Medical University Hamburg, Martinistr. 52, 20251, Hamburg, Germany.
Care Vision Hamburg, Martinistr. 52, 20251, Hamburg, Germany.
Graefes Arch Clin Exp Ophthalmol. 2020 May;258(5):1115-1121. doi: 10.1007/s00417-020-04628-5. Epub 2020 Feb 19.
To investigate the refractive results of a LASIK enhancement and its impact on treatment safety, efficacy, predictability and patient reported outcome in eyes after clear lens extraction and diffractive trifocal lens implantation.
A retrospective cohort multicentre study of Care Vision Refractive Centres in Germany compared two groups of patients. Group 1 consisted of eyes that had non-toric MIOL surgery only, whereas group 2 had a consecutive laser enhancement after 3 months follow-up. Refractive and subjective results of the two groups were compared. Patient reported outcome measurements were assessed by using a 30-item questionnaire with four subscales. (Spectacle Dependence, Eye Comfort, Freedom and Looking/Feeling Well). Refractive results were reported following standard reporting in refractive surgery.
139 eyes of 79 patients were included in which either MIOL surgery or MIOL surgery plus LASIK enhancement had been performed between January and December 2017. UDVA reached 0.1logMAR (0.8; 20/25) in 94% in group 2 and 85% in group 1. Compared to preoperative CDVA no change in Snellen lines of CDVA was shown in 89% in group 1 and in 93% in group 2. Spectacle dependence (P = 0.41), eye comfort (P = 0.15), freedom (P = 0.48) and looking/feeling well (P = 0.45) showed no statistically significant difference between both the groups.
In patients with residual ametropia after MIOL implantation, LASIK provides a reliable, safe and efficient way to achieve the desired refractive outcome and patient satisfaction. We recommend performing Laser enhancement at 3 months after MIOL implantation (Bioptics) in trifocal MIOL patients that benefit from improvement of residual ametropia.
研究 LASIK 增强术的屈光效果及其对白内障摘除和衍射三焦点人工晶状体植入术后患者的治疗安全性、疗效、可预测性和患者报告结果的影响。
德国 Care Vision 屈光中心的一项回顾性队列多中心研究比较了两组患者。第 1 组仅接受非散光性 MIOL 手术，第 2 组在 3 个月随访后行连续激光增强术。比较两组的屈光和主观结果。采用包含四个分量表的 30 项问卷评估患者报告的结果（对眼镜的依赖、眼睛舒适度、自由感和外观/感觉良好）。屈光结果按照屈光手术的标准报告进行报告。
2017 年 1 月至 12 月期间，共有 79 例患者的 139 只眼接受了 MIOL 手术或 MIOL 手术联合 LASIK 增强术。第 2 组的 UDVA 达到 0.1logMAR（0.8；20/25），占 94%；第 1 组为 85%。与术前最佳矫正视力（BCVA）相比，第 1 组的 BCVA 无变化占 89%，第 2 组为 93%。对眼镜的依赖（P=0.41）、眼睛舒适度（P=0.15）、自由感（P=0.48）和外观/感觉良好（P=0.45）在两组之间无统计学显著差异。
在 MIOL 植入术后仍有残余屈光不正的患者中，LASIK 提供了一种可靠、安全且有效的方法来实现理想的屈光效果和患者满意度。我们建议在 MIOL 植入（Bioptics）后 3 个月对三焦点 MIOL 患者行激光增强术，以改善残余屈光不正。
