Aljindan Mohanna, Neyaz Hanan A, Bin Helayel Halah, Alwohaibi Nada N, Rushood Adel Aziz
Department of Ophthalmology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Department of Ophthalmology, Ohud Hospital, Madinah, Saudi Arabia.
Clin Ophthalmol. 2024 Oct 28;18:3043-3051. doi: 10.2147/OPTH.S471712. eCollection 2024.
To investigate the visual outcomes and patient satisfaction following trifocal intraocular lens (IOL) implantation after radial keratotomy (RK).
This was a retrospective chart review wherein we studied 14 eyes from 7 patients who had undergone cataract surgery and had trifocal intraocular lens (IOL) implanted in the Eastern Province of Saudi Arabia's King Fahd University Hospital and Kahhal private centre. Data such as demographic characteristics, the time between RK and cataract removal, intraoperative and postoperative complications, preoperative and postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and refraction were evaluated. In addition, visual complaints and satisfaction were assessed through a questionnaire.
All eyes included had 8 RK sections. The mean spherical equivalent was +1.81 ± 4.27 D preoperatively and was -0.41 ± 1.2 D at the last follow-up. The mean uncorrected distance visual acuity (UDVA) increased from 0.32 ± 0.2 prior to surgery to 0.64 ± 0.2 following surgery. The mean efficacy index was 1.01 and a safety index was 1.26. In the last follow-up, 29% reported having 0.5 spherical equivalents, while 86% were within 1D. Improvement in cylindrical correction was noticed in the last follow-up with 36% not more than 0.5 D and 43% within 1D. In total, 80% of patients had a distance-corrected near visual acuity (DCNVA) of better than 20/40. The survey response rate was 100%, and two patients reported a lower degree of satisfaction. Glare and difficulty seeing at night were the most often reported complaints, with a mean of 2.86 ± 1.95 and 22 ± 1.9, respectively.
Our results suggest that implantation of a trifocal IOL is safe and effective in patients with previous RK. However, several factors, including the patient's preoperative expectations, glare testing, refractive error, number of cuts, optical zone size, and visual phenomena related to RK, should be considered before implantation.
探讨放射状角膜切开术（RK）后植入三焦点人工晶状体（IOL）的视觉效果和患者满意度。
这是一项回顾性病历审查，我们研究了沙特阿拉伯东部省法赫德国王大学医院和卡哈尔私人中心7例接受白内障手术并植入三焦点人工晶状体（IOL）患者的14只眼。评估了人口统计学特征、RK与白内障摘除之间的时间、术中及术后并发症、术前及术后未矫正远视力（UDVA）、矫正远视力（CDVA）和屈光等数据。此外，通过问卷调查评估视觉主诉和满意度。
所有纳入的眼睛均有8个RK切口。术前平均球镜等效度为+1.81±4.27D，最后一次随访时为-0.41±1.2D。平均未矫正远视力（UDVA）从术前的0.32±0.2提高到术后的0.64±0.2。平均有效指数为1.01，安全指数为1.26。在最后一次随访中，29%的患者球镜等效度为0.5，86%在1D以内。在最后一次随访中发现柱镜矫正有所改善，36%不超过0.5D，43%在1D以内。总体而言，80%的患者远距矫正近视力（DCNVA）优于20/40。调查回复率为100%，两名患者报告满意度较低。眩光和夜间视物困难是最常报告的主诉，平均分别为2.86±1.95和2.2±1.9。
我们的结果表明，对于既往行RK的患者，植入三焦点IOL是安全有效的。然而，在植入前应考虑几个因素，包括患者的术前期望、眩光测试、屈光不正、切口数量、光学区大小以及与RK相关的视觉现象。
