Mu Jiancheng, Xiong Tianxu, Xu Feng, Guo Wanyue, Sun Chuhuan, Chen Hao, Fan Wei
Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Front Med (Lausanne). 2024 Aug 23;11:1462205. doi: 10.3389/fmed.2024.1462205. eCollection 2024.
Residual astigmatism is common after cataract surgery involving implantation of an intraocular lens, yet the tolerance of presbyopia-correcting intraocular lens to astigmatism of different magnitudes and axes is poorly understood. Here we compared visual acuity and quality in the presence of induced astigmatism after implantation of a trifocal or extended-depth-of-focus (EDOF) intraocular lens, the two widely used presbyopia-correcting intraocular lenses.
At least 3 months after implantation of a TFNT00 or ZXR00 intraocular lens, patients were analyzed by slit-lamp examination, non-contact tonometry, subjective refraction, iTrace aberrometry, and corneal topography. After correction of residual astigmatism, astigmatism of different magnitudes on different axes was induced using cylindrical lenses, and overall visual acuity was measured, while objective visual quality was measured using the Optical Quality Analysis System II. Subjects were also asked about subjective visual quality using the Visual Function-14 questionnaire.
Comparison of 18 individuals who received a trifocal lens and 19 who received an EDOF lens showed that objective visual quality was better in the EDOF group regardless of the magnitude or axis of the induced astigmatism. In both groups, astigmatism of at least -1.00 DC influenced distant vision more severely when the axis was 45° than 0° or 90°, meanwhile astigmatism of at least -1.50 DC influenced near and intermediate vision more severely when the axis was 45° than 0° or 90°.
Trifocal or EDOF intraocular lenses are less tolerant of oblique astigmatism than astigmatism with or against the rule. EDOF lenses may provide better objective visual quality than trifocal lenses in the presence of astigmatism, regardless of its magnitude or axis.
在涉及人工晶状体植入的白内障手术后，残余散光很常见，但人们对矫正老花眼的人工晶状体对不同度数和轴向散光的耐受性了解甚少。在此，我们比较了植入三焦点或扩展景深（EDOF）人工晶状体（两种广泛使用的矫正老花眼的人工晶状体）后，在存在诱导散光的情况下的视力和视觉质量。
在植入TFNT00或ZXR00人工晶状体至少3个月后，通过裂隙灯检查、非接触眼压测量、主观验光、iTrace像差测量和角膜地形图对患者进行分析。在矫正残余散光后，使用柱面透镜在不同轴向上诱导不同度数的散光，并测量总体视力，同时使用光学质量分析系统II测量客观视觉质量。还使用视觉功能-14问卷询问受试者关于主观视觉质量的情况。
对18名接受三焦点晶状体植入的个体和19名接受EDOF晶状体植入的个体进行比较，结果显示，无论诱导散光的度数或轴向如何，EDOF组的客观视觉质量均更好。在两组中，当散光轴向为45°时，至少-1.00 DC的散光对远视力的影响比轴向为0°或90°时更严重，同时，当散光轴向为45°时，至少-1.50 DC的散光对近视力和中视力的影响比轴向为0°或90°时更严重。
三焦点或EDOF人工晶状体对斜向散光的耐受性低于顺规或逆规散光。在存在散光的情况下，无论散光度数或轴向如何，EDOF晶状体可能比三焦点晶状体提供更好的客观视觉质量。
