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Klin Monbl Augenheilkd 2015; 232(08): 947-952
DOI: 10.1055/s-0035-1545833
Klinische Studie
Georg Thieme Verlag KG Stuttgart · New York

Grad der binokularen Pseudoakkommodation mit einer apodisierten, diffraktiven und trifokalen Multifokallinse

Level of Binocular Pseudoaccommodation in Patients Implanted with an Apodised, Diffractive and Trifocal Multifocal Intraocular Lens
F. T. A. Kretz
1   Augenklinik, Universitätsklinikum Heidelberg
,
M. A. S. Attia
2   Augenheilkunde, International Vision Correction and Research Centre (IVCRC) & David J Apple International Laboratory for Ocular Pathology, Univiversitäts-Augenklinik Heidelberg
,
K. Linz
1   Augenklinik, Universitätsklinikum Heidelberg
2   Augenheilkunde, International Vision Correction and Research Centre (IVCRC) & David J Apple International Laboratory for Ocular Pathology, Univiversitäts-Augenklinik Heidelberg
,
G. U. Auffarth
1   Augenklinik, Universitätsklinikum Heidelberg
2   Augenheilkunde, International Vision Correction and Research Centre (IVCRC) & David J Apple International Laboratory for Ocular Pathology, Univiversitäts-Augenklinik Heidelberg
› Author Affiliations
Further Information

Publication History

eingereicht 22 January 2015

akzeptiert 13 February 2015

Publication Date:
30 April 2015 (online)

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Zusammenfassung

Fragestellung: Beurteilung der Pseudoakkommodationsbreite und klinischen Ergebnisse nach Implantation einer diffraktiven apodisierten und trifokalen Multifokallinse mit Blaulichtfilter. Methodik: Im Rahmen einer prospektiven, monozentrischen Studie wurde die Micro-F MIOL (PhysIOL, Belgien) im Rahmen der mikrochirurgischen Kataraktoperation bei 28 Augen von 14 Patienten in den Kapselsack implantiert. Zwei bis 4 Monate postoperativ wurden die Nachkontrollen durchgeführt. Beurteilt wurden die Refraktion, die Sehschärfe monokular und binokular (Nähe in 40 cm, Intermediär in 80 cm und Ferne) sowie die binokularen Defokuskurven. Ergebnisse: Die mittlere monokulare UDVA (unkorrigierter Fernvisus) stieg von 0,471 ± 0,22 logMAR auf 0,144 ± 0,14 logMAR statistisch signifikant (p < 0,0001) an. Für die monokularen UNVA (unkorrigierter Nahvisus), UIVA (unkorrigierter Intermediärvisus) zeigten sich postoperative Sehschärfenwerte von 0,127 ± 0,117 und 0,158 ± 0,20 logMAR im Vergleich zu den binokular gemessenen Werten von 0,057 ± 0,137 und 0,094 ± 0,181 logMAR. In der Analyse der binokularen Defokuskurven zeigten sich 2 Maxima von 0,0 bis − 0,5 dpt mit einer Sehschärfe von 0,0 logMAR und bei − 3,0 dpt mit einer Sehschärfe von 0,068 logMAR. Im Zwischenbereich konnte eine konstante Pseudoakkommodation von 0,2 logMAR festgestellt werden. Schlussfolgerung: Die trifokale, diffraktive MIOL zeigt gute funktionelle Ergebnisse in allen Distanzen mit einer Pseudoakkommodationsbreite von 3 dpt. Bei einem mittleren Visus von 0,2 logMAR und besser. Sie ermöglicht hierdurch ein hohes Maß an Brillenunabhängigkeit im Alter ohne den für bifokale, diffraktive Multifokallinsen typischen Verlust der Sehschärfe im Intermediärbereich.

Abstract

Purpose: The aim of this study was to make an evaluation of the pseudoaccommodation span and clinical results after implantation of a diffractive, apodised and trifocal multifocal intraocular lens (MIOL). Methods: In a prospective, single-centre study 28 eyes of 14 patients were evaluated after in the bag implantation of the Micro-F MIOL (PhysIOL, Belgium) during routine microsurgical cataract surgery. Two to four months postoperatively the final examinations were performed. Refraction, visual acuity monocular and binocular (near in 40 cm, intermediate in 80 cm and distance) as well as binocular defocus curves were evaluated. Results: Mean monocular UDVA (uncorrected distance visual acuity) increased significantly (p < 0.0001) from 0.471 ± 0.22 logMAR to 0.144 ± 0.14 logMAR. For the monocular UNVA (uncorrected near visual acuity) and UIVA (uncorrected intermediate visual acuity) postoperative values of 0.127 ± 0.117 and 0.158 ± 0.20 logMAR compared to binocular results of 0.057 ± 0.137 and 0.094 ± 0.181 logMAR were found. In the analysis of the binocular defocus curve two peaks could be found between 0.0 and − 0.5 D with a visual acuity of 0.0 logMAR and at − 3.0 D with a visual acuity of 0.068 logMAR. In the intermediate range a constant pseudoaccommodation of 0.2 logMAR could be found. Conclusions: The trifocal, diffractive MIOL shows good functional results in all distances with a span of pseudoaccommodation of 3D and a mean visual acuity of 0.2 logMAR and better. Indeed it is offering a high level of spectacle independency without the typical intermediate gap of bifocal diffractive MIOLs.

Schlüsselwörter

Katarkt - refraktive Chirurgie - multifokale Intraokularlinse - trifokale MIOL

Key words

cataract - refractive surgery - multifocal intraocular lens - trifocal MIOL
 

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