Medical Director, Head of Oculoplasty Department, H.V. Desai Eye Hospital, Pune, Maharashtra, India.
Indian J Ophthalmol. 2020 Nov;68(11):2421-2426. doi: 10.4103/ijo.IJO_1951_19.
: To assess feasibility, acceptability, and outcome of multifocal intraocular lenses (IOL) in patients with bilateral immature cataract.
1691 patients with bilateral immature cataract were included in the study. The feasibility of these IOLs was calculated by studying ocular parameters using Visionix VX120 and subjective characteristics. A prospective study was then conducted in 148 eyes of 74 patients in which multifocal IOLs were implanted. Their visual outcome was assessed using LogMAR for distance and Snellen's chart for near vision, contrast sensitivity by Pelli-Robson chart, and satisfaction using visual function-7 questionnaire.
Considering ocular and subjective characteristics, it was feasible to implant the lens in 920 patients (54.40%) and the acceptability rate was 8.04%, most common reason for decreased acceptability was cost (85%) of IOL. The median distance uncorrected visual acuity (UCVA) at day 7 and at 30 days was LogMAR 0.2 (0.1-0.3) and 0.15 (0.1-0.2), respectively, which was statistically significant compared to preoperative distance UCVA (P < 0.001). The median near UCVA at day 7 and 30 days was N6 for both and statistically significant (P < 0.001) compared to preoperative near UCVA. 77.02% patients had distance UCVA of LogMAR (0.0-0.2) and 91.8% had near UCVA of N6-N8 at 30 days. The contrast sensitivity was decreased in all patients.
Appropriately selected patients can achieve spectacle independence and good visual satisfaction which begins with proper patient education, lifestyle and personality dynamics, and individualized weighing of benefits and side effects of multifocal IOLs.
评估多焦点人工晶状体(IOL)在双侧未成熟白内障患者中的可行性、可接受性和结果。
本研究纳入了 1691 例双侧未成熟白内障患者。通过使用 Visionix VX120 研究眼参数和主观特征来计算这些 IOL 的可行性。然后对 74 例 148 只眼的患者进行了前瞻性研究,植入了多焦点 IOL。使用 LogMAR 评估距离视力,Snellen 图表评估近视力,Pelli-Robson 图表评估对比敏感度,视觉功能-7 问卷评估满意度。
考虑到眼和主观特征,920 例患者(54.40%)可植入该晶状体,可接受率为 8.04%,最常见的不可接受原因是 IOL 的费用(85%)。术后 7 天和 30 天未矫正的远视力(UCVA)中位数分别为 LogMAR 0.2(0.1-0.3)和 0.15(0.1-0.2),与术前远 UCVA 相比有统计学意义(P < 0.001)。术后 7 天和 30 天近视力的中位数均为 N6,与术前近视力相比有统计学意义(P < 0.001)。77.02%的患者术后 30 天远视力 UCVA 为 LogMAR(0.0-0.2),91.8%的患者近视力 UCVA 为 N6-N8。所有患者的对比敏感度均下降。
适当选择的患者可以实现无需戴镜,并获得良好的视觉满意度,这需要通过适当的患者教育、生活方式和个性动态,以及对多焦点 IOL 的获益和副作用进行个体化权衡来实现。