Leydolt Christina, Neumayer Thomas, Prinz Ana, Findl Oliver
Department of Ophthalmology, Medical University of Vienna, Austria.
Am J Ophthalmol. 2009 Mar;147(3):398-405.e3. doi: 10.1016/j.ajo.2008.09.002. Epub 2008 Nov 20.
To investigate the effect of 'training' the patients' near vision and motivating them towards a spectacle-independent outcome on near vision performance in pseudophakic patients with standard intraocular lens (IOL).
Prospective randomized, controlled, examiner-masked clinical trial.
Eighty eyes of 40 patients with standard cataract surgery were randomly assigned to a "motivated" or "control" group. In the motivated group, subjects were told that they are taking part in a special protocol to improve their near-reading ability after cataract surgery and were instructed not to use reading glasses for at least three months and received cycloplegic eye drops for 10 days after surgery. Follow-up examinations at three months included best-corrected distance visual acuity (VA), distance-corrected near VA, best-corrected near VA, assessment of the defocus curve, and reading speed, as well as pilocarpine-, cyclopentolate- and nearpoint-induced IOL shift assessed with partial coherence interferometry. Additionally, a questionnaire evaluating patients' postoperative satisfaction, independency of reading glasses, and daily-life performance without glasses was carried out three months and one year postoperatively.
No difference in reading ability and IOL shift between "motivated" and "control" patients could be detected. However, the motivated patients were less dependent on reading glasses and their ability to be able to perform activities of daily life without glasses was significantly better.
There was no improvement of ciliary body function in pseudophakic patients with a special training protocol. However, near vision training made patients more independent of reading glasses.
研究对假晶状体患者进行“训练”其近视力并促使他们达到不依赖眼镜的近视力结果对植入标准人工晶状体(IOL)的假晶状体患者近视力表现的影响。
前瞻性随机、对照、检查者盲法临床试验。
40例接受标准白内障手术患者的80只眼被随机分为“激励组”或“对照组”。在激励组中,受试者被告知他们正在参与一项特殊方案以改善白内障手术后的近读能力,并被指示至少三个月不使用阅读眼镜,且术后接受10天的睫状肌麻痹眼药水。三个月时的随访检查包括最佳矫正远视力(VA)、远矫正近视力、最佳矫正近视力、散焦曲线评估、阅读速度,以及用部分相干干涉测量法评估毛果芸香碱、环喷托酯和近点诱导的IOL移位。此外,在术后三个月和一年进行了一份评估患者术后满意度、阅读眼镜独立性以及不戴眼镜时日常生活表现的问卷。
未检测到“激励组”和“对照组”患者在阅读能力和IOL移位方面存在差异。然而,激励组患者对阅读眼镜的依赖程度较低,且他们不戴眼镜进行日常生活活动的能力明显更好。
采用特殊训练方案对假晶状体患者的睫状体功能没有改善。然而,近视力训练使患者对阅读眼镜的依赖程度降低。