Karanpreet Multani, Liam Redden, David Hoang, Scott Vadala, Nitin Rangu, Justin D Dvorak, Kai Ding, Jascha Wendelstein, Kamran M Riaz
{"title":"三联DMEK手术中中性像差与单焦+人工晶状体的视力结果。","authors":"Karanpreet Multani, Liam Redden, David Hoang, Scott Vadala, Nitin Rangu, Justin D Dvorak, Kai Ding, Jascha Wendelstein, Kamran M Riaz","doi":"10.1007/s10792-025-03558-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To compare visual acuity outcomes of two monofocal IOL models, a zero-aberration monofocal IOL (Envista MX60E; Bausch and Lomb) and a monofocal plus IOL (Eyhance DIB00; Johnson and Johnson), in eyes undergoing combined cataract surgery and Descemet membrane endothelial keratoplasty (DMEK) (triple DMEK).</p><p><strong>Methods: </strong>Retrospective, single-center case series of 91 eyes (66 patients) undergoing triple DMEK with either IOL between 2019 and 2023 at a tertiary academic center. Eyes were divided into 2 groups: zero-aberration IOL (49 eyes) and monofocal plus IOL (42 eyes). Among these, 20 eyes received a zero-aberration IOL, and 26 eyes received a monofocal plus IOL in both eyes. Visual acuity measurements at 3-6 months and 6-12 months postoperatively included uncorrected distance, intermediate, and near (UDVA, UIVA, UNVA) and distance-corrected distance, intermediate, and near (CDVA, DCIVA, DCNVA) visual acuities for monocular (Uni) and binocular (Bi) assessments. Patients were administered the Intraocular Lens Satisfaction questionnaire to assess their level of spectacle independence at the 3-6 month visit. Statistical analysis was performed using Wilcoxon rank-sum and Fisher's exact tests.</p><p><strong>Results: </strong>UDVA<sub>Uni</sub>, CDVA<sub>Uni</sub>, and UNVA<sub>Uni</sub> were favorable and comparable between the two groups. At the 3-6 month timepoint, the Eyhance group had significantly better UIVA<sub>Uni</sub> (0.17 ± 0.12 vs. 0.23 ± 0.13, p = 0.03), DCIVA<sub>Uni</sub> (0.23 ± 0.08 vs. 0.31 ± 0.08, p < 0.001), and DCNVA<sub>Uni</sub> (0.36 ± 0.09 vs. 0.40 ± 0.08, p = 0.04). However, at 6-12 months, all six VA measurements were similar between the 2 groups. Bilateral cases at the 3-6 month timepoint demonstrated superior DCNVA<sub>Bi</sub> in the Eyhance group versus the Envista group (0.31 ± 0.08 vs. 0.41 ± 0.03, p = 0.008). The spherical equivalent refractive error (- 0.51 ± 0.94D vs. - 0.55 ± 1.05D, p = 0.89) for all eyes and inter-eye refractive error in the binocular subgroup (0.29 ± 1.36D vs. 0.42 ± 1.11D, p = 0.80) was similar for both groups. Postoperative complications and patient satisfaction were comparable between the two groups.</p><p><strong>Conclusion: </strong>Both IOLs can provide favorable corrected and uncorrected VA in triple DMEK eyes. Eyhance may provide better DCIVA<sub>Uni</sub> and UIVA<sub>Uni</sub> in single eyes and better DCNVA<sub>Uni/Bi</sub> in all eyes up to six months postoperatively.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"45 1","pages":"193"},"PeriodicalIF":1.4000,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Visual outcomes of aberration neutral versus monofocal plus IOLs in triple DMEK surgery.\",\"authors\":\"Karanpreet Multani, Liam Redden, David Hoang, Scott Vadala, Nitin Rangu, Justin D Dvorak, Kai Ding, Jascha Wendelstein, Kamran M Riaz\",\"doi\":\"10.1007/s10792-025-03558-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To compare visual acuity outcomes of two monofocal IOL models, a zero-aberration monofocal IOL (Envista MX60E; Bausch and Lomb) and a monofocal plus IOL (Eyhance DIB00; Johnson and Johnson), in eyes undergoing combined cataract surgery and Descemet membrane endothelial keratoplasty (DMEK) (triple DMEK).</p><p><strong>Methods: </strong>Retrospective, single-center case series of 91 eyes (66 patients) undergoing triple DMEK with either IOL between 2019 and 2023 at a tertiary academic center. Eyes were divided into 2 groups: zero-aberration IOL (49 eyes) and monofocal plus IOL (42 eyes). Among these, 20 eyes received a zero-aberration IOL, and 26 eyes received a monofocal plus IOL in both eyes. Visual acuity measurements at 3-6 months and 6-12 months postoperatively included uncorrected distance, intermediate, and near (UDVA, UIVA, UNVA) and distance-corrected distance, intermediate, and near (CDVA, DCIVA, DCNVA) visual acuities for monocular (Uni) and binocular (Bi) assessments. Patients were administered the Intraocular Lens Satisfaction questionnaire to assess their level of spectacle independence at the 3-6 month visit. Statistical analysis was performed using Wilcoxon rank-sum and Fisher's exact tests.</p><p><strong>Results: </strong>UDVA<sub>Uni</sub>, CDVA<sub>Uni</sub>, and UNVA<sub>Uni</sub> were favorable and comparable between the two groups. At the 3-6 month timepoint, the Eyhance group had significantly better UIVA<sub>Uni</sub> (0.17 ± 0.12 vs. 0.23 ± 0.13, p = 0.03), DCIVA<sub>Uni</sub> (0.23 ± 0.08 vs. 0.31 ± 0.08, p < 0.001), and DCNVA<sub>Uni</sub> (0.36 ± 0.09 vs. 0.40 ± 0.08, p = 0.04). However, at 6-12 months, all six VA measurements were similar between the 2 groups. Bilateral cases at the 3-6 month timepoint demonstrated superior DCNVA<sub>Bi</sub> in the Eyhance group versus the Envista group (0.31 ± 0.08 vs. 0.41 ± 0.03, p = 0.008). The spherical equivalent refractive error (- 0.51 ± 0.94D vs. - 0.55 ± 1.05D, p = 0.89) for all eyes and inter-eye refractive error in the binocular subgroup (0.29 ± 1.36D vs. 0.42 ± 1.11D, p = 0.80) was similar for both groups. Postoperative complications and patient satisfaction were comparable between the two groups.</p><p><strong>Conclusion: </strong>Both IOLs can provide favorable corrected and uncorrected VA in triple DMEK eyes. Eyhance may provide better DCIVA<sub>Uni</sub> and UIVA<sub>Uni</sub> in single eyes and better DCNVA<sub>Uni/Bi</sub> in all eyes up to six months postoperatively.</p>\",\"PeriodicalId\":14473,\"journal\":{\"name\":\"International Ophthalmology\",\"volume\":\"45 1\",\"pages\":\"193\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-05-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Ophthalmology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10792-025-03558-7\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10792-025-03558-7","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：比较两种单焦人工晶体模型的视力结果，一种零像差单焦人工晶体(Envista MX60E；Bausch and Lomb)和单焦点人工晶状体(Eyhance DIB00；Johnson and Johnson)，在接受联合白内障手术和Descemet膜内皮角膜移植术（DMEK）（三重DMEK）的眼睛中。方法：回顾性，单中心病例系列，91眼（66例）于2019年至2023年在某三级学术中心接受三联DMEK合并IOL。眼分为2组：零像差人工晶状体（49眼）和单焦联合人工晶状体（42眼）。其中，20眼接受了零像差人工晶状体植入术，26眼接受了双眼单焦+人工晶状体植入术。术后3-6个月和6-12个月的视力测量包括未矫正的距离、中间和近（UDVA、UIVA、UNVA）和距离矫正的距离、中间和近（CDVA、DCIVA、DCNVA）的单眼（Uni）和双眼（Bi）视力评估。在3-6个月的随访中，对患者进行人工晶状体满意度问卷调查，以评估其眼镜独立性水平。采用Wilcoxon秩和和Fisher精确检验进行统计分析。结果：UDVAUni、CDVAUni和UNVAUni在两组间具有良好的可比性。在3 ~ 6个月时间点，Eyhance组UIVAUni（0.17±0.12比0.23±0.13,p = 0.03）、DCIVAUni（0.23±0.08比0.31±0.08,p = 0.04）显著优于DCIVAUni（0.36±0.09比0.40±0.08）。然而，在6-12个月时，两组之间所有六项VA测量结果相似。3-6个月时间点的双侧病例显示Eyhance组的DCNVABi优于Envista组（0.31±0.08比0.41±0.03,p = 0.008）。两组全眼的球面等效屈光不正（- 0.51±0.94D vs - 0.55±1.05D, p = 0.89）和双眼亚组的眼间屈光不正（0.29±1.36D vs 0.42±1.11D, p = 0.80）相似。两组术后并发症和患者满意度具有可比性。结论：两种人工晶状体均可为三联DMEK眼提供良好的矫正和未矫正晶状体。Eyhance可能提供更好的单眼DCIVAUni和UIVAUni，并在术后6个月提供更好的全眼DCNVAUni/Bi。
Visual outcomes of aberration neutral versus monofocal plus IOLs in triple DMEK surgery.
Purpose: To compare visual acuity outcomes of two monofocal IOL models, a zero-aberration monofocal IOL (Envista MX60E; Bausch and Lomb) and a monofocal plus IOL (Eyhance DIB00; Johnson and Johnson), in eyes undergoing combined cataract surgery and Descemet membrane endothelial keratoplasty (DMEK) (triple DMEK).
Methods: Retrospective, single-center case series of 91 eyes (66 patients) undergoing triple DMEK with either IOL between 2019 and 2023 at a tertiary academic center. Eyes were divided into 2 groups: zero-aberration IOL (49 eyes) and monofocal plus IOL (42 eyes). Among these, 20 eyes received a zero-aberration IOL, and 26 eyes received a monofocal plus IOL in both eyes. Visual acuity measurements at 3-6 months and 6-12 months postoperatively included uncorrected distance, intermediate, and near (UDVA, UIVA, UNVA) and distance-corrected distance, intermediate, and near (CDVA, DCIVA, DCNVA) visual acuities for monocular (Uni) and binocular (Bi) assessments. Patients were administered the Intraocular Lens Satisfaction questionnaire to assess their level of spectacle independence at the 3-6 month visit. Statistical analysis was performed using Wilcoxon rank-sum and Fisher's exact tests.
Results: UDVAUni, CDVAUni, and UNVAUni were favorable and comparable between the two groups. At the 3-6 month timepoint, the Eyhance group had significantly better UIVAUni (0.17 ± 0.12 vs. 0.23 ± 0.13, p = 0.03), DCIVAUni (0.23 ± 0.08 vs. 0.31 ± 0.08, p < 0.001), and DCNVAUni (0.36 ± 0.09 vs. 0.40 ± 0.08, p = 0.04). However, at 6-12 months, all six VA measurements were similar between the 2 groups. Bilateral cases at the 3-6 month timepoint demonstrated superior DCNVABi in the Eyhance group versus the Envista group (0.31 ± 0.08 vs. 0.41 ± 0.03, p = 0.008). The spherical equivalent refractive error (- 0.51 ± 0.94D vs. - 0.55 ± 1.05D, p = 0.89) for all eyes and inter-eye refractive error in the binocular subgroup (0.29 ± 1.36D vs. 0.42 ± 1.11D, p = 0.80) was similar for both groups. Postoperative complications and patient satisfaction were comparable between the two groups.
Conclusion: Both IOLs can provide favorable corrected and uncorrected VA in triple DMEK eyes. Eyhance may provide better DCIVAUni and UIVAUni in single eyes and better DCNVAUni/Bi in all eyes up to six months postoperatively.
期刊介绍：
International Ophthalmology provides the clinician with articles on all the relevant subspecialties of ophthalmology, with a broad international scope. The emphasis is on presentation of the latest clinical research in the field. In addition, the journal includes regular sections devoted to new developments in technologies, products, and techniques.
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