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四种人工晶状体的视觉效果比较分析:单焦点、多焦点和扩展视程。

Comparative analysis of visual outcomes with 4 intraocular lenses: Monofocal, multifocal, and extended range of vision.

机构信息

From the Department of Neurosciences, Biomedicine and Movement Sciences (Pedrotti, Mastropasqua, Bruni, Bonacci, Talli, Marchini), Eye Clinic, University of Verona, Verona, the Carones Ophthalmology Center (Carones), Milano, the Department of Experimental Medicine and Surgery (Aiello, Nucci), University of Rome Tor Vergata, Rome, and Ophthalmology (Mastropasqua, Mariotti), Department of Neuroscience, Polytechnic University of Marche, Ancona, Italy; Moorfields Eye Hospital (Aiello, Mastropasqua), NHS Foundation Trust, London, United Kingdom.

From the Department of Neurosciences, Biomedicine and Movement Sciences (Pedrotti, Mastropasqua, Bruni, Bonacci, Talli, Marchini), Eye Clinic, University of Verona, Verona, the Carones Ophthalmology Center (Carones), Milano, the Department of Experimental Medicine and Surgery (Aiello, Nucci), University of Rome Tor Vergata, Rome, and Ophthalmology (Mastropasqua, Mariotti), Department of Neuroscience, Polytechnic University of Marche, Ancona, Italy; Moorfields Eye Hospital (Aiello, Mastropasqua), NHS Foundation Trust, London, United Kingdom.

出版信息

J Cataract Refract Surg. 2018 Feb;44(2):156-167. doi: 10.1016/j.jcrs.2017.11.011.

DOI:10.1016/j.jcrs.2017.11.011
PMID:29587972
Abstract

PURPOSE

To compare the visual acuity, refractive outcomes, and quality of vision in patients with bilateral implantation of 4 intraocular lenses (IOLs).

SETTINGS

Department of Neurosciences, Biomedicine and Movement Sciences, Eye Clinic, University of Verona, Verona, and Carones Ophthalmology Center, Milano, Italy.

DESIGN

Prospective case series.

METHODS

The study included patients who had bilateral cataract surgery with the implantation of 1 of 4 IOLs as follows: Tecnis 1-piece monofocal (monofocal IOL), Tecnis Symfony extended range of vision (extended-range-of-vision IOL), Restor +2.5 diopter (D) (+2.5 D multifocal IOL), and Restor +3.0 D (+3.0 D multifocal IOL). Visual acuity, refractive outcome, defocus curve, objective optical quality, contrast sensitivity, spectacle independence, and glare perception were evaluated 6 months after surgery.

RESULTS

The study comprised 185 patients. The extended-range-of-vision IOL (55 patients) showed better distance visual outcomes than the monofocal IOL (30 patients) and high-addition apodized diffractive-refractive multifocal IOLs (P ≤ .002). The +3.0 D multifocal IOL (50 patients) showed the best near visual outcomes (P < .001). The +2.5 D multifocal IOL (50 patients) and extended-range-of-vision IOL provided significantly better intermediate visual outcomes than the other 2 IOLs, with significantly better vision for a defocus level of -1.5 D (P < .001). Better spectacle independence was shown for the +2.5 D multifocal IOL and extended-range-of-vision IOL (P < .001).

CONCLUSIONS

The extended-range-of-vision IOL and +2.5 D multifocal IOL provided significantly better intermediate visual restoration after cataract surgery than the monofocal IOL and +3.0 D multifocal IOL, with significantly better quality of vision with the extended-range-of-vision IOL.

摘要

目的

比较双侧植入 4 枚人工晶状体(IOL)患者的视力、屈光结果和视觉质量。

设置

意大利维罗纳大学神经科学、生物医学和运动科学系,眼科诊所,以及米兰 Carones 眼科中心。

设计

前瞻性病例系列。

方法

该研究纳入了双侧白内障手术患者,共植入以下 4 种 IOL 之一:Tecnis 1 件式单焦点(单焦点 IOL)、Tecnis Symfony 扩展视程(扩展视程 IOL)、Restor +2.5 屈光度(D)(+2.5 D 多焦点 IOL)和 Restor +3.0 D(+3.0 D 多焦点 IOL)。术后 6 个月评估视力、屈光结果、离焦曲线、客观光学质量、对比敏感度、不戴眼镜的独立性和眩光感知。

结果

该研究共纳入 185 例患者。与单焦点 IOL(30 例)和高附加渐变衍射折射多焦点 IOL(P≤.002)相比,扩展视程 IOL(55 例)在远距视力方面表现更好。+3.0 D 多焦点 IOL(50 例)在近距视力方面表现最佳(P<.001)。+2.5 D 多焦点 IOL(50 例)和扩展视程 IOL 提供了显著更好的中距视觉结果,与其他 2 种 IOL 相比,在 -1.5 D 的离焦水平下具有显著更好的视力(P<.001)。+2.5 D 多焦点 IOL 和扩展视程 IOL 具有更好的不戴眼镜的独立性(P<.001)。

结论

与单焦点 IOL 和+3.0 D 多焦点 IOL 相比,扩展视程 IOL 和+2.5 D 多焦点 IOL 能显著更好地恢复白内障手术后的中距视力,并且扩展视程 IOL 具有更好的视觉质量。

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