Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China; Key Laboratory of Myopia, Ministry of Health, Shanghai, China; Key Laboratory of Visual Impairment and Restoration, Shanghai, China.
Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China.
Am J Ophthalmol. 2018 Apr;188:1-8. doi: 10.1016/j.ajo.2018.01.007. Epub 2018 Jan 31.
To investigate the tilt and decentration of multifocal intraocular lenses (MfIOLs) implanted in myopic eyes.
A prospective cohort study.
Twenty-eight myopic eyes and 56 emmetropic eyes were evaluated. Phacoemulsification with Tecnis ZMB00 MfIOL (Abbott Medical Optics, Santa Ana, California, USA) implantation was performed. At 1 year post-surgery, routine postoperative examinations were performed, and tilt and decentration of the MfIOLs, high-order aberrations, and modulation transfer function (MTF) were evaluated using the OPD-Scan III aberrometer (Nidek Co, Ltd, Gamagori, Japan). Subjective symptoms were assessed with a Quality of Vision questionnaire.
Postoperative uncorrected distance visual acuity (VA), best-corrected distance VA, and uncorrected near VA did not differ between the 2 groups. The mean IOL tilt and horizontal decentration were not different between the control and myopic groups. However, the myopic group presented significantly inferior decentration in the capsular bag compared with the control group (-0.03 ± 0.22 mm vs -0.21 ± 0.29 mm, P = .002). The overall decentration values were 0.32 ± 0.14 mm in the controls and 0.40 ± 0.18 mm in the myopic group (P = .023). Axial length was negatively correlated with vertical decentration (r = -0.268, P = 0.014) and positively correlated with overall decentration (r = 0.334, P = .002). Worse aberration data, poorer MTF, and more subjective symptoms were also found in the myopic group than in the controls.
Greater inferior decentration of MfIOLs and a consequent decrease in visual quality were found in myopic eyes, indicating that the increasing incompatibility between IOL and capsular bag size with axial length elongation should not be underestimated.
研究植入近视眼中的多焦点人工晶状体（MfIOL）的倾斜和偏心。
前瞻性队列研究。
评估了 28 只近视眼和 56 只正视眼。行超声乳化白内障吸除术并植入 Tecnis ZMB00 MfIOL（美国雅培医疗光学公司）。术后 1 年，行常规术后检查，使用 OPD-Scan III 眼前节分析仪（日本尼德克公司）评估 MfIOL 的倾斜和偏心、高阶像差和调制传递函数（MTF）。使用视觉质量问卷评估主观症状。
两组术后未矫正远视力（VA）、最佳矫正远视力和未矫正近视力无差异。对照组和近视组的平均 IOL 倾斜和水平偏心无差异。然而，与对照组相比，近视组在囊袋中的偏心明显更差（-0.03 ± 0.22mm 比-0.21 ± 0.29mm，P=0.002）。对照组的总偏心值为 0.32 ± 0.14mm，近视组为 0.40 ± 0.18mm（P=0.023）。眼轴长度与垂直偏心呈负相关（r=-0.268，P=0.014），与总偏心呈正相关（r=0.334，P=0.002）。近视组的像差数据更差、MTF 更差且主观症状更多。
在近视眼中发现 MfIOL 更明显的下偏心，导致视觉质量下降，表明随着眼轴延长，IOL 和囊袋尺寸之间的不匹配增加，这种情况不应被低估。
