三种人工晶状体植入术后静态视力和动态视力的评估及比较

目的：对三焦点、双焦点及连续视程人工晶状体植入术后的单眼视力和动态视力（DVA）进行评估及比较。方法：前瞻性临床研究。选取2020年1月至2021年1月于重庆医科大学附属第一医院眼科行白内障超声乳化摘除联合人工晶状体植入且资料完整的白内障患者65例（81眼）。根据所选择的IOL 类型分为3组：双焦点组33眼,植入Tecnis ZMB00 IOL;三焦点组20眼,植入AT Lisatri.839MP IOL;EDOF组28眼,植入Tecnis ZXR00 IOL。术后3个月分别检测每眼的裸眼静态视力（SVA）：包括裸眼远视力（UDVA）、裸眼中视力（UIVA）、裸眼近视力（UNVA）（LogMAR视力）。采用运动视标法检测裸眼DVA（检测速度分别为4、8、12、24fps）：包括裸眼动态远视力（UDDVA)、裸眼动态中视力（UIDVA）、裸眼动态近视力（UNVA）（LogMAR视力）,并进行评估比较。通过“手抓尺子试验”检测患者反应速度。数据采用卡方检验、方差分析、Kruskal-WallisH检验进行统计分析。结果：3组的总体UDVA、UNVA差异均无统计学意义;3组的总体UIVA差异有统计学意义（H=23.13,P<0.001）,进一步两两比较发现EDOF组优于双焦点组（P<0.001）;三焦点组优于双焦点组（P=0.016）;EDOF 组与三焦点组差异无统计学意义。3组的总体UDDVA在4、8fps时差异均无统计学意义;而在12、24fps时总体差异均有统计学意义（H=10.96,P=0.004;H=11.52,P=0.003）,进一步比较发现双焦点组优于三焦点组（H=-16.21,P=0.003;H=-17.98,P=0.004）,EDOF组优于三焦点组（H=-12.67,P=0.030;H=-16.48,P=0.009）,双焦点组与EDOF组差异无统计学意义。3组的总体UIDVA在8fps 时差异无统计学意义,而在4、12、24fps时差异均有统计学意义（H=8.17~11.36,P<0.05）：4、12fps 时,EDOF组优于双焦点组（H=14.61,P=0.013;H=14.52,P=0.009）,与三焦点组差异无统计学意义;24fps时,EDOF组优于双焦点组、三焦点组（H=15.31,P=0.008;H=-16.60,P=0.027）。3组的总体UNDVA在4、8、12、24fps时差异均有统计学意义（H=11.25~17.61,P<0.05）,且EDOF组均分别优于双焦点组（H=12.71~17.87,P<0.05）和三焦点组（H=-23.04~-15.87,P<0.05）,双焦点组与三焦点组差异均无统计学意义（均P>0.05）。结论：在SVA方面,三焦点IOL及EDOFIOL均可获得较好的UDVA、UIVA、UNVA,而双焦点IOL的UIVA较弱。在DVA方面,远距离、低速度时,3种IOL结果相当;但是近距离、高速度时,EDOFIOL的DVA较其余二者更佳。     

连续视程IOL植入术后患者主观视觉质量及阅读能力的临床观察

目的:比较双眼及单眼植入Tecnis Symfony连续视程人工晶状体(IOL)术后患者主观视觉质量、阅读流畅性及术后满意度的差异.方法:对我院48例71眼行白内障超声乳化吸除联合IOL植入术的患者进行回顾性分析,根据植入IOL类型不同分为2组,其中23例46眼双眼植入Symfony IOL为双眼组,25例25眼一眼植...     

Comparison of an aspheric monofocal intraocular lens with the new generation monofocal lens using defocus curve

Purpose:The aim of this study was to compare the visual outcomes of two monofocal intraocular lenses (IOLs), with emphasis on the defocus curve.Methods:A total of 116 consecutive eyes with cataract, undergoing phacoemulsification with IOL implantation were included in the observational case series, and divided into two groups. 71 eyes were implanted with Tecnis Eyhance and 45 with Tecnis 1 monofocal IOL. Eyes with ocular comorbidities, previous ocular surgeries and corneal astigmatism >1 Diopters (D) were excluded from the study. Complete ophthalmic evaluation including uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), corrected intermediate visual acuity (CIVA), uncorrected visual acuity (UNVA), corrected near visual acuity (CNVA) was noted and defocus levels ranging from - 4.00 D to + 1.00 D were plotted postoperatively in both groups.Results:Uncorrected intermediate visual acuity (UIVA) and uncorrected near visual acuity (UNVA) was significantly better in Tecnis Eyhance group compared to Tecnis 1 monofocal. Both the IOLs have similar performance for distance vision but visual acuity at intermediate and near is significantly better with Tecnis Eyhance compared to Tecnis 1 piece IOL.Conclusion:Tecnis Eyhance IOL with its better defocus curve, not only provides good distance, but intermediate vision as well. With significantly better visual acuity across the range of near and intermediate vision, Tecnis Eyhance IOL can prove to be a viable and reasonable option for patients who are more dependent on intermediate vision in daily activities.     

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.     

比较两种人工晶状体矫正老视效果的临床研究

目的比较非对称区域折射型多焦点人工晶状体(IOL)与衍射型三焦点IOL治疗年龄相关性白内障的疗效。 方法回顾性研究。收集2016年11月至2018年6月于成都爱尔眼科医院白内障中心行超声乳化白内障吸除联合IOL植入术57例(57只眼)患者的病历资料。其中,男性28例(28只眼),女性29例(29只眼);年龄50~76岁,平均年龄(63.3±5.5)岁。按照植入IOL的类型将患者分为区域折射组和衍射三焦组。检查并记录两组患者术前与术后3个月的术眼屈光度、裸眼远距离视力(UDVA)、裸眼中距离视力(UIVA)、裸眼近距离视力(UNVA)、最佳矫正远视力(BCDVA)、客观散射指数(OSI)、调制传递函数截止空间频率(MTF cutoff)、斯特列尔比值(SR)以及对比度视力。根据中文版VF-14视功能指数量表对上述指标进行评分,并对患者进行问卷调查。两组患者患眼的眼轴长度、角膜散光、术前UDVA、术前BCDVA、术后OSI、MTF cutoff、SR及中文版VF-14视功能指数量表评分等指标采用均数±标准差表示,并以独立样本t检验进行比较。UDVA、UIVA、UNVA、BCDVA及对比度视力采用中位数和四分位数间距表示。采用Mann-Whitney U检验,比较两组患者术后3个月术眼的UDVA、UIVA、UNVA、BCDVA以及对比度视力。 结果区域折射组和衍射三焦组患者的术后球镜屈光度分别为-0.75 D~+0.50 D和-0.50 D~+1.00 D。两组患者球镜屈光度位于-0.50 D~+0.50 D区间者占比的比较,差异无统计学意义(χ²＝0.000,P>0.05)。两组患者术后柱镜屈光度分别为0.00 D~-0.75 D和0.00 D~-1.00 D。两组患者柱镜屈光度位于-0.75 D~-1.00 D者占比的比较,差异无统计学意义(χ²＝0.459,P>0.05)。区域折射组患者术后的UDVA、UIVA、UNVA及BCDVA分别为0.10(0.00,0.10)、0.20(0.20,0.20)、0.20(0.10,0.20)及0.00(0.00,0.10);衍射三焦组患者术后分别为0.05(0.00,0.10)、0.20(0.10,0.20)、0.10(0.10,0.20)及0.00(0.00,0.05)。经Mann-Whitney U检验,两组患者术后UDVA、UNVA和BCDVA的比较,差异无统计学意义(Z＝-0.169,-1.265,-1.410;P>0.05);UIVA的比较,差异有统计学意义(Z＝-2.708,P<0.05)。区域折射组患者术后的OSI、MTF cutoff及SR分别为(1.9±0.7)、(24.755±7.751)c/deg和(0.126±0.029);衍射三焦组患者术后分别为(1.6±0.7)、(35.813±9.984)c/deg和(0.195±0.083)。经t检验,两组患者MTF cutoff和SR的比较,差异有统计学意义(t＝-5.419,-4.822;P<0.05);OSI的比较,差异无统计学意义(t＝1.959,P>0.05)。区域折射组患者术后在100%、20%和9%对比度下的对比度视力分别为0.70(0.60,0.90)、0.50(0.40,0.60)和0.30 (0.20,0.30);衍射三焦组分别为1.20(0.95,1.50)、0.70(0.60,0.90)和0.50(0.30,0.70)。经Mann-Whitney U检验,两组患者对比度视力的比较,差异有统计学意义(Z＝-4.882,-4.829,-3.676;P<0.05)。区域折射组与衍射三焦组的中文版VF-14视功能指数量表评分分别为(94.39±4.74)分与(96.86±3.63)分,两者比较的差异无统计学意义(t＝-0.075,P>0.05)。区域折射组与衍射三焦组眩光的发生率分别为10.7%与6.9%。两组近脱镜率和眩光发生率的比较,差异无统计学意义(χ²＝0.181,0.002;P>0.05)。区域折射组与衍射三焦组轻度光晕的发生率分别为3.57%与27.59%,差异有统计学意义(χ²＝4.505,P<0.05)。 结论两种老视矫正型IOL均能为年龄相关性白内障患者提供较好的全程视力,术后患眼屈光度可预测性好,而衍射型三焦点IOL客观视网膜成像质量的评估方面较区域折射型多焦点IOL略好。     

Comparison on visual function after implantation of an apodized diffractive aspheric multifocal or monofocal intraocular lens

 Purpose: To evaluate visual outcomes after implantation of an aspheric multifocal/ intraocular lens (MIOL) or an aspheric monofocal intraocular lens (IOL). Methods: This was a prospective nonrandomized study. During 3-months of post-operative follow-up, the following outcomes for SN6AD1 MIOL (multifocal group) and SN60WF IOL (monofocal group) were compared: uncorrected (UDVA) and corrected (CDVA) distance visual acuity, uncorrected (UNVA) and distance-corrected (DCNVA) near visual acuity, Chinese character near visual acuity, uncorrected intermediate visual acuity (UIVA) under high (100% contrast) and low contrast (10% contrast), UIVA for different IOL powers, and a quality-of-life questionnaire. Results: UNVA, DCNVA, and UIVA under high contrast in the multifocal group were significantly better than those in the monofocal group (P＜0.05). UDVA, CDVA and UIVA under low contrast did not differ between groups at 63 cm and 100 cm (P＞0.05). In most of the cases, Chinese character near visual acuity was significantly better in the multifocal group (P＜0.05). UNVA and UIVA at 63cm were improved 3 months post-operatively. Better UIVA was found in emmetropic and mild myopic eyes as compared to hyperopic ones. The patients in the multifocal group had a higher degree of satisfaction and performed better on near and intermediate tasks, although with greater complaints of visual disturbance.    Conclusion: The SN6AD1 MIOL provides significantly better UNVA, DCNVA and UIVA under high contrast conditions, and better Chinese character near visual acuity. Patients receiving the SN6AD1 MIOL reported a better quality of vision in spite of more serious visual disturbances. Better UIVA was observed in emmetropic and mildly myopic eyes.     

多焦点人工晶状体植入术后视觉质量和阅读能力的研究

目的:研究多焦点人工晶状体(IOL)植入术后白内障患者的视觉质量及阅读能力。方法:前瞻性临床研究。选择2018年6月至2019年10月于重庆医科大学附属第一医院眼科就诊并行双眼白内障手术的患者共75例(150眼),依据患者选择的IOL进行分组,双眼植入Tecnis ZCB00 IOL 25例(50眼)作为单焦组,双眼植入Tecnis ZMB00 IOL 25例(50眼)作为双焦组,双眼植入AT Lisa tri.839MP IOL 25例(50眼)作为三焦组,对比3组患者术后3个月时的祼眼远视力(UDVA)、祼眼中视力(UIVA)、祼眼近视力(UNVA) (LogMAR)及阅读能力。使用NEI-RQL-42量表中文版评价3组患者术后视觉质量的差异。数据采用卡方检验、方差分析、Kruskal-Wallis检验、Mann-Whitney U检验进行统计分析。 结果:共75例(150眼)患者纳入研究。3组间UDVA差异无统计学意义( H=3.187, P=0.203)。三焦组UIVA(0.2±0.1)优于双焦组(0.3±0.2) ( Z=-2.041, P=0.041)和单焦组(0.3±0.3) ( Z=-2.142, P=0.032)。三焦组UNVA(0.3±0.2)和双焦组UNVA(0.3±0.2)优于单焦组(0.4±0.2) ( t=2.332, P=0.017;t=3.014, P=0.036)。3组阅读视力( F=0.421, P=0.658)、阅读速度( F=1.754, P=0.182)、阅读错误率( H=6.347, P=0.052)差异均无统计学意义。三焦组近视力维度得分(92±14)和双焦组近视力维度得分(100±11)均高于单焦组(50±42) ( U=-3.139, P=0.005;U=-3.726, P=0.001);三焦组中视力维度得分(100±12)高于双焦组(75±25)和单焦组(25±75) ( U=-2.758, P=0.017;U=-3.145, P=0.002)。三焦组脱镜率维度得分(100±25)和双焦组脱镜率维度得分(100±40)高于单焦组(30±100) ( U=-3.004, P=0.008;U=-3.766, P=0.001)。 结论:多焦点IOL植入患者可获得与单焦点IOL植入患者配戴老花镜时相同的近距离视觉质量;AT Lisa tri.839MP IOL与Tecnis ZMB00 IOL可提供相同的远近视力及近距离阅读能力,但前者中距离视觉质量更佳。     

三焦点人工晶状体植入术后中期立体视功能及视觉质量研究

目的　评价三焦点非球面衍射型人工晶状体植入术后的双眼立体视功能及视觉质量。方法　非随机同期对照临床研究。对38例76眼单纯性白内障患者行超声乳化吸出联合人工晶状体植入术，依据植入人工晶状体类型不同分为2组:双眼均植入三焦点人工晶状体组18例36眼为三焦组，双眼均植入单焦点人工晶状体组20例40眼为单焦组。随访记录2组患者术后双眼近立体视功能、视力［单眼及双眼裸眼远距离视力（uncorrected distance visual acuity，UDVA）、裸眼中距离视力（uncorrected intermediate visual acuity，UIVA）、裸眼近距离视力（uncorrected near visual acuity，UNVA）、矫正远距离视力（corrected distance visual acuity，CDVA）、矫正远视力基础上的中距离视力（distance-corrected intermediate visual acuity，DCIVA）、矫正远视力基础上的近距离视力（distance-corrected near visual acuity，DCNVA）］和等效球镜度。利用VF-14-CN量表行主观问卷调查，对夜间光晕及老视眼镜依赖与否行问卷并记录；利用双通道视觉质量分析系统测量客观散射指数、调制传递函数截止频率（modulation transfer function，MTF-cutoff）、斯特列尔比值（strehl ratio，SR）及100%、20%、9%对比度视力（contrast visual acuity，CVA）等指标。结果　三焦组术后近立体视功能明显优于单焦组（P=0.001）。三焦组和单焦组所有术眼术后单眼UDVA较术前均明显提高（均为P<0.05）。三焦组单眼UDVA、UIVA、UNVA均明显优于单焦组（均为P<0.05）；三焦组单眼DCDVA与单焦组差异无统计学意义（P>0.05），但DCIVA和DCNVA均明显优于单焦组（均为P<0.01）。三焦组双眼UDVA、UIVA、UNVA均明显优于单焦组（均为P<0.01）；三焦组双眼DCDVA与单焦组比较差异无统计学意义（P>0.05），但DCIVA和DCNVA均明显优于单焦组（均为P<0.01）。两组等效球镜度差异无统计学意义（P=0.437）。VF-14量表评分单焦组明显低于三焦组（P=0.000）。90.0%单焦组患者依赖老视眼镜，5.6%三焦组患者依赖老视眼镜，差异有统计学意义（P=0.000）；两组眩光发生率差异无统计学意义（P=0.437）；两组夜间光晕发生率（单焦组2/20，三焦组7/18）差异有统计学意义（P=0.027）。三焦组和单焦组客观散射指数、斯特列尔比值、调制传递函数截止频率差异均无统计学意义（均为P>0.05）。三焦组100%CVA、20%CVA均好于单焦组（均为P<0.01）；9%CVA两组差异无统计学意义（P>0.05）。结论　双眼植入三焦点人工晶状体患者可获得良好的立体视功能和视觉质量，术后满意度高。     

Visual outcomes of binocular implantation of a new extended depth of focus intraocular lens

Purpose:To evaluate the visual outcomes of bilateral implantation of a new hydrophobic foldable extended depth of focus (EDOF) IOL.Methods:All cases undergoing phacoemulsification with bilateral implantation of Supraphob Infocus IOL between December 2017 and July 2018 at a tertiary eye care center were recruited in this prospective interventional study. The primary outcome measures were uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), and uncorrected near visual acuity (UNVA). Postoperative follow-up was done on day 1, 1 week, 1 month, and 3 months.Results:One hundred and four eyes of 52 patients with a mean age of 58.4 ± 9.3 years were included. The mean UDVA improved from 0.84 ± 0.32 logMAR preoperatively to 0.11 ± 0.08 logMAR at 3 months following surgery. At the final follow-up, the binocular UDVA, UIVA, and UNVA was 0.03 ± 0.07, 0.14 ± 0.06, and 0.36 ± 0.05 logMAR, respectively. The mean CS was 1.47 ± 0.06 logCS. The distance and near stereopsis was 90.2 ± 24.8 s of arc (arcsec) and 62.5 ± 19.4 arcsec, respectively. The mean total higher-order aberration (HOA), point spread function, and modulation transfer function were 0.30 ± 0.13, 0.07 ± 0.08, and 0.26 ± 0.07, respectively.Conclusion:The Supraphob Infocus EDOF IOL provides good unaided visual acuity for distance, intermediate, and near along with a high quality of vision as assessed by contrast sensitivity, HOAs, and stereoacuity. It may be a potential alternative to the currently available EDOF IOLs in providing good visual acuity at variable distances.     

两种新型多功能人工晶状体矫正老视的疗效比较

目的:比较双焦点人工晶状体(AtLisa tri 809MP)与三焦点人工晶状体(AtLisa tri 839MP)植入术后矫正老视疗效的差异。方法:纳入于我院行白内障超声乳化吸除联合人工晶状体植入术的患者共40例51眼进行分析,其中A组20例25眼植入809MP双焦点人工晶状体,B组20例26眼植入839MP三焦点人工晶状体。收集两组患者术后3mo时远中近视力数值、离焦曲线分析,并通过满意度调查问卷进行统计分析。结果:术后3mo两组裸眼远视力与最佳矫正视力均无差异(P>0.05);中距离视力(80cm)B组显著优于A组(P<0.01);近距离视力改善程度A组、B组无差异(P>0.05)。术后3mo离焦曲线结果A组在0、-3D处形成2个波峰;B组在0、-2.5D处形成2个波峰;两组患者术后均有不同程度的眩光、光晕等表现,但总体满意度较高,视近满意度较高。结论:两种类型人工晶状体均可以为患者提供兼顾远、近的全程视力,术后近距离视物脱镜率高,均可提高良好的近距离视力,三焦点人工晶状体中距离视力更好。     

连续视程与三焦点人工晶状体植入术后视觉质量的比较

目的：比较Tecnis Symfony连续视程人工晶状体与Zeiss三焦点人工晶状体(At Lisa tri 839MP)植入术后患者视觉质量的差异。

方法：选取2019-01/2020-12于我院行白内障超声乳化吸除联合人工晶状体植入术的患者42例53眼,其中A组22例29眼植入Tecnis Symfony连续视程人工晶状体,B组20例24眼植入Zeiss三焦点人工晶状体。观察两组患者术后3mo时远中近视力,绘制离焦曲线,并评估生活质量,记录并发症发生情况。

结果：术后3mo,两组患者视力均明显改善,两组患者裸眼远(5m)、中(80cm)距离视力及最佳矫正远距离视力(5m)无差异(均P>0.05),但B组患者裸眼中(60cm)、近(40cm)距离视力优于A组(均P<0.05)。术后3mo绘制离焦曲线示A组在+1.0～-2.0D段跨度平稳形成平台期; B组在0、-2.5D处形成两个波峰; 0D处两组远视力无显著差异(P>0.05),-2.5、-3.5D处B组近视力显著优于A组(均P<0.01)。两组患者术后脱镜率均在90%以上,均出现不同程度眩光、光晕等光学现象,但生活质量总体满意度较高,A组阅读速度明显高于B组,且夜间视物满意度较高(均P<0.05)。

结论：两种类型人工晶状体植入术后脱镜率均在90%以上,可为患者提供兼顾远、中、近的全程视力,Symfony连续视程人工晶状体植入术后流畅阅读及夜间视物满意度较高; Zeiss三焦点人工晶状体植入术后近距离视力更好,更适合近距离工作者。     

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。     

Extent of multifocality with corneal manipulation in manual small incision cataract surgery with monofocal posterior chamber intraocular lens implantation

Purpose:To compare the visual outcome in terms of multifocality in Manual Small Incision Cataract Surgery (MSICS) with and without intraoperative manipulation of corneal curvature.Methods:This was a prospective study on 80 subjects (80 eyes) who underwent MSICS with monofocal posterior chamber intraocular lens (PCIOL) implantation between January 2018 and October 2019. Intraoperative manipulation of corneal curvature using viscoelastics was performed during MSICS in 40 subjects (cases) while this intraoperative manipulation was not performed in the remaining 40 subjects (controls). Uncorrected distance visual acuity (UDVA) and uncorrected near visual acuity (UNVA) were compared at day 1, 7, 30 and 180postoperatively.Results:At 1 month and 6 months of follow up, UDVA was comparable in the 2 groups. UNVA was better in cases than controls at 1 month and6 months (P < 0.001). At 6 months of follow up,76% of cases with UDVA of 6/9 or better had UNVA of N8 while only 15% of controls with UDVA of 6/9 or better had UNVA of N8 (P <0.001). Mean near add requirement to achieve a best corrected near vision (BCNV)of N6 at 6 months was significantly lesser (P =0.002) in cases (+2.05 D) compared to controls (+2.43D).Conclusion:MSICS with intra operative manipulation of corneal curvature resulted in better unaided near visual acuity compared to that without intra operative manipulation of corneal curvature, without compromising unaided distant visual acuity.     

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.     

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。     

Clinical outcomes of a diffractive trifocal intraocular lens with femtosecond laser,digital tracking,and intraoperative aberrometry

ObjectiveTo evaluate clinical outcomes of a trifocal intraocular lens using femtosecond laser-assisted cataract surgery (FLACS), digital tracking (DT), and intraoperative aberrometry (IA).SettingOne site (Abbotsford, B.C., Canada)DesignRetrospective, single-surgeon study.MethodsThis was a retrospective, single-surgeon study examining 200 eyes of 100 bilaterally implanted patients. Eligible participants were those presenting with visually significant cataracts or as a candidate for clear lens extraction who were interested in implantation of a diffractive toric or non-toric intraocular lens. Preoperative and postoperative data were collected for manifest refraction spherical equivalent (MRSE), refractive astigmatism (RA), and monocular uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), and uncorrected near visual acuity (UNVA).ResultsMean postoperative manifest refraction spherical equivalent (MRSE) was 0.006 ± 0.27 D. The absolute prediction error was 0.50 D or less in 88.0% (176/200) of eyes. Postoperative RA was 0.50 D or less in 98.5% (197/200) of eyes. Postoperative UDVA was 0.10 logMAR or better in 86% (172/200) of eyes, and 66.0% (132/200) of eyes were 0.00 logMAR or better. Postoperative UIVA was 0.10 logMAR or better in 99.5% (199/200) of eyes, and 95.0% (190/200) of eyes were 0.00 logMAR or better. Postoperative UNVA was 0.10 logMAR or better in 91.5% (183/200) of eyes, and 73.5% (147/200) of eyes were 0.00 logMAR or better.ConclusionThe results demonstrate that trifocal implantation with FLACS, DT, and IA can provide excellent refractive and visual outcomes.     

Optical performance after bilateral implantation of apodized aspheric diffractive multifocal intraocular lenses with +3.00‐D addition power

Purpose: To determine whether bilateral implantation of an aspheric apodized diffractive multifocal intraocular lens (IOL) with +3.00 diopters (D) results in optical adverse effects compared with an aspheric monofocal IOL. Methods: In a prospective, randomized study of 204 eyes (102 patients) with bilateral implantation of an AcrySof ReSTOR SN6AD1 IOL or an AcrySof IQ SN60WF IOL, binocular uncorrected (UDVA) and corrected distance visual acuities (CDVA), uncorrected (UIVA) and distance‐corrected intermediate visual acuities (DCIVA), uncorrected (UNVA) and distance‐corrected near visual acuities (DCNVA), defocus curve, intraocular straylight, wavefront aberrations, modulation transfer functions (MTF) and patient questionnaires were evaluated postoperatively. Results: Both groups resulted in similar UDVA and CDVA (p > 0.05), whereas the multifocal IOL group performed significantly better UIVA and DCIVA at 50, 60 cm, and better UNVA and DCNVA at 40 cm (p ≤ 0.001). Higher intraocular straylight was obtained in the multifocal IOL group (p = 0.016). Total, higher‐order, spherical and coma aberrations performed similar in both groups (p > 0.05). MTF was lower in the multifocal IOL group than in the monofocal IOL group with 3.0‐mm pupils at 5 and 10 cycles per degree (cpd). Although patients in the multifocal IOL group complained more glare/flare, problems with night vision, and halos, they reported excellent spectacle independence, and high satisfaction. Conclusions: Compared with the AcrySof IQ IOL, the ReSTOR SN6AD1 IOL provided excellent visual outcomes, satisfactory spectacle independence without compromising wavefront aberrations; however, optical adverse effects with respect to higher intraocular straylight and lower MTF at lower spatial frequency were demonstrated.     

Binocular visual function of myopic pseudophakic monovision

Purpose

To compare binocular visual function of myopic pseudophakic patients with myopic monovision to patients without monovision.

Study design

Randomized comparative study

Methods

Sixty patients were randomized to one of two groups: patients whose refraction was targeted to -2.75 diopters (D) in the dominant eye and -1.75D in the nondominant eye (myopic monovision group), and patients whose refraction was targeted to -2.75D bilaterally (non-monovision group). Binocular uncorrected and corrected visual acuity at various distances was measured using an all-distance vision tester, and contrast visual acuity and near stereoacuity were examined.

Results

In the myopic monovision group mean refraction was -2.74D in the dominant eyes and -1.94D in the nondominant eyes, and in the non-monovision group it was -2.96D bilaterally. Mean binocular uncorrected distance (UDVA) and intermediate visual acuity (UIVA) from 0.5 m to 5.0 m were significantly better in the myopic monovision group than in the non-monovision group (P≤ 0.0134), while binocular uncorrected near visual acuity (UNVA) at 0.3 m did not differ significantly between groups. The distribution of UIVA and UDVA was significantly better in the myopic monovision group (P≤ 0.0035). Corrected visual acuity at any distance, photopic and mesopic contrast visual acuity, and stereoacuity did not differ significantly between groups.

Conclusion

Patients with myopic monovision exhibited significantly better binocular UIVA and UDVA than those without monovision, while UNVA, corrected visual acuity, contrast sensitivity, and stereoacuity were comparable between groups, suggesting that this method is useful for patients who want to see near and intermediate distances without spectacles.

     

双焦点Toric人工晶状体植入矫正白内障合并角膜散光的疗效观察

目的:评价白内障超声乳化吸除联合双焦点Toric人工晶状体(IOL)植入术的散光矫正临床效果。方法:回顾性分析。纳入2020-08/2021-09间我院白内障超声乳化吸除联合双焦点Toric IOL治疗白内障合并角膜规则散光患者46例46眼的临床资料。术后随访3mo,评价术前及术后1、3mo裸眼远视力(UDVA)、裸眼近视力(UNVA)、矫正远视力(BCDVA)、矫正近视力(BCNVA)及散光的变化。测量并计算IOL轴位旋转度,行问卷调查在不同距离使用眼镜的必要性以及总体满意度。结果:术后1、3mo UDVA、BCDVA、UNVA、BCNVA与术前比较均有差异(均P<0.001),而术后1mo UDVA、BCDVA、UNVA、BCNVA与术后3mo比较均无差异(均P>0.0167)。术后3mo UDVA达到0.20(LogMAR)者46眼(100%),UNVA达到0.20(LogMAR)者40眼(87%)。散光矢量分析显示,术前角膜散光均值为1.88±0.70D,质心值为0.61D@177°±1.93D,术后3mo残余散光均值为0.33±0.30D,质心值为0.03D@34...     

多焦点人工晶状体与非球面人工晶状体植入术后视觉质量的临床研究

目的客观与主观检测结合评价非球面设计的多焦点与单焦点人工晶状体植入术后的视觉质量。方法132例（207只眼）白内障患者分别植入非球面的多焦点人工晶状体AcrySof IQ ReSTOR IOL和单焦点人工晶状体AcrySof IQ IOL。记录患者手术后的裸眼远、近视力,矫正远、近视力。术后3个月检测患者明视、暗视和暗视眩光状态的对比敏感度。采用VF-14（Visual function-14）视功能和生存质量调查问卷评价患者主观的视觉质量。结果术后两组裸眼远视力（t=0．61,P〉0．05）最佳矫正近视力（t=1．877,P〉0．05）差异无统计学意义。非矫正近视力多焦点组优于单焦点组（t=11．38,P〈0．001）,单焦点组在明光、暗光、暗光眩光条件下各空间频率对比敏感度均高于多焦点组,明光条件下3cpd和6cpd空间频率差异有统计学意义（P〈0．05）,暗光眩光条件下中高频率差异有统计学意义（P〈0．05）,两组无患者存在严重的视觉干扰现象。两组术后视远时脱镜率均大于98％,视近时脱镜率多焦点组为78．9％,单焦点组为10．9％。结论与单焦点人工晶状体相比,除了对比敏感度下降,多焦点人工晶状体能提供令人满意的术后视功能和生活质量,患者能获得较高的视觉质量。