Zhang Yu, Zhang Jiaqing, Liang Chen, Xu Yifan, Wu Jiaying, Wu Junming, Zhang Yifan, Jin Aixia, Tan Xuhua, Luo Lixia
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China.
Sun Yat-Sen University of Medical Sciences, Guangzhou, China.
BMC Ophthalmol. 2025 Feb 3;25(1):58. doi: 10.1186/s12886-025-03884-5.
To explore the potential of crystalline lens decentration and tilt as indicators for screening cataract patients for presbyopia-correcting intraocular lens (IOL) implantation.
Prospective observational study. Patients undergoing phacoemulsification with bifocal (Tecnis ZMB00) or extended depth-of-focus (EDOF) (Tecnis ZXR00) IOL implantation were consecutively enrolled. The decentration and tilt of the crystalline lens and the IOL were quantified through the utilization of swept-source optical coherence tomography (SS-OCT, Casia2). Postoperative visual acuity (VA), contrast sensitivity (CS), objective optical quality, and patient-reported outcomes were assessed at a 3-month follow-up. A LOWESS (LOcally WEighted Scatterplot Smoothing) curve was employed to analyze the changes in VA, CS, and objective optical quality relative to the decentration or tilt of crystalline lenses. A further comparison of visual outcomes was conducted based on the inflection points suggested by the curves.
Eighty‑seven patients with ZMB00 IOL and 76 patients with ZXR00 IOL were included. Multiple 6-mm internal aberrations showed a nonlinear increase with greater crystalline lens decentration. The inflection points for the steep increase were observed to be 0.28 mm for the bifocal group and 0.35 mm for the EDOF group. Beyond these points, internal aberrations such as coma increased significantly (all P < 0.01). Patient satisfaction decreased (P < 0.01). Moreover, the bifocal group exhibited a decline in spectacle-independence from 98.67% to 83.33% (P = 0.049), along with a reduction in CS (P < 0.05).
The increased decentration of crystalline lenses compromises specific visual quality aspects in eyes implanted with ZMB00 and ZXR00 IOLs, with cut-off values of 0.28 mm and 0.35 mm, respectively.
探讨晶状体偏心和倾斜作为筛选白内障患者进行老视矫正人工晶状体（IOL）植入指标的潜力。
前瞻性观察研究。连续纳入接受双焦点（Tecnis ZMB00）或扩展焦深（EDOF）（Tecnis ZXR00）IOL植入的白内障超声乳化手术患者。通过扫频光学相干断层扫描（SS-OCT，Casia2）对晶状体和IOL的偏心和倾斜进行量化。在术后3个月随访时评估视力（VA）、对比敏感度（CS）、客观光学质量和患者报告的结果。采用局部加权散点图平滑（LOWESS）曲线分析VA、CS和客观光学质量相对于晶状体偏心或倾斜的变化。根据曲线提示的拐点进一步比较视觉结果。
纳入87例植入ZMB00 IOL的患者和76例植入ZXR00 IOL的患者。多个6毫米内部像差随晶状体偏心度增加呈非线性增加。双焦点组陡峭增加的拐点为0.28毫米，EDOF组为0.35毫米。超过这些点，诸如彗差等内部像差显著增加（所有P<0.01）。患者满意度下降（P<0.01）。此外，双焦点组的脱镜率从98.67%下降至83.33%（P=0.049），同时CS降低（P<0.05）。
晶状体偏心度增加会损害植入ZMB00和ZXR00 IOL眼的特定视觉质量方面，截断值分别为0.28毫米和0.35毫米。
