Altun A
Bahcesehir University, Faculty of Medicine, Department of Ophthalmology, Istanbul, Turkey.
J Ophthalmol. 2020 Jul 20;2020:1375298. doi: 10.1155/2020/1375298. eCollection 2020.
To compare the effects of previously implanted monofocal and multifocal intraocular lenses (IOL) on macular surgery.
Seventy eyes of 70 patients with epiretinal membrane (ERM) and symptomatic vitromacular traction syndrome that previously had IOL implantation for cataract surgery were included in this prospective randomized clinical trial. Cases were divided into two groups. Group 1 and Group 2 were composed of eyes with monofocal and multifocal IOLs, respectively. The effects of refraction error and IOL decentration at the time of macular surgery performed for ERM and ILM peeling, according to the lens type, were investigated. Pars plana vitrectomy (PPV) was performed to peel ERM and ILM in all cases. Complete ophthalmological examination, fundus fluorescein angiography, and optical coherence tomography imaging were made to all cases, preoperatively and postoperatively.
The mean BCVA in Group 1 and Group 2 improved from 0.69 ± 0.15 and 0.38 ± 0.14 logMAR to 0.40 ± 0.14 and 0.10 ± 0.04 logMAR, respectively, at the 6 month. There was no statistically significant difference between the groups in terms of the mean spherical refraction error ( > 0.05) and IOL decentration level ( > 0.05). The mean time required for macular surgery in Group 2 was statistically significantly longer than that for Group 1 ( < 0.05). There was no statistically significant relationship between IOL decentration and macular surgery time in Group 1 ( > 0.05), but there it was found in Group 2 ( < 0.05). In Group 2, there was a positive correlation between IOL decentration and macular surgery time.
In cases with multifocal IOL implants, especially with lens decentration, the time of macular surgery for ERM and ILM peeling during PPV is longer than that of eyes with monofocal IOL due to fluctuations in the clarity of the surgeon's view.
比较先前植入的单焦点和多焦点人工晶状体（IOL）对黄斑手术的影响。
本前瞻性随机临床试验纳入了70例曾因白内障手术植入IOL的视网膜前膜（ERM）和有症状的玻璃体黄斑牵引综合征患者的70只眼。病例分为两组。第1组和第2组分别由植入单焦点和多焦点IOL的眼组成。根据晶状体类型，研究了为ERM和内界膜（ILM）剥除而进行黄斑手术时的屈光不正和IOL偏心的影响。所有病例均行玻璃体切割术（PPV）剥除ERM和ILM。所有病例在术前和术后均进行了全面的眼科检查、眼底荧光血管造影和光学相干断层扫描成像。
6个月时，第1组和第2组的平均最佳矫正视力（BCVA）分别从0.69±0.15和0.38±0.14 logMAR提高到0.40±0.14和0.10±0.04 logMAR。两组在平均球镜屈光不正（>0.05）和IOL偏心程度（>0.05）方面无统计学显著差异。第2组黄斑手术所需的平均时间在统计学上显著长于第1组（<0.05）。第1组中IOL偏心与黄斑手术时间之间无统计学显著关系（>0.05），但在第2组中发现有此关系（<0.05）。在第2组中，IOL偏心与黄斑手术时间呈正相关。
在植入多焦点IOL的病例中，尤其是存在晶状体偏心时，由于手术医生视野清晰度的波动，PPV期间进行ERM和ILM剥除的黄斑手术时间比植入单焦点IOL的眼更长。
