Naeser Kristian, Hjortdal Jesper Ø, Harris William F
Department of Ophthalmology, Randers Regional Hospital, Randers, DenmarkDepartment of Ophthalmology, Aarhus University Hospital, Aarhus, DenmarkDepartment of Optometry, University of Johannesburg, Johannesburg, South Africa.
Acta Ophthalmol. 2014 May;92(3):270-5. doi: 10.1111/aos.12148. Epub 2013 May 7.
To determine the optimal distribution of refractions in monofocal, pseudophakic monovision.
A previously reported mathematical method for describing defocus for a single eye (Acta Ophthalmol, 89, 2011, 111) is expanded to the binocular situation. The binocular distribution of refractions yielding the least defocus over the most extended fixation intervals is identified by mathematical optimization. The results are tested in a group of 22 pseudophakic patients.
For the fixation interval 0.25-6.0 m, the optimal refractions are pure spheres of -0.27D for the distance eye and -1.15D for near eye. The mathematically derived defocus structure is confirmed in the clinical series.
The reported mathematical method enables identification of the optimal distribution of refractions over any fixation interval. Monovision with refractions of approximately -0.25 and -1.25D may lead to spectacle independence for distance and intermediate vision. Binocular problems--such as monovision suppression, reduced stereoacuity and binocular inhibition--are likely to be minimal with the suggested anisometropia of 1.0D. This moderate monovision is fully reversible with spectacle correction, as the induced aniseikonia is minimal and it therefore represents a safe alternative to multifocal intraocular lenses (IOLs).
确定单焦点人工晶状体单眼视中屈光不正的最佳分布。
将先前报道的用于描述单眼散焦的数学方法（《眼科学报》，89卷，2011年，第111页）扩展至双眼情况。通过数学优化确定在最长注视间隔内产生最小散焦的双眼屈光不正分布。在一组22例人工晶状体植入患者中对结果进行测试。
对于0.25 - 6.0米的注视间隔，最佳屈光不正为远距离眼为-0.27D的纯球镜，近距离眼为-1.15D的纯球镜。临床系列证实了数学推导的散焦结构。
所报道的数学方法能够确定任何注视间隔内屈光不正的最佳分布。大约-0.25D和-1.25D的屈光不正单眼视可能使患者在看远和中间距离时无需佩戴眼镜。建议的1.0D屈光参差可能使双眼问题（如单眼视抑制、立体视锐度降低和双眼抑制）降至最低。这种适度的单眼视通过眼镜矫正完全可逆，因为诱发的像不等最小，因此是多焦点人工晶状体的一种安全替代方案。
