AIM： To investigate the independent factors associated with photic phenomena in patients implanted with refractive,rotationally asymmetric,multifocal intraocular lenses（MIOLs）.METHODS： Thirty-four eyes of 34 patie...AIM： To investigate the independent factors associated with photic phenomena in patients implanted with refractive,rotationally asymmetric,multifocal intraocular lenses（MIOLs）.METHODS： Thirty-four eyes of 34 patients who underwent unilateral cataract surgery,followed by implantation of rotationally asymmetric MIOLs were included.Distance and near visual acuity outcomes,intraocular aberrations,preferred reading distances,preoperative and postoperative refractive errors,mesopic and photopic pupil diameters,and the mesopic and photopic kappa angles were assessed.Patients were also administered a satisfaction survey.Photic phenomena were graded by questionnaire.Independent-related factors were identified by correlation and bivariate logistic regression analyses.RESULTS： The distance from the photopic to the mesopic pupil center（pupil center shift） was significantly associated with glare/halo symptoms [odds ratio（OR）=2.065,95% confidence interval（CI）=0.916-4.679,P=0.006] and night vision problems（OR=1.832,95% CI=0.721-2.158,P=0.007）.The preoperative photopic angle kappa was significantly associated with glare/halo symptoms（OR=2.155,95% CI=1.065-4.362,P=0.041）.The photopic angle kappa was also significantly associated with glare/halo symptoms（OR=2.155,95% CI=1.065-4.362,P=0.041） and with night vision problems（OR=1.832,95% CI=0.721-2.158,P=0.007） in patients implanted with rotationally asymmetric MIOLs.CONCLUSION： A large pupil center shift and misalignment between the visual and pupillary axis（angle kappa）may play a role in the occurrence of photic phenomena after implantation of rotationally asymmetric MIOLs.展开更多
·AIM:To compare visual quality after unilateral cataract surgery with implantation of trifocal intraocular lens(IOL)and asymmetric refractive multifocal IOL.·METHODS:The prospective nonrandom,comparative stu...·AIM:To compare visual quality after unilateral cataract surgery with implantation of trifocal intraocular lens(IOL)and asymmetric refractive multifocal IOL.·METHODS:The prospective nonrandom,comparative study consisted of 60 eyes of 60 patients suffering unilateral cataract surgery with implantation of two different IOLs:AT LISA tri 839 MP(30 eyes;Carl Zeiss Meditec,Germany)and LS-313 MF30(30 eyes;Oculentis GmbH,Germany).Visual acuity,refractive outcome,contrast sensitivity,defocus curves,quality of vision,and optical phenomena were evaluated at3 mo postoperatively.·RESULTS:There were no statistical differences between groups in uncorrected distance visual acuity(P=0.13)and uncorrected near visual acuity(P=0.54).In contrast,uncorrected intermediate visual acuity was better in trifocal group compared to the refractive multifocal group(P=0.02).No significant statistical between-group difference was detected in cylinder(P=0.43).Compared to trifocal group,spherical refraction and spherical equivalent in refractive multi focal group were more myopic(P<0.01).Under photopic conditions,no significant statistical differences were found between groups in contrast sensitivity at 3 and 6 cycles per degree(cpd).The refractive multifocal group performed better at 12 and 18 cpd than the trifocal group(P=0.01,P=0.034,respectively).The questionnaires of quality of vision and optical phenomena showed no differences between groups.·CONCLUSION:Trifocal IOL is superior to refractive multifocal IOL in intermediate visual acuity.Rotationally asymmetric refractive multifocal IOL is more myopic in automated refraction and significantly better for the photopic contrast sensitivity at high frequency.展开更多
BACKGROUND Asymmetric multifocal intraocular lenses(IOLs)are now widely used in the modern cataract surgery,providing a good level of visual performance over a range of distances and high postoperative patient satisfa...BACKGROUND Asymmetric multifocal intraocular lenses(IOLs)are now widely used in the modern cataract surgery,providing a good level of visual performance over a range of distances and high postoperative patient satisfaction.We report a case of improved visual quality after shifting the near segment of an asymmetrical multifocal IOL to the superotemporal placement in the dominant eye of a glaucoma patient.CASE SUMMARY A 72-year-old woman with bilateral glaucoma underwent phacoemulsification in the dominant eye(left eye)with implantation of an asymmetrical multifocal IOL.Postoperative uncorrected distance visual acuity(UDVA)was 0.0 logMAR(20/20 Snellen)and uncorrected near visual acuity(UNVA)was 0.1 logMAR(20/25 Snellen).Two weeks later,the patient presented to our clinic with decreased vision due to migration of lens epithelial cells to IOL anterior surface and edema of corneal endothelial cells.Anterior capsule polishing and superotemporal placement of near segment[+3.00 diopter(D)addition(add)]of IOL were performed.As a result,UDVA at the first week and first year after reposition was 0.0 logMAR(20/20 Snellen),and compared with 0.3 logMAR(20/40 Snellen)in the first week,the UNVA was improved to 0.0 logMAR(20/20 Snellen)one year after surgery.CONCLUSION The postoperative inflammatory reaction and lens epithelial cells proliferation were obvious in this glaucoma patient.Capsule polishing and rotation of the lens were beneficial to the patient,which not only enhanced the patient's vision,but also improved the patient's satisfaction.Therefore,glaucoma patients need to be cautious of implanting multifocal IOLs.Placement of a near segment of an asymmetrical multifocal IOL in the dominant eye should be performed on an individual basis.展开更多
AIM：To evaluate the refractive correction for standard automated perimetry（SAP）in eyes with refractive multifocal contact lenses（CL）in healthy young participants.METHODS：Twenty-nine eyes of 29 participants were ...AIM：To evaluate the refractive correction for standard automated perimetry（SAP）in eyes with refractive multifocal contact lenses（CL）in healthy young participants.METHODS：Twenty-nine eyes of 29 participants were included.Accommodation was paralyzed in all participants with 1%cyclopentolate hydrochloride.SAP was performed using the Humphrey SITA-standard 24-2 and 10-2 protocol under three refractive conditions：monofocal CL corrected for near distance（baseline）;multifocal CL corrected for distance（m CL-D）;and m CL-D corrected for near vision using a spectacle lens（m CL-N）.Primary outcome measures were the foveal threshold,mean deviation（MD）,and pattern standard deviation（PSD）.RESULTS：The foveal threshold of m CL-N with both the24-2 and 10-2 protocols significantly decreased by 2.2-2.5 d B（P〈0.001）,while that of m CL-D with the 24-2 protocol significantly decreased by 1.5 d B（P=0.0427）,as compared with that of baseline.Although there was no significant difference between the MD of baseline and m CL-D with the24-2 and 10-2 protocols,the MD of m CL-N was significantly decreased by 1.0-1.3 d B（P〈0.001）as compared with that of both baseline and m CL-D,with both 24-2 and 10-2 protocols.There was no significant difference in the PSD among the three refractive conditions with both the 24-2 and 10-2 protocols.CONCLUSION：Despite the induced mydriasis and the optical design of the multifocal lens used in this study,our results indicated that,when the dome-shaped visual field test is performed with eyes with large pupils and wearing refractive multifocal CLs,distance correction without additional near correction is to be recommended.展开更多
目的:观察区域折射型多焦点人工晶状体(MIOL)SBL-3植入术后视觉质量。方法:回顾性对照研究南昌大学第二附属医院2019-09/2020-07收治的57例68眼白内障患者。其中植入区域折射型MIOL SBL-3者33例36眼(SBL-3组),植入非球面单焦点人工晶状...目的:观察区域折射型多焦点人工晶状体(MIOL)SBL-3植入术后视觉质量。方法:回顾性对照研究南昌大学第二附属医院2019-09/2020-07收治的57例68眼白内障患者。其中植入区域折射型MIOL SBL-3者33例36眼(SBL-3组),植入非球面单焦点人工晶状体(SIOL)ZCB00者24例32眼(ZCB00组),对比两组术后3mo裸眼和矫正远、中、近视力、离焦曲线、OPDIII客观视觉质量、QoV问卷调查、患者满意度及术后脱镜率。结果:术后3mo SBL-3组和ZCB00组裸眼和矫正远视力LogMAR值(0.13±0.09 vs 0.10±0.08,0.06±0.06 vs 0.08±0.08,均P>0.05)无显著差异,裸眼远视力均较术前有显著改善(P<0.05)。SBL-3组裸眼及最佳矫正远视力下的中、近视力明显优于ZCB00组(0.10±0.14 vs 0.27±0.10,0.05±0.16 vs 0.35±0.17,0.11±0.14 vs 0.26±0.11,0.03±0.17 vs 0.35±0.17,均P<0.05)。在所评估的各个空间频率上患者对比敏感度的比较中ZCB00组均优于SBL-3组(P<0.05)。SBL-3组总像差、总高阶像差、彗差、三叶草差均大于ZCB00组且有显著差异(P<0.05),SBL-3组平均SR值小于ZCB00组(P<0.05)。术后3mo SBL-3组出现眩光1例,光晕1例,视远模糊4例。SBL-3组和ZCB00组患者表示非常满意者分别占82%、88%。两组间满意度比较无显著差异(P>0.05),脱镜率(94%vs 67%)比较有显著差异(P<0.05),且SBL-3组脱镜率更高。结论:新型区域折射型MIOL SBL-3提供了良好的全程视力,术后不良视觉症状少,满意度和脱镜率高。展开更多
目的:观察区域折射多焦点人工晶状体(IOL)植入术后的视觉质量。方法:选取2016-06/2017-02在我院行白内障超声乳化吸除联合IOL植入术的白内障患者50例83眼,按植入的IOL类型不同分为观察组(22例37眼,植入多焦点IOL)和对照组(28例46眼,植...目的:观察区域折射多焦点人工晶状体(IOL)植入术后的视觉质量。方法:选取2016-06/2017-02在我院行白内障超声乳化吸除联合IOL植入术的白内障患者50例83眼,按植入的IOL类型不同分为观察组(22例37眼,植入多焦点IOL)和对照组(28例46眼,植入单焦点IOL)。术后3mo,观察裸眼视力,使用OQASⅡ客观视觉质量分析系统评估视觉质量,并采用问卷调查术后视觉干扰症状、脱镜率及满意度。结果:术后3mo,观察组和对照组裸眼远视力(0.095±0.031 vs 0.078±0.025)无差异(P=0.273),但观察组患者裸眼中、近视力均优于对照组(0.146±0.043 vs 0.537±0.102,0.165±0.048 vs 0.754±0.150,均P<0.05);两组患者MTF cut-off和对比度视力无差异,但OSI(2.64±0.68 vs 1.52±0.47)和客观调节幅度(2.91±0.71D vs 1.32±0.41D)均有明显差异(P<0.01);观察组脱镜率明显高于对照组(91%vs 7%,P<0.05),但两组术后视学干扰症状发生率和满意度无明显差异(均P>0.05)。结论:区域折射多焦点IOL可提供良好的全程视力和视觉质量,提高了患者的脱镜率,且满意度高。展开更多
文摘AIM： To investigate the independent factors associated with photic phenomena in patients implanted with refractive,rotationally asymmetric,multifocal intraocular lenses（MIOLs）.METHODS： Thirty-four eyes of 34 patients who underwent unilateral cataract surgery,followed by implantation of rotationally asymmetric MIOLs were included.Distance and near visual acuity outcomes,intraocular aberrations,preferred reading distances,preoperative and postoperative refractive errors,mesopic and photopic pupil diameters,and the mesopic and photopic kappa angles were assessed.Patients were also administered a satisfaction survey.Photic phenomena were graded by questionnaire.Independent-related factors were identified by correlation and bivariate logistic regression analyses.RESULTS： The distance from the photopic to the mesopic pupil center（pupil center shift） was significantly associated with glare/halo symptoms [odds ratio（OR）=2.065,95% confidence interval（CI）=0.916-4.679,P=0.006] and night vision problems（OR=1.832,95% CI=0.721-2.158,P=0.007）.The preoperative photopic angle kappa was significantly associated with glare/halo symptoms（OR=2.155,95% CI=1.065-4.362,P=0.041）.The photopic angle kappa was also significantly associated with glare/halo symptoms（OR=2.155,95% CI=1.065-4.362,P=0.041） and with night vision problems（OR=1.832,95% CI=0.721-2.158,P=0.007） in patients implanted with rotationally asymmetric MIOLs.CONCLUSION： A large pupil center shift and misalignment between the visual and pupillary axis（angle kappa）may play a role in the occurrence of photic phenomena after implantation of rotationally asymmetric MIOLs.
基金Supported by Key Research and Development Projects of Shaanxi Province(No.2017SF-246)Science and Technology Planning Project of Xi’an(No.2017116SF/YX010No.201805097YX5SF31)。
文摘·AIM:To compare visual quality after unilateral cataract surgery with implantation of trifocal intraocular lens(IOL)and asymmetric refractive multifocal IOL.·METHODS:The prospective nonrandom,comparative study consisted of 60 eyes of 60 patients suffering unilateral cataract surgery with implantation of two different IOLs:AT LISA tri 839 MP(30 eyes;Carl Zeiss Meditec,Germany)and LS-313 MF30(30 eyes;Oculentis GmbH,Germany).Visual acuity,refractive outcome,contrast sensitivity,defocus curves,quality of vision,and optical phenomena were evaluated at3 mo postoperatively.·RESULTS:There were no statistical differences between groups in uncorrected distance visual acuity(P=0.13)and uncorrected near visual acuity(P=0.54).In contrast,uncorrected intermediate visual acuity was better in trifocal group compared to the refractive multifocal group(P=0.02).No significant statistical between-group difference was detected in cylinder(P=0.43).Compared to trifocal group,spherical refraction and spherical equivalent in refractive multi focal group were more myopic(P<0.01).Under photopic conditions,no significant statistical differences were found between groups in contrast sensitivity at 3 and 6 cycles per degree(cpd).The refractive multifocal group performed better at 12 and 18 cpd than the trifocal group(P=0.01,P=0.034,respectively).The questionnaires of quality of vision and optical phenomena showed no differences between groups.·CONCLUSION:Trifocal IOL is superior to refractive multifocal IOL in intermediate visual acuity.Rotationally asymmetric refractive multifocal IOL is more myopic in automated refraction and significantly better for the photopic contrast sensitivity at high frequency.
基金Supported by National Natural Science Foundation of China,No.81974130Natural Science Foundation of Hunan Province,China,No.2020JJ4882.
文摘BACKGROUND Asymmetric multifocal intraocular lenses(IOLs)are now widely used in the modern cataract surgery,providing a good level of visual performance over a range of distances and high postoperative patient satisfaction.We report a case of improved visual quality after shifting the near segment of an asymmetrical multifocal IOL to the superotemporal placement in the dominant eye of a glaucoma patient.CASE SUMMARY A 72-year-old woman with bilateral glaucoma underwent phacoemulsification in the dominant eye(left eye)with implantation of an asymmetrical multifocal IOL.Postoperative uncorrected distance visual acuity(UDVA)was 0.0 logMAR(20/20 Snellen)and uncorrected near visual acuity(UNVA)was 0.1 logMAR(20/25 Snellen).Two weeks later,the patient presented to our clinic with decreased vision due to migration of lens epithelial cells to IOL anterior surface and edema of corneal endothelial cells.Anterior capsule polishing and superotemporal placement of near segment[+3.00 diopter(D)addition(add)]of IOL were performed.As a result,UDVA at the first week and first year after reposition was 0.0 logMAR(20/20 Snellen),and compared with 0.3 logMAR(20/40 Snellen)in the first week,the UNVA was improved to 0.0 logMAR(20/20 Snellen)one year after surgery.CONCLUSION The postoperative inflammatory reaction and lens epithelial cells proliferation were obvious in this glaucoma patient.Capsule polishing and rotation of the lens were beneficial to the patient,which not only enhanced the patient's vision,but also improved the patient's satisfaction.Therefore,glaucoma patients need to be cautious of implanting multifocal IOLs.Placement of a near segment of an asymmetrical multifocal IOL in the dominant eye should be performed on an individual basis.
基金Supported by School of Allied Health Sciences,Kitasato University,Kanagawa,Japan
文摘AIM：To evaluate the refractive correction for standard automated perimetry（SAP）in eyes with refractive multifocal contact lenses（CL）in healthy young participants.METHODS：Twenty-nine eyes of 29 participants were included.Accommodation was paralyzed in all participants with 1%cyclopentolate hydrochloride.SAP was performed using the Humphrey SITA-standard 24-2 and 10-2 protocol under three refractive conditions：monofocal CL corrected for near distance（baseline）;multifocal CL corrected for distance（m CL-D）;and m CL-D corrected for near vision using a spectacle lens（m CL-N）.Primary outcome measures were the foveal threshold,mean deviation（MD）,and pattern standard deviation（PSD）.RESULTS：The foveal threshold of m CL-N with both the24-2 and 10-2 protocols significantly decreased by 2.2-2.5 d B（P〈0.001）,while that of m CL-D with the 24-2 protocol significantly decreased by 1.5 d B（P=0.0427）,as compared with that of baseline.Although there was no significant difference between the MD of baseline and m CL-D with the24-2 and 10-2 protocols,the MD of m CL-N was significantly decreased by 1.0-1.3 d B（P〈0.001）as compared with that of both baseline and m CL-D,with both 24-2 and 10-2 protocols.There was no significant difference in the PSD among the three refractive conditions with both the 24-2 and 10-2 protocols.CONCLUSION：Despite the induced mydriasis and the optical design of the multifocal lens used in this study,our results indicated that,when the dome-shaped visual field test is performed with eyes with large pupils and wearing refractive multifocal CLs,distance correction without additional near correction is to be recommended.
文摘目的:观察区域折射型多焦点人工晶状体(MIOL)SBL-3植入术后视觉质量。方法:回顾性对照研究南昌大学第二附属医院2019-09/2020-07收治的57例68眼白内障患者。其中植入区域折射型MIOL SBL-3者33例36眼(SBL-3组),植入非球面单焦点人工晶状体(SIOL)ZCB00者24例32眼(ZCB00组),对比两组术后3mo裸眼和矫正远、中、近视力、离焦曲线、OPDIII客观视觉质量、QoV问卷调查、患者满意度及术后脱镜率。结果:术后3mo SBL-3组和ZCB00组裸眼和矫正远视力LogMAR值(0.13±0.09 vs 0.10±0.08,0.06±0.06 vs 0.08±0.08,均P>0.05)无显著差异,裸眼远视力均较术前有显著改善(P<0.05)。SBL-3组裸眼及最佳矫正远视力下的中、近视力明显优于ZCB00组(0.10±0.14 vs 0.27±0.10,0.05±0.16 vs 0.35±0.17,0.11±0.14 vs 0.26±0.11,0.03±0.17 vs 0.35±0.17,均P<0.05)。在所评估的各个空间频率上患者对比敏感度的比较中ZCB00组均优于SBL-3组(P<0.05)。SBL-3组总像差、总高阶像差、彗差、三叶草差均大于ZCB00组且有显著差异(P<0.05),SBL-3组平均SR值小于ZCB00组(P<0.05)。术后3mo SBL-3组出现眩光1例,光晕1例,视远模糊4例。SBL-3组和ZCB00组患者表示非常满意者分别占82%、88%。两组间满意度比较无显著差异(P>0.05),脱镜率(94%vs 67%)比较有显著差异(P<0.05),且SBL-3组脱镜率更高。结论:新型区域折射型MIOL SBL-3提供了良好的全程视力,术后不良视觉症状少,满意度和脱镜率高。
文摘目的:观察区域折射多焦点人工晶状体(IOL)植入术后的视觉质量。方法:选取2016-06/2017-02在我院行白内障超声乳化吸除联合IOL植入术的白内障患者50例83眼,按植入的IOL类型不同分为观察组(22例37眼,植入多焦点IOL)和对照组(28例46眼,植入单焦点IOL)。术后3mo,观察裸眼视力,使用OQASⅡ客观视觉质量分析系统评估视觉质量,并采用问卷调查术后视觉干扰症状、脱镜率及满意度。结果:术后3mo,观察组和对照组裸眼远视力(0.095±0.031 vs 0.078±0.025)无差异(P=0.273),但观察组患者裸眼中、近视力均优于对照组(0.146±0.043 vs 0.537±0.102,0.165±0.048 vs 0.754±0.150,均P<0.05);两组患者MTF cut-off和对比度视力无差异,但OSI(2.64±0.68 vs 1.52±0.47)和客观调节幅度(2.91±0.71D vs 1.32±0.41D)均有明显差异(P<0.01);观察组脱镜率明显高于对照组(91%vs 7%,P<0.05),但两组术后视学干扰症状发生率和满意度无明显差异(均P>0.05)。结论:区域折射多焦点IOL可提供良好的全程视力和视觉质量,提高了患者的脱镜率,且满意度高。
