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Klin Monbl Augenheilkd 2017; 234(10): 1276-1282
DOI: 10.1055/s-0043-102573
Klinische Studie
Georg Thieme Verlag KG Stuttgart · New York

Klinischer Vergleich einer trifokalen und einer trifokal-torischen Intraokularlinse auf gleicher diffraktiver Plattform

Clinical Comparison of a Trifocal and a Trifocal-Toric Intraocular Lens Based on the Same Diffractive Platform
M. Gerl
1   Augenheilkunde, Augenklinik Ahaus-Raesfeld-Rheine, Ahaus
2   International Vision Correction Research Centre Network (IVCRC.net), Universitäts-Augenklinik Heidelberg
,
D. R. H. Breyer
2   International Vision Correction Research Centre Network (IVCRC.net), Universitäts-Augenklinik Heidelberg
3   Augenchirurgie, Breyer, Kaymak und Klabe, Düsseldorf
,
P. Hagen
2   International Vision Correction Research Centre Network (IVCRC.net), Universitäts-Augenklinik Heidelberg
3   Augenchirurgie, Breyer, Kaymak und Klabe, Düsseldorf
,
M. J. Koss
2   International Vision Correction Research Centre Network (IVCRC.net), Universitäts-Augenklinik Heidelberg
4   Augenzentrum Nymphenburger Höfe, München
,
M. Mueller
1   Augenheilkunde, Augenklinik Ahaus-Raesfeld-Rheine, Ahaus
2   International Vision Correction Research Centre Network (IVCRC.net), Universitäts-Augenklinik Heidelberg
,
M. Al Saad
1   Augenheilkunde, Augenklinik Ahaus-Raesfeld-Rheine, Ahaus
,
R. H. Gerl
1   Augenheilkunde, Augenklinik Ahaus-Raesfeld-Rheine, Ahaus
2   International Vision Correction Research Centre Network (IVCRC.net), Universitäts-Augenklinik Heidelberg
,
H. Kaymak
2   International Vision Correction Research Centre Network (IVCRC.net), Universitäts-Augenklinik Heidelberg
3   Augenchirurgie, Breyer, Kaymak und Klabe, Düsseldorf
,
K. Klabe
2   International Vision Correction Research Centre Network (IVCRC.net), Universitäts-Augenklinik Heidelberg
3   Augenchirurgie, Breyer, Kaymak und Klabe, Düsseldorf
,
F. T. A. Kretz
1   Augenheilkunde, Augenklinik Ahaus-Raesfeld-Rheine, Ahaus
2   International Vision Correction Research Centre Network (IVCRC.net), Universitäts-Augenklinik Heidelberg
› Author Affiliations
Further Information

Publication History

eingereicht 15 November 2016

akzeptiert 09 January 2017

Publication Date:
05 April 2017 (online)

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Zusammenfassung

Hintergrund Trifokale Linsen ergänzen seit wenigen Jahren die Möglichkeiten der chirurgischen Presbyopiekorrektur. In dieser Studie werden 2 Intraokularlinsen (IOL) auf Basis des gleichen trifokalen diffraktiven Designs verglichen, ein Modell ohne und eines mit torischer Komponente zur Astigmatismuskorrektur.

Patienten/Material und Methoden Prospektive nicht randomisierte Vergleichsstudie mit 142 Augen von 77 Patienten (Alter 40–73 Jahre) mit komplikationsloser Linsenchirurgie. Die Patienten wurden entsprechend dem implantierten Linsenmodell in 2 Gruppen aufgeteilt, die trifokale Gruppe (98 Augen von 50 Patienten) mit der trifokalen diffraktiven IOL AT LISA tri 839MP (Carl Zeiss Meditec) und die trifokal-torische Gruppe (44 Augen von 27 Patienten) mit Implantation der trifokal-torischen diffraktiven IOL AT LISA tri toric 939MP (Carl Zeiss Meditec). Sehschärfe und Refraktion wurden 3 Monate postoperativ ausgewertet.

Ergebnisse Es gab keine signifikanten Unterschiede zwischen den Gruppen in Bezug auf postoperative Refraktion (p ≥ 0,144), monokularen und binokularen unkorrigierten Intermediärvisus (UIVA; p = 0,519 bzw. 0,398) und binokularen unkorrigierten Nahvisus (UNVA; p = 0,073). Dagegen wurden in der trifokalen Gruppe ein signifikant besserer monokularer und binokularer unkorrigierter Fernvisus (UDVA; p ≤ 0,002) und monokularer UNVA (p = 0,005) beobachtet. Das sphärische Äquivalent lag bei 98 bzw. 100 % der Patienten innerhalb von ± 1,00 dpt bei der trifokalen Gruppe und der trifokal-torischen Gruppe. Ein postoperativer binokularer UDVA, UIVA und UNVA von 0,63 dezimal oder besser wurde bei 100, 95 bzw. 100 % der Augen in der trifokalen Gruppe und bei 96,3, 95,8 bzw. 90,9 % der Augen mit dem torischen Linsenmodell beobachtet.

Abstract

Purpose To evaluate and compare the visual performance of a trifocal and a trifocal-toric intraocular lens (IOL) based on the same diffractive platform.

Methods Prospective non-randomized comparative study enrolling 142 eyes of 77 patients (age 40–73 years) undergoing uneventful phacoemulsification lens surgery. Two groups were differentiated according to the implanted IOL: trifocal group, 98 eyes (50 patients) implanted with the trifocal diffractive IOL AT LISA tri 839MP (Carl Zeiss Meditec), and trifocal-toric group, 44 eyes (27 patients) implanted with the trifocal-toric diffractive IOL AT LISA trifocal-toric 939MP (Carl Zeiss Meditec). Visual and refractive changes were evaluated 3 months postoperatively.

Results No significant differences between groups were found in postoperative refraction (p ≥ 0.144), monocular and binocular uncorrected intermediate visual acuity (UIVA; p = 0.519 and 0.398, respectively) and binocular uncorrected near visual acuity (UNVA; p = 0.073). In contrast, significantly better monocular and binocular uncorrected distance visual acuity (UDVA; p ≤ 0.002), as well as monocular UNVA (p = 0.005), were found in the trifocal group. A postoperative spherical equivalent within ± 1.00 D was found in 98 % and 100 % of eyes in the trifocal and trifocal-toric groups, respectively. Postoperative binocular UDVA, UIVA and UNVA of 20/30 or better were found in 100, 95 and 100 % of eyes, and in 96.3, 95.8 and 90.9 % of eyes in the trifocal and trifocal-toric groups, respectively.

Conclusions The evaluated trifocal and trifocal-toric IOLs both provide a successful restoration of the visual function after cataract surgery, with good levels of refractive precision, as well as UIVA and UNVA.

Schlüsselwörter

trifokal - torisch - Intraokularlinse - Visus - Refraktion

Key words

trifocal - toric - intraocular lens - visual acuity - refraction
 

  • Literatur

  • 1 Cochener B. Prospective clinical comparison of patient outcomes following implantation of trifocal or bifocal intraocular lenses. J Refract Surg 2016; 32: 146-151
    CrossrefPubMedGoogle Scholar
  • 2 Mendicute J, Kapp A, Lévy P. et al. Evaluation of visual outcomes and patient satisfaction after implantation of a diffractive trifocal intraocular lens. J Cataract Refract Surg 2016; 42: 203-210
    CrossrefPubMedGoogle Scholar
  • 3 Alfonso JF, Fernández-Vega Cueto L, Belda-Salmerón L. et al. Visual function after implantation of a diffractive aspheric trifocal intraocular lens. Eur J Ophthalmol 2016; 26: 405-411
    CrossrefPubMedGoogle Scholar
  • 4 Kohnen T, Titke C, Böhm M. Trifocal intraocular lens implantation to treat visual demands in various distances following lens removal. Am J Ophthalmol 2016; 161: 71-77.e1
    CrossrefPubMedGoogle Scholar
  • 5 Mojzis P, Majerova K, Hrckova L. et al. Implantation of a diffractive trifocal intraocular lens: one-year follow-up. J Cataract Refract Surg 2015; 41: 1623-1630
    CrossrefPubMedGoogle Scholar
  • 6 Kretz FT, Breyer D, Diakonis VF. et al. Clinical outcomes after binocular implantation of a new trifocal diffractive intraocular lens. J Ophthalmol 2015; 2015: 962891
    PubMedGoogle Scholar
  • 7 Kretz FT, Müller M, Gerl M. et al. Binocular function to increase visual outcome in patients implanted with a diffractive trifocal intraocular lens. BMC Ophthalmol 2015; 15: 110
    CrossrefPubMedGoogle Scholar
  • 8 Kretz FT, Breyer D, Klabe K. et al. Clinical outcomes after implantation of a trifocal toric intraocular lens. J Refract Surg 2015; 31: 504-510
    CrossrefPubMedGoogle Scholar
  • 9 Carballo-Alvarez J, Vazquez-Molini JM, Sanz-Fernandez JC. et al. Visual outcomes after bilateral trifocal diffractive intraocular lens implantation. BMC Ophthalmol 2015; 15: 26
    CrossrefPubMedGoogle Scholar
  • 10 Cochener B, Vryghem J, Rozot P. et al. Clinical outcomes with a trifocal intraocular lens: a multicenter study. J Refract Surg 2014; 30: 762-768
    CrossrefPubMedGoogle Scholar
  • 11 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
    CrossrefPubMedGoogle Scholar
  • 12 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
    CrossrefPubMedGoogle Scholar
  • 13 Mojzis P, Majerova K, Plaza-Puche AB. et al. Visual outcomes of a new toric trifocal diffractive intraocular lens. J Cataract Refract Surg 2015; 41: 2695-2706
    CrossrefPubMedGoogle Scholar
  • 14 Gundersen KG, Potvin R. Comparison of visual outcomes after implantation of diffractive trifocal toric intraocular lens and a diffractive apodized bifocal toric intraocular lens. Clin Ophthalmol 2016; 10: 455-461
    PubMedGoogle Scholar
  • 15 Thibos LN, Horner D. Power vector analysis of the optical outcome of refractive surgery. J Cataract Refract Surg 2001; 27: 80-85
    CrossrefPubMedGoogle Scholar
  • 16 Jonker SM, Bauer NJ, Makhotkina NY. et al. Comparison of a trifocal intraocular lens with a + 3.0 D bifocal IOL: results of a prospective randomized clinical trial. J Cataract Refract Surg 2015; 41: 1631-1640
    CrossrefPubMedGoogle Scholar
  • 17 Marques JP, Rosa AM, Quendera B. et al. Quantitative evaluation of visual function 12 months after bilateral implantation of a diffractive trifocal IOL. Eur J Ophthalmol 2015; 25: 516-524
    CrossrefPubMedGoogle Scholar
  • 18 Law EM, Aggarwal RK, Kasaby H. Clinical outcomes with a new trifocal intraocular lens. Eur J Ophthalmol 2014; 24: 501-508
    CrossrefPubMedGoogle Scholar
  • 19 Alió JL, Montalbán R, Peña-García P. et al. Visual outcomes of a trifocal aspheric diffractive intraocular lens with microincision cataract surgery. J Refract Surg 2013; 29: 756-761
    CrossrefPubMedGoogle Scholar
  • 20 Höhn F, Tandogan T, Breyer DR. et al. [Functional results one year after implantation of a bitoric, trifocal intraocular lens]. Klin Monatsbl Augenheilkd 2015; 232: 957-961
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 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
    CrossrefPubMedGoogle Scholar