S.N. Fedorov IRTC Eye Microsurgery, Cheboksary Branch, pr. Tractorostroiteley 10, Cheboksary, Russia.
Graefes Arch Clin Exp Ophthalmol. 2010 Sep;248(9):1299-306. doi: 10.1007/s00417-010-1424-8. Epub 2010 Jun 5.
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.
Thirty-six eyes after implantation of diffractive intraocular lens MIOL-Record were evaluated. This IOL has a diffractive lens profile binary in phase and produces three useful foci. Outcome measures recorded 6 months postoperatively were uncorrected and distance-corrected (far, near, intermediate) visual acuities, contrast sensitivity (under photopic and mesopic condition), root-mean-square (RMS) of higher order aberrations (HOA), patients' quality of life (visual function questionnaire VFQ-25, halos and glare presence, overall satisfaction), and spectacle independence.
Postoperatively, monocularly, the uncorrected (UDVA) and the corrected distance visual acuity (CDVA) were 0.74 +/- 0.21 and 0.86 +/- 0.23 respectively (P < 0.05). No differences were found between uncorrected (UNVA)-0.85 +/- 0.13 and best distance-corrected near visual acuity (CNVA) 0.89 +/- 0.12 (P > 0.05). The uncorrected (UIVA) and best distance-corrected acuities of intermediate vision (CIVA) at 50 cm were 0.58 +/- 0.16 and 0.6 +/- 0.2 respectively. The photopic contrast sensitivity was within the standard normal range. But under dim light conditions it was inferior at all spatial frequencies by more than 0.2 logarithmic units. The mean aberration values were: total HOA RMS-0.816 +/- 0.362 mum, spherical aberration (SA)-0.207 +/- 0.136 mum, coma-0.335 +/- 0.206 mum. The percentage of patients achieving spectacle freedom was 94%. On the questionnaire, 25% of patient noted nighttime halos; glare difficulty was reported by 16.7% of patients, difficulties with night vision persisted in 22.3% of cases.
Diffractive trifocal intraocular lens MIOL-Record provided good uncorrected distance, intermediate and near vision, gave high rates of spectacle freedom and overall patient satisfaction.
双焦点人工晶状体（IOL）旨在减少手术后对眼镜的依赖，但它们无法提供全方位的视力，并且在中间距离的视力会有一定程度的下降。这个问题可以通过三焦点镜片来解决，三焦点镜片可以产生三个有用的焦点。本研究旨在评估三焦点衍射 IOL-MIOL-Record 植入术后的临床结果、功能视力和不戴眼镜的情况。
对 36 只植入衍射型人工晶状体 MIOL-Record 的眼睛进行评估。该 IOL 具有双相位衍射透镜轮廓，可产生三个有用焦点。术后 6 个月记录的评估指标包括未矫正（远距）和矫正（远、近、中距）视力、对比敏感度（明、暗光条件下）、均方根（RMS）高阶像差（HOA）、患者生活质量（视力功能问卷 VFQ-25、光晕和眩光存在、总体满意度）和不戴眼镜的情况。
术后单眼未矫正（UDVA）和矫正远视力（CDVA）分别为 0.74 +/- 0.21 和 0.86 +/- 0.23（P < 0.05）。未矫正（UNVA）-0.85 +/- 0.13 和最佳远距矫正近视力（CNVA）0.89 +/- 0.12 之间无差异（P > 0.05）。未矫正（UIVA）和最佳远距矫正中距视力（CIVA）分别为 0.58 +/- 0.16 和 0.6 +/- 0.2。明视条件下的对比敏感度处于标准正常范围内。但在暗光条件下，所有空间频率的敏感度均下降超过 0.2 个对数单位。平均像差值为：总 RMS 高阶像差 0.816 +/- 0.362 mum，球差 0.207 +/- 0.136 mum，彗差 0.335 +/- 0.206 mum。达到不戴眼镜自由的患者比例为 94%。在问卷调查中，25%的患者夜间有光晕；16.7%的患者有眩光困难，22.3%的患者夜间视力持续困难。
衍射三焦点人工晶状体 MIOL-Record 提供了良好的远距、中距和近距未矫正视力，具有较高的不戴眼镜自由率和总体患者满意度。
