Zhuo Baoxian, Shen Wenqian, Cai Lei, Ni Shuang, Zhang Limei, Chen Xu, Guo Haike, Shen Jiying, Yang Jin
Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China.
Key National Health Committee Laboratory of Myopia, Fudan University, and Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.
PLoS One. 2025 Aug 21;20(8):e0330473. doi: 10.1371/journal.pone.0330473. eCollection 2025.
To evaluate the visual performance and optical quality of a trifocal intraocular lens (IOL) in patients with high myopic cataracts.
This is a prospective, multicenter, non-randomized cohort study. Patients scheduled for cataract surgery with binocular AcrySof IQ® PanOptix® TFNT00 IOL implantation were enrolled. Participants with axial length (AL) ≥ 26 mm were assigned to the high myopia group, while age- and sex-matched patients with AL < 26 mm in the control group. Key outcomes measured included uncorrected distance visual acuity (UDVA), intermediate and near visual acuity (UIVA, UNVA), best-corrected distance visual acuity, defocus curve, contrast sensitivity, visual quality (objective and subjective), and reading ability.
58 eyes from 29 patients in the high myopia group and 56 eyes from 28 patients in the control group were included. Both groups showed significant improvements in visual acuity postoperatively although the UIVA and UNVA of patients with high myopia were significantly worse than those in the control group after 1 month, 3 months, and 1 year (both P < .05). The high myopia group had lower mean visual function-index scores for near-range activities and fewer photic phenomena (halo) than the control group (all P < .05). Preferred reading distance and speed did not differ significantly between the groups.
Trifocal IOL implantation improved visual acuity in both groups. However, patients with high myopia experienced significantly poorer intermediate/near vision outcomes and also less complains about photic phenomena than controls. These findings support cautious patient selection and preoperative counseling for this population.
评估三焦点人工晶状体（IOL）在高度近视性白内障患者中的视觉性能和光学质量。
这是一项前瞻性、多中心、非随机队列研究。纳入计划接受双眼AcrySof IQ® PanOptix® TFNT00 IOL植入白内障手术的患者。眼轴长度（AL）≥26 mm的参与者被分配到高度近视组，而对照组为年龄和性别匹配、AL < 26 mm的患者。测量的主要结果包括未矫正远视力（UDVA）、中视力和近视力（UIVA、UNVA）、最佳矫正远视力、散焦曲线、对比敏感度、视觉质量（客观和主观）以及阅读能力。
高度近视组29例患者的58只眼和对照组28例患者的56只眼被纳入研究。两组术后视力均有显著改善，尽管高度近视患者的UIVA和UNVA在术后1个月、3个月和1年时明显低于对照组（均P < .05）。高度近视组近距离活动的平均视觉功能指数得分低于对照组，且光现象（光晕）较少（均P < .05）。两组之间的偏好阅读距离和速度没有显著差异。
三焦点IOL植入改善了两组患者的视力。然而，高度近视患者的中/近视力结果明显较差，且光现象的抱怨也比对照组少。这些发现支持对此类患者进行谨慎的患者选择和术前咨询。
