Badalà Federico, Bona Elena, Devincenzi Giulia, Nouri-Mahdavi Kouros
Micro Chirurgia Oculare, Eye Clinic, Milan, Italy.
Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Clin Ophthalmol. 2024 Oct 4;18:2765-2775. doi: 10.2147/OPTH.S481570. eCollection 2024.
To determine long-term efficacy and safety of an extended macular vision intraocular lens (IOL) implanted in patients with dry age-related macular degeneration (AMD) and visually insignificant cataracts.
Retrospective observational case series.
MicroChirurgia Oculare, Italy.
A retrospective case series of patients with dry AMD and visually insignificant cataracts undergoing phacoemulsification and implantation of an extended macular vision IOL designed to optimize image quality up to 10° from the foveal center (EyeMax Mono, Sharpview Ophthalmology, London, UK). Criteria for implantation were visually insignificant cataract (NC1 according to LOCS III classification) with dry age-related macular degeneration. Hypermetropia was targeted in most eyes to provide magnification when corrected with spectacles. Primary outcome measures were changes in corrected distant and secondary outcome measures included near visual acuity (CDVA and CNVA, respectively) between baseline and latest follow-up and safety outcomes.
113 eyes of 86 patients (mean age 70.3±7.9 years) were included (mean follow-up: 48.3±25.1 months). Mean CDVA improved by 0.22 logMAR (11 ETDRS letters), from 0.53±0.4 to 0.31±0.3 (n=113, p<0.001). Similarly, mean CNVA improved by 0.08 logMAR (4 ETDRS letters), from 0.45±0.2 to 0.37±0.2 (n=77, p<0.001). Eleven eyes had AMD with extensive atrophy, and their mean CDVA improved by 0.32 logMAR (16 ETDRS letters). Three eyes (2.7%) experienced loss of more than one line in logMAR CDVA and four eyes (5.2%) experienced loss of more than one line in logMAR CNVA. No complications or instances of IOL exchange were reported.
Visual improvement in eyes with visually insignificant cataract and AMD who underwent phacoemulsification and were implanted with EyeMax Mono IOL appears to be influenced by the IOL optical design. Vision enhancement in eyes with visually insignificant cataracts underscores the IOL's ability to optimize use of healthy retinal areas. Prospective studies with control groups are needed to confirm these findings.
确定植入扩展型黄斑视力人工晶状体（IOL）对干性年龄相关性黄斑变性（AMD）合并视力无明显影响的白内障患者的长期疗效和安全性。
回顾性观察病例系列。
意大利眼科显微外科。
对干性AMD合并视力无明显影响的白内障患者进行回顾性病例系列研究，这些患者接受了超声乳化手术并植入了一种扩展型黄斑视力IOL，该IOL旨在优化距黄斑中心10°范围内的图像质量（EyeMax Mono，Sharpview Ophthalmology，英国伦敦）。植入标准为干性年龄相关性黄斑变性合并视力无明显影响的白内障（根据LOCS III分类为NC1）。大多数眼睛以远视作为目标，以便在佩戴眼镜矫正时提供放大效果。主要观察指标为矫正远视力的变化，次要观察指标包括基线和最新随访之间的近视力（分别为CDVA和CNVA）以及安全性指标。
纳入了86例患者的113只眼（平均年龄70.3±7.9岁）（平均随访时间：48.3±25.1个月）。平均CDVA提高了0.22 logMAR（11个ETDRS字母），从0.53±0.4提高到0.31±0.3（n = 113，p<0.001）。同样，平均CNVA提高了0.08 logMAR（4个ETDRS字母），从0.45±0.2提高到0.37±0.2（n = 77，p<0.001）。11只眼患有广泛萎缩的AMD，其平均CDVA提高了0.32 logMAR（16个ETDRS字母）。3只眼（2.7%）的logMAR CDVA下降超过1行，4只眼（5.2%）的logMAR CNVA下降超过1行。未报告并发症或IOL置换情况。
接受超声乳化手术并植入EyeMax Mono IOL的视力无明显影响的白内障合并AMD患者的视力改善似乎受IOL光学设计影响。视力无明显影响的白内障患者的视力增强突出了IOL优化利用健康视网膜区域的能力。需要进行有对照组的前瞻性研究来证实这些发现。
