From the Cullen Eye Institute (Kim, Sajjad, Montes de Oca, Koch, Wang, Weikert, Al-Mohtaseb), Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA; the Shanxi Eye Hospital (Wang), Taiyuan, Shanxi Province, China.
From the Cullen Eye Institute (Kim, Sajjad, Montes de Oca, Koch, Wang, Weikert, Al-Mohtaseb), Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA; the Shanxi Eye Hospital (Wang), Taiyuan, Shanxi Province, China.
J Cataract Refract Surg. 2017 Jun;43(6):761-766. doi: 10.1016/j.jcrs.2017.03.034.
To evaluate the refractive outcomes after multifocal intraocular lens (IOL) exchange.
Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA.
Retrospective case series.
Patients had multifocal IOL explantation followed by IOL implantation. Outcome measures included type of IOL, surgical indication, corrected distance visual acuity (CDVA), and refractive prediction error.
The study comprised 29 patients (35 eyes). The types of IOLs implanted after multifocal IOL explantation included in-the-bag IOLs (74%), iris-sutured IOLs (6%), sulcus-fixated IOLs with optic capture (9%), sulcus-fixated IOLs without optic capture (9%), and anterior chamber IOLs (3%). The surgical indication for exchange included blurred vision (60%), photic phenomena (57%), photophobia (9%), loss of contrast sensitivity (3%), and multiple complaints (29%). The CDVA was 20/40 or better in 94% of eyes before the exchange and 100% of eyes after the exchange (P = .12). The mean refractive prediction error significantly decreased from 0.22 ± 0.81 diopter (D) before the exchange to -0.09 ± 0.53 D after the exchange (P < .05). The median absolute refractive prediction error significantly decreased from 0.43 D before the exchange to 0.23 D after the exchange (P < .05).
Multifocal IOL exchange can be performed safely with good visual outcomes using different types of IOLs. A lower refractive prediction error and a higher likelihood of 20/40 or better vision can be achieved with the implantation of the second IOL compared with the original multifocal IOL, regardless of the final IOL position.
评估多焦点人工晶状体（IOL）置换后的屈光结果。
美国德克萨斯州休斯顿贝勒医学院卡伦眼科研究所。
回顾性病例系列。
患者行多焦点 IOL 摘除术，然后植入 IOL。观察指标包括 IOL 类型、手术适应证、矫正远视力（CDVA）和屈光预测误差。
本研究共纳入 29 例（35 只眼）患者。多焦点 IOL 摘除术后植入的 IOL 类型包括囊袋内 IOL（74%）、虹膜固定 IOL（6%）、巩膜固定 IOL 伴光学襻固定（9%）、巩膜固定 IOL 无光学襻固定（9%）和前房 IOL（3%）。置换的手术适应证包括视力模糊（60%）、视觉干扰（57%）、畏光（9%）、对比敏感度丧失（3%）和多种不适（29%）。置换前，94%的眼 CDVA 为 20/40 或更好，置换后 100%的眼 CDVA 为 20/40 或更好（P=.12）。置换前平均屈光预测误差为 0.22±0.81 屈光度（D），置换后为-0.09±0.53 D（P<.05）。置换前中位数绝对屈光预测误差为 0.43 D，置换后为 0.23 D（P<.05）。
使用不同类型的 IOL 安全地进行多焦点 IOL 置换，可以获得良好的视觉效果。与原始多焦点 IOL 相比，无论最终 IOL 位置如何，第二枚 IOL 的植入都能获得更低的屈光预测误差和更高的 20/40 或更好视力的可能性。
