David J. Apple Center for Vision Research, Department of Ophthalmology, University Hospital Heidelberg, Heidelberg, Germany.
David J. Apple Center for Vision Research, Department of Ophthalmology, University Hospital Heidelberg, Heidelberg, Germany.
Am J Ophthalmol. 2019 Dec;208:56-63. doi: 10.1016/j.ajo.2019.07.001. Epub 2019 Jul 16.
Wavelength dependence of diffractive intraocular lenses (IOLs) was recognized in vitro but not yet assessed in vivo. By examining pseudophakic patients who had extended-depth-of-focus diffractive implants, this spectral effect on their vision was measured clinically and the lens was tested in vitro.
Cross-sectional study with laboratory investigation.
Twelve pseudophakic patients (23 eyes) with a Symfony lens (Johnson & Johnson Vision) were measured monocularly under red and white light at far, intermediate, and near distances. Corrected distance visual acuity (CDVA), distance-corrected intermediate visual acuity (DCIVA), and distance corrected near visual acuity (DCNVA) were assessed. Contrast sensitivity was examined at several spatial frequencies. The in vitro lens modulation transfer function was measured under different spectral conditions by using an IOL metrology device.
CDVA was comparable under red and white light. DCIVA and DCNVA were significantly better under white light by 0.06 and 0.09, respectively. Contrast sensitivity was slightly better with a red filter at far distance but was worse at intermediate distance, although differences were significant only at 1 frequency. Near contrast sensitivity was better under polychromatic than red light, which was significant at 3 frequencies. The in vitro analysis confirmed Symfony's wavelength dependence: performance was improved at far distance but was worse at intermediate and near distances.
Symfony's spectral dependence was observed to affect visual acuity and contrast sensitivity. Although the red filter did not improve distance vision, it caused visual deterioration at near distance. One should take this effect into account when optimizing the reading performance of patients with diffractive IOLs.
已在体外认识到折射型人工晶状体（IOL）的波长依赖性，但尚未在体内进行评估。通过检查具有扩展景深的折射性植入物的后房型人工晶状体患者，我们从临床角度测量了这种光谱效应对其视力的影响，并在体外对镜片进行了测试。
具有实验室研究的横断面研究。
对 12 名（23 只眼）接受 Symfony 镜片（Johnson & Johnson Vision）的后房型人工晶状体患者进行单眼测量，分别在远、中、近距离进行红光和白光检查。评估矫正远视力（CDVA）、矫正中距离视力（DCIVA）和矫正近视力（DCNVA）。在多个空间频率下检查对比敏感度。使用 IOL 计量设备在不同光谱条件下测量体外镜片调制传递函数。
红光和白光下的 CDVA 相当。白光下的 DCIVA 和 DCNVA 分别显著提高了 0.06 和 0.09。远距时，红色滤光片的对比敏感度略有提高，但中距时则降低，尽管仅在 1 个频率时差异显著。多色光下的近距对比敏感度优于红光，在 3 个频率时差异显著。体外分析证实了 Symfony 的波长依赖性：远距时性能提高，但中距和近距时性能下降。
观察到 Symfony 的光谱依赖性会影响视力和对比敏感度。尽管红色滤光片并未改善远距视力，但在近距时会导致视力下降。在优化具有折射性 IOL 的患者的阅读性能时，应考虑到这种影响。
