Jiang Yuanfeng, Bu Shaochong, Tian Fang, Liang Jingli, Wang Tiecheng, Xing Xiuli, Zhang Hong, Zhang Xiaomin
Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute & Tianjin Medical University School of Optometry and Ophthalmology, No. 251, Fukang Road, Nankai District, Tianjin 300384, China.
J Ophthalmol. 2019 Jan 14;2019:6789263. doi: 10.1155/2019/6789263. eCollection 2019.
To compare long-term clinical outcomes between patients with bilateral implantation of +3.0 diopter (D) multifocal intraocular lenses (IOLs) and mix and match implantation of +2.5 D and +3.0 D multifocal IOLs.
This retrospective observer-masked cohort study comprised 66 eyes of 33 patients with two different strategies of binocular multifocal IOLs implantation: bilateral +3.0 D (17 patients) (bilateral group) and mix and match +2.5 D and +3.0 D (16 patients) (blended group). Patients were recruited 1 year (±3 months) after second-eye surgery. The primary effectiveness endpoint was binocular uncorrected intermediate visual acuity (UCIVA) at 70 cm. The secondary assessments included binocular visual quality tests and quality-of-vision questionnaire.
The blended group showed clinically better UCIVA (0.10 ± 0.07 logMAR) at 70 cm than the bilateral group (0.26 ± 0.09 logMAR) with a difference of 0.16 ± 0.08 logMAR ( < 0.001). Similar binocular visual acuities were achieved between the two groups at the near and far distance. The binocular defocus curves showed better performance in the blended group from 50 cm to 1 m. The mean binocular contrast sensitivities under the photopic conditions with or without glare and mesopic condition without glare were clinically better in the blended group. Both the groups reported low rate of visual phenomena, high rate of spectacle independence, and satisfaction.
Comparing with bilateral implantation of +3.0 D multifocal IOLs during the cataract surgery, mix and match implantation of +2.5 D and +3.0 D multifocal IOLs provides a wider depth of binocular focus, especially for intermediate distances, and better binocular visual quality.
比较双侧植入+3.0屈光度（D）多焦点人工晶状体（IOL）的患者与混合植入+2.5D和+3.0D多焦点IOL的患者的长期临床结局。
这项回顾性、观察者设盲的队列研究纳入了33例患者的66只眼，这些患者采用两种不同的双眼多焦点IOL植入策略：双侧植入+3.0D（17例患者）（双侧组）和混合植入+2.5D和+3.0D（16例患者）（混合组）。患者在第二眼手术后1年（±3个月）入组。主要有效性终点是70cm处的双眼未矫正中间视力（UCIVA）。次要评估包括双眼视觉质量测试和视觉质量问卷。
混合组在70cm处的UCIVA（0.10±0.07对数最小分辨角）在临床上优于双侧组（0.26±0.09对数最小分辨角），差值为0.16±0.08对数最小分辨角（P<0.001）。两组在近距和远距的双眼视力相似。双眼散焦曲线显示混合组在50cm至1m处表现更好。在明视条件下有或无眩光以及在暗视条件下无眩光时，混合组的平均双眼对比敏感度在临床上更好。两组报告的视觉现象发生率低、不依赖眼镜率高且满意度高。
与白内障手术期间双侧植入+3.0D多焦点IOL相比，混合植入+2.5D和+3.0D多焦点IOL可提供更宽的双眼聚焦深度，尤其是对于中间距离，并且具有更好的双眼视觉质量。
