Gouvea Larissa, Alshaker Sara, Rocha Karolinne Maia, Chamon Wallace, Chan Clara C, Rootman David S
From the Department of Ophthalmology and Visual Sciences, University of Toronto (L.G., S.A., C.C.C., D.S.R.), Toronto, Ontario, Canada; Department of Ophthalmology, Federal University of São Paulo (L.G., W.C.), São Paulo, Brazil; Storm Eye Institute, Medical University of South Carolina (L.G., K.M.R.), Charleston, South Carolina, USA.
From the Department of Ophthalmology and Visual Sciences, University of Toronto (L.G., S.A., C.C.C., D.S.R.), Toronto, Ontario, Canada.
Am J Ophthalmol. 2025 Jan;269:450-456. doi: 10.1016/j.ajo.2024.09.019. Epub 2024 Sep 26.
To compare scanning-slit retinoscopy automated refraction spherical equivalent (ARSE) to subjective manifest refraction spherical equivalent (MRSE) in normal eyes with four different types of intraocular lenses (IOLs).
Retrospective cross-sectional study.
A total of 279 pseudophakic eyes that underwent lens extraction at a private center with implantation of either a wavefront shaped IOL (Acrysof® Vivity, DFT015), a nonapodized diffractive trifocal IOL (Acrysof® Panoptix), or a monofocal IOL with negative spherical aberration (Tecnis ZCBOO) or aberration-free (Envista Mx60E). Patients who had an automated refraction measurement with retinoscopy refractometer and aberrometer (NIDEK OPD Scan III, Nidek Technologies) and subjective refraction data 1-2 months postoperatively were included in the study. Main outcome measured was the difference between automated refraction and subjective refraction.
Sixty-one eyes implanted with a DFT015 IOL, 78 eyes with a TFNT00 IOL, 40 with a ZCBOO IOL and 100 with a Mx60E IOL were enrolled in this study. Statistically significant myopic results were observed when using ARSE compared to MRSE in the DFT015 (-0.95 ± 0.64, -0.33 ± 0.65, P < .001), TFNT00 (-0.43 ± 0.36, -0.2 ± 0.35, P < .001), ZCBOO (-0.81 ± 0.63, -0.4 ± 0.69, P = .008) and Mx60E (-0.75 ± 0.65, -0.45 ± 0.52; P < .05) IOL groups. The absolute difference between the 2 methods was statistically significant in the DFT015 IOL group (0.65 ± 0.49; P < .05).
Automated refraction yields myopic results in pseudophakic eyes with monofocal and presbyopia correcting IOLs and may be used with caution. Manifest refraction "push-plus" technique should be used in all pseudophakic eyes to avoid over-minus prescriptions, especially in patient with residual refractive error following cataract surgery.
比较在植入四种不同类型人工晶状体（IOL）的正常眼中，扫描裂隙视网膜检影自动验光球镜等效度（ARSE）与主观显验光球镜等效度（MRSE）。
回顾性横断面研究。
共有279只人工晶状体眼在一家私立中心接受了晶状体摘除术，并植入了波前塑形IOL（Acrysof® Vivity，DFT015）、非变迹衍射三焦点IOL（Acrysof® Panoptix）、具有负球差的单焦点IOL（Tecnis ZCBOO）或无像差IOL（Envista Mx60E）。在术后1至2个月进行了视网膜检影验光仪和像差仪（NIDEK OPD Scan III，尼德克科技公司）自动验光测量以及主观验光数据测量的患者被纳入研究。主要测量结果是自动验光与主观验光之间的差异。
本研究纳入了61只植入DFT015 IOL的眼睛、78只植入TFNT00 IOL的眼睛、40只植入ZCBOO IOL的眼睛和100只植入Mx60E IOL的眼睛。在DFT015（-0.95±0.64，-0.33±0.65，P<.001）、TFNT00（-0.43±0.36，-0.2±0.35，P<.001）、ZCBOO（-0.81±0.63，-0.4±0.69，P=.008）和Mx60E（-0.75±0.65，-0.45±0.52；P<.05）IOL组中，与MRSE相比，使用ARSE时观察到具有统计学意义的近视结果。在DFT015 IOL组中，两种方法之间的绝对差异具有统计学意义（0.65±0.49；P<.05）。
自动验光在植入单焦点和矫正老花眼的IOL的人工晶状体眼中会产生近视结果，使用时应谨慎。在所有人工晶状体眼中都应采用显验光“推加”技术，以避免过负的处方，尤其是在白内障手术后有残余屈光不正的患者中。
