Yim Cindi K, Dave Amisha, Strawn Alyx, Chan Jeffrey, Zhou Irene, Zhu Dagny C
Department of Ophthalmology, Keck School of Medicine, USC Roski Eye Institute, University of Southern California, Los Angeles, CA, 90033, USA.
LAC+USC Medical Center, Los Angeles, CA, 90033, USA.
Ophthalmol Ther. 2023 Jun;12(3):1757-1773. doi: 10.1007/s40123-023-00708-x. Epub 2023 Apr 13.
Refractive lens exchange (RLE) patients represent a unique population with a different baseline and set of expectations compared to their cataract counterparts. Visual outcomes and patient satisfaction following RLE with bilateral implantation of a trifocal intraocular lens (IOL) were assessed in a cohort of patients with presbyopia and without cataract.
Charts of patients with presbyopia who underwent femtosecond laser-assisted RLE with bilateral implantation of the PanOptix trifocal IOL (toric and non-toric) at a single-surgeon, private practice center from September 2019 to August 2020 were retrospectively reviewed. Eyes with prior keratorefractive surgery, amblyopia, or underlying pathology were excluded. Primary endpoints included corrected and uncorrected visual acuity at distance (CDVA and UDVA), intermediate (DCIVA and UIVA), and near (DCNVA and UNVA) at 6 months. Secondary endpoints included residual refractive error, patient-reported satisfaction, spectacle independence, and visual disturbance profile as assessed by a validated questionnaire at 6 months.
Seventy-eight eyes of 39 patients (mean age 56 ± 6 years; 79% female) were included. Most eyes were hyperopic (mean SE 2.35 ± 1.81). Postoperatively, 100% and 92% of eyes were within ± 1.00 D and ± 0.50 D of emmetropia, respectively. One hundred percent, 97%, and 97% of patients achieved UDVA, UNVA, and UIVA of logMAR 0.1 or better. Starbursts were the most frequent (67%) and bothersome (41%) visual disturbance cited, but nearly half (41%) of patients rated them as absent or "not bothersome at all." Overall, 77% of patients reported achieving complete spectacle independence with 87% and 90% of patients stating they were satisfied with their vision and would recommend the same procedure to others, respectively.
RLE with bilateral implantation of the PanOptix IOL is a safe and effective procedure with good patient satisfaction. Because of their relatively clear native lenses and visually demanding needs compared to their cataract counterparts, surgeons should take extra precautions to counsel RLE patients on the limitations of trifocal technology.
与白内障患者相比，屈光性晶状体置换术（RLE）患者是一个独特的群体，其基线情况和期望有所不同。我们对一组患有老花眼且无白内障的患者进行了评估，以了解双眼植入三焦点人工晶状体（IOL）后的视觉效果和患者满意度。
回顾性分析了2019年9月至2020年8月在一家单医生私人诊所中心接受飞秒激光辅助RLE并双眼植入PanOptix三焦点IOL（散光型和非散光型）的老花眼患者的病历。排除有先前角膜屈光手术史、弱视或潜在病理状况的眼睛。主要终点包括6个月时远距离（矫正远视力和未矫正远视力，CDVA和UDVA）、中距离（矫正中视力和未矫正中视力，DCIVA和UIVA）和近距离（矫正近视力和未矫正近视力，DCNVA和UNVA）的视力。次要终点包括残余屈光不正、患者报告的满意度、摆脱眼镜依赖情况以及通过一份经过验证的问卷在6个月时评估的视觉干扰情况。
纳入了39例患者的78只眼（平均年龄56±6岁；79%为女性）。大多数眼睛为远视（平均球镜等效度数2.35±1.81）。术后，分别有100%和92%的眼睛屈光不正度数在正视眼±1.00D和±0.50D范围内。100%、97%和97%的患者达到了logMAR 0.1或更好的UDVA、UNVA和UIVA。星芒是最常见（67%）且令人困扰（41%）的视觉干扰，但近一半（41%）的患者将其评为不存在或“一点也不困扰”。总体而言，77%的患者报告完全摆脱了眼镜依赖，87%和90%的患者分别表示对自己的视力满意并会向他人推荐相同的手术。
双眼植入PanOptix IOL的RLE是一种安全有效的手术，患者满意度良好。由于与白内障患者相比，RLE患者的天然晶状体相对清晰且视觉需求较高，外科医生应格外注意向RLE患者告知三焦点技术的局限性。
