2nd Chair and Department of Ophthalmology, Pomeranian Medical University, Powstańców Wlkp. 72, 70-111, Szczecin, Poland.
Chair and Department of Basic and Clinical Anatomy, Pomeranian Medical University, Szczecin, Poland.
Int Ophthalmol. 2020 Oct;40(10):2553-2562. doi: 10.1007/s10792-020-01435-z. Epub 2020 Jun 2.
To compare visual outcomes after implantation of AtLisa tri 839 MP and Symfony intraocular lenses (IOLs).
All subjects underwent sequential bilateral cataract extraction with AtLisa tri 839 MP or Symfony IOL implantation. The design is prospective case series. Each group consists of 20 patients (40 eyes). At 1 year postoperatively, the following parameters were analysed: binocular uncorrected visual acuity (log MAR): for distance (UDVA) at 4 m, for intermediate distances (UIVA) at 60, 70, 80 cm and for near (UNVA) at 40 cm, defocus curve, mesopic and photopic contrast sensitivities (CSs), spectacle independence, visual function test questionnaire modified VFQ-25), photopic phenomena and postoperative complications.
In the AtLisa tri 839 MP group, the mean binocular UNVA and UIVA were significantly better than in the Symfony group (UNVA: - 0.01 ± 0.04 vs. 0.21 ± 0.15; p = 0.000; 60 cm UIVA: - 0.01 ± 0.04 vs. 0.09 ± 0.09, p = 0.001; 70 cm UIVA - 0.05 ± 0.06 vs. 0.11 ± 0.08, p = 0.002; 80 cm UIVA - 0.01 ± 0.06 vs. 0.15 ± 0.08, p = 0.019). There were no significant between-group differences in the mean binocular UDVA and CS, with one exception: the mean binocular distance CS (18 cpd) under mesopic conditions was significantly better in the Symfony group than in the AtLisa tri 839 MP group (1.39 ± 0.22 vs. 1.17 ± 0.27; p = 0.015). The defocus curve analysis revealed significant between-group differences at vergences of 2.0 to - 4.0 D (p < 0.05), except for 2.0, 1.0, 0 and - 1.5. All subjects in AtLisa tri 839 MP group and 18 subjects (90%) in Symfony group were spectacle independent. Patients from both groups highly rated their overall vision quality in the VFQ-25 (1.67 ± 0.47 vs. 1.85 ± 0.5 in the Symfony and AtLisa tri 839 MP group, respectively, p = NS). The scores for daytime driving (1.00 ± 0.00 vs. 1.21 ± 0.36; p = 0.002), night driving (1.57 ± 0.55 vs. 2.13 ± 1.15; p = 0.027) and difficult situation driving (1.14 ± 0.31 vs. 1.53 ± 0.56; p = 0.049) were significantly better in the AtLisa tri 839 MP group than in the Symfony group. The incidence and perception level of halo and glare were significantly reduced (p = 0.00) in the Symfony group as compared to the AtLisa tri 839 MP group. The postoperative course was uneventful in all subjects.
Visual outcomes achieved with both IOLs are comparable. In both groups, 90% of patients achieved spectacle independence. Whereas the AtLisa tri 839 MP IOL implantation was associated with slightly better intermediate distance VA and significantly better near VA, photic phenomena were less perceived by patients with Symfony IOLs.
比较 AtLisa tri 839 MP 和 Symfony 人工晶状体（IOL）植入术后的视觉效果。
所有患者均行双眼顺序白内障超声乳化吸除术联合 AtLisa tri 839 MP 或 Symfony IOL 植入术。本研究为前瞻性病例系列研究。每组 20 例（40 眼）。术后 1 年，分析以下参数：双眼未矫正视力（logMAR）：远距（UDVA）4 m，中距（UIVA）60、70、80 cm，近距（UNVA）40 cm，离焦曲线，中、明视对比度敏感度（CSs），脱镜率，视觉功能测试问卷改良 VFQ-25，明视和术后并发症。
在 AtLisa tri 839 MP 组中，双眼 UNVA 和 UIVA 均显著优于 Symfony 组（UNVA：-0.01±0.04 vs. 0.21±0.15；p=0.000；60 cm UIVA：-0.01±0.04 vs. 0.09±0.09，p=0.001；70 cm UIVA：-0.05±0.06 vs. 0.11±0.08，p=0.002；80 cm UIVA：-0.01±0.06 vs. 0.15±0.08，p=0.019）。两组间双眼 UDVA 和 CS 均值无显著差异，但有一个例外：明视条件下双眼距离 CS（18 cpd）在 Symfony 组显著优于 AtLisa tri 839 MP 组（1.39±0.22 vs. 1.17±0.27；p=0.015）。离焦曲线分析显示，2.0 至-4.0 D 之间的差异有统计学意义（p<0.05），2.0、1.0、0 和-1.5 除外。AtLisa tri 839 MP 组所有患者和 Symfony 组 18 例（90%）患者均脱镜。两组患者在 VFQ-25 中对总体视觉质量的评分均较高（Symfony 和 AtLisa tri 839 MP 组分别为 1.67±0.47 和 1.85±0.5，p=NS）。日间驾驶（1.00±0.00 vs. 1.21±0.36；p=0.002）、夜间驾驶（1.57±0.55 vs. 2.13±1.15；p=0.027）和困难情况驾驶（1.14±0.31 vs. 1.53±0.56；p=0.049）评分在 AtLisa tri 839 MP 组显著优于 Symfony 组。Symfony 组的光晕和眩光发生率和感知水平显著降低（p=0.00）。所有患者术后均无并发症。
两种 IOL 的视觉效果相当。两组中，90%的患者脱镜。虽然 AtLisa tri 839 MP IOL 植入术后中距视力和近距视力略好，但 Symfony IOL 植入术后患者对光幻视的感知较少。
