocal group, severe halos and moderate halos occurred in 3.8% [corrected] of eyes and 16.3% [corrected] of eyes, respectively. CONCLUSIONS: The AcrySof ReSTOR IOL provided predictably good uncorrected distance and uncorrected near acuities. Spectacle independence was significantly higher with this multifocal IOL, which outweighed the photic symptoms it caused.     

Acrysof IQ Restor多焦点Toric人工晶状体植入术后临床效果观察

目的：评价白内障患者超声乳化术中植入Acrysof IQ Restor多焦点Toric人工晶体矫正术前规则角膜散光的早期临床效果、安全性,以及术后人工晶状体眼的视功能状态。方法：搜集自2013年至今在我院行白内障超声乳化术并植入Acrysof IQ Restor多焦点Toric人工晶状体的白内障患者18例(23眼)进行分析,术前患者散光均大于1.0 D。术后随访3个月,分别观察术后1周、1个月以及3个月的裸眼远视力,最佳矫正远视力以及裸眼近视力,术前散光以及术后3个月时残余散光、等效球镜度数和人工晶状体的旋转度。结果：术后3个月患者裸眼远视力0.89±0.21,最佳矫正远视力0.95±0.38,等效球镜为?0.5~+0.25D,裸眼近视力为0.82±0.19。术后3个月验光全眼散光为(0.38±0.15) D,较术前散光(1.79±0.43) D有明显降低(P<0.05)。术后3个月人工晶状体的轴位平均偏离(3.48±1.21)°。结论：Acrysof IQ Restor多焦点Toric人工晶状体为白内障患者提供了良好的术后全程视力和视觉质量,并校正了术前角膜散光,实现了患者高度满意率和脱镜率,可预测性好,并有良好的旋转稳定性。     

双眼多焦点人工晶状体ReSTOR植入术后视功能观察

目的 通过比较植入单、多焦人工晶状体(IOL)术后双眼视功能情况,以了解国人植入多焦点IOL的有效性及安全性.方法 选择年龄相关性白内障患者43例,按患者意愿植入多焦点或单焦点IOL.单焦点人工晶状体(MoIOL)组:双眼植入AcrysofNatural25例50只眼.多焦点人工晶状体(MIOL)组:双眼植入AcrysofReSTOR 18例36只眼.观察两组组患者术后双眼裸眼远视力(UCDVA)、裸眼近视力(UCNVA)、最佳矫正远视力(BCDVA)、最佳矫正近视力(BCNVA)、远矫正下的近视力(DCNVA),中间距离视力(40、60、80cm),对比敏感度(CS),视觉症状.结果 MIOL组UCNVA、DCNVA、中间距离视力均优于单焦点人工晶状体MoIOL组,差异有统计学意义(P＜0.05).两组之间,CS无明显差异.MIOL组术后视觉症状较轻,脱镜率80%,患者满意度高.结论 双眼植入MIOL能提供更好的近、中距离视力,视觉症状轻,更好地提高白内障患者术后生活质量.     

非球面多焦点人工晶状体＋3．0D视觉功能的临床研究

目的比较三种多焦点人工晶状体（IOL）ReSTOR＋4．0D、IQReSTOR＋4．0D和IQReSTOR＋3．0D的临床效果,评估植入IOReSTOR＋3．0D后的视觉功能。设计前瞻性病例系列研究。研究对象老年性白内障患者47例（72眼）。方法对以上患者行白内障超声乳化吸除和IOL植入术,按患者自愿原则,分别植入ReSTOR＋4．0D18例（27眼）,IQReSTOR＋4．0D15例（25眼）,IQReSTOR＋3．0D14例（20眼）。比较患者术后3个月的近距离、中距离和远距离视力、对比敏感度、波前像差和离焦曲线。主要指标近距离、中距离和远距离裸眼和矫正视力,对比敏感度,波前像差,离焦曲线和问卷调查。结果术后3个月,IQReSTOR＋3．0D组裸眼中距离LogMAR视力（0．169±0．07）较ReSTOR＋4．0D组（0．256±0．08）和IQReSTOR＋4．0D组（0．252±0．08）好,差异有统计学意义（P=0．000,P=0．001）。近距离和远距离视力,三组没有统计学差异（P均〉0．05）。离焦曲线显示IQReSTOR＋3．0D组的近距离视力在…2．0D2．5D,相当于眼前40～50cm范围有一高的平台,而ReSTOR＋4．0D组和IQReSTOR＋4．0D组仅为一个点。三组患者术后3个月的夜间视力模糊、眩光和光晕没有统计学差异。结论衍射多焦人工晶状体＋3．0D较＋4．0D能够提供更好的中距离视力和一定距离范围近视力。（眼科。2010,19：84-88）     

A comparative clinical study of the visual results between three types of multifocal lenses

Purpose

To compare the patients’ visual results after bilateral implantation of the multifocal intraocular lenses (MIOLs): ReZoom (NXG1, Abbott Medical Optics, Abbott Park, IL, USA), Acrysof ReSTOR (SA60D3, Alcon Laboratories, Fort Worth, TX, USA) and Tecnis MF (ZM900, Abbott Medical Optics).

Materials and methods

A prospective, nonrandomized, comparative trial of 30 patients (60 eyes) aged 46–71 (mean age 56.3?±?5.96) divided into three equal groups with implanted bilaterally multifocal lenses: ReZoom IOL, Acrysof ReSTOR IOL and Tecnis MF IOL. The patient selection criteria included no other eye disease besides cataract, and corneal astigmatism of 1.5 diopters or less. In each case, the patients were scheduled to have standard phacoemulsification surgery with IOL implantation into the bag. The postoperative target was emmetropia. The mean follow-up was 6 months in all eyes. The following parameters were assessed/carried out: slit-lamp examination, uncorrected and best spectacle-corrected far and near visual acuity, autorefractometry, intraocular pressure, contrast sensitivity and subjective satisfaction with vision using the VF-14 survey.

Results

After surgery, all eyes were within ±2.0D of target refraction. The mean uncorrected distance visual acuity improved in all cases. The postoperative BCDVA was better than 20/30 at the sixth month in all eyes. Six months postoperatively, the mean uncorrected distance visual acuity (UCDVA) ± standard error (SE) in the ReZoom, ReSTOR and Tecnis MF groups was 0.11?±?0.01, 0.17?±?0.02 and 0.14?±?0.02 (LogMAR) respectively. All results were significantly better compared to preoperative values (p?<?0.001) but did not differ between the study groups (p?>?0.05). At the final visit, 75% of eyes in the ReZoom group achieved J1 (Jaeger standard) in comparison to 85% in the ReSTOR and Tecnis MF groups. Eighty percent of patients with bilaterally implanted ReSTOR and Tecnis MF IOL were spectacle-independent, in comparison to 70% with implanted ReZoom IOL. Thirty percent of patients with implanted Rezoom and Acrysof Restor IOL and 20% with implanted Tecnis multifocal IOL reported little or moderate halo and glare. The patients’ satisfaction after the procedure was excellent; the scoring on the VF-14 survey ranged from 70–100%, with an average of 93%. No patient was dissatisfied with the results of the surgery.

Conclusions

The implantation of tested multifocal intraocular lenses provides good near and distance visual acuity. We did not observe any statistically significant differences between the tested multifocal intraocular lenses with regard to best-corrected distance visual acuity, presence of glare and halo, as well as satisfaction with vision.