三焦点人工晶状体植入术后激光角膜增强治疗既往光吸收性角膜屈光手术眼。
Laser corneal enhancement after trifocal intraocular lens implantation in eyes that previously had photoablative corneal refractive surgery.
机构信息
From the Clinica Baviera-AIER Eye Group, Valencia, Spain (Mayordomo-Cerdá, Llovet-Osuna); Clinica Baviera-AIER Eye Group, Bilbao, Spain (Ortega-Usobiaga); Clinica Baviera-AIER Eye Group, Madrid, Spain (Bilbao-Calabuig, González-López, Llovet-Osuna, Cobo-Soriano); Clinica Baviera-AIER Eye Group, Burgos, Spain (Fernández-García); Cardenal Herrera-CEU University, College of Medicine, Valencia, Spain (Llovet-Osuna); Universidad Francisco de Vitoria, Madrid, Spain (Cobo-Soriano).
出版信息
J Cataract Refract Surg. 2022 Jul 1;48(7):790-798. doi: 10.1097/j.jcrs.0000000000000847.
PURPOSE
To evaluate the visual and refractive outcomes of laser corneal enhancement after trifocal intraocular lens (IOL) implantation in eyes previously treated with myopic/hyperopic laser corneal refractive surgery (LCRS).
SETTING
Clinica Baviera-AIER-Eye Group, Spain.
DESIGN
Retrospective comparative case series.
METHODS
Patients were divided by primary LCRS into myopic and hyperopic groups. The outcomes evaluated were uncorrected distance (UDVA), corrected distance (CDVA), uncorrected intermediate (UIVA), and uncorrected near visual acuity (UNVA), and predictability, safety, efficacy, and satisfaction after implantation of 2 trifocal IOL models (Physiol-FineVision and Zeiss-ATLisa 839) and subsequent laser enhancement.
RESULTS
186 eyes (89 myopic and 97 hyperopic eyes) from 146 patients were assessed. At the last visit, refractive outcomes were better in myopic than those in hyperopic eyes, with statistically significant differences for sphere ( P < .001), cylinder ( P < .001), manifest refraction spherical equivalent (MRSE) ( P = .003), CDVA ( P = .005), UDVA ( P = .047), and UNVA ( P = .003) but not for UIVA ( P = .580), binocular UIVA ( P = .660), or binocular UNVA ( P = .836). Predictability differences were nonsignificant between groups for a final MRSE of ±0.5 diopters (D) and ±1.0 D (P = .167 and .502, respectively). Efficacy and safety were similar in both groups ( P = .235 and P = .080). A greater myopic MRSE was present after trifocal implantation in myopic than in hyperopic eyes (MRSE = -0.93 vs -0.69 D, P = .013), and the statistically significant differences were maintained after enhancement between both groups (MRSE -0.00 vs 0.00 D, P = .003). Overall satisfaction was similar in both groups ( P > .05 all items).
CONCLUSIONS
Corneal laser enhancement after implantation of a trifocal IOL in eyes previously treated for myopia or hyperopia with LCRS was safe, effective, predictable, and highly satisfactory.
目的
评估三焦点人工晶状体（IOL）植入术后行激光角膜增强术对既往接受过近视/远视激光角膜屈光手术（LCRS）的患者的视力和屈光效果。
设置
西班牙 Baviera-AIER-Eye 集团临床中心。
设计
回顾性对比病例系列研究。
方法
根据初次 LCRS 将患者分为近视组和远视组。评估的结果包括未矫正远视力（UDVA）、矫正远视力（CDVA）、未矫正中间视力（UIVA）和未矫正近视力（UNVA），以及植入 2 种三焦点 IOL 模型（Physiol-FineVision 和 Zeiss-ATLisa 839）后的预测性、安全性、有效性和满意度，以及随后行激光增强。
结果
共评估了 146 例患者的 186 只眼（89 只近视眼和 97 只远视眼）。末次随访时，与远视眼相比，近视眼的屈光结果更好，在球镜（P <.001）、柱镜（P <.001）、角膜镜值等效球镜（MRSE）（P =.003）、CDVA（P =.005）、UDVA（P =.047）和 UNVA（P =.003）方面有统计学差异，但在 UIVA（P =.580）、双眼 UIVA（P =.660）或双眼 UNVA（P =.836）方面无统计学差异。对于最终的等效球镜值在±0.5 屈光度（D）和±1.0 D，两组之间的预测性差异无统计学意义（P =.167 和.502）。两组之间的有效性和安全性相似（P =.235 和 P =.080）。与远视眼相比，在近视眼患者中植入三焦点 IOL 后出现更大的近视性 MRSE（MRSE = -0.93 与 -0.69 D，P =.013），且两组之间的差异在增强后仍具有统计学意义（MRSE 差值为-0.00 与 0.00 D，P =.003）。两组的总体满意度相似（P >.05 所有项目）。
结论
在既往接受 LCRS 治疗近视或远视的患者中植入三焦点 IOL 后行激光角膜增强术是安全、有效、可预测和高度满意的。
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