Schallhorn Steven C, Schallhorn Julie M, Pelouskova Martina, Venter Jan A, Hettinger Keith A, Hannan Stephen J, Teenan David
Department of Ophthalmology, University of California, San Francisco, CA, USA.
Roski Eye Institute, University of Southern California, Los Angeles, CA, USA.
Clin Ophthalmol. 2017 Aug 28;11:1569-1581. doi: 10.2147/OPTH.S143201. eCollection 2017.
To compare refractive and visual outcomes, patient satisfaction, and complication rates among different age categories of patients who underwent refractive lens exchange (RLE).
A stratified, simple random sample of patients matched on preoperative sphere and cylinder was selected for four age categories: 45-49 years (group A), 50-54 years (group B), 55-59 years (group C), and 60-65 years (group D). Each group contained 320 patients. All patients underwent RLE with a multifocal intraocular lens at least in one eye. Three months postoperative refractive/visual and patient-reported outcomes are presented.
The percentage of patients that achieved binocular uncorrected distance visual acuity 20/20 or better was 91.6% (group A), 93.8% (group B), 91.6% (group C), 88.8% (group D), =0.16. Binocularly, 80.0% of patients in group A, 84.7% in group B, 78.9% in group C, and 77.8% in group D achieved 20/30 or better uncorrected near visual acuity (=0.13). The proportion of eyes within 0.50 D of emmetropia was 84.4% in group A, 86.8% in group B, 85.7% in group C, and 85.8% in group D (=0.67). There was no statistically significant difference in postoperative satisfaction, visual phenomena, dry eye symptoms, distance or near vision activities. Apart from higher rate of iritis in the age group 50-55 years, there was no statistically significant difference in postoperative complication rates.
RLE can be safely performed in younger as well as older presbyopes. No significant difference was found in clinical or patient-reported outcomes.
比较接受屈光性晶状体置换术（RLE）的不同年龄组患者的屈光和视觉效果、患者满意度及并发症发生率。
选取术前球镜和柱镜度数匹配的患者，按年龄分为四个组：45 - 49岁（A组）、50 - 54岁（B组）、55 - 59岁（C组）和60 - 65岁（D组），每组320例。所有患者至少一只眼接受了多焦点人工晶状体植入的RLE手术。报告术后三个月的屈光/视觉及患者报告的结果。
双眼未矫正远视力达到20/20或更好的患者百分比在A组为91.6%，B组为93.8%，C组为91.6%，D组为88.8%，P = 0.16。双眼而言，A组80.0%、B组84.7%、C组78.9%、D组77.8%的患者未矫正近视力达到20/30或更好（P = 0.13）。屈光不正度数在0.50 D以内的眼比例在A组为84.4%，B组为86.8%，C组为85.7%，D组为85.8%（P = 0.67）。术后满意度、视觉现象、干眼症状、远视力或近视力活动方面无统计学显著差异。除50 - 55岁年龄组虹膜炎发生率较高外，术后并发症发生率无统计学显著差异。
RLE手术在年轻和年长的老花眼患者中均可安全进行。临床及患者报告的结果未发现显著差异。
