Tarfaoui N, Nochez Y, Luong T H, Majzoub S, Pisella P-J
Service d'ophtalmologie, CHU de Bretonneau, 2, boulevard Tonnellé, 37000 Tours, France.
J Fr Ophtalmol. 2013 Jan;36(1):55-61. doi: 10.1016/j.jfo.2012.02.017. Epub 2012 Oct 13.
One of the remaining challenges in cataract surgery is to compensate for lost accommodative function. The purpose of our study is to evaluate reading ability with a combination of two different aspheric intraocular lenses.
This retrospective study included 40 eyes (20 patients). The control group (28 eyes, 14 patients) received two negative aspheric intraocular lenses (Acrismart 36A(®), Carl Zeiss Meditec), while the aspheric-optimized group (12 eyes, six patients) received an AcriSmart 36A(®) in the dominant eye and a zero-aspheric intraocular lens (Acrismart 46 LC(®), Carl Zeiss Meditec) in the fellow eye. Patients with corneal asphericity between 0.15 and 0.30 μm and a bilateral monocular postoperative visual acuity of at least 20/20 were eligible for inclusion. Uncorrected and best corrected visual acuity was measured for near, intermediate and distance vision. Corneal and total higher-order aberrations, monocular and binocular defocus curve, and stereoscopic performance were assessed.
Postoperative spherical equivalent and best corrected distance visual acuity were not significantly different between the two groups (P=0.11 and P=0.82 respectively). However, the aspheric-optimized group (36A(®)/46 LC(®)) exhibited better near and intermediate visual acuity (P<0.05), and better stereoscopic vision (P=0.027).
The depth of field results in pseudophakes implanted with "mix-and-match" aspheric lenses demonstrates that the binocular combination of two different aspheric profiles seems to improve near vision without affecting stereoscopic vision.
白内障手术中尚存的挑战之一是补偿丧失的调节功能。我们研究的目的是评估两种不同非球面人工晶状体联合使用时的阅读能力。
这项回顾性研究纳入了40只眼(20例患者)。对照组(28只眼,14例患者)植入两枚负性非球面人工晶状体(Acrismart 36A(®),卡尔蔡司医疗),而非球面优化组(12只眼,6例患者)在优势眼植入一枚AcriSmart 36A(®),在对侧眼植入一枚零非球面人工晶状体(Acrismart 46 LC(®),卡尔蔡司医疗)。角膜非球面度在0.15至0.30μm之间且双眼单眼术后视力至少为20/20的患者符合纳入标准。测量了近、中、远距离视力的未矫正和最佳矫正视力。评估了角膜和总高阶像差、单眼和双眼散焦曲线以及立体视觉性能。
两组术后等效球镜度和最佳矫正远距离视力无显著差异(分别为P = 0.11和P = 0.82)。然而,非球面优化组(36A(®)/46 LC(®))表现出更好的近视力和中视力(P < 0.05)以及更好的立体视觉(P = 0.027)。
植入“混合搭配”非球面晶状体的假晶状体的景深结果表明,两种不同非球面轮廓的双眼联合似乎可改善近视力而不影响立体视觉。