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多焦点与单焦点人工晶状体患者孔源性视网膜脱离修复手术后的视力结果。

Visual outcome after rhegmatogenous retinal detachment repair surgery in patients with multifocal vs monofocal intraocular lenses.

机构信息

From the Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany (Freissinger, Vounotrypidis, Bayer, Shajari, Kreutzer, Keidel, Kern, Priglinger, Wolf); University Eye Hospital Ulm, Ulm, Germany (Vounotrypidis, Stetzer, Wolf).

出版信息

J Cataract Refract Surg. 2021 Dec 1;47(12):1561-1567. doi: 10.1097/j.jcrs.0000000000000684.

Abstract

PURPOSE

To evaluate functional outcome after retinal detachment (RD) repair surgery in eyes with a multifocal intraocular lens (mIOL).

SETTING

Ludwig-Maximilians-University, Munich, Germany.

DESIGN

Single-center case control study.

METHODS

52 pseudophakic eyes with successful anatomical outcome after surgical RD repair were included. Retrospectively, 21 mIOL eyes were compared with a matched group of 21 monofocal eyes over 6 weeks. Prospectively, corrected distance visual acuity (CDVA) was evaluated over 12 months in these eyes. Furthermore, uncorrected distance, intermediate, and near visual acuity (UDVA, UIVA, and UNVA, respectively), defocus curves, and patient-reported outcomes were evaluated at 1 year in 24 mIOL eyes.

RESULTS

52 eyes of 48 patients comprised the study. The mean CDVA (logMAR) improved significantly from 1.35 ± 1.38 to 0.29 ± 0.37 at 6 weeks and remained stable at 12 months postoperatively in monofocal eyes (P = .001) and from 1.16 ± 1.2 to 0.37 ± 0.29 (6 weeks) and 0.20 ± 0.36 (12 months) in mIOL eyes (P = .001). Univariate factorial analysis of variance showed no statistically significant differences in CDVA at 6 weeks or 12 months postoperatively for IOL type or for preoperative macular status (P > .05). In the prospective cohort of 24 mIOL eyes, a mean CDVA of 0.13 ± 0.33 logMAR, UDVA of 0.21 ± 0.34 logMAR, UIVA of 0.17 ± 0.28 logMAR, and UNVA of 0.23 ± 0.32 logMAR was achieved. Macular status did not affect final outcome significantly (P > .05). Most patients stated they usually did not need spectacles; no patient wanted mIOL replacement.

CONCLUSIONS

1 year after successful anatomical repair after 23-gauge vitrectomy with gas tamponade, functionality of mIOL was restored, and CDVA was comparable with that of patients with monofocal IOL.

摘要

目的

评估伴有多焦点人工晶状体(mIOL)的视网膜脱离(RD)修复手术后的功能结果。

设置

德国慕尼黑路德维希-马克西米利安大学。

设计

单中心病例对照研究。

方法

纳入 52 例成功接受手术 RD 修复的后发性白内障眼。回顾性地,将 21 例 mIOL 眼与 21 例单焦点眼进行比较,观察时间为 6 周。前瞻性地,对这些眼在 12 个月内进行矫正远视力(CDVA)评估。此外,在 24 例 mIOL 眼中,在 1 年时评估未矫正远视力、中间视力和近视力(UDVA、UIVA 和 UNVA)、离焦曲线和患者报告的结果。

结果

48 例患者的 52 只眼纳入本研究。单焦点眼的 CDVA(logMAR)从术前的 1.35 ± 1.38 显著提高到术后 6 周的 0.29 ± 0.37,并且在术后 12 个月保持稳定(P =.001);mIOL 眼的 CDVA(logMAR)从术前的 1.16 ± 1.2 提高到术后 6 周的 0.37 ± 0.29 和术后 12 个月的 0.20 ± 0.36(P =.001)。单变量方差分析显示,术后 6 周和 12 个月时,IOL 类型或术前黄斑状态对 CDVA 没有统计学上的显著差异(P >.05)。在 24 例 mIOL 眼的前瞻性队列中,平均 CDVA 为 0.13 ± 0.33 logMAR,UDVA 为 0.21 ± 0.34 logMAR,UIVA 为 0.17 ± 0.28 logMAR,UNVA 为 0.23 ± 0.32 logMAR。黄斑状态对最终结果没有显著影响(P >.05)。大多数患者表示他们通常不需要戴眼镜;没有患者希望更换 mIOL。

结论

在 23G 玻璃体切割联合气体填充术后成功解剖复位 1 年后,mIOL 的功能得到恢复,与单焦点 IOL 患者的 CDVA 相当。

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