Journal of The Korean Ophthalmological Society (대한안과학회지)

The Korean Ophthalmological Society (대한안과학회)
권호 표지
DOI QR코드

DOI QR Code

One-year Outcome of Monocular Implant of Aspheric Multifocal IOL

비구면 다초점 인공수정체를 단안에 삽입한 백내장수술의 장기 임상결과

  • Cheon, Mi-Hyun (Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Lee, Joo-Eun (Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Kim, Jae-Hyung (Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Kim, Kyung-Hoon (Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Lee, Hee-Gyung (Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Kim, Jae-Yong (Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Kim, Myoung-Joon (Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Tchah, Hung-Won (Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center)
  • 전미현 (울산대학교 의과대학 서울아산병원 안과학교실) ;
  • 이주은 (울산대학교 의과대학 서울아산병원 안과학교실) ;
  • 김재형 (울산대학교 의과대학 서울아산병원 안과학교실) ;
  • 김경훈 (울산대학교 의과대학 서울아산병원 안과학교실) ;
  • 이희경 (울산대학교 의과대학 서울아산병원 안과학교실) ;
  • 김재용 (울산대학교 의과대학 서울아산병원 안과학교실) ;
  • 김명준 (울산대학교 의과대학 서울아산병원 안과학교실) ;
  • 차흥원 (울산대학교 의과대학 서울아산병원 안과학교실)
  • Received : 2009.12.31
  • Accepted : 2010.04.14
  • Published : 2010.06.15
⟨ Previous Next ⟩

Abstract

Purpose: To evaluate near and far visual acuity, subjective visual symptoms, and patient satisfaction with a monocular implant of aspheric multifocal IOL (AMO Tecnis ZM900$^{(R)}$). Methods: Thirty eyes of 30 patients received phacoemulsifications and monocular implantation of Tecnis ZM900 IOL. The main outcome measures at postoperative 1 week, 1 month, 3 months, and 1 year were uncorrected and corrected near and distant visual acuity, refractory errors, contrast sensitivity, subjective visual symptoms (glare and halo), spectacle independency, and satisfaction. Results: At a 3 month postoperative visit, the mean uncorrected near and distant visual acuities were 0.29${\pm}$0.17 (logMAR) and 0.16${\pm}$0.12 (logMAR),respectively. At 1 year, the mean uncorrected near and distant visual acuities were 0.25${\pm}$0.17 (logMAR) and 0.11${\pm}$0.08 (logMAR). Glare and halo decreased, and contrast sensitivity increased upon 1-year follow-up after monocular implantation of ZM900. Most patients (87%) were satisfied with their visual outcome. Conclusions: Monocular implantation of multifocal IOL Tecnis ZM900 shows stable surgical outcomes with a high satisfaction rate and enables a high rate of spectacle independency. Postoperative glare and halo, youth, and residual refractive error could be risk factors for dissatisfaction with monocular implantation of multifocal IOL Tecnis ZM900. Proper patient selection can lead to satisfying outcomes.

목적: 비구면 다초점 인공수정체인 Tecnis ZM900을 단안에 삽입한 환자들의 장기 임상결과를 알아보고자 하였다. 대상과 방법: Tecnis ZM900을 단안에 삽입한 30안을 대상으로 술 후 1주, 1개월, 3개월, 1년에 나안 근거리 및 원거리 시력, 근거리 및 원거리 최대교정시력, 굴절오차 및 대비감도를 측정하였고, 주관적인 시각증상(빛번짐, 눈부심), 안경 착용 유무 및 만족도에 대해 조사하였다. 결과: 술 후 1년째 평균 나안 원거리시력은 0.11${\pm}$0.08 (logMAR), 근거리 시력은 0.25${\pm}$0.17 (logMAR)이었다. 대비감도검사상 술 후 1년째 명순응(1.5,3 cpd)과 암순응(6,12,18 cpd) 영역에서 유의한 호전을 보였다(p<0.05). 만족도 조사에서 30명의 환자 중 26명에서 만족스러운 결과를 보였으며, 안경 착용자는 6명이었다. 술 후 결과에 불만족스러웠던 경우는 8안이었고 주원인은 야간 눈부심과 빛번짐 때문이었다. 결론: Tecnis ZM900 인공수정체는 만족스러운 원거리 및 근거리 시력 교정, 대비 감도, 술 후 환자의 만족도를 보여 안정적인 인공수정체라고 판단되지만 빛번짐 및 야간 눈부심 현상은 만족도를 떨어뜨리는 요인으로 조사되었다.

Keywords

References

  1. Goes FJ. Refractive lens exchange with the diffractive multifocal tecnis ZM900 intraocular lens. J Refract Surg 2008;24:243-50.
  2. Lee DY, Roh JH, Shyn KH. Current trends in cataract surgery in Korea - 2005 survey for KSCRS members. J Korean Ophthalmol Soc 2007;48:485-92.
  3. Fernandez-Vega L, Alfonso JF, Rodriguez PP, Montes-Mico R. Clear lens extraction with multifocal apodized intraocular lens implantation. Ophthalmology 2007;114:1491-8. https://doi.org/10.1016/j.ophtha.2006.10.058
  4. Fernandez-Vega L, Alfonso JF, Montes-Mico R, Amhaz H. Visual acuity tolerance to residual refractive errors in patients with an apodized diffractive intraocular lens. J Cataract Refract Surg 2008; 34:199-204. https://doi.org/10.1016/j.jcrs.2007.10.020
  5. Claoue C, Parmar D. Multifocal intraocular lenses. Dev Ophthalmol 2002;34:217-37. https://doi.org/10.1159/000060800
  6. Monte's-Mico' R, Espana E, Bueno I, et al. Visual performance with multifocal intraocular lenses mesopic contrast sensitivity under distance and near conditions. Ophthalmology 2004;111:85-96. https://doi.org/10.1016/S0161-6420(03)00862-5
  7. Sen HN, Sarikkola A-U, Uusitalo RJ, Laatikainen L. Quality of vision after AMO Array multifocal intraocular lens implantation. J Cataract Refract Surg 2004;30:2483-93. https://doi.org/10.1016/j.jcrs.2004.04.049
  8. Schmitz S, Dick HB, Krummenauer F, et al. Contrast sensitivity and glare disability by halogen light after monofocal and multifocal lens implantation. Br J Ophthalmol 2000;84:1109-12. https://doi.org/10.1136/bjo.84.10.1109
  9. Kamlesh, Dadeya S, Kaushik S. Contrast sensitivity and depth of focus with aspheric multifocal versus conventional monofocal intraocular lens. Can J Ophthalmol 2001;36:197-201.
  10. Heo JY, Kim YH, Joo CK. Clinical results of AMO ARRAY multifocal intraocular lens. J Korean Ophthalmol Soc 1999;40:978-86.
  11. Lee JM, Seo KY, Kim EK. Comparison of optical aberrations and contrast sensitivity between monofocal and multifocal intraocular lens. J Korean Ophthalmol Soc 2002;43:1882-6.
  12. Song MJ, Lee MK, Park BI. A Clinical study of 3M multifocal intraocular lens implant. J Korean Ophthalmol Soc 1991;32:234-40.
  13. Allen ED, Burton RL, Webber SK, et al. Comparison of a diffractive bifocal and a monofocal intraocular lens. J Cataract Refract Surg 1996;22:446-51. https://doi.org/10.1016/S0886-3350(96)80040-X
  14. Rossetti L, Carraro F, Rovati M, Orzalesi N. Performance of diffractive multifocal intraocular lenses in extracapsular cataractsurgery. J Cataract Refract Surg 1994;20:124-8. https://doi.org/10.1016/S0886-3350(13)80150-2
  15. Leyland MD, Langan L, Goolfee F, et al. Prospective randomized double-masked trial of bilateral multifocal, bifocal or monofocal intraocular lenses. Eye 2002;16:481-90. https://doi.org/10.1038/sj.eye.6700077
  16. Song MJ, Lee MK, Park BI. A Clinical study of 3M multifocal intraocular lens implant. J Korean Ophthalmol Soc 1991;32:234-40.
  17. Kim YS, Han TW, Kim MS, Kim JH. Clinical experience of 3M multifocal intraocular lens implantation. J Korean Ophthalmol Soc 1990; 31:1308-17.
  18. Choi HS, Lim SJ, Kim HB. Clinical results of unilateral implantation of AMO Array multifocal intraocular lens. J Korean Ophthalmol Soc 2001;42:702-8.
  19. Gray PJ, Lyall MG. Diffractive multifocal intraocular lens implants for unilateral cataracts in prepresbyopic patients. Br J Ophthalmol 1992; 76:336-7. https://doi.org/10.1136/bjo.76.6.336
  20. Jacobi PC, Dietlein TS, Lu¨ke C, Jacobi FK. Multifocal intraocular lens implantation in prepresbyopic patients with unilateral cataract. Ophthalmology 2002;109:680-6. https://doi.org/10.1016/S0161-6420(01)01029-6
  21. Souza CE, Gerente VM, Chalita MR, et al. Visual acuity, contrast sensitivity, reading speed, and wavefront analysis; pseudophakic eye with multifocal IOL (ReSTOR) versus fellow phakic eye in non-presbyopic patients. J Refract Surg 2006;22:303-5.
  22. Shoji N, Shimizu K. Binocular function of the patient with the refractive multifocal intraocular lens. J Cataract Refract Surg 2002; 28:1012-7. https://doi.org/10.1016/S0886-3350(02)01300-7
  23. Haring G, Gronemeyer A, Hedderich J, de Decker W. Stereoacuity and aniseikonia after unilateral and bilateral implantation of the Array refractive multifocal intraocular lens. J Cataract Refract Surg 1999; 25:1151-6. https://doi.org/10.1016/S0886-3350(99)00136-4
  24. Chang M, Eom Y, Kang SY, et al. Clinical outcome of diffractive multifocal aspheric intraocular lens. J Korean Ophthalmol Soc 2009;50: 529-36. https://doi.org/10.3341/jkos.2009.50.4.529
  25. Simpson MJ. The diffractive multifocal intraocular lens. Eur J Implant Ref Surg 1989;1:115-21.
  26. Yoon JU, Chung JL, Hong JP, et al. Comparison of wavefront analysis and visual function between monofocal and multifocal aspheric intraocular lenses. J Korean Ophthalmol Soc 2009;50:195-201. https://doi.org/10.3341/jkos.2009.50.2.195
  27. Mayer S, Bohm T, Haberle H, et al. Combined implantation of monofocal and multifocal intraocular lenses for presbyopia correction in cataract patients. Klin Monatsbl Augenheilkd 2008;225:812-7. https://doi.org/10.1055/s-2008-1027604
  28. Cionni RJ, Osher RH, Snyder ME, Nordlund ML. Visual outcome comparison of unilateral versus bilateral implantation of apodized diffractive multifocal intraocular lenses after cataract extraction Prospective 6-month study. J Cataract Refract Surg 2009;35:1033-9. https://doi.org/10.1016/j.jcrs.2009.02.018

Cited by

  1. The Study on Target Refraction to Improve Visual Quality in Patients Implanted with Multifocal IOL vol.53, pp.2, 2010, https://doi.org/10.3341/jkos.2012.53.2.223
  2. Quantitative Measurement of Glare Disability Using a Glaremeter vol.53, pp.7, 2010, https://doi.org/10.3341/jkos.2012.53.7.953
  3. 백내장 환자에서 비구면 다초점 인공수정체 삽입 후 시기능 평가 vol.18, pp.3, 2010, https://doi.org/10.14479/jkoos.2013.18.3.347
  4. Clinical Outcomes of Patients with Refractive Aspheric Multifocal IOL Implantation vol.55, pp.7, 2010, https://doi.org/10.3341/jkos.2014.55.7.991
  5. Clinical Outcomes of Diffractive Multifocal Toric Intraocular Lens Implantation vol.55, pp.8, 2010, https://doi.org/10.3341/jkos.2014.55.8.1139
  6. Comparison of Clinical Outcomes between Diffractive and Refractive Multifocal Intraocular Lens with Same Near Added vol.56, pp.6, 2010, https://doi.org/10.3341/jkos.2015.56.6.875
  7. Comparison of Clinical Long-Term Outcomes with Two Types of One-Piece Aspheric Intraocular Lenses after Cataract Surgery vol.57, pp.2, 2010, https://doi.org/10.3341/jkos.2016.57.2.221
  8. A Case of Acute Angle Closure Caused by Dislocation of Accommodative Intraocular Lens vol.57, pp.9, 2010, https://doi.org/10.3341/jkos.2016.57.9.1493
  9. Clinical Efficacy of Bunny Multifocal Intraocular Lens after Cataract Surgery vol.59, pp.12, 2010, https://doi.org/10.3341/jkos.2018.59.12.1129