Klin Monbl Augenheilkd 2015; 232(08): 957-961
DOI: 10.1055/s-0041-103335
Klinische Studie
Georg Thieme Verlag KG Stuttgart · New York

Funktionelle Ergebnisse 1 Jahr nach Implantation einer bitorischen, trifokalen Intraokularlinse

Functional Results One Year after Implantation of a Bitoric, Trifocal Intraocular Lens
F. Höhn
1   Augenheilkunde, Helios Klinikum Pforzheim
2   International Vision Correction Research Centre Network (IVCRC.net), Heidelberg
,
T. Tandogan
2   International Vision Correction Research Centre Network (IVCRC.net), Heidelberg
3   Augenklinik, Universitätsklinikum Heidelberg
,
D. R. H. Breyer
2   International Vision Correction Research Centre Network (IVCRC.net), Heidelberg
4   Augenchirurgie, Breyer, Kaymak und Klabe Augenchirurgie, Düsseldorf
,
H. Kaymak
2   International Vision Correction Research Centre Network (IVCRC.net), Heidelberg
4   Augenchirurgie, Breyer, Kaymak und Klabe Augenchirurgie, Düsseldorf
,
P. Hagen
2   International Vision Correction Research Centre Network (IVCRC.net), Heidelberg
4   Augenchirurgie, Breyer, Kaymak und Klabe Augenchirurgie, Düsseldorf
,
K. Klabe
2   International Vision Correction Research Centre Network (IVCRC.net), Heidelberg
4   Augenchirurgie, Breyer, Kaymak und Klabe Augenchirurgie, Düsseldorf
,
M. J. Koss
2   International Vision Correction Research Centre Network (IVCRC.net), Heidelberg
3   Augenklinik, Universitätsklinikum Heidelberg
,
M. Gerl
2   International Vision Correction Research Centre Network (IVCRC.net), Heidelberg
5   Augenheilkunde, 2. Augenklinik Ahaus – Raesfeld – Rheine, Gerl Group, Ahaus
,
G. U. Auffarth
2   International Vision Correction Research Centre Network (IVCRC.net), Heidelberg
3   Augenklinik, Universitätsklinikum Heidelberg
,
F. T. A. Kretz
2   International Vision Correction Research Centre Network (IVCRC.net), Heidelberg
3   Augenklinik, Universitätsklinikum Heidelberg
5   Augenheilkunde, 2. Augenklinik Ahaus – Raesfeld – Rheine, Gerl Group, Ahaus
› Author Affiliations
Further Information

Publication History

eingereicht 26 May 2015

akzeptiert 23 June 2015

Publication Date:
19 August 2015 (online)

Zusammenfassung

Ziel: Beurteilung der visuellen, refraktiven Ergebnisse 1 Jahr nach Implantation einer trifokalen diffraktiven torischen Intraokularlinse (IOL) im Rahmen einer Kataraktoperation. Methode: In einer prospektiven Studie wurde bei Patienten mit einer kalkulierten postoperativen Hornhautverkrümmung von ≥ 0,75 dpt im Rahmen der Kataraktoperation eine diffraktiv-trifokale torische Intraokularlinse (AT LISA tri toric 939MP, Carl Zeiss Meditec, Jena, Deutschland) implantiert. Ein Jahr postoperativ wurden der monokulare und binokulare Nah-, Intermdiär- und Fernvisus, unkorrigiert und korrigiert, sowie die Refraktion evaluiert. Ergebnis: 20 Patienten (40 Augen) mit einem mittleren Alter von 59 ± 11 Jahren, hiervon 15 Frauen, wurden im Rahmen der Studie bilateral an einer Katarakt operiert. Ein Jahr postoperativ zeigte sich ein binokularer unkorrigierter Fernvisus (UDVA) von 0,10 logMAR ± 0,11 bei einem korrigierten Fernvisus (CDVA) von 0,00 logMAR ± 0,08. Der binokulare Intermediärvisus (UIVA) lag bei 0,00 logMAR ± 0,05, der binokulare unkorrigierte Nahvisus (UNVA) bei 0,09 logMAR ± 0,07. 100 % der Patienten lagen postoperativ ± 1,0 dpt von der Zielrefraktion. Selbst nach 1 Jahr zeigte sich bei keinem der Patienten eine IOL-Rotation > 5°. Schlussfolgerung: Die Implantation einer trifokal-torischen Intraokularlinse bietet eine effektive Wiederherstellung für das Sehen im Nah-, Intermediär- und Fernbereich bei guter Rotationsstabilität der IOL.

Abstract

Purpose: An evaluation of the visual and refractive results was undertaken one year after implantation of a trifocal diffractive toric intraocular lens (IOL) during cataract surgery. Methods: In a prospective study patients with a calculated postoperative corneal astigmatism of ≥ 0.75 D received a diffractive trifocal toric IOL (AT LISA tri toric 939MP, Carl Zeiss Meditech, Jena, Germany) during cataract surgery. One year postoperatively the near, intermediate and distance visual acuity, corrected and uncorrected vision as well as refraction were evaluated. Results: 20 patients (40 eyes) with a median age of 59 ± 11 years of which 15 were female underwent bilateral cataract surgery. One year postoperatively a binocular uncorrected distance visual acuity (UDVA) of 0.10 logMAR ± 0.11 and a corrected distance visual acuity (CDVA) of 0.00 logMAR ± 0.08 could be found. Binocular intermediate visual acuity (UIVA) and near visual acuity (UNVA) were 0.00 logMAR ± 0.05 and 0.09 logMAR ± 0.07, respectively. 100 % of patients were between ± 1.0 D from target refraction. Even 1 year after surgery no patient had an IOL rotation greater than 5°. Conclusion: The implantation of a trifocal toric intraocular lens offers an effective way for visual rehabilitation in near, intermediate and far distances with a good rotational stability of the IOL platform.

 
  • Literatur

  • 1 Zheleznyak L, Kim MJ, MacRae S et al. Impact of corneal aberrations on through-focus image quality of presbyopia-correcting intraocular lenses using an adaptive optics bench system. J Cataract Refract Surg 2012; 38: 1724-1733
  • 2 Behndig A, Montan P, Stenevi U et al. Aiming for emmetropia after cataract surgery: Swedish National Cataract Register study. J Cataract Refract Surg 2012; 38: 1181-1186
  • 3 Alio JL, Pinero DP, Tomas J et al. Vector analysis of astigmatic changes after cataract surgery with implantation of a new toric multifocal intraocular lens. J Cataract Refract Surg 2011; 37: 1217-1229
  • 4 Bellucci R, Bauer NJ, Daya SM et al. Visual acuity and refraction with a diffractive multifocal toric intraocular lens. J Cataract Refract Surg 2013; 39: 1507-1518
  • 5 Crema AS, Walsh A, Ventura BV et al. Visual outcomes of eyes implanted with a toric multifocal intraocular lens. J Refract Surg 2014; 30: 486-491
  • 6 Ferreira TB, Marques EF, Rodrigues A et al. Visual and optical outcomes of a diffractive multifocal toric intraocular lens. J Cataract Refract Surg 2013; 39: 1029-1035
  • 7 Frieling-Reuss EH. Comparative analysis of the visual and refractive outcomes of an aspheric diffractive intraocular lens with and without toricity. J Cataract Refract Surg 2013; 39: 1485-1493
  • 8 Knorz MC, Rincon JL, Suarez E et al. Subjective outcomes after bilateral implantation of an apodized diffractive + 3.0 D multifocal toric IOL in a prospective clinical study. J Refract Surg 2013; 29: 762-767
  • 9 Kretz FT, Bastelica A, Carreras H et al. Clinical outcomes and surgeon assessment after implantation of a new diffractive multifocal toric intraocular lens. Br J Ophthalmol 2015; 99: 405-411
  • 10 Mojzis P, Pinero DP, Studeny P et al. Comparative analysis of clinical outcomes obtained with a new diffractive multifocal toric intraocular lens implanted through two types of corneal incision. J Refract Surg, 2011; 27: 648-657
  • 11 Venter J, Pelouskova M. Outcomes and complications of a multifocal toric intraocular lens with a surface-embedded near section. J Cataract Refract Surg 2013; 39: 859-866
  • 12 Visser N, Nuijts RM, de Vries NE et al. Visual outcomes and patient satisfaction after cataract surgery with toric multifocal intraocular lens implantation. J Cataract Refract Surg 2011; 37: 2034-2042
  • 13 Khoramnia R, Auffarth GU, Rabsilber TM et al. Implantation of a multifocal toric intraocular lens with a surface-embedded near segment after repeated LASIK treatments. J Cataract Refract Surg 2012; 38: 2049-2052
  • 14 Rabsilber TM, Kretz FT, Holzer MP et al. Bilateral implantation of toric multifocal additive intraocular lenses in pseudophakic eyes. J Cataract Refract Surg 2012; 38: 1495-1498
  • 15 Alio JL, Montalban R, Pena-Garcia P et al. Visual outcomes of a trifocal aspheric diffractive intraocular lens with microincision cataract surgery. J Refract Surg 2013; 29: 756-761
  • 16 Cochener B, Vryghem J, Rozot P et al. Visual and refractive outcomes after implantation of a fully diffractive trifocal lens. Clin Ophthalmol 2012; 6: 1421-1427
  • 17 Law EM, Aggarwal RK, Kasaby H. Clinical outcomes with a new trifocal intraocular lens. Eur J Ophthalmol 2014; 24: 501-508
  • 18 Kretz FT, Attia MA, Linz K et al. [Level of Binocular Pseudoaccommodation in Patients Implanted with an Apodised, Diffractive and Trifocal Multifocal Intraocular Lens]. Klin Monatsbl Augenheilkd 2015; [Epub ahead of print]
  • 19 Brito P, Salgado-Borges J, Neves H et al. Light-distortion analysis as a possible indicator of visual quality after refractive lens exchange with diffractive multifocal intraocular lenses. J Cataract Refract Surg 2015; 41: 613-622
  • 20 Alfonso JF, Knorz M, Fernandez-Vega L et al. Clinical outcomes after bilateral implantation of an apodized + 3.0 D toric diffractive multifocal intraocular lens. J Cataract Refract Surg 2014; 40: 51-59
  • 21 Mojzis P, Pena-Garcia P, Liehneova I et al. Outcomes of a new diffractive trifocal intraocular lens. J Cataract Refract Surg 2014; 40: 60-69
  • 22 Lesieur G. [Outcomes after implantation of a trifocal diffractive IOL]. J Fr Ophtalmol 2012; 35: 338-342
  • 23 Sheppard AL, Shah S, Bhatt U et al. Visual outcomes and subjective experience after bilateral implantation of a new diffractive trifocal intraocular lens. J Cataract Refract Surg 2013; 39: 343-349
  • 24 Mojzis P, Kukuckova L, Majerova K et al. Comparative analysis of the visual performance after cataract surgery with implantation of a bifocal or trifocal diffractive IOL. J Refract Surg 2014; 30: 666-672
  • 25 Marques EF, Ferreira TB. Comparison of visual outcomes of 2 diffractive trifocal intraocular lenses. J Cataract Refract Surg 2015; 41: 354-363
  • 26 Alba-Bueno F, Vega F, Millan MS. [Halos and multifocal intraocular lenses: origin and interpretation]. Arch Soc Esp Oftalmoll 2014; 89: 397-404