Macsai Marian S, Padnick-Silver Lissa, Fontes Bruno M
Division of Opthalmology, Evanston Northwestern Healthcare, Evanston, Illinois 60026, USA.
J Cataract Refract Surg. 2006 Apr;32(4):628-33. doi: 10.1016/j.jcrs.2006.01.027.
To evaluate and compare the visual outcomes and accommodative amplitude in cataract patients after implantation of the Crystalens intraocular lens (IOL) (Eyeonics) versus standard monofocal IOLs.
Ten clinics in a nationwide multicenter study in the United States.
A multicenter comparative interventional case series with masked randomized postoperative examination of 224 eyes of 112 patients was performed by a single observer. Patients were divided into 2 groups (56 patients; 112 eyes each) depending on which IOL was implanted (Crystalens or monofocal). Accommodation was measured using 1 objective (dynamic retinoscopy) and 2 subjective methods (defocus and near point of accommodation). Visual acuity measurements were performed under the same conditions with standard visual acuity charts.
Uncorrected monocular near vision was significantly better in the Crystalens group than in the standard monofocal group, with 101 of 112 eyes (90%) and 17 of 112 (15%), respectfully, reading J3 or better postoperatively. All 56 Crystalens patients had a binocular uncorrected near visual acuity of J3 or better compared with 16 of 56 (29%) standard monofocal patients. The mean postoperative monocular (0.85 +/- 0.30 [SD] versus 0.70 +/- 0.19, P<.01) and binocular (1.16 +/- 0.17 versus 1.01 +/- 0.14, P<.01) distance uncorrected visual acuities were also better in the Crystalens group than in the control group. All patients in the study achieved a corrected distance visual acuity of 20/20 or better. Measures of accommodation were significantly higher in Crystalens patients than in the monofocal IOL patients (dynamic retinoscopy 2.42 +/- 0.39 diopters [D] versus 0.91 +/- 0.24 D, P<.01; monocular defocus 1.74 +/- 0.48 D versus 0.75 +/- 0.25 D, P<.01; monocular near point of accommodation 9.5 +/- 3.1 inches versus 34.7 +/- 9.8 inches, P<.01). Perceived accommodation (5.79 D) was significantly greater than the measured accommodation (1.96 to 2.42 D) in Crystalens patients (paired t test, P<.01).
The Crystalens IOL provided better uncorrected near and distance visual outcomes than standard monofocal IOLs in all analyses performed. Patients perceived a greater accommodation than measured. Understanding why this occurred could lead to valuable advances in accommodating IOL technology.
评估并比较白内障患者植入可调节人工晶状体（IOL）（Eyeonics公司的Crystalens）与标准单焦点IOL后的视觉效果和调节幅度。
在美国全国多中心研究中的十家诊所。
由一名观察者对112例患者的224只眼进行多中心对比干预性病例系列研究，并在术后进行盲法随机检查。根据植入的IOL类型（Crystalens或单焦点）将患者分为2组（每组56例患者；112只眼）。使用1种客观方法（动态检影法）和2种主观方法（散焦和调节近点）测量调节功能。在相同条件下使用标准视力表进行视力测量。
Crystalens组未矫正的单眼近视力明显优于标准单焦点组，术后112只眼中分别有101只眼（90%）和112只眼中的17只眼（15%）能阅读J3或更好的视力。所有56例Crystalens患者的双眼未矫正近视力为J3或更好，而56例标准单焦点患者中只有16例（29%）达到此视力。Crystalens组术后单眼（0.85±0.30[标准差]对0.70±0.19，P<0.01）和双眼（1.16±0.17对1.01±0.14，P<0.01）未矫正远视力也优于对照组。研究中的所有患者矫正远视力均达到20/20或更好。Crystalens患者的调节测量值明显高于单焦点IOL患者（动态检影法2.42±0.39屈光度[D]对0.91±0.24 D，P<0.01；单眼散焦1.74±0.48 D对0.75±0.25 D，P<0.01；单眼调节近点9.5±3.1英寸对34.7±9.8英寸，P<0.01）。Crystalens患者的感知调节（5.79 D）明显大于测量的调节（1.96至2.42 D）（配对t检验，P<0.01）。
在所有进行的分析中，Crystalens IOL提供的未矫正近视力和远视力效果均优于标准单焦点IOL。患者感知的调节幅度大于测量值。了解其原因可能会在可调节IOL技术方面取得有价值的进展。
