Department of Ophthalmology, Cantonal Hospital Lucerne, Lucerne, Switzerland.
Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
Klin Monbl Augenheilkd. 2024 Apr;241(4):369-373. doi: 10.1055/a-2211-8796. Epub 2024 Apr 23.
Extended depth of focus intraocular lenses (EDOF-IOLs) provide unaided far- and mid-range vision. Refractive IOLs, in contrast to diffractive designs, are associated with a lower depth of focus and absence of dysphotopsia. The aim of this study was to assess spectacle independence for far-range, mid-range, and near-vision activities in patients after implantation of refractive or diffractive EDOF-IOLs using patient-reported outcome measures (PROMs) in a real-world setting.
In 2021 and 2022, all patients in a single center referred for bilateral cataract surgery were assigned to 7 experienced cataract surgeons who either bilaterally implanted only a diffractive EDOF-IOL (Carl Zeiss Meditec AG, AT LARA Jena, Germany, three surgeons) or refractive EDOF-IOL (Johnson & Johnson Vision Inc., Tecnis Eyhance Irvine, California, USA, four surgeons) at the surgeon's discretion, with the aim of bilateral emmetropia. Six months after both cataract surgeries, all patients were contacted by telephone and asked to report their outcomes using a structured questionnaire investigating their spectacle usage for various daily activities and their experience with night glare or halos. Inclusion criteria were a normal postoperative visual potential based on the preoperative examination and completion of the questionnaire regarding postoperative visual experience.
Of the patients, 514 underwent bilateral cataract surgery aiming for bilateral emmetropia with the implantation of EDOF-IOLs (422 with Tecnis Eyhance and 92 with AT LARA). A complete questionnaire was obtained from 472 (92%) patients, who were included in the study (393 vs. 79). Comparing Tecnis Eyhance with AT LARA IOL, 54 vs. 57% patients were able to perform most of their daily activities without spectacles, 9 vs. 19% reported not being dependent on spectacles at all, 25 vs. 29% reported using their smartphones without spectacles, 15 vs. 49% patients reported experiencing glares or halos at night, and 1 vs.15% with driving disturbance. Overall, 95 vs. 93% patients described themselves as "satisfied" or "highly satisfied" with their IOL.
With both types of EDOF-IOLs, the majority of patients could perform most of their daily activities without spectacles, except reading, and were highly satisfied with their IOLs. Patients with diffractive Zeiss AT LARA EDOF-IOLs were more likely to accomplish unaided near-range visual tasks; however, they were also at a higher risk of experiencing glares or halos at night.
扩展景深人工晶状体 (EDOF-IOL) 可提供无需辅助的远距和中距视力。与衍射设计相比，折射型 IOL 的景深较低，且不存在视觉干扰。本研究旨在通过真实世界环境中的患者报告结局测量 (PROM) 评估折射型或衍射型 EDOF-IOL 植入术后患者的远距、中距和近距视觉活动的不依赖眼镜情况。
在 2021 年和 2022 年，在一家单中心就诊的所有患者均被分配给 7 位经验丰富的白内障手术医生，他们根据患者的情况决定双侧植入仅衍射型 EDOF-IOL（卡尔蔡司 Meditec AG，德国 AT LARA Jena，三位医生）或折射型 EDOF-IOL（强生视力公司，美国加利福尼亚州欧文的 Tecnis Eyhance），以实现双眼正视。双眼白内障手术后 6 个月，通过电话联系所有患者，并使用结构化问卷调查他们在各种日常活动中对眼镜的使用情况以及他们对夜间眩光或晕影的体验。纳入标准为基于术前检查的正常术后视觉潜能以及完成术后视觉体验问卷调查。
共有 514 例患者接受了双侧白内障手术，目的是通过 EDOF-IOL 植入实现双眼正视（422 例植入 Tecnis Eyhance，92 例植入 AT LARA）。从 472 例（92%）患者中获得了完整的问卷，这些患者被纳入研究（393 例 vs. 79 例）。与 Tecnis Eyhance 相比，54% vs. 57%的患者能够在大多数日常活动中不戴眼镜，9% vs. 19%的患者表示完全不依赖眼镜，25% vs. 29%的患者表示可以在不戴眼镜的情况下使用智能手机，15% vs. 49%的患者报告夜间有眩光或晕影，1% vs. 15%的患者表示夜间驾驶有干扰。总体而言，95% vs. 93%的患者表示对他们的 IOL 非常满意或满意。
使用两种类型的 EDOF-IOL，大多数患者除阅读外，都可以在不戴眼镜的情况下完成大多数日常活动，对他们的 IOL 非常满意。植入衍射型蔡司 AT LARA EDOF-IOL 的患者更有可能完成无需辅助的近距离视觉任务；然而，他们夜间出现眩光或晕影的风险也更高。
