Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, Almería, Spain.
Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain.
Eur J Ophthalmol. 2021 Nov;31(6):2989-2996. doi: 10.1177/1120672120940202. Epub 2020 Jul 3.
To identify the most sensitive visual performance metric for evaluating the pupil-dependency of a multifocal intraocular lens (MIOL) and to determine the pupil measurement method most correlated with such metric.
Twenty-seven right eyes implanted with a MIOL were included in the analysis. Three pupil size measurements were obtained preoperatively and at 1 month after surgery with the Keratograph 5M system: photopic (PP), mesopic (MP), and the average from both (AP). Pupil was also measured with a rule (RP) under the same light conditions of postoperative visual performance measurements that included, corrected visual acuities (VA) at three distances (far, 67 cm and 40 cm), visual acuity (VADC) and contrast sensitivity defocus curves for optotype sizes of 0.3 logMAR (CSDC3) and 0.7 logMAR (CSDC7). Differences in visual performance were also analyzed for eyes with RP > 3 mm (Group A) and RP ⩽ 3 mm (Group B).
PP diameter decreased after surgery by 16% ( = 0.001), whereas MP ( = 0.013) and AP ( = 0.008) decreased by 10%. The best agreement with RP was obtained for AP. Group B showed a trend to better performance than Group A for all the included metrics ( > 0.05). From the three types of defocus curves, CSDC3 obtained generally highest statistical power for testing differences between groups. The strongest statistically significant correlations between pupil size and CSDC3 were obtained for RP and AP.
The CSDC3 was the most sensitive metric to detect MIOL pupil-dependency. PR and AP were more correlated with CSDC3 than PP and MP.
确定最敏感的视觉性能指标来评估多焦点人工晶状体（MIOL）的瞳孔依赖性，并确定与该指标相关性最强的瞳孔测量方法。
本研究共纳入 27 只右眼，这些眼睛均植入了 MIOL。术前和术后 1 个月使用角膜地形图仪 5M 系统进行了 3 次瞳孔大小测量：明视（PP）、中间视（MP）和平均（AP）。术后在与视觉性能测量相同的光条件下，使用直尺（RP）测量瞳孔大小，包括远距（67cm 和 40cm）、近距离（33cm）的矫正视力（VA）、视敏度（0.3logMAR 和 0.7logMAR）的对比度敏感度离焦曲线（CSDC3 和 CSDC7）。还分析了 RP > 3mm（A 组）和 RP ⩽ 3mm（B 组）的眼睛之间的视觉性能差异。
术后 PP 直径减少了 16%（ = 0.001），而 MP（ = 0.013）和 AP（ = 0.008）减少了 10%。AP 与 RP 的一致性最好。对于所有包含的指标，B 组的表现均优于 A 组（ > 0.05）。在三种离焦曲线中，CSDC3 通常对测试组间差异具有最高的统计学效能。RP 和 AP 与 CSDC3 的相关性最强。
CSDC3 是检测 MIOL 瞳孔依赖性最敏感的指标。RP 和 AP 与 CSDC3 的相关性强于 PP 和 MP。
