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Klin Monbl Augenheilkd 2023; 240(04): 426-434
DOI: 10.1055/a-2031-2556
Experimentelle Studie

Bilateral Implantation of Multifocal Intraocular Lenses: 10-Year Follow-Up

Bilaterale Implantation von multifokalen Intraokularlinsen: 10-Jahres-Follow-up
Rosa Giglio
1   Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
,
Chiara De Giacinto
1   Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
,
Leandro Inferrera
1   Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
,
Daniela Fanni
1   Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
,
Serena Milan
1   Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
,
Alessandra Cuna
1   Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
,
Mario Damiano Toro
2   Eye Clinic, Department of Public Health, University of Naples Federico II, Napoli, Italy
3   Chair and Department of General and Paediatric Ophthalmology, Medical University of Lublin, Lublin, Poland
,
Sandrine Zweifel
4   Eye Clinic, University Hospital Zürich, Zurich, Switzerland
,
Giuseppe Ravalico
1   Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
,
Daniele Tognetto
1   Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
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Abstract

Purpose To evaluate and compare the long-term results after bilateral implantation of different multifocal intraocular lenses (MIOLs).

Methods This retrospective comparative study included 42 patients who underwent cataract surgery with bilateral MIOL implantation. Patients were divided into 5 groups: Group 1 received a refractive ReZoom NGX1 IOL (AMO), Group 2 a diffractive Acrysof ReSTOR SA60D3 IOL (Alcon), and Group 3 a diffractive Tecnis ZM900 IOL (AMO). Group 4 and Group 5 were implanted using the mix and match approach with refractive ReZoom-diffractive ReSTOR IOL and refractive ReZoom-diffractive Tecnis ZM900 IOL, respectively. Primary outcome measures were distance, near, and intermediate distance visual acuity measured 6 months (T0) and 10 years (T1) after surgery. Secondary outcomes were defocus curves, contrast sensitivity, patientsʼ satisfaction, and spectacle independence.

Results All patients achieved best-corrected distance visual acuity (BCDVA) greater than 0.11 logMAR and uncorrected distance visual acuity (UCDVA) greater than 0.14 logMAR at both time points. A decrease in contrast sensitivity was evident, particularly at high spatial frequencies; at T1, Group 4 reported statistically higher values than Group 2 at 12 cycles/degree and 18 cycles/degree and statistically higher values than Group 3 at 18 cycles/degree. Great overall satisfaction was reported even in the presence of dysphotopsia. Tecnis ZM900 IOL showed the lowest incidence of posterior capsular opacification.

Conclusion MIOLs could provide adequate functional vision and patient satisfaction, despite the incidence of side effects, in carefully selected patients desiring spectacle independence.

Zusammenfassung

Hintergrund Auswertung und Vergleich der langfristigen Ergebnisse nach bilateraler verschiedener MIOLs-Implantation (MIOLs: Multifokallinsen).

Methoden Diese retrospektive Vergleichsstudie umfasste 42 Patienten. Die Patienten unterzogen sich einer Kataraktoperation mit bilateraler MIOL-Implantation. Die Patienten wurden in 5 Gruppen eingeteilt: Gruppe 1 wurde bilateral eine refraktive ReZoom NGX1 IOL (AMO) implantiert, Gruppe 2 erhielt eine diffraktive Acrysof ReSTOR SA60D3 IOL (Alcon) bilateral und Gruppe 3 erhielt eine diffraktive Tecnis ZM900 IOL (AMO) bilateral. Gruppe 4 und Gruppe 5 erhielten 2 kombinierte Multifokallinsen: eine diffraktive und eine refraktive MIOLs. Gruppe 4 erhielt eine refraktive ReZoom-diffraktive ReSTOR IOL und Gruppe 5 erhielt eine refraktive ReZoom-diffraktive Tecnis ZM900 IOL. Primäre Endpunkte waren die Fern-, Nah- und Mitteldistanz-Sehschärfe, gemessen 6 Monate und 10 Jahre nach der Operation. Sekundäre Endpunkte waren Defokussierungskurven, Kontrastempfindlichkeit, Patientenzufriedenheit und Brillenunabhängigkeit.

Ergebnisse Alle Patienten erreichten einen korrigierten Fernvisus besser als 0.11 logMAR und einen unkorrigierten Fernvisus besser als 0.14 logMAR. Die Abnahme der Kontrastempfindlichkeit war insbesondere bei hohen Ortsfrequenzen offensichtlich. Gruppe 4 zeigte eine statistisch signifikante Differenz zu Gruppe 2 (12 Zyklen/Grad und18 Zyklen/Grad) und eine statistisch signifikante Differenz zu Gruppe 3 (18 Zyklen/Grad) zum T1-Zeitpunkt. Die allgemeine Zufriedenheit nach der Implantation von multifokalen Intraokularlinsen erwies sich als hoch, selbst bei den Patienten, die über das Vorhandensein von Dysphotopien klagten. Tecnis ZM900 IOL zeigte die niedrigste Inzidenz von posteriorer Kapseltrübung zum T1.

Schlussfolgerung Multifokale Intraokularlinsen könnten ein ausreichendes funktionelles Sehen und die Zufriedenheit der Patienten gewährleisten. Es gibt Nebenwirkungen, daher empfehlen wir die Verwendung dieser Multifokallinsen nur bei ausgewählten Patienten, die brillenunabhängig werden wollen.

Key words

cataract surgery - multifocal IOLs - visual outcomes - patient satisfaction

Schlüsselwörter

Kataraktchirurgie - multifokale IOLs - visuelle Ergebnisse - Patientenzufriedenheit


Publication History

Received: 16 September 2022

Accepted: 31 January 2023

Article published online:
25 April 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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