Résumé
Objective@#To compare the efficacy and visual quality of biocular cataract surgery combined with TECNIS Symfony intraocular lens(IOL) implantation in the correction of presbyopia with three different methods of reserved diopters.@*Methods@#A prospective cohort design was adopted.From October in 2016 to December in 2018, 120 patients 240 eyes with binocular cataract surgery implanted TECNIS Symfony IOL were divided into regular group, micro-near-vision group and micro-monovision group according to different reserved diopters, 40 patients 80 eyes in each group.The binocular IOL reserved diopter is + 0.10--0.20 D in regular group.The binocular IOL reserved diopter is -0.20--0.50 D in micro-near-vision group, meanwhile, the dominant eye reserved diopter is + 0.10--0.20 D, and the non-dominant eye reserved the myopia of -0.50--0.75 D in micro-monovision group.Defocus curves of single eye and binocular were measured and full distance visual acuity were analyzed 3 months after surgery.MTF values were detected by iTrace and compared between different groups.Visual function questionnaire of multifocal intraocular lenes (MIOLs)were analyzed and spectacle independence rate of presbyopia correction and disturbing photic phenomena were compared 3 months after surgery.This study protocol was approved by the ethics committee of Chongqing Aier Mega Eye Hospital, and this study followed the Declaration of Helsinki.@*Results@#Compared with regular group, the whole defocus curve of micro-near-vision group actually shifted to the right by 0.35 D, with almost no change in shape.The shape of the binocular defocus curve of micro-monovision group changed significantly compared with that of regular group, that is the wave peak became significantly wider, and the downward trend was more gentle.Spectacle independence rate of the three groups were all 100.00%, spectacle independence rate of intermediate distance in Micro-monovision group was 100.00%, which was higher than that of regular group(80.00%) and micro-near-vision group(90.00%), and the differences were statistically significant (χ2=37.04; P<0.01). The MTF value of the dominant eye was higher than that of the non-dominant eye in the Micro-monovision group, and the difference was statistically significant(t=3.74, P=0.001). There was no statistically significant difference in the occurrence rate of disturbing photic phenomena among the three groups(P>0.05).@*Conclusions@#Different reserved diopter design during cataract extraction combined with TECNIS Symfony IOL implantation suits different patients.Among the three different reserved diopters methods, the effect of micro-monovision method can obtain the highest spectacle independence rate, and provide satisfactory binocular far to near full-distance visual acuity.
Résumé
Objective To compare the efficacy and visual quality of biocular cataract surgery combined with TECNIS Symfony intraocular lens( IOL) implantation in the correction of presbyopia with three different methods of reserved diopters. Methods A prospective cohort design was adopted. From October in 2016 to December in 2018,120 patients 240 eyes with binocular cataract surgery implanted TECNIS Symfony IOL were divided into regular group,micro-near-vision group and micro-monovision group according to different reserved diopters,40 patients 80 eyes in each group. The binocular IOL reserved diopter is +0. 10--0. 20 D in regular group. The binocular IOL reserved diopter is -0. 20--0. 50 D in micro-near-vision group, meanwhile, the dominant eye reserved diopter is +0. 10--0. 20 D, and the non-dominant eye reserved the myopia of -0. 50--0. 75 D in micro-monovision group. Defocus curves of single eye and binocular were measured and full distance visual acuity were analyzed 3 months after surgery. MTF values were detected by iTrace and compared between different groups. Visual function questionnaire of multifocal intraocular lenes ( MIOLs ) were analyzed and spectacle independence rate of presbyopia correction and disturbing photic phenomena were compared 3 months after surgery. This study protocol was approved by the ethics committee of Chongqing Aier Mega Eye Hospital, and this study followed the Declaration of Helsinki. Results Compared with regular group, the whole defocus curve of micro-near-vision group actually shifted to the right by 0. 35 D,with almost no change in shape. The shape of the binocular defocus curve of micro-monovision group changed significantly compared with that of regular group,that is the wave peak became significantly wider,and the downward trend was more gentle. Spectacle independence rate of the three groups were all 100. 00％, spectacle independence rate of intermediate distance in Micro-monovision group was 100. 00％, which was higher than that of regular group (80. 00％) and micro-near-vision group(90. 00％),and the differences were statistically significant (χ2=37. 04;P<0. 01). The MTF value of the dominant eye was higher than that of the non-dominant eye in the Micro-monovision group,and the difference was statistically significant(t=3. 74,P=0. 001). There was no statistically significant difference in the occurrence rate of disturbing photic phenomena among the three groups(P>0. 05). Conclusions Different reserved diopter design during cataract extraction combined with TECNIS Symfony IOL implantation suits different patients. Among the three different reserved diopters methods, the effect of micro-monovision method can obtain the highest spectacle independence rate, and provide satisfactory binocular far to near full-distance visual acuity.
Résumé
@#AIM: To evaluate the clinical outcomes in terms of vision across distances(near, intermediate and far), contrast sensitivity and subjective patient satisfaction after femtosecond laser-assisted cataract surgery(FLACS)with implantation of an extended range of vision(ERV)intraocular lens(IOL).<p>METHODS: Forty patients(55 eyes)underwent bilateral or monocular FLACS with implantation of the ERV IOL Tecnis Symfony(Johnson & Johnson Vision)were enrolled. Uncorrected distance(UDVA), intermediate(UIVA)and near visual acuities(UNVA)were evaluated at 3mo after surgery, as well the defocus curve, contrast sensitivity, patient satisfaction and spectacle independence.<p>RESULTS:No severe complications occurred. All eyes showed a central position of the IOL in the capsular bag without tilting at 3mo after surgery. 3mo postoperative mean logMAR visual acuity at 5 m, 67 cm and 40 cm were -0.04 ±0.08, -0.17±0.22, 0.37±0.17, respectively. All patients obtained satisfactory UDVA and UIVA, as well as functional UNVA, meeting the needs of daily life. Spectacle independence rate was 94.55%. Contrast sensitivity results did not differ from those obtained with monofocal aspheric lenses. Likewise, no moderate and severe photic phenomena were reported. Mean patient satisfaction scores with distance, intermediate and near vision were 9.0, 9.0, and 7.0, respectively.<p>CONCLUSION: FLACS with implantation of the ERV IOL TECNIS Symfony provides a successful visual restoration at far, intermediate distance and a functional-range near vision acuity, with minimal level of disturbing photic phenomena, and high rates of spectacle independence and patient satisfaction.