Song Ji Eun, Han So Young, Khoramnia Ramin, Tandogan Tamer, Auffarth Gerd U, Choi Chul Young
Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
The David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany.
J Ophthalmol. 2021 Sep 7;2021:9034258. doi: 10.1155/2021/9034258. eCollection 2021.
To evaluate monocular and binocular visual performance and patient-reported outcomes following combined implantation of a diffractive extended depth of focus (EDoF) IOL (Carl Zeiss AT LARA 829MP) and a diffractive trifocal IOL (Carl Zeiss AT LISA tri 839MP).
This prospective study enrolled consecutive patients undergoing lens phacoemulsification of cataract and combined implantation of an EDoF IOL in the dominant eye and a trifocal IOL in the nondominant eye. Assessment included uncorrected visual acuity at near distances (UNVA), intermediate distances (UIVA), and far distances (UDVA), uncorrected defocus curve, contrast sensitivity (CS), reading speed, and patient satisfaction, evaluated six months after the surgery with the Visual Function Questionnaire (VFQ-25).
A total of 25 patients were enrolled. At six months postoperatively, outcomes of binocular UNVA, UIVA, and UDVA were superior to those of monocular outcomes. The binocular defocus curve showed significantly better results in comparison with the AT LISA tri IOL eyes at defocus levels of -1.0 D and -1.5 D (=0.008 and =0.002, respectively) and compared to the AT LARA IOL eyes at defocus levels of -3.0, -3.5 D, and -4.0 D (=0.019, =0.019, and =0.035, respectively). All of the patients were spectacle-free at far and intermediate distances, while 4% of patients needed spectacles at the near distance. Reading speed showed a rather high and gentle slope curve between 0.1 logMAR and 0.4 logMAR, and optical phenomena were improved after combined implantation of IOLs except halos. There were no significant differences in CS between the binocular and monocular results of each IOL.
The combined implantation of an EDoF IOL and a trifocal IOL seems to be a good option for patients with demands for spectacle independence in their daily life, with minimal photic phenomena.
评估在联合植入衍射型扩展焦深（EDoF）人工晶状体（Carl Zeiss AT LARA 829MP）和衍射型三焦点人工晶状体（Carl Zeiss AT LISA tri 839MP）后，单眼和双眼的视觉性能以及患者报告的结果。
这项前瞻性研究纳入了连续接受白内障晶状体超声乳化术的患者，在优势眼植入EDoF人工晶状体，在非优势眼植入三焦点人工晶状体。评估包括近距离（未矫正近视力，UNVA）、中距离（未矫正中视力，UIVA）和远距离（未矫正远视力，UDVA）的未矫正视力、未矫正散焦曲线、对比敏感度（CS）、阅读速度以及患者满意度，在术后6个月使用视觉功能问卷（VFQ - 25）进行评估。
共纳入25例患者。术后6个月，双眼的UNVA、UIVA和UDVA结果优于单眼结果。双眼散焦曲线在散焦水平为 - 1.0 D和 - 1.5 D时（分别为=0.008和=0.002），与AT LISA tri人工晶状体眼相比显示出明显更好的结果；在散焦水平为 - 3.0 D、 - 3.5 D和 - 4.0 D时（分别为=0.019、=0.019和=0.035），与AT LARA人工晶状体眼相比也显示出明显更好的结果。所有患者在远距离和中距离无需佩戴眼镜，而4%的患者在近距离需要佩戴眼镜。阅读速度在0.1 logMAR至0.4 logMAR之间呈现出相当高且平缓的斜率曲线，除了光晕外，联合植入人工晶状体后光学现象有所改善。每种人工晶状体的双眼和单眼CS结果之间没有显著差异。
对于日常生活中需要摆脱眼镜依赖且光现象最小的患者，联合植入EDoF人工晶状体和三焦点人工晶状体似乎是一个不错的选择。
