三种不同IOL植入术后短期的视力和视觉干扰现象及脱镜率的对比

Comparison of short-term visual acuity and visual disturbance phenomena and spectacle independence after implantation of three different intraocular lenses

摘要:

目的：对比分析单眼植入三焦点、多焦点及连续视程人工晶状体(IOL)术后短期的视力、视觉干扰现象及脱镜率。方法：回顾性分析2019-03/2022-12行超声乳化白内障吸除联合IOL植入术的白内障患者67例67眼。35例35眼植入Symfony连续视程IOL； 21例21眼植入AcrySof IQ ReSTOR+3D多焦点IOL； 11例11眼植入AcrySof IQ PanOptix三焦点IOL。记录术前及术后3 mo裸眼远视力(UDVA)、中视力(UIVA)、近视力(UNVA)，术后3 mo离焦曲线、视觉干扰现象及脱镜率。结果：术后3 mo，三组间UDVA无差异(P>0.05)； Symfony组及PanOptix组UIVA优于ReSTOR组(均P<0.01)； ReSTOR组及PanOptix组UNVA优于Symfony组(均P<0.01)。离焦曲线显示，在中视力区间(-1.00--1.50 D)，Symfony组视力优于ReSTOR组(P<0.05)； 在近视力区间(-2.50--3.50 D)，ReSTOR组视力优于Symfony组(P<0.05)； PanOptix组在近视力区间(-2.00--3.50 D)的视力优于Symfony组(P<0.05)，同时在中视力区间(-1.00--2.00 D)的视力优于ReSTOR组(P<0.05)。三组间眩光或光晕的发生率及双眼相互干扰现象发生率均无差异(P>0.05)。PanOptix组和ReSTOR组脱镜率比Symfony组高(P<0.0167)。结论：与Symfony连续视程IOL和ReSTOR多焦点IOL相比，PanOptix三焦点IOL能够兼顾远中近视力，眩光和光晕发生率不高，脱镜率较高； 单眼植入老视矫正型IOL仍需慎重。

Abstract:

AIM: To compare the short-term postoperative visual acuity, visual disturbance phenomena, and spectacle independence rate in patients who underwent monocular implantation with trifocal, multifocal, or extended range of vision intraocular lens(IOL).METHODS: A retrospective analysis was conducted on 67 cataract patients(67 eyes)who underwent phacoemulsification cataract extraction combined with IOL implantation from March 2019 to December 2022. A total of 35 cases(35 eyes)received Symfony extended range of vision IOL implantation, 21 cases(21 eyes)received AcrySof IQ ReSTOR +3D multifocal IOL, and 11 cases(11 eyes)received AcrySof IQ PanOptix trifocal IOL. The preoperative uncorrected distance visual acuity(UDVA), uncorrected intermediate visual acuity(UIVA), and uncorrected near visual acuity(UNVA)and 3 mo postoperatively were documented. Moreover, defocus curves, visual disturbance phenomena, and spectacle independence rates were recorded at 3 mo postoperatively.RESULTS: At 3 mo postoperatively, no statistically significant differences were observed in UDVA among the three groups(P>0.05). A comparison of UIVA showed superior results in the Symfony and PanOptix groups compared to the ReSTOR group(all P<0.01). The UNVA of both the ReSTOR and PanOptix groups outperformed the Symfony group(all P<0.01). The defocus curves indicated that in the intermediate vision range(-1.00 to -1.50 D), the Symfony group exhibited better performance than the ReSTOR group(P<0.05); while in the near vision range(-2.50 to -3.50 D), the ReSTOR group was superior to the Symfony group(P<0.05). The PanOptix group demonstrated superior visual acuity in the near vision range(-2.00 to -3.50 D)compared to the Symfony group(P<0.05)and was also superior in the intermediate vision range(-1.00 to -2.00 D)compared to the ReSTOR group(P<0.05). No significant differences were observed in the incidence of glare or halo and binocular interference phenomena among the three groups(P>0.05). The PanOptix and ReSTOR groups exhibited a higher spectacle independence rate compared to the Symfony group(P<0.0167).CONCLUSION: Compared to Symfony extended range of vision IOL and ReSTOR multifocal IOL, PanOptix trifocal IOL offers a balanced approach to distance, intermediate, and near visual acuity, without a high incidence of glare and halo, and with a higher spectacle independence rate. Caution is still advised when considering monocular implantation with presbyopia-correcting IOLs.