Wang Lan, Meng Jiaqi, Qi Jiao, Guo Dongling, Lu Yi, Zhu Xiangjia
Department of Ophthalmology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Xuhui District, Shanghai, 200031, China.
Key laboratory of Myopia and Related Eye Diseases, NHC; Key laboratory of Myopia and Related Eye Diseases , Chinese Academy of Medical Sciences, Shanghai, 200031, China.
BMC Ophthalmol. 2025 Jan 14;25(1):19. doi: 10.1186/s12886-025-03860-z.
To investigate the impact of central corneal astigmatism on postoperative visual outcomes in patients with trifocal intraocular lens (IOL) implantation.
This retrospective study included 278 eyes of 278 patients who underwent uneventful cataract surgery with implantation of the trifocal IOL (AT LISA tri 839MP). Patients were divided into two groups according to the total corneal refractive power (TCRP) in 3 mm zone centered on the corneal apex: low astigmatism group, TCRP ≤ 0.75 diopter (D); high astigmatism group, TCRP > 0.75D. Postoperative evaluations were conducted at 3 months after surgery, including visual acuity, defocus curves, contrast sensitivity (CS), and objective and subjective visual quality.
The low astigmatism group exhibited significantly better uncorrected near and intermediate visual acuity than the high astigmatism group (both P < 0.05). Significantly higher percentages of eyes in the low astigmatism group achieved uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) of 0.00 logMAR or better compared to the high astigmatism group (UDVA: 67% vs. 54%, CDVA: 76% vs. 64%, both P < 0.05). Defocus curves revealed that the low astigmatism group showed better visual acuity at defocus levels of + 0.5D, 0D, -0.5D, -3.0D, and - 3.5D than the high astigmatism group (all P < 0.05). Moreover, the high astigmatism group showed significantly poorer CS, greater higher-order aberrations, and more symptoms of blurred vision and diplopia. Percentages of spectacle independence and patient satisfaction did not differ between groups.
In eyes with central corneal astigmatism above 0.75D, suboptimal postoperative visual outcomes may be obtained after trifocal IOL implantation.
探讨中央角膜散光对三焦点人工晶状体（IOL）植入术后视觉效果的影响。
这项回顾性研究纳入了278例接受了顺利的白内障手术并植入三焦点IOL（AT LISA tri 839MP）的患者的278只眼。根据以角膜顶点为中心的3mm区域内的总角膜屈光力（TCRP）将患者分为两组：低散光组，TCRP≤0.75屈光度（D）；高散光组，TCRP>0.75D。术后3个月进行评估，包括视力、散焦曲线、对比敏感度（CS）以及客观和主观视觉质量。
低散光组的未矫正近视力和中视力明显优于高散光组（均P<0.05）。与高散光组相比，低散光组中达到未矫正远视力（UDVA）和矫正远视力（CDVA）为0.00 logMAR或更好的眼睛百分比显著更高（UDVA：67%对54%，CDVA：76%对64%，均P<0.05）。散焦曲线显示，低散光组在+0.5D、0D、-0.5D、-3.0D和-3.5D的散焦水平下的视力优于高散光组（均P<0.05）。此外，高散光组的CS明显较差，高阶像差更大，并且有更多的视力模糊和复视症状。两组之间的眼镜独立率和患者满意度百分比没有差异。
在中央角膜散光高于0.75D的眼中，三焦点IOL植入术后可能获得不理想的术后视觉效果。
