Clinical College of Ophthalmology, Tianjin Medical University, No 4. Gansu Rd, Heping District, Tianjin, 300020, China.
Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin Eye Institute, No 4. Gansu Rd, Heping District, Tianjin, 300020, China.
BMC Ophthalmol. 2019 Sep 2;19(1):198. doi: 10.1186/s12886-019-1204-0.
This study aims to evaluate the efficacy and safety of extended depth of focus (EDOF) intraocular lenes (IOLs) in cataract surgery.
All comparative clinical trials that involved bilaterally implanting EDOF IOLs in patients with cataract were retrieved from the literature database. We used random effects models to pool weighted mean differences (WMD) and risk ratio (RR) for continuous and dichotomous variables, respectively.
Nine studies with a total of 1336 eyes were identified. The subgroup analysis was conducted according to the type of IOLs used in the control group. Compared with monofocal IOLs, EDOF IOLs produced better uncorrected intermediate visual acuity (WMD: -0.17, 95% CI: - 0.26 to - 0.08, P = 0.0001) and uncorrected near visual acuity (WMD: -0.17, 95% CI: - 0.21 to - 0.12, P < 0.00001). EDOF IOLs resulted in reduced contrast sensitivity, more frequent halos, however, higher spectacle independence (RR: 2.81, 95% CI: 1.06 to 7.46, P = 0.04) than monofocal IOLs. Compared with trifocal IOLs, EDOF IOLs produced worse near visual acuity (MD: 0.10, 95% CI: 0.07 to 0.13, P < 0.0001). EDOF IOLs performed better than trifocal IOls in contrast sensitivity, and there were no significant difference in halos and spectacle independence. Serious postoperative complications were rare, with no adverse events were reported in most studies.
Increasing the risk of contrast reduction and more frequent halos, EDOF IOLs provided better intermediate and near VAs than monofocal IOLs. At the expense of near vision, patients receiving EDOF IOLs have better contrast sensitivity than those receiving trifocal IOLs. Halo incidence and spectacle independence of EDOF IOLs were similar to those of trifocal IOLs.
本研究旨在评估扩展景深（EDOF）人工晶状体（IOL）在白内障手术中的疗效和安全性。
从文献数据库中检索到所有涉及双侧植入 EDOF IOL 治疗白内障患者的对照临床试验。我们使用随机效应模型分别对连续变量和二分类变量进行加权均数差（WMD）和风险比（RR）的汇总。
确定了 9 项共涉及 1336 只眼的研究。根据对照组中使用的 IOL 类型进行了亚组分析。与单焦点 IOL 相比，EDOF IOL 可获得更好的未矫正中间视力（WMD：-0.17，95%CI：-0.26 至-0.08，P=0.0001）和未矫正近视力（WMD：-0.17，95%CI：-0.21 至-0.12，P<0.00001）。EDOF IOL 导致对比敏感度降低，更频繁出现光晕，但更能实现脱镜（RR：2.81，95%CI：1.06 至 7.46，P=0.04）。与三焦点 IOL 相比，EDOF IOL 近视力较差（MD：0.10，95%CI：0.07 至 0.13，P<0.0001）。EDOF IOL 在对比敏感度方面优于三焦点 IOL，而在光晕和脱镜方面无显著差异。术后严重并发症罕见，大多数研究均未报告不良事件。
尽管 EDOF IOL 增加了对比敏感度降低和光晕发生率的风险，但与单焦点 IOL 相比，它提供了更好的中间和近视力。在牺牲近视力的情况下，接受 EDOF IOL 的患者具有比接受三焦点 IOL 的患者更好的对比敏感度。EDOF IOL 的光晕发生率和脱镜率与三焦点 IOL 相似。
