Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea.
J Korean Med Sci. 2018 Sep 27;33(44):e275. doi: 10.3346/jkms.2018.33.e275. eCollection 2018 Oct 29.
We compared the efficacy between trifocal and bifocal diffractive intraocular lens (IOL) implantation.
Through PubMed, MEDLINE, EMBASE, and CENTRAL, we searched potentially relevant articles published from 1990 to 2018. Defocus curves, visual acuities (VAs) were measured as primary outcomes. Spectacle dependence, postoperative refraction, contrast sensitivity (CS), glare, and higher-order aberrations (HOAs) were measured as secondary outcomes. Effects were pooled using random-effects method.
We included 11 clinical trials, with a total of 787 eyes (395 subjects). The trifocal IOL group showed better binocular distance VA corrected with defocus levels of -0.5, -1.0, -1.5, and -2.5 diopter than the bifocal IOL group (All ≤ 0.004). The trifocal IOL group showed better monocular uncorrected distance and intermediate VAs (mean difference [MD], -0.04 logarithm of the minimum angle of resolution [logMAR]; 95% confidence interval [CI], -0.07, -0.01; = 0.006 and MD, -0.07 logMAR; 95% CI, -0.13, -0.01; = 0.03, respectively). Postoperative refraction, glare, CS, and HOAs were not significantly different from each other.
The overall findings indicate that trifocal diffractive IOL implantation is better than the bifocal diffractive IOL in intermediate VA, and provides similar or better in distance and near VAs without any major deterioration in the visual quality.
我们比较了三焦点和双焦点衍射型人工晶状体（IOL）植入的疗效。
通过 PubMed、MEDLINE、EMBASE 和 CENTRAL，我们检索了 1990 年至 2018 年发表的潜在相关文章。离焦曲线和视力（VA）是主要的观察指标。术后屈光不正、对比敏感度（CS）、眩光和高阶像差（HOAs）是次要观察指标。采用随机效应模型对效应进行合并。
我们纳入了 11 项临床试验，共 787 只眼（395 例）。三焦点 IOL 组在 0.5、1.0、1.5 和 2.5 屈光度的离焦水平下双眼远距 VA 矫正值优于双焦点 IOL 组（均 ≤ 0.004）。三焦点 IOL 组在单眼未矫正远距和中距 VA 方面表现更好（差异均数 [MD]，-0.04 最小角分辨力对数视力 [logMAR]；95%置信区间 [CI]，-0.07，-0.01； = 0.006 和 MD，-0.07 logMAR；95% CI，-0.13，-0.01； = 0.03）。术后屈光不正、眩光、CS 和 HOAs 之间无显著差异。
总体而言，三焦点衍射型 IOL 植入在中距 VA 方面优于双焦点衍射型 IOL，在远距和近距 VA 方面提供了相似或更好的视力，且视觉质量无明显恶化。
