Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
Hayashi Eye Hospital, Fukuoka, Japan.
Am J Ophthalmol. 2019 Dec;208:133-144. doi: 10.1016/j.ajo.2019.07.019. Epub 2019 Aug 1.
To conduct a nationwide prospective cohort study of multifocal intraocular lens (mfIOL) implantation to determine clinical outcomes and patient satisfaction and assess factors affecting patient satisfaction.
Prospective, multicenter cohort study.
Setting: institutional; patient population: a total of 1051 consecutive patients (1631 eyes) who underwent cataract surgery with mfIOL implantation at 65 Japanese institutions from January 2017 to June 2018. The inclusion criteria were patient age of 20 years and older and cataract surgery with mfIOL implantation. The exclusion criteria were the absence of informed consent, completed postoperative questionnaires, and no record of the IOL models implanted.
the uncorrected and corrected distance visual acuities (UDVAs and CDVAs) at 5 m; uncorrected VAs at 50, 40, and 30 cm; and questionnaires regarding subjective visual symptoms, spectacle independence, and surgical satisfaction were assessed 3 months postoperatively.
odds ratios for the overall surgical satisfaction were computed for the preoperative/postoperative factors.
We analyzed data from 1384 eyes of 871 patients. The UDVAs and CDVAs, respectively, improved significantly at 3 months postoperatively. The intermediate and near VAs varied with the IOL models; 68.4% of patients were almost or totally spectacle-independent; 3.9% of patients reported surgical dissatisfaction. In patients implanted bilaterally with the same mfIOLs, postoperative blurred vision and/or decreased contrast was the most important factor in the overall surgical satisfaction.
MfIOLs provided good visual outcomes and high satisfaction rates in this large patient cohort. The difference in the outcomes with the extended depth-of-focus IOLs did not differ significantly from the bifocal IOLs. The postoperative blurred vision is important to the overall surgical satisfaction.
开展一项全国范围的多焦点人工晶状体（mfIOL）植入前瞻性队列研究，以确定临床结果和患者满意度，并评估影响患者满意度的因素。
前瞻性、多中心队列研究。
设置：机构；患者人群：2017 年 1 月至 2018 年 6 月，65 家日本机构共对 1051 例（1631 只眼）接受 mfIOL 植入的白内障患者进行了前瞻性队列研究。纳入标准为患者年龄 20 岁及以上，接受 mfIOL 植入的白内障手术。排除标准为无知情同意书、术后问卷未完成、未记录植入的 IOL 型号。
术后 3 个月评估未矫正和矫正远视力（UDVA 和 CDVA）；50、40 和 30cm 处未矫正视力；以及主观视觉症状、眼镜依赖和手术满意度问卷。
计算术前/术后各因素对总体手术满意度的优势比。
我们分析了 871 例患者的 1384 只眼数据。术后 3 个月，UDVA 和 CDVA 分别显著改善。中间和近视力因 IOL 型号而异；68.4%的患者几乎或完全不需要戴眼镜；3.9%的患者报告手术不满意。在双侧植入相同 mfIOL 的患者中，术后视力模糊和/或对比度下降是影响总体手术满意度的最重要因素。
在该大样本患者队列中，mfIOL 提供了良好的视觉效果和高满意度。扩展景深 IOL 的结果与双焦点 IOL 无显著差异。术后视力模糊对总体手术满意度很重要。
