Hammer Maximilian, Heggemann Yvonne, Auffarth Gerd U
David J. Apple Laboratory for Vision Research, Heidelberg, Germany.
Department of Ophthalmology, University of Heidelberg, International Vision Correction Research Centre, Heidelberg, Germany.
Ophthalmol Sci. 2023 Jul 24;4(2):100374. doi: 10.1016/j.xops.2023.100374. eCollection 2024 Mar-Apr.
Anterior iris-claw phakic intraocular lens (pIOL) implantation is a treatment option for refractive, ametropic patients. However, the postoperative accommodative ability has not been systematically researched. Dynamic stimulation aberrometry allows the objective and dynamical measurement of accommodation by observing ocular aberrations during the accommodation process. We investigated the dynamic accommodative ability after pIOL implantation compared with a healthy age- and gender-matched control group.
Clinical, comparative case-control study.
We included patients aged 18-50 years that either underwent pIOL implantation > 1 month ago or served as a healthy, phakic control group.
The accommodative ability and pupil dynamics of both groups were investigated using dynamic stimulation aberrometry. The method allows the analysis of dynamic parameters during accommodation, such as the accommodation speed. A 1:1 propensity score matching was conducted based on the patients' age and gender.
Parameters of objective accommodation, such as accommodative amplitude and pupil dynamic during accommodation.
Fifty-eight healthy, phakic eyes < 50 years of age and 21 eyes after pIOL implantation to correct myopia (pIOL, Verisyse, AMO, Inc) were enrolled. Patients that underwent anterior pIOL implantation were examined on average 24 ± 18 months after surgery. After matching, the mean age of both groups was not significantly different (35 ± 8 vs. 34 ± 8 years). No significant difference in dynamic parameters of accommodation or the accommodative amplitude (2.8 ± 1.4 and 2.9 ± 1.4 diopters [D] for pIOL and control group, = 0.82) were seen. Maximum and minimum pupil sizes were not significantly different. The change in pupil size during deaccommodation was significantly faster in patients after pIOL implantation ( < 0.001).
Dynamic stimulation aberrometry allowed the objective, dynamic, measurement of wavefronts in subjects with accommodative amplitudes up to 7 D. Phakic intraocular lens implantation does not impair the accommodative ability. It alters pupil dynamics during deaccommodation.
Proprietary or commercial disclosure may be found after the references.
前房型虹膜爪式有晶状体眼人工晶状体（pIOL）植入术是屈光不正、屈光参差患者的一种治疗选择。然而，术后调节能力尚未得到系统研究。动态刺激像差仪可通过观察调节过程中的眼像差来客观、动态地测量调节。我们将pIOL植入术后的动态调节能力与年龄和性别匹配的健康对照组进行了比较。
临床、对比病例对照研究。
我们纳入了年龄在18至50岁之间，在1个月前接受过pIOL植入术的患者或作为健康有晶状体对照组的患者。
使用动态刺激像差仪研究两组的调节能力和瞳孔动态。该方法可分析调节过程中的动态参数，如调节速度。根据患者的年龄和性别进行1:1倾向评分匹配。
客观调节参数，如调节幅度和调节过程中的瞳孔动态。
纳入了58只年龄小于50岁的健康有晶状体眼和21只植入pIOL（Verisyse，AMO公司）矫正近视后的眼睛。接受前房型pIOL植入术的患者在术后平均24±18个月接受检查。匹配后，两组的平均年龄无显著差异（35±8岁对34±8岁）。在调节的动态参数或调节幅度方面未见显著差异（pIOL组和对照组分别为2.8±1.4和2.9±1.4屈光度[D]，p = 0.82）。最大和最小瞳孔大小无显著差异。pIOL植入术后患者在放松调节期间瞳孔大小的变化明显更快（p<0.001）。
动态刺激像差仪能够客观、动态地测量调节幅度高达7 D的受试者的波前像差。有晶状体眼人工晶状体植入术不会损害调节能力。它会改变放松调节期间的瞳孔动态。
参考文献之后可能会有专利或商业披露。
