Visual Outcomes and Patient-Reported Dysphotopsia After PanOptix and PanOptix Toric Implantation Stratified by Preoperative Chord Mu: A Prospective Observational Cohort Study.
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引用次数: 0
Abstract
Introduction: We aimed to evaluate the tolerance of preoperative chord mu (angle kappa) after cataract or clear lens exchange surgery and implantation of AcrySof IQ PanOptix and PanOptix Toric in a Chinese cohort.
Methods: This prospective observational study consecutively enrolled patients undergoing PanOptix/PanOptix Toric implantation at Peking Union Medical College Hospital. Eyes were analyzed by chord mu (< 0.3 mm vs. ≥ 0.3 mm), lens opacity (clear lens or cataract), and intraocular lens (PanOptix or PanOptix Toric). Visual acuity was assessed at 1 and 3 months. Patient-reported outcomes were assessed at 3 months using the IOLSAT and the QUVID.
Results: A total of 122 eyes from 62 patients were analyzed. Seventy-nine eyes received PanOptix Toric lenses, and 43 eyes received non-toric PanOptix lenses. The κ ≥ 0.3 mm group had less myopic spherical equivalent (P = 0.004) than the κ < 0.3 mm group. At 1 and 3 months, the uncorrected and corrected distance, intermediate, and near visual acuity outcomes were excellent and did not differ significantly between κ groups in the overall cohort (all P > 0.05). In the toric subgroup,1-m UNVA was better in eyes with κ < 0.3 mm (P < 0.001, adj. P = 0.024) than in those with κ ≥ 0.3 mm. Overall spectacle independence was 90% (45/50), with 100% for distance and intermediate vision in both κ groups; near spectacle independence was similar between groups (P = 0.797). The most frequent visual disturbances were halos (78%, 39/50), starbursts (60%, 30/50), and glare (42%, 21/50), with no significant differences between the κ groups (all P > 0.05). Patient-reported outcomes and disturbance frequencies were similar between PanOptix and PanOptix Toric (all P > 0.05). Compared with cataract surgery, clear lens exchange resulted in increased rates of halos (92.3% vs. 62.5%, P = 0.016).
Conclusions: In this carefully selected, small sample Chinese cohort implanted with PanOptix/PanOptix Toric lense and restricted to eyes with chord mu ≤ 0.5 mm, a κ ≥ 0.3 mm was not associated with worse overall visual acuity, spectacle independence, or the likelihood/severity of visual disturbances. The PanOptix Toric lens demonstrated patient-reported outcomes comparable to those of the non-toric PanOptix. Patients who underwent clear lens exchange reported more visual disturbances than those who underwent cataract surgery, suggesting a need for careful candidate selection and preoperative counseling.
前言：我们的目的是评估中国队列白内障或透明晶状体置换手术和植入acryysof IQ PanOptix和PanOptix Toric后术前chord mu （angle kappa）的耐受性。方法：本前瞻性观察性研究连续纳入在北京协和医院行PanOptix/PanOptix环形静脉植入的患者。结果：共分析62例患者122只眼。79只眼接受PanOptix环面镜片，43只眼接受非环面PanOptix镜片。κ≥0.3 mm组近视球当量小于κ 0.05组（P = 0.004）。在toric亚组中，1 m UNVA在眼内较好（κ 0.05）。PanOptix和PanOptix Toric患者报告的结果和干扰频率相似（均P < 0.05）。与白内障手术相比，透明晶状体置换术导致光晕发生率增加（92.3%比62.5%,P = 0.016）。结论：在这个精心挑选的小样本中国队列中，植入PanOptix/PanOptix Toric晶体并限制在弦mu≤0.5 mm, a κ≥0.3 mm的眼睛中，与较差的整体视力，眼镜独立性或视力障碍的可能性/严重程度无关。PanOptix环形晶状体的患者报告结果与非环形PanOptix相似。接受透明晶状体置换的患者比接受白内障手术的患者报告更多的视力障碍，这表明需要仔细选择候选人和术前咨询。
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