Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, 23 Bundesgasse, Harbin, Heilongjiang Province, China.
Department of Ophthalmology, The Daqing Oilfields General Hospital, 19 ZhongKang Roud, Daqing, Heilongjiang Province, China.
Int Ophthalmol. 2021 Jul;41(7):2513-2520. doi: 10.1007/s10792-021-01809-x. Epub 2021 Mar 22.
To evaluate the clinical effect of TECNIS Symfony intraocular lens (IOL) implantation and identify the effect of kappa angle on the depth of focus (DOF) after implantation.
This prospective clinical study included consecutive patients who underwent cataract surgery and TECNIS Symfony IOL implantation at the Daqing Oilfield General Hospital from January 2019 to September 2019. Patients were divided into three groups according to the preoperative kappa angle (r): A (0 < r ≤ 0.2), B (0.2 < r ≤ 0.4), and C (r > 0.4). Uncorrected visual acuity was performed preoperatively and at 7 days, 1 month, and 3 months postoperatively. Synthetical optometry, higher-order aberrations, and defocus examinations were performed at 3 months postoperatively. Single-factor analysis of variance and Spearman correlation coefficient were used for data analysis.
The uncorrected visual acuity values of the three groups were significantly improved postoperatively, compared with preoperative values (p < 0.001). Three months postoperatively, the best-corrected visual acuity values of the three groups were 0.11 ± 0.02 logarithm of the minimum angle of resolution (logMAR), 0.09 ± 0.03 logMAR, and 0.11 ± 0.03 logMAR, respectively. Spherical equivalent (SE) values were 0.37 ± 0.08 D, 0.41 ± 0.06 D, and 0.42 ± 0.06 D, respectively. Best-corrected visual acuity and SE did not significantly differ among the three groups (F = 1.254, p = 0.135; F = 0.849, p = 0.228). There was no significant difference in SE between the three groups (F = 1.658, p = 0.312). Moreover, higher-order aberrations did not significantly differ among the three groups (p > 0.05). The kappa angle was negatively correlated with the postoperative DOF (r = -4.341, p = 0.026). Three months postoperatively, 54.55% of patients exhibited DOF ≥ 3 D, while 92.42% of patients exhibited DOF ≥ 2 D. The ranges of DOF in the three groups were 3.18 ± 0.27 D, 2.83 ± 0.80 D, and 2.57 ± 0.89 D, respectively; the difference among the three groups was statistically significant (F = 5.689, p = 0.037).
Most patients achieved full-range vision after TECNIS Symfony IOL implantation, but the DOF narrowed for those with an excessively large kappa angle, which indicates a need for careful selection.
评估 Tecnis Symfony 人工晶状体（IOL）植入的临床效果，并确定术前kappa 角对植入术后景深（DOF）的影响。
本前瞻性临床研究纳入了 2019 年 1 月至 2019 年 9 月在大庆油田总医院接受白内障手术和 Tecnis Symfony IOL 植入的连续患者。根据术前 kappa 角（r）将患者分为三组：A 组（0<r≤0.2）、B 组（0.2<r≤0.4）和 C 组（r>0.4）。术前和术后 7 天、1 个月和 3 个月分别行裸眼视力检查。术后 3 个月行综合验光、高阶像差和离焦检查。采用单因素方差分析和 Spearman 相关系数进行数据分析。
三组患者术后裸眼视力均明显优于术前（p<0.001）。术后 3 个月，三组最佳矫正视力分别为 0.11±0.02 最小角分辨率对数视力（logMAR）、0.09±0.03 logMAR 和 0.11±0.03 logMAR。等效球镜（SE）值分别为 0.37±0.08 D、0.41±0.06 D 和 0.42±0.06 D。三组间最佳矫正视力和 SE 差异均无统计学意义（F=1.254，p=0.135；F=0.849，p=0.228）。三组间 SE 差异亦无统计学意义（F=1.658，p=0.312）。此外，三组间高阶像差差异无统计学意义（p>0.05）。kappa 角与术后 DOF 呈负相关（r=-4.341，p=0.026）。术后 3 个月，54.55%的患者 DOF≥3 D，92.42%的患者 DOF≥2 D。三组的 DOF 范围分别为 3.18±0.27 D、2.83±0.80 D 和 2.57±0.89 D，组间差异有统计学意义（F=5.689，p=0.037）。
大多数患者在 Tecnis Symfony IOL 植入后获得了全程视力，但对于 kappa 角过大的患者，DOF 变窄，表明需要仔细选择。
