Visual Performance of a Polynomial Extended Depth of Focus Intraocular Lens

Purpose: To clinically evaluate a new extended depth of focus intraocular lens (ISOPURE, PhysIOL) with optic design modification based on a unique polynomial concept to improve intermediate vision while keeping the quality of distance vision equal to a monofocal lens. Methods: 18 patients (11 female, 7 male, mean age of 69.4 years) with bilateral cataract and regular corneal astigmatism ≤ 1.0 D underwent bilateral cataract surgery with ISOPURE implantation. Patients were followed for up to 6 months. Measured parameters were uncorrected (UDVA) and corrected distance visual acuity (CDVA), uncorrected (UIVA) and distance-corrected intermediate visual acuity at 80 cm and 66 cm (DCI80VA, DCI66VA) subjective refraction, defocus curve, tolerance of cylinder induction, and contrast sensitivity. The data from all implanted eyes (all-eyes) and a subset only including the first eye implanted for each patient were analysed. Results: The mean manifest refraction spherical equivalent (MRSE) decreased from 1.05 D pre-operatively to ?0.15 D at the 4 - 6 month assessment, with 80.6% of eyes within ±0.50 D of emmetropia. At the final follow-up, mean (SD) monocular CDVA was ?0.06 (0.04) logMAR, DCI80VA was 0.18 (0.08) logMAR and DCI66VA was 0.27 (0.13) logMAR. Despite a cylinder induction of ?0.50 D, uncorrected distance visual acuity of 0.02 logMAR was still achieved. Conclusion: The ISOPURE intraocular lens provides excellent distance corrected visual acuity for far and intermediate distances along with high contrast sensitivity and good tolerance of residual refractive cylinder.

两种TECNIS多焦点人工晶状体不同组合方式植入术后视力对比

目的:对比双眼均植入Tecnis Symfony ZXR00(ZXR00)、双眼分别植入ZXR00和Tecnis ZMB00(ZMB00)以及双眼均植入ZMB00患者术后视力、视觉质量及患者满意度。方法:回顾性病例对照研究。收集2020-08/2021-12行白内障超声乳化吸除联合人工晶状体(IOL)植入的白内障患者117例(234眼),根据IOL不同分为三组:37例(74眼)双眼植入ZMB00为MM组;44例(88眼)双眼分别植入ZXR00和ZMB00为MR组;36例(72眼)双眼均植入ZXR00为RR组。观察三组患者术后3 mo裸眼远视力(UDVA,5 m)、裸眼中视力(UIVA,80 cm)、裸眼近视力(UNVA,40 cm)、矫正远视力(CDVA)、离焦曲线、立体视及VF-14、QoV视觉质量评分表问卷调查。结果:MM和MR组UNVA优于RR组(P<0.05);而MM组与MR组不具有统计学差异。RR组UIVA最优。三组的UDVA、CDVA和立体视均不具有统计学意义(P>0.05)。术后3 mo时MR、MM、RR组40 cm近立体视锐度分别为107.27±80.53、105.67±83.79、108.69±97.66 (20-400)弧秒(P> 0.05)。MR、MM、RR组的满意度均达到90%以上。结论:三组术后均具有良好的远、中、近视力和双眼近立体视。其中,MR组具有更优异的全程视力。三组患者术后满意度均较高,可以根据患者的不同需求选择合适的多焦点人工晶状体。

景深延长型人工晶状体植入后患者屈光状态准确性评估

目的:使用电脑验光和OPD-ScanⅢ自动验光检查白内障患者植入景深延长型人工晶状体术后屈光状态。方法:回顾性病例观察研究。收集2022-05/2023-05于上海市眼病防治中心行白内障超声乳化吸除术并植入TECNIS Symfony ZXR00人工晶状体(IOL)患者61例76眼。所有患者术后同一天行电脑验光、OPD-ScanⅢ自动验光和综合验光仪主觉验光检查。结果:电脑验光球镜、等效球镜与综合验光仪主觉验光球镜、等效球镜比较均有差异(均P<0.01),球镜、等效球镜差异值分别为-0.67±0.37 D和-0.75±0.35 D,与综合验光仪主觉验光相比,电脑验光球镜、等效球镜均偏近视;电脑验光柱镜与综合验光仪主觉验光柱镜有差异(P<0.01),二者差异绝对值较小(0.21±0.24 D)。电脑验光球镜、柱镜、等效球镜与综合验光仪主觉验光球镜、柱镜、等效球镜均正相关(r=0.7994、0.7929、0.8118,均P<0.01)。OPD-ScanⅢ自动验光球镜、柱镜、等效球镜与综合验光仪主觉验光比较均有差异(P<0.01),球镜、柱镜、等效球镜差异绝对值(0.63±0.36、0.35±0.26和0.53±0.36 D)较小。OPD-ScanⅢ自动验光球镜、柱镜、等效球镜与主觉验光球镜、柱镜、等效球镜均正相关(r=0.4410、0.4982、0.5224,均P<0.01)。结论:景深延长型IOL植入术后电脑验光、OPD-ScanⅢ自动验光与综合验光仪主觉验光一致性较好,电脑验光球镜和等效球镜平均差异较大,但均呈现近视偏差,柱镜差异小;OPD-ScanⅢ自动验光与主觉验光平均差异较小,但差异方向不稳定,有时为近视偏差,有时为远视偏差。

Comparison of dynamic defocus curve Checkfor updates on cataract patients implanting extended depth of focus and monofocal intraocular

Background:The aim of the study was to compare the dynamic defocus curve on patients post-implantation of the extended depth-of-focus(EDOF)and monofocal intraocular lens(IOL).Methods:A total of 62 age-related cataract patients receiving phacoemulsification with implantation of TECNIS Symfony(ZXRoO)or monofocal IOLs were enrolled.The binocular static and dynamic defocus curves with corrected distance visual acuity were evaluated at one month postoperatively.Results:The ZXR00 group achieved signifcantly better intermediate(P=0.044)and near(P=0.017)visual acuity(VA)than the monofocal group.Two groups had similar uncorrected and corrected distance VA(P>0.05,respectively).The dynamic defocus curve revealed a smoother decline from 0.0 D to-2.0 D in the ZXRo0 group.Defocused dynamic VA in the ZXR00 group was significantly better(P<0.05)except at 0.0 D(P=0.724)and-0.5 D(P=0.176).The area under the curve(P=0.002)and corrected dynamic vision accommodation(P=0.001)derived from the dynamic defocus curves were better in the ZxRoo group.A positive correlation was observed between defocused dynamic and static VA in both groups(P<0.001).Multiple linear regression analysis indicated that defocused static VA and cor-rected dynamic vision accommodation were significant influential factors for the defocused dynamic VA from-1.0 D to-3.0 D(P<0.05).Conclusions:The EDOF IOL provided similar distant vision,better intermediate and near vision,and a better overall dynamic defocus curve than the monofocal IOL.The dynamic defocus curve may be comprehensively applied to evaluate the all-distance dynamic visual performance post-cataract surgery.