Borkenstein Andreas F, Borkenstein Eva-Maria
Privatklinik der Kreuzschwestern Graz, Kreuzgasse 35, 8010 Graz, Austria.
Medicine (Baltimore). 2019 Jul;98(30):e16583. doi: 10.1097/MD.0000000000016583.
Many studies have shown that cataract surgery can be performed safely and improve visual acuity, without increasing the risk of progression of existing age-related macular degeneration (AMD). Data are emerging for an intraocular lens (IOL) that utilizes an advanced optical design to optimize the image supplied to all areas of the macula and not just the foveal center, which may benefit patients with center-involving macular disorders.
An 83-year-old Caucasian female presented with poor contrast sensitivity and color perception with increasing glare over the preceding year.
She had a progressive cortical cataract and stable dry AMD in the left eye, and wet AMD in the right eye. In the left eye, preoperative best-corrected distance visual acuity (BCDVA) was 0.2 (decimal) and best-corrected near visual acuity (BCNVA) was 0.05 (decimal).
Standard small-incision phacoemulsification was performed in the left eye, with capsular bag implantation of EyeMax Mono (LEH Pharma, London, UK), a single-piece, soft, hydrophobic, acrylic IOL designed to optimize image quality across the macula, rather than a standard monofocal lens.
At 6 months postoperation, visual acuity in the left eye had markedly improved, with a BCDVA of 0.5 (decimal) and a BCNVA of 0.2 (decimal).
In this first case undertaken at our center (and the first in Austria), cataract extraction and EyeMax Mono implantation were performed safely, with good subjective and objective outcome measures consistent with the effects of image optimization across the macula. Further studies of this IOL in patients with center-involving macular disorders, such as AMD, are warranted.
许多研究表明,白内障手术可以安全进行并提高视力,且不会增加现有年龄相关性黄斑变性(AMD)进展的风险。一种采用先进光学设计的人工晶状体(IOL)的数据正在出现,该设计可优化提供给黄斑所有区域而非仅中央凹中心的图像,这可能使患有累及黄斑中心疾病的患者受益。
一名83岁的白种女性,在前一年中出现对比敏感度和色觉下降,眩光增加。
她左眼患有进行性皮质性白内障和稳定的干性AMD,右眼患有湿性AMD。左眼术前最佳矫正远视力(BCDVA)为0.2(小数),最佳矫正近视力(BCNVA)为0.05(小数)。
左眼进行了标准的小切口超声乳化手术,在囊袋内植入了EyeMax Mono(英国伦敦LEH制药公司),这是一种单件式、软性、疏水性丙烯酸人工晶状体,旨在优化整个黄斑的图像质量,而非标准单焦点晶状体。
术后6个月,左眼视力明显改善,BCDVA为0.5(小数),BCNVA为0.2(小数)。
在我们中心进行的首例此类手术(也是奥地利的首例)中,白内障摘除和EyeMax Mono植入手术安全进行,主观和客观结果良好,与整个黄斑图像优化的效果一致。有必要对这种人工晶状体在患有累及黄斑中心疾病(如AMD)的患者中进行进一步研究。