Goldberg Debora Goetz, Goldberg Michael H, Shah Riddhi, Meagher Jane N, Ailani Haresh
Department of Health Administration and Policy, George Mason University Peterson Family Health Sciences Hall, 4400 University Drive, MS: 1J3, Fairfax, Virginia, 22030, USA.
Eye Consultants of Northern Virginia, 8134 Old Keene Mill Rd., Ste. 300, Springfield, VA, 22152, USA.
BMC Ophthalmol. 2018 Nov 9;18(1):293. doi: 10.1186/s12886-018-0963-3.
Cataract surgery with pseudophakic mini-monovision has lower out-of-pocket patient expense than premium multifocal intraocular lenses (IOL). The purpose of this study was to evaluate patient-reported satisfaction and spectacle dependence for key activities of daily living after cataract surgery with pseudophakic mini-monovision. The study also examined statistical relationships between patient demographic variables, visual acuity and satisfaction.
Prospective cohort study of 56 patients (112 eyes) who underwent bilateral cataract surgery with pseudophakic mini-monovision. Mini-monovision corrects one eye for distance vision and the other eye is focused at near with - 0.75 to - 1.75 D of myopia. All patients with 1 diopter or greater of corneal astigmatism had a monofocal toric IOLs implanted or limbal relaxing incision. The main study outcomes were assessed at the last follow-up appointment and included refraction, visual acuity, patient reported spectacle use, and patient satisfaction. Descriptive statistics, correlation matrixes and Pearson's chi-square tests were examined.
Uncorrected visual acuity was significantly better post-operatively. Most patients reported the surgery met their expectations for decreased dependence on spectacles (93%). Most patients report little or no use of spectacles post-operatively for computer use (93%), distance viewing (93%) and general use throughout the day (87%). A small number of patients report spectacle use for reading (9%) and night driving (18%). There were no relationships detected between demographic variables and visual acuity or patient satisfaction.
Aging of the population presents one of the biggest challenges in the health sector, which includes a rising number of individuals with chronic vision impairment and increased demand for accessible treatment strategies. Cataract surgery with pseudophakic mini-monovision results in high patient satisfaction and considerable reduction in spectacle dependence. Pseudophakic mini-monovision technique is a low-cost, valuable option for patients who would like to reduce dependence on spectacles post-operatively and should be considered along with premium multifocal IOLs in options available for patients based on their needs, preferences and clinical indicators. Reducing spectacle dependence with the pseudophakic mini-monovision technique could improve the functionality, independence and quality of life for many patients who are unsuitable or are unable to pay additional fees associated with premium multifocal IOLs.
与高端多焦点人工晶状体（IOL）相比，采用假晶状体微单视的白内障手术患者自付费用更低。本研究的目的是评估患者报告的采用假晶状体微单视进行白内障手术后日常生活关键活动中的满意度和对眼镜的依赖程度。该研究还考察了患者人口统计学变量、视力与满意度之间的统计关系。
对56例患者（112只眼）进行前瞻性队列研究，这些患者均接受了双侧采用假晶状体微单视的白内障手术。微单视矫正一只眼用于远视力，另一只眼通过 -0.75至 -1.75 D的近视度数聚焦于近视力。所有角膜散光1屈光度或更高的患者均植入了单焦点散光人工晶状体或进行了角膜缘松解切口。主要研究结局在最后一次随访时进行评估，包括验光、视力、患者报告的眼镜使用情况以及患者满意度。进行了描述性统计、相关矩阵分析和Pearson卡方检验。
术后未矫正视力显著提高。大多数患者报告手术达到了他们减少对眼镜依赖的期望（93%）。大多数患者报告术后在使用电脑（93%）、远距离观看（93%）和全天日常使用时很少或根本不使用眼镜（87%）。少数患者报告在阅读时（9%）和夜间驾驶时（18%）使用眼镜。未发现人口统计学变量与视力或患者满意度之间存在关联。
人口老龄化是卫生部门面临的最大挑战之一，其中包括慢性视力障碍患者数量不断增加以及对可及治疗策略的需求增加。采用假晶状体微单视的白内障手术可带来较高的患者满意度，并显著降低对眼镜的依赖程度。对于希望术后减少对眼镜依赖的患者而言，假晶状体微单视技术是一种低成本且有价值的选择，应根据患者的需求、偏好和临床指标，与高端多焦点人工晶状体一同作为可供患者选择的方案加以考虑。采用假晶状体微单视技术减少对眼镜的依赖，可为许多不适合或无力支付与高端多焦点人工晶状体相关额外费用的患者改善功能、独立性和生活质量。
