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一种新型标准化测试系统评估三焦点或单焦点人工晶状体植入术后动态视力:一项多中心研究。

A novel standardized test system to evaluate dynamic visual acuity post trifocal or monofocal intraocular lens implantation: a multicenter study.

机构信息

Department of Ophthalmology, Peking University Third Hospital, Beijing, China.

Department of Ophthalmology, Gansu Province Hospital Rehabilitation Center, Gansu, China.

出版信息

Eye (Lond). 2020 Dec;34(12):2235-2241. doi: 10.1038/s41433-020-0780-9. Epub 2020 Feb 5.

Abstract

OBJECTIVES

To compare the dynamic visual acuity (DVA) following implantation of trifocal with monofocal intraocular lenses (IOL) and using a novel test system.

METHODS

The present research was a retrospective, multicenter clinical study. Two hundred and ten eyes of 149 patients that underwent cataract phacoemulsification and IOL implantation were enrolled. One hundred and ten eyes of patients received trifocal (AT LISA tri839MP, Carl Zeiss Meditec, Germany) and 100 eyes received monofocal (Tecnis ZCB00, Abbott, United States) lenses and were evaluated 3 months after implantation. Outcome measures included monocular uncorrected distance (UDVA), intermediate (UIVA) and near (UNVA) visual acuity and best corrected distance visual acuity (BCDVA; logMAR units); contrast sensitivity under photopic, mesopic, with glare conditions; and dynamic visual acuity using a self-developed system.

RESULTS

There was no statistically significant difference in baseline characteristics between groups. Monocular UDVA, UIVA, and UNVA were significantly better (all p < 0.001) in the trifocal IOL group, but not BCDVA. The trifocal IOL group showed better contrast sensitivity under photopic, mesopic, with or without glare conditions (p < 0.05) and statistically significantly better dynamic vision at 15, 30, 60, and 90 degrees per second (dps) compared with the monofocal group (all p < 0.001). The strength of positive association only between UIVA and dynamic visual acuity increased as the velocity increased, but not UDVA or UNVA.

CONCLUSIONS

Diffractive trifocal IOL provides better postoperative full range vision acuity, contrast sensitivity, and dynamic vision compared with monofocal IOLs. And intermediate visual acuity is increasingly associated with DVA as the velocity increasing.

摘要

目的

比较三焦点与单焦点人工晶状体(IOL)植入后动态视力(DVA),并使用新型测试系统。

方法

本研究为回顾性、多中心临床研究。纳入 149 例患者的 210 只眼,这些患者均接受白内障超声乳化吸除术和 IOL 植入术。110 只眼的患者植入三焦点(AT LISA tri839MP,卡尔蔡司,德国),100 只眼植入单焦点(Tecnis ZCB00,雅培,美国)晶状体,术后 3 个月进行评估。主要观察指标包括:单眼未矫正远视力(UDVA)、中间视力(UIVA)和近视力(UNVA)和最佳矫正远视力(BCDVA;logMAR 单位);明、中、眩光条件下的对比敏感度;以及使用自主研发系统进行的动态视力。

结果

两组患者的基线特征无统计学差异。三焦点 IOL 组的单眼 UDVA、UIVA 和 UNVA 明显更好(均 P<0.001),但 BCDVA 无差异。三焦点 IOL 组在明、中、眩光和无眩光条件下的对比敏感度更好(均 P<0.05),在 15、30、60 和 90 度每秒(dps)时的动态视力明显更好(均 P<0.001),与单焦点 IOL 组相比。UIVA 与动态视力之间的正相关强度仅随着速度的增加而增加,而 UDVA 和 UNVA 则不然。

结论

与单焦点 IOL 相比,衍射型三焦点 IOL 提供更好的术后全范围视力、对比敏感度和动态视力。随着速度的增加,中间视力与 DVA 的相关性逐渐增强。

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