Studený P, Kacerovský M, Kacerovská J, Gajarová N, Straňák Z
Cesk Slov Oftalmol. 2017 Spring;73(1):13-16.
To evaluate our own results of the use of hybrid monovision technique, in patients after bilateral cataract surgery, where in the dominant eye the monofocal intraocular lens is implanted and in the non-dominant eye the multifocal intraocular lens (IOL) is implanted.
Prospective follow-up of group of 33 patients with bilateral cataract surgery and induced hybrid monovision. In the dominant eye, the hydrophilic monofocal aspheric intraocular lens Auroflex (Aurolab) was implanted, and in the non-dominant eye the hydrophilic multifocal aspheric intraocular lens Seelens (Hanita) was implanted. During the post-operative period, the uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), best-corrected near visual acuity (CNVA), and distance-corrected near visual acuity (DCNVA) were established. Further, the monocular contrast sensitivity, subjective satisfaction, and dysfotopsias appearance were examined. The examinations were held 3 and 6 months after the surgery.
In dominant eyes with implanted monofocal lens, UDVA improved from 0.61 ± 0.39 logMAR preoperatively to 0.03 ± 0.14 logMAR at 6 months after the surgery. In non-dominant eyes, with implanted multifocal intraocular lens, UDVA improved from 0.30 ± 0.23 logMAR preoperatively to -0.04 ± 0.06 logMAR. The average binocular UDVA (bUDVA) was -0.07 ± 0.08 logMAR and binocular CDVA (bCDVA) -0.12 ± 0.06. The average UNVA in dominant eyes 6 months after the surgery was 0.62 ± 0.18 logMAR, in non-dominant eyes 0.18 ± 0,15 logMAR, binocularly 0.15 ± 0.11 logMAR. The contrast sensitivity was in the eyes with implanted multifocal IOL slightly worse comparing to the eyes with implanted monofocal lens, albeit only in the space frequency of 6 cycles per degree (CPD) this difference was statistically significant. Subjectively, the presence of dysfotopsia and other problems were very low, the average values of single answers were from 1.3 to 2.1 (on the scale 1 - 5, 1 - no problems and 5 - severe problems). Also, we noticed high percentage of subjective satisfaction with the surgery results (94 %). Six percent of patients wear glasses for near distance as a standard, 42 % of patients wear them occasionally, and 45 % of patients dont use glasses for near distance at all.
The technique of hybrid monovision is effective, safe, and relatively cheap method solving the loss of accommodation in patients after the cataract surgery. This method extends the spectrum of our possibilities how to solve the loss of accommodation in these patients.Key words: hybrid monovision, multifocal intraocular lens, contrast sensitivity.
评估我们自身在双侧白内障手术后患者中使用混合单眼视技术的效果，即在优势眼中植入单焦点人工晶状体，在非优势眼中植入多焦点人工晶状体（IOL）。
对33例接受双侧白内障手术并诱导形成混合单眼视的患者进行前瞻性随访。在优势眼中植入亲水性单焦点非球面人工晶状体Auroflex（Aurolab），在非优势眼中植入亲水性多焦点非球面人工晶状体Seelens（Hanita）。在术后期间，测定未矫正远视力（UDVA）、最佳矫正远视力（CDVA）、未矫正近视力（UNVA）、最佳矫正近视力（CNVA）以及远矫正近视力（DCNVA）。此外，检查单眼对比敏感度、主观满意度和不良视觉现象的出现情况。检查在手术后3个月和六个月进行。
在植入单焦点晶状体的优势眼中，UDVA从术前的0.61±0.39 logMAR提高到术后6个月的0.03±0.14 logMAR。在植入多焦点人工晶状体的非优势眼中，UDVA从术前的0.30±0.23 logMAR提高到-0.0-4±0.06 logMAR。平均双眼UDVA（bUDVA）为-0.07±0.08 logMAR，双眼CDVA（bCDVA）为-0.12±0.06。术后6个月优势眼的平均UNVA为0.62±0.18 logMAR，非优势眼为0.18±0.15 logMAR，双眼为0.15±0.11 logMAR。与植入单焦点晶状体的眼睛相比，植入多焦点IOL的眼睛的对比敏感度略差，尽管仅在每度6周/次（CPD）的空间频率下，这种差异具有统计学意义。主观上，不良视觉现象和其他问题的发生率非常低，单个答案的平均值为1.3至2.1（范围为1-5，1-无问题，5-严重问题）。此外，我们注意到对手术结果的主观满意度很高（94%）。6%的患者将佩戴眼镜作为标准的近视力矫正方式，42%的患者偶尔佩戴，4%的患者根本不使用眼镜进行近视力矫正。
混合单眼视技术是一种有效、安全且相对便宜的方法，可解决白内障手术后患者的调节功能丧失问题。该方法扩展了我们解决这些患者调节功能丧失问题的可能性范围。关键词：混合单眼视；多焦点人工晶状体；对比敏感度。
