单眼和双眼三焦点IOL植入术后视觉相关生活质量的比较

目的:对比分析双眼三焦点IOL(AT LISA tri 839MP IOL)植入与一眼植入AT LISA tri 839MP IOL而另一眼植入非球面单焦点IOL患者术后视觉相关生活质量。方法:前瞻性临床研究。收集2018-05/2019-08在我院行白内障超声乳化联合三焦点AT LISA tri 839MP IOL植入的患者45例,按是否双眼植入AT LISA tri 839MP IOL分为两组,双眼植入者24例纳入双眼三焦点组;一眼植入AT LISA tri 839MP IOL而另一眼植入非球面单焦点IOL者21例纳入单眼三焦点组。术后3mo,检测两组患者裸眼视力及等效球镜度,并通过中国版视功能指数量表(VF-14-CN)评价视觉相关生活质量,评估日常生活脱镜率及满意度。结果:术后3mo,双眼三焦点组和单眼三焦点组患者双眼裸眼远、中、近视力均无明显差异(P>0.05),两组患者VF-14-CN问卷得分(96.2±0.50、92.43±1.32分)、日常生活脱镜率(96%、90%)及患者主观满意度(96%、95%)均无差异(P>0.05)。结论:双眼植入AT LISA tri 839MP IOL和一眼植入AT LISA tri 839MP IOL而另一眼植入非球面单焦点IOL的患者术后均具有良好的双眼裸眼远、中、近视力,术后视觉相关生活质量、脱镜率、满意度无明显差异。对一眼不适合植入三焦点IOL或既往一眼已植入非球面单焦点IOL的患者,可考虑另一眼行三焦点IOL植入以满足患者双眼全程视力的要求。     

Visual outcomes and patient satisfaction after bilateral implantation of a new trifocal diffractive intraocular lens

Purpose

To assess the visual outcomes, patient satisfaction and spectacle independence following implantation of new diffractive trifocal intraocular lenses.

Visual Outcomes after Bilateral Implantation of an Extended Depth of Focus Intraocular Lens: A Multicenter Study

PurposeTo evaluate visual performance after bilateral implantation of an extended depth of focus (EDOF) intraocular lens (IOL).MethodsThis multicenter, prospective, observational study included 100 patients who underwent bilateral cataract surgery with a toric or non-toric EDOF IOL (Tecnis Symfony), and 96 patients completed the final assessment at 4 to 6 months. Binocular corrected distance visual acuity and uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), and uncorrected near visual acuity (UNVA), spectacle independence, visual symptoms, and patient satisfaction were evaluated.ResultsMean decimal visual acuity results showed a binocular corrected distance visual acuity of 1.10 ± 0.18, UDVA of 1.04 ± 0.17, UIVA of 0.96 ± 0.16, and UNVA of 0.68 ± 0.18. Binocular UDVA and UIVA were 0.8 (decimal) or better in 98% and 94% of patients, respectively. Binocular UNVA was 0.63 (decimal) or better in 76% of patients. Overall, 76% of the patients achieved spectacle independence across all distances, and more than 85% reported no or mild dysphotoptic phenomena. On a scale of 0 to 10, the median patient satisfaction score was 9 for far, 9.5 for intermediate, and 8 for near vision.ConclusionsThe Symfony EDOF IOL provided excellent distance, intermediate visual outcome, and functional near visual acuity. The visual results were associated with prominent levels of spectacle independence and patient satisfaction.     

A prospective study of a new presbyopia pseudophakic intraocular lens: Safety,efficacy and satisfaction

Purpose:To evaluate the safety, visual performance, and patient satisfaction of a new presbyopic pseudophakic intraocular lens (IOL).Methods:A prospective non-randomized case-series study was performed in Buenos Aires, Argentina. Patients included in the study underwent a programmed Femtosecond laser assisted cataract surgery (FLACS), performed between October and December 2020, with a 6-month follow-up period. The Intensity (Hanita Lenses) IOL was bilaterally implanted. Spherical equivalent (SE) refraction, uncorrected distance and near visual acuity (UDVA/UNVA), defocus curve, endothelial cell density (ECD), central corneal thickness (CCT), and a satisfaction questionnaire were evaluated.Results:A total of 56 patients (112 eyes), aged 65 ± 6.12 years were included. The mean ± SD of preoperative SE was 1.85 ± 2.24 D (range; −4.50 to 4.75), which had decreased 6 months after surgery to −0.08 ±0.32 D (range; −0.75 to 0.63). No eyes experienced a loss of lines of vision, and 94% obtained SE values between ± 0.50 D. Defocus curve for different additions was 0.03 LogMAR (logarithm of the minimum angle of resolution) for −3.0 D, −0.005 LogMAR for −1.5 D, and −0.07 LogMAR for 0 D. The ECD, CCT remained stable (P: 0.09 and 0.58, respectively) and all patients achieved their preoperative expectations, with a 6-month follow-up period.Conclusion:Patients who underwent a safe bilateral implantation with Intensity IOL achieved a high degree of spectacle independence and satisfaction, 6 months after surgery.     

A novel standardized test system to evaluate dynamic visual acuity post trifocal or monofocal intraocular lens implantation: a multicenter study

ObjectivesTo compare the dynamic visual acuity (DVA) following implantation of trifocal with monofocal intraocular lenses (IOL) and using a novel test system.MethodsThe present research was a retrospective, multicenter clinical study. Two hundred and ten eyes of 149 patients that underwent cataract phacoemulsification and IOL implantation were enrolled. One hundred and ten eyes of patients received trifocal (AT LISA tri839MP, Carl Zeiss Meditec, Germany) and 100 eyes received monofocal (Tecnis ZCB00, Abbott, United States) lenses and were evaluated 3 months after implantation. Outcome measures included monocular uncorrected distance (UDVA), intermediate (UIVA) and near (UNVA) visual acuity and best corrected distance visual acuity (BCDVA; logMAR units); contrast sensitivity under photopic, mesopic, with glare conditions; and dynamic visual acuity using a self-developed system.ResultsThere was no statistically significant difference in baseline characteristics between groups. Monocular UDVA, UIVA, and UNVA were significantly better (all p < 0.001) in the trifocal IOL group, but not BCDVA. The trifocal IOL group showed better contrast sensitivity under photopic, mesopic, with or without glare conditions (p < 0.05) and statistically significantly better dynamic vision at 15, 30, 60, and 90 degrees per second (dps) compared with the monofocal group (all p < 0.001). The strength of positive association only between UIVA and dynamic visual acuity increased as the velocity increased, but not UDVA or UNVA.ConclusionsDiffractive trifocal IOL provides better postoperative full range vision acuity, contrast sensitivity, and dynamic vision compared with monofocal IOLs. And intermediate visual acuity is increasingly associated with DVA as the velocity increasing.Subject terms: Quality of life, Outcomes research     

Clinical outcomes and rotational stability following implantation of Eyecryl toric intraocular lens – Results of a 12-months prospective study

Purpose:To evaluate the clinical performance and rotational stability after implantation of Eyecryl Toric monofocal IOL following cataract surgery.Methods:Patients undergoing phacoemulsification for age-related cataract and satisfying the eligibility criteria were implanted with Eyecryl Toric IOL. All implantations were done under balanced salt solution. A marker-less system Callisto Eye (Carl Zeiss Meditec, Germany) was used to guide the intra-operative alignment of the toric IOL.Results:A total of 50 eyes from 39 patients with mean age of 68.2 ± 8.7 years were included in the study. At 12 months, 82% (41) eyes had cumulative UDVA of 20/20 or better. Post-op SE refraction accuracy was within ± 0.50 D for 94% (n = 47) eyes and refractive cylinder accuracy was within ≤0.50 D in 98% (n = 49) eyes. Average post-op rotation at 1 year was 4.06 ± 2.15 degrees. Eighty-four percent of eyes were within 5 degrees and 16% were within 6-10 degrees of intended axis. Two eyes required IOL re-positioning due to significant rotation of the toric IOL (>10 degrees), identified within the 1^st week after surgery.Conclusion:Eyecryl toric IOL demonstrated the ability to achieve a significant reduction in astigmatism, improved UDVA outcomes, high levels of spectacle independence, low rates of intra-operative injector related complications and good rotational stability at 12 months post-op.     

双眼三焦点人工晶状体和双焦点人工晶状体植入术后早期视觉质量比较

对双眼植入三焦点人工晶状体（IOL）或双焦点IOL术后早期的视觉质量进行比较研究。方法：前瞻性临床研究。选择武汉爱尔眼科医院2017年4月至2018年5月收治的双眼单纯年龄相关性白内障患者52例（104眼），依据患者选择的IOL进行分组，双眼均植入双焦点IOL 26例（52眼）作为双焦点组，双眼均植入三焦点IOL 26例（52眼）患者作为三焦点组，术后随访3个月，观察2组间裸眼远视力（UDVA）、裸眼中视力（UIVA）、裸眼近视力（UNVA）、矫正远视力（BCDVA）、矫正远中视力（DCIVA）、矫正远近视力（DCNVA）、离焦曲线、对比敏感度、波前像差、调制传递函数等，并进行VF-14-CN生活质量问卷满意度及脱镜率调查。数据采用独立样本t检验、Mann-Whitney U检验及χ2 检验进行统计分析。结果：三焦点组UIVA明显优于双焦点组（Z=-2.347，P=0.019），而2组间 UDVA、UNVA、BCDVA、DCIVA、DCNVA差异均无统计学意义。三焦点组在-1.0、-3.0、-3.5、 -4.0 D离焦下视力明显优于双焦点组（Z=-2.619、-2.452、-2.452、-2.147，P=0.009、0.014、0.014、 0.032）。2组间明视及明视眩光对比敏感度差异均无统计学意义。3、5 mm瞳孔直径时，三焦点组眼内总高阶像差、眼内彗差、眼内三叶草差以及全眼总高阶像差、全眼三叶草差均明显低于双焦点组，差异均有统计学意义（P<0.05）。5 mm瞳孔直径时，三焦点组眼内球差明显低于双焦点组（Z=-3.053， P=0.002），余指标组间差异无统计学意义。2组在3、5 mm瞳孔直径时的调制传递函数差异均无统计学意义。2组间VF-14-CN得分、日常生活脱镜率以及患者满意度差异均无统计学意义。结论：与双眼植入双焦点IOL相比，双眼植入三焦点IOL能够为患者带来更好的中间距离视力，但二者在远近视力、视觉质量以及术后生活质量方面相近。     

Functional outcomes after implantation of Tecnis ZM900 and Array SA40 multifocal intraocular lenses

PURPOSE: To evaluate the functional outcome after implantation of the Tecnis ZM900 multifocal intraocular lens (IOL) (AMO) and the Array SA40 multifocal IOL (AMO). SETTING: Department of Ophthalmology, Bundesknappschaft s Hospital, Sulzbach, and the Department of Ophthalmology, Marienhospital, Aachen, Germany. METHODS: In a prospective comparative 2-center trial, Tecnis ZM900 and the Array SA40 multifocal IOLs were bilaterally implanted in 50 patients (50 eyes Tecnis, 50 eyes Array) by 1 surgeon at each center. The following parameters were assessed 30 to 60 days and 120 to 180 days after surgery in both eyes: refraction, pupil size, uncorrected and best corrected visual acuities for distance and near at different contrast levels, and photopic and mesopic contrast sensitivity at different spatial frequencies. Patient satisfaction (spectacle independence, photic phenomena, overall satisfaction) was assessed by a questionnaire. RESULTS: The main differences between the 2 multifocal IOLs were the better uncorrected near visual acuity (P<.001), distance-corrected near visual acuity (P<.001), the mesopic contrast sensitivity at high spatial frequencies (P<.05) as well as greater independence from spectacles in patients with the Tecnis multifocal IOL, resulting in higher levels of patient satisfaction. CONCLUSION: The aspherical diffractive Tecnis multifocal IOL gave better outcomes than the Array multifocal IOL.     

三种IOL对年龄相关性白内障患者视力和视觉质量的影响

目的:分析植入AT LISA tri 839MP三焦点人工晶状体(IOL)、Lenstec SBL-3区域折射型非球面IOL、CT SPHERIS 209M单焦点IOL对年龄相关性白内障(ARC)患者视力水平及视觉质量的影响。方法:前瞻性临床研究。选择2018-10/2019-04本院拟行手术治疗的ARC患者114例114眼,以随机数字表法分为LISA tri组、SBL组、单焦点组,各38例38眼,分别植入AT LISA tri 839MP三焦点IOL、Lenstec SBL-3区域折射型非球面IOL、CT SPHERIS 209M单焦点IOL。比较术前、术后3mo角膜内皮镜、视力检查及视觉质量。结果:术后3mo三组患者角膜内皮细胞密度(ECD)、中央角膜厚度(CCT)及六角形细胞比例较术前均无差异(P>0.05)。术后3mo三组患者裸眼远视力(UCDVA)、裸眼中距离视力(UCIVA)、裸眼近视力(UCNVA)较术前均显著改善(P<0.001),LISA tri组UCDVA、UCIVA、UCNVA(LogMAR)分别为0.11±0.03、0.17±0.05、0.09±0.02,SBL组为0.12±0.02、0.19±0.05、0.08±0.02,均优于单焦点组(0.21±0.04、0.24±0.07、0.15±0.03)(P<0.05)。术后3mo LISA tri组视近脱镜率、视觉满意度为92%、97%,SBL组为95%、92%,均显著高于单焦点组的66%、68%(P<0.017)。术后3mo三组患者美国国立眼科研究开发的视功能与生存质量(VF-QOL)各类评分较术前均明显升高(P<0.001),LISA tri组、SBL组VF-QOL各类评分均显著高于单焦点组(P<0.05)。结论:ARC患者应用AT LISA tri 839MP三焦点IOL和区域折射型非球面多焦点IOL(SBL-3)植入的治疗效果均优于单焦点IOL,可有效改善视力水平、提高视觉质量。     

Clinical outcomes after femtosecond laser assisted cataract surgery with implantation of the TECNIS Symfony intraocular lens

AIM: To evaluate the clinical outcomes in terms of vision across distances (near, intermediate, and far), contrast sensitivity and subjective patient satisfaction after femtosecond laser-assisted cataract surgery (FLACS) with implantation of an extended range of vision (ERV) intraocular lens (IOL). METHODS: Forty patients (55 eyes) undergoing bilateral or monocular FLACS with implantation of the ERV IOL TECNIS Symfony (Johnson & Johnson Vision) were enrolled. Uncorrected distance (UDVA), intermediate (UIVA) and near visual acuities (UNVA) were evaluated at 3mo after surgery, as well the defocus curve, contrast sensitivity, patient satisfaction and spectacle independence. RESULTS: No severe complications occurred. All eyes showed a central position of the IOL in the capsular bag without tilting at 3mo after surgery. 3mo postoperative mean logMAR visual acuity at 5 m, 67 cm and 40 cm were -0.04 ±0.08, -0.17±0.22, 0.37±0.17, respectively. All patients obtained satisfactory UDVA and UIVA, as well as functional UNVA, meeting the needs of daily life. Spectacle independence rate was 94.55%. Contrast sensitivity results did not differ from those obtained with monofocal aspheric lenses. Likewise, no moderate and severe photic phenomena were reported. Mean patient satisfaction scores with distance, intermediate and near vision were 9.0, 9.0, and 7.0, respectively. CONCLUSION: FLACS with implantation of the ERV IOL TECNIS Symfony provides a successful visual restoration at far, intermediate distance and a functional-range near vision acuity, with minimal level of disturbing photic phenomena, and high rates of spectacle independence and patient satisfaction.     

Stabilization of refraction and timing of spectacle prescription following manual small-incision cataract surgery

Purpose:To determine the stabilization of refraction at 2 weeks following MSICS by comparing the difference in spherical, cylindrical component and also spherical equivalent of refraction of 2 weeks follow-up with that of 6 weeks following surgery.Methods:The difference of spherical, cylindrical component and also spherical equivalent of refraction at 2 weeks and 6 weeks follow-up of 194 eyes that underwent uncomplicated MSICS with implantation of PMMA IOL conducted by a single experienced surgeon were compared to find out the amount of change and its significance was statistically tested by Wilcoxon-Signed Rank Test.Results:The difference in spherical power (0.04 ± 0.30), cylinder power (0.03 ± 0.40), and spherical equivalent (0.06 ± 0.34) were very small and not significant statistically (P-value ≤0.05).Conclusion:Necessary spectacle correction can safely be prescribed after 2 weeks following MSICS as subjective refraction stabilizes by that time without undergoing significant change. However, our observation was applicable in patients who had an uneventful cataract surgery without any risk factor, which can delay wound healing or cause poor visual outcome.     

飞秒激光辅助白内障手术联合三焦点人工晶状体植入术的疗效观察

目的：观察飞秒激光辅助白内障手术联合三焦点人工晶状体(IOL)植入术后的临床疗效。

方法：回顾性自身前后对照研究。选择2016-09/2017-11就诊于山西省眼科医院植入三焦点IOL的白内障患者42例59眼,随访至术后6mo,分别观察术前、术后1wk,1、3、 6mo单眼裸眼远、中、近距离视力(LogMAR)、离焦曲线、屈光稳定性、高阶像差、患者满意度和脱镜率。

结果：所有患者在术后各随访时间点远、中、近距离均可获得优于0.1LogMAR的良好视力,术后各距离视力与术前相比显著提高(P<0.05)。术后6mo离焦曲线在0～-2.5D之间曲线过渡平缓,术眼达到优于0.8的视力水平。术后6mo,63%(37眼)的患眼SE位于±0.25D之间,88%(52眼)的患眼SE则位于±0.50D之间。术后各时期全眼的总高阶像差、彗差、球差、三叶草像差明显低于术前(P<0.05)。

结论：飞秒激光辅助白内障手术联合三焦点IOL植入术可以为患者提供舒适自然的全程视力,实现真正的脱镜,患者术后满意度高。     

三焦点人工晶状体与双焦点人工晶状体植入术后视力及视觉质量的对比

目的:比较三焦点人工晶状体(IOL) (Zeiss 839)及双焦点IOL(Zeiss 809)植入术后视力及视觉质量。方法:回顾性研究。选取2017年8月至2019年1月中国中医科学院眼科医院行白内障手术患者54例(83眼)。其中植入三焦点Zeiss 839 IOL(839组)28例(42眼),植入双焦点Zeiss 809 IOL(809组)26例(41眼)。对比2组术后1周、1个月、3个月裸眼视力,客观视觉质量分析仪分析客观散射指数(OSI)、传递函数截止频率(MTF cutoff)、斯特列尔比值(SR)、模拟对比度视力(PVA100%、PVA20%、PVA9%),术后3个月离焦曲线及进行问卷调查。数据采用配对样本 t检验及重复测量方差分析。 结果:术后1、3个月839组裸眼远视力优于809组,术后各观察时间中距离视力优于809组,差异均有统计学意义( P<0.05),术后裸眼近视力2组差异无统计学意义。术后2组OSI、MTF cutoff、SR、PVA100%、PVA20%、PVA9%差异均无统计学意义。离焦曲线示839组波形较平稳且在-3^-1 D范围内居于高位。术后3个月839组与809组眩光发生率、明暗视觉适应力、脱镜率、满意度分别为2%和7%、93%和88%、98%和78%、90%和85%。 结论:Zeiss 839 IOL和Zeiss 809 IOL均具有较好的远、近视力及视觉质量,Zeiss 839具有出色的中距离视力、高脱镜率及更佳的满意度。     

Randomized trial comparing visual outcomes of toric intraocular lens implantation using manual and digital marker

Purpose:The aim of this study was to compare the visual outcome of participants undergoing toric intraocular lens (IOL) implantation after cataract extraction using manual marking versus digital marking for intraoperative guidance.Methods:Randomized controlled trial of participants with cataract and corneal astigmatism of 1.00 D-4.50 D. The eyes were grouped into manual marking (Group 1) and digital marking (Group 2). Preoperative Uncorrected distance visual acuity (UDVA), Corrected distance visual acuity (CDVA), and corneal astigmatism were determined. IOL power and axis of alignment were determined using Barrett toric calculator. Eyes were marked by bubble marker and Mendez ring in group 1 and by VERION (Alcon, Fort Worth, Texas) digital overlay in Group 2. Postoperatively, UDVA, CDVA, residual refractive cylinder and IOL misalignment were determined (iTrace system, Tracey technologies) at 1 week, 6 weeks, and 3 months.Results:A total of 61 eyes of 50 participants, 31 in Group 1 and 30 in Group 2, were studied. The mean postoperative cylindrical error was 0.50 ± 0.39 D in Group 1 and 0.29 ± 0.34 D in Group 2 (P = 0.03). 67.74% (n = 21) and 93.55% (n = 29) eyes achieved a residual astigmatism of ≤0.50 D and ≤1.00 D, respectively, in Group 1, whereas 83.33% (n = 25) and 100% (n = 30) eyes achieved a residual astigmatism of ≤0.50 D and ≤1.00 D, respectively, in Group 2 at 3 months postoperatively. Toric IOL misalignment was 4.71 ± 3.12° in Group 1 and 4.03 ± 2.99° in Group 2 (P = 0.39).Conclusion:Accurate manual marking and digital marking are equally effective guides for toric IOL alignment, intraoperatively.     

飞秒激光辅助白内障联合TECNIS Symfony人工晶状体植入术后视觉质量的评价

目的：通过观察飞秒激光辅助的白内障手术联合TECNIS Symfony连续视程人工晶状体植入术后远中近全程视力、对比敏感度,主观满意度,综合评价TECNIS Symfony人工晶状体植入术后患者的视觉质量。

方法：收集我院目前已实施40例55眼飞秒激光辅助白内障联合TECNIS Symfony 连续视程人工晶状体植入术资料,检测术后3mo裸眼远视力(5 m)、中视力(67 cm)及近视力(40 cm),绘制离焦曲线,根据多焦晶体满意度调查表并计算脱镜率。

结果：所有患者术中术后无严重并发症发生。术后3mo,所有患者人工晶状体位置居中,无明显偏位或倾斜。术后3mo, 5 m、67 cm、40 cm平均裸眼LogMAR视力分别为：-0.04±0.08, -0.17±0.22, 0.37±0.17。总体脱镜率95%。不同空间频率的对比敏感度较普通单焦非球面人工晶状体无明显下降。无中等或严重光学干扰现象发生。远中近各功能区满意度评分分别为9.0,9.0,7.0分。

结论：飞秒激光辅助的白内障手术联合TECNIS Symfony连续视程人工晶状体植入术后可获得满意的远中裸眼视力和基本满足日常生活的近视力,术后光学干扰少,脱镜率高,患者满意度高。     

Visual and autorefraction outcomes following toric intraocular lens insertion without calculation of posterior corneal astigmatism in the UK National Health Service

ObjectiveTo ascertain visual and refractive outcomes following toric intraocular lens (IOL) implantation in the UK National Health Service (NHS) without posterior corneal astigmatism calculation, with multiple surgeons of different grades, pooled input and output pathways and autorefraction as the refractive outcome measure.MethodsPreoperative and 1-month post-operative data were analysed retrospectively in 114 eyes (95 patients) receiving a toric IOL between 2014 and 2016 at Imperial College NHS Trust. Preoperative keratometric astigmatism was ≥2 dioptres (D).ResultsMean preoperative best-corrected visual acuity (BCVA) was 0.50 logMAR (±0.46), improving to a mean uncorrected VA (UCVA) of 0.35 logMAR (±0.36) postoperatively (p < 0.001) with 65% of eyes attaining a UCVA ≤ 0.30 logMAR. Excluding 33 eyes with pre-existing visual comorbidities and one targeting monovision, mean post-operative UCVA was 0.24 logMAR (±0.29) (p < 0.001), and 85% had UCVA ≤ 0.30 logMAR, 62% UCVA ≤ 0.20 logMAR. Mean refractive astigmatism improved from 3.04 D (±1.46) to 1.36 D (±1.13) (p < 0.001). In total, 52% of eyes had post-operative refractive astigmatism ≤1.00 D. The Alpins correction index was 1.05 (±0.22), indicating a tendency to overcorrect. Toric IOL misalignment was noted in two eyes, and two cases of posterior capsule rupture were converted to a non-toric IOL.ConclusionsVisual outcomes of toric IOL implantation in our pooled pathway are comparable to single-surgeon case series where posterior corneal astigmatism has not been accounted for. However, with 1-month post-operative autorefraction, only 52% of eyes had ≤1 D refractive astigmatism, which is lower than previously published series, but may be standard for 1-month autorefraction outcomes.Subject terms: Outcomes research, Health services     

Initial results of trifocal diffractive IOL implantation

Background  

Bifocal intraocular lenses (IOL) are designed to reduce dependence on eyeglasses after surgery, but they cannot provide full range of vision, and have a drop of visual acuity in the intermediate distance. This problem may be solved with a trifocal lens, which produces three useful focal points. This study was conducted to evaluate clinical outcomes, functional vision and spectacle independence in patients with trifocal diffractive IOLs.     

两焦点与三焦点人工晶状体植入术后视觉质量的比较

目的:比较两焦点(AT LISA 809MP)和三焦点(AT LISA tri 839MP)IOL植入术后的视觉质量。方法:回顾性研究。共收集2018-03/2019-02行超声乳化吸除术联合多焦点IOL植入术的白内障患者28例49眼。两焦点组18例30眼,年龄40~85(平均67.08±10.80)岁。三焦点组10例19眼,年龄38~79(平均62.21±14.50)岁。所有患者均行视觉质量分析系统(OQAS)、离焦曲线等检查。结果:两焦点组近BCVA优于三焦点,三焦点组中UCVA和远BCVA均优于两焦点组(P<0.05)。三焦点组+1.5、-1.0、-1.5、-2.0、-2.5、-3.0D视力显著优于两焦点组。两组间OQAS视觉质量参数两焦点组OV 20%、OV 9%、SR均优于三焦点组(P<0.05)。结论:两焦点和三焦点IOL植入术后均可获得良好的裸眼远和近视力,视觉质量均较高,而三焦点IOL可获得更佳的中间视力。     

Comparative analysis of visual quality between unilateral implantation of a trifocal intraocular lens and a rotationally asymmetric refractive multifocal intraocular lens

AIM: To compare visual quality after unilateral cataract surgery with implantation of trifocal intraocular lens (IOL) and asymmetric refractive multifocal IOL. METHODS: The prospective nonrandom, comparative study consisted of 60 eyes of 60 patients suffering unilateral cataract surgery with implantation of two different IOLs: AT LISA tri 839MP (30 eyes; Carl Zeiss Meditec, Germany) and LS-313 MF30 (30 eyes; Oculentis GmbH, Germany). Visual acuity, refractive outcome, contrast sensitivity, defocus curves, quality of vision, and optical phenomena were evaluated at 3mo postoperatively. RESULTS: There were no statistical differences between groups in uncorrected distance visual acuity (P=0.13) and uncorrected near visual acuity (P=0.54). In contrast, uncorrected intermediate visual acuity was better in trifocal group compared to the refractive multifocal group (P=0.02). No significant statistical between-group difference was detected in cylinder (P=0.43). Compared to trifocal group, spherical refraction and spherical equivalent in refractive multi focal group were more myopic (P<0.01). Under photopic conditions, no significant statistical differences were found between groups in contrast sensitivity at 3 and 6 cycles per degree (cpd). The refractive multifocal group performed better at 12 and 18 cpd than the trifocal group (P=0.01, P=0.034, respectively). The questionnaires of quality of vision and optical phenomena showed no differences between groups. CONCLUSION: Trifocal IOL is superior to refractive multifocal IOL in intermediate visual acuity. Rotationally asymmetric refractive multifocal IOL is more myopic in automated refraction and significantly better for the photopic contrast sensitivity at high frequency.     

Array multifocal intraocular lens in a charity hospital training program: a resident's experience

PURPOSE: To evaluate the frequency of spectacle use for distance and near activities and the satisfaction with visual acuity for distance and near activities in low-income patients implanted with the Arra multifocal intraocular lens (IOL) (Allergan, Inc.) by residents in a charity hospital.SETTING: E.A. Conway Medical Center, Monroe, Louisiana, USA.METHODS: This retrospective study compared patients who had bilateral implantation of the Array multifocal IOL and those who had bilateral implantation of a monofocal IOL. The primary outcome measures were postoperative spherical equivalent, cylinder, corrected and uncorrected distance visual acuities, frequency of spectacle use for distance and near, satisfaction with overall vision, satisfaction with the ability to see at distance and near with and without spectacles, and problems with unwanted visual phenomena such as glare, rings, and halos.RESULTS: There were 17 patients in the multifocal group and 14 patients in the monofocal group. Postoperatively, more patients in the monofocal group used spectacles (86% and 53%, respectively; P =.068). Significantly fewer patients in the multifocal group used spectacles for near vision (P =.018). Problems with glare, rings, and halos were more frequent in the multifocal group (P =.041). The multifocal group reported significantly greater satisfaction with the ability to see at distance (P =.002) and at near (P =.002) without spectacles.CONCLUSION: Implantation with the multifocal IOL may be a cost-effective option for low-income patients because it reduces the need for spectacles after cataract surgery.