Comparing Clinical Outcomes of Various Presbyopia-Correcting Intraocular Lenses Using a Novel Composite Method for the Analysis and Reporting of Uncorrected Distance, Intermediate, and Near Visual Acuities

采用新型综合方法分析和报告未矫正的远、中、近视力,比较各种老花眼矫正型人工晶状体的临床结果

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Abstract

INTRODUCTION: This work aims to monitor the stability of composite descriptors of uncorrected distance (UCDVA), intermediate (UCIVA), and near (UCNVA) logMAR acuities after uneventful phacoemulsification and presbyopia correcting intra-ocular lenses (PCIOLs) implantation. METHODS: Patients implanted with AcrySof IQ PanOptix (group 1, n = 32), TECNIS Symfony (group 2, n = 35), TECNIS bifocal (group 3, n = 34), or TECNIS monofocal (comparative, group 4, n = 32) were followed up for 12 months. In each case, the errors in the composite descriptor of [I] UCDVA and UCNVA doublets (EDN = √[(UCDVA)(2) + (UCNVA)(2)]) and [II] UCDVA, UCIVA and UCNVA triplets (EDIN = √[(UCDVA)(2) + (UCIVA)(2) + (UCNVA)(2)]) were monitored for targeted postoperative uncorrected logMAR acuities of zero. EDN and EDIN values were subjected to 2D and 3D graphical treatments to identify the absolute changes (ΔEDN and ΔEDIN) occurring between 1 week and 1 month, 1 and 6 months, and 6 and 12 months. RESULTS: There were small changes in residual refractive errors, UCDVA, UCIVA, UCNVA, EDN, EDIN, ΔEDN, and ΔEDIN values within, or between, groups 1-3. In groups 1 to 4, respectively. (i) Between 1 week and 1 month postop, the mean (± SD, 95% CI) ΔEDN values were 0.03 (± 0.05, 0.01-0.05), 0.05 (± 0.08, 0.02-0.08), 0.04 (± 0.07, 0.02-0.06), 0.19 (± 0.14, 0.14-0.24) and the ΔEDIN values were 0.04 (± 0.06, 0.01-0.05), 0.06 (± 0.10, 0.03-0.09), 0.04 (± 0.08, 0.01-0.07), 0.23 (± 0.14, 0.18-0.28). Differences were significant (one-way ANOVA for ΔEDN, F = 20.65, p < 0.001; for ΔEDIN, F = 25.03, p < 0.001), but not after excluding group 4. (ii) Between 6 and 12 months, postop ΔEDIN values > 0.1 logMAR occurred in 3 (10%), 6 (17%), 4 (12%), and 1 (3%) of cases. CONCLUSIONS: The changes in uncorrected distance, intermediate, and near visual acuities were small and remained relatively stable 1 week following implantation with PCIOLs. Fewer than 20% of cases experienced a change in composite description of acuities > 0.1 logMAR between 6 and 12 months postop. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT07008768.

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