Bianchi German Roberto
Clínica de Ojos Dr. Nano. Centro Panamericana. Blas Parera 4201. B1636CSS - OLIVOS. Buenos Aires, Argentina.
Med Hypothesis Discov Innov Ophthalmol. 2020;9(1):38-46. Epub 2020 Jan 1.
Our aim was to review clinical outcome and patient satisfaction after cataract surgery to obtain spectacle independence following multifocal intraocular lens (IOL) implantation. A prospective case-series study was designed to evaluate the safety and efficacy of the Hanita FullRange pseudophakic multifocal intraocular lens in patients with programmed cataract surgery, performed between October 2017 and May 2018, with follow-up after 12 months. Manifest refraction spherical equivalent (SE), SE refractive accuracy, uncorrected distance (UDVA), intermediate (UIVA) and near visual acuity (UNVA) and a binocular defocus curve were evaluated. In addition, a short "satisfaction questionnaire" was developed. Surgeries were performed without viscoelastic substance. The corneal endothelial cell density (ECD), central corneal thickness (CCT) and intraocular pressure (IOP) were also evaluated. A total of 480 eyes of 240 patients with mean ± standard deviation (SD) of age of 75 ± 6.12 years were included. The mean ± standard deviation (SD) of preoperative SE was 2.0 ± 2.18 D (range; -5.50 to 4.75) which decreased to -0.04 ± 0.28 D (range; -0.75 to 0.625) 12 months after surgery. Regarding SE refractive accuracy 82.9 % of eyes obtained SE values between -0.5 and 0.5 D. There was no loss of lines of vision and 98.3% of patients achieved UDVA between 20/20 and 20/25. The UNVA (binocular) obtained was J1 for 72.5% and J2 for 27.5% of patients. Regarding defocus curve, 0.04 logMAR for -3.0 D, 0.09 logMAR for -1.5 D and 0.03 logMAR for 0 D was achieved. The mean CCT was increased by 6.62 ± 2.79 micrometer (1.24%), the mean ECD was decreased by 226.08 ± 11.63 cell/mm (9.00 %) and the IOP remained stable one year after surgery. In response to the satisfaction questionnaire, 92% of patients stated that they had obtained spectacle independence. Finally, spectacle independence was achieved in most of the cases, with a high level of patient satisfaction one year after implantation of a FullRange IOL. No complications were detected. We concluded that the refractive efficacy of FullRange multifocal IOL was proved in majority of cases. A large follow up period is necessary in future studies to confirm the results.
我们的目的是回顾白内障手术后的临床结果和患者满意度，以在植入多焦点人工晶状体（IOL）后实现无需眼镜。设计了一项前瞻性病例系列研究，以评估2017年10月至2018年5月期间接受计划性白内障手术的患者中Hanita全范围假晶状体多焦点人工晶状体的安全性和有效性，并在12个月后进行随访。评估了显验光球镜等效度（SE）、SE屈光精度、未矫正远视力（UDVA）、中视力（UIVA）和近视力（UNVA）以及双眼散焦曲线。此外，还编制了一份简短的“满意度问卷”。手术在无粘弹性物质的情况下进行。还评估了角膜内皮细胞密度（ECD）、中央角膜厚度（CCT）和眼压（IOP）。共纳入240例患者的480只眼，年龄平均±标准差（SD）为75±6.12岁。术前SE的平均±标准差（SD）为2.0±2.18 D（范围：-5.50至4.75），术后12个月降至-0.04±0.28 D（范围：-0.75至0.625）。关于SE屈光精度，82.9%的眼睛获得的SE值在-0.5至0.5 D之间。没有视力丧失，98.3%的患者UDVA在20/20至20/25之间。获得的双眼UNVA，72.5%的患者为J1，27.5%的患者为J2。关于散焦曲线，-3.0 D时为0.04 logMAR，-1.5 D时为0.09 logMAR，0 D时为0.03 logMAR。平均CCT增加了6.62±2.79微米（1.24%），平均ECD减少了226.08±11.63个细胞/mm²（9.00%），术后一年IOP保持稳定。在对满意度问卷的回答中，92%的患者表示他们已无需眼镜。最后，在大多数病例中实现了无需眼镜，在植入全范围IOL一年后患者满意度较高。未检测到并发症。我们得出结论，在大多数病例中证明了全范围多焦点IOL的屈光效果。未来的研究需要更长的随访期来证实结果。
