Department of Ophthalmology, Hong Kong Sanatorium & Hospital, Hong Kong.
Department of Ophthalmology, Hong Kong Sanatorium & Hospital, Hong Kong.
Am J Ophthalmol. 2020 Apr;212:105-115. doi: 10.1016/j.ajo.2019.11.010. Epub 2019 Nov 23.
We report the visual outcomes and patient satisfaction after bilateral implantation of a bifocal diffractive intraocular lens with monovision.
Prospective, observational case series.
Twenty-one subjects underwent cataract surgery or refractive lens exchange with bilateral implantation of the ZMB00 intraocular lens, with the dominant eye and nondominant eye targeted for plano and -1.25 to -1.00 diopters, respectively. Postoperative assessments included visual acuity (VA) at various distances under photopic and mesopic conditions; defocus curve, contrast sensitivity, and stereopsis; and Visual Function Questionnaire-25 and supplementary questionnaire.
Mean binocular uncorrected VA at distance, intermediate (67 cm), and near (30 cm) were -0.03 ± 0.06, 0.12 ± 0.18, and 0.11 ± 0.05, respectively. No eyes lost >1 line of corrected distance VA. Binocular intermediate VA was significantly better in the uncorrected condition (P = .004) whereas binocular distance VA was better in the distance-corrected condition (P = .014). Near VA was similar in both conditions (P > .05). Stereoacuity and contrast sensitivity were within normal limits. All subjects had a composite score of ≥90 for vision-targeted items in the National Eye Institute Visual Function Questionnaire-25. Halos, glare, and starbursts occurred in 52%, 29%, and 24% of subjects, respectively. All subjects reported a satisfaction score of ≥3.5 of 5 and required no spectacles postoperatively. No intraocular lens exchange was required.
Monovision with bilateral bifocal multifocal intraocular lens was safe and provided satisfactory vision at various distances, with good stereopsis and contrast sensitivity. Complete spectacle independence and high satisfaction score were achieved. In comparison with bilateral emmetropic bifocal multifocal intraocular lens, it provided better vision at intermediate and at very near distances without inducing more dysphotopsia.
我们报告了双眼植入双焦衍射型人工晶状体并单眼视的视觉结果和患者满意度。
前瞻性、观察性病例系列。
21 例患者接受白内障手术或屈光性晶状体置换，双眼植入 ZMB00 人工晶状体，优势眼和非优势眼的目标屈光度分别为平光和-1.25 至-1.00 屈光度。术后评估包括明、暗光条件下不同距离的视力（VA）；离焦曲线、对比敏感度和立体视；视觉功能问卷-25 及补充问卷。
平均双眼未矫正远、中（67cm）、近（30cm）视力分别为-0.03±0.06、0.12±0.18 和 0.11±0.05。无 1 只眼矫正远视力损失超过 1 行。双眼未矫正中距离 VA 明显优于未矫正（P=0.004），而双眼远距矫正视力优于远距矫正（P=0.014）。近距 VA 在两种情况下相似（P＞0.05）。立体视敏度和对比敏感度均在正常范围内。所有患者的国家眼科研究所视觉功能问卷-25 的视觉目标项目综合评分均≥90。52%、29%和 24%的患者分别出现光晕、眩光和星爆。所有患者的满意度评分均≥3.5 分（满分 5 分），术后无需戴眼镜。无需进行人工晶状体置换。
双眼植入双焦多焦点人工晶状体的单眼视是安全的，可为不同距离提供满意的视力，具有良好的立体视和对比敏感度。完全摆脱眼镜和高满意度评分得以实现。与双眼正视性双焦多焦点人工晶状体相比，它在中距和非常近的距离提供了更好的视力，而不会引起更多的视觉不适。
