Journal of Korean Ophthalmic Optics Society (한국안광학회지)

The Korean Ophthalmic Optics Society (한국안광학회)
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Evaluation of Visual Performance for Implanted Aspheric Multifocal Intraocular Lens in the Cataract Patients

백내장 환자에서 비구면 다초점 인공수정체 삽입 후 시기능 평가

  • Kim, Jae-Yoon (Dept. of Optometry, Graduate School of Health Science, Eulji University) ;
  • Lee, Koon-Ja (Dept. of Optometry, Graduate School of Health Science, Eulji University)
  • 김재윤 (을지대학교 보건대학원 안경광학과) ;
  • 이군자 (을지대학교 보건대학원 안경광학과)
  • Received : 2013.07.31
  • Accepted : 2013.09.14
  • Published : 2013.09.30
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Abstract

Purpose: To evaluate the visual acuity and visual performance after implantation of a aspheric multifocal (ReSTOR$^{(R)}$ SN6AD3) intraocular lens (IOL). Methods: Nineteen cataract patients (30 eyes) implanted with an aspheric multifocal IOL (ReSTOR$^{(R)}$ SN6AD3) either unilaterally or bilaterally were participated. Visual acuity (VA) and objective optical performance were evaluated at the time of preoperation, 1 week, 1 month, and 3 month after operation. At 3 month of post-operation, objective visual performance were measured and compared with the 38 eyes of 20 age-matched normal control. Distance VA was measured by using the ETDRS LCD chart and intermediate and near visual acuity were measured using Jaeger chart. Objective visual performance was assessed preoperatively and 1 week, 1 month and 3 month postoperatively using a double-pass system (Optical Quality Analysis System) with a 4-mm pupil diameter, the OSI (objective scatter index), MTF (modulation transfer function) cut off and strehl ratio. At 3 month of post-operation, visual acuity and visual performance compared with age matched normal control. Results: The uncorrected distance VA, OSI, MTF cut off and strehl ratio were significantly improved (p<0.05) until 1 month postoperatively. Visual performance of MTF cut off and strehl ratio after 3 month of operation were significantly improved compared to the normal control (p=0.063, p=0.103 respectively), however, OSI was higher than normal control. Patients implanted with aspheric multifocal IOL were satisfied with distance and near VA however, were unsatisfied with intermediate VA and reported glare and halos. Conclusions: The visual performance reaches to a stable condition in 1 month of implantation of aspheric multifocal IOL and improved to the level of age-mated normal patients. Also patients were satisfied with their quality of vision, however, intermediate VA, glare and halos were reported as complications.

목적: 비구면 다초점 인공수정체인 ReSTOR$^{(R)}$ SN6AD3 삽입안의 시력과 시기능 변화를 분석하였다. 방법: 양안 또는 단안에 비구면 다초점 인공수정체(ReSTOR$^{(R)}$ SN6AD3)를 삽입한 백내장 환자 19명의 30안을 대상으로 하였다. 수술 전, 수술 후 1주일, 1개월 및 3개월 후에 시력과 객관적인 시기능을 측정하였고 수술 3개월 후 인공수정체 삽입안의 시기능 측정값을 동일 연령대의 정상안 20명(38안)과 비교하였다. 원거리 시력은 2 m 거리에서 LCD chart ETDRS 시력표를 이용하여 측정하였고, 중간거리(50 cm)과 근거리(30 cm) 시력은 Jaeger chart를 이용하였다. 객관적인 시기능은 OQAS 장비를 이용하여 OSI (objective scatter index, 객관적 산란지수), MTF (modulation transfer function, 변조전달함수) cut off, Strehl ratio를 4 mm 동공크기에서 측정하여 수술 후 경과기간에 따른 측정값을 비교 평가하였다. 수술 3개월 째 시력 및 시기능은 객관적 평가와 주관적인 평가를 통해 동일 연령대의 정상안과 비교하였다. 결과: 나안 원거리 시력과 OSI, MTF와 Strehl ratio는 다초점 인공수정체 삽입 1개월까지 유의하게 향상되었다(p<0.05). 수술 3개월 후 다초점 인공수정체 삽입안의 MTF와 Strehl ratio는 정상 대조군의 수준으로 회복되었지만, OSI는 대조군보다 높은 값으로 측정되었다(p<0.001). 자각적인 원거리 및 근거리 시력에 대한 만족도는 높았지만, 중간거리 시력에 대한 만족도가 낮으며 눈부심과 빛 번짐 증상이 나타났다. 결론: 비구면 다초점 인공수정체 삽입안의 시기능은 수술 1개월 후부터 안정화되며 동일 연령대의 정상안의 수준으로 개선되지만 만족스러운 중간거리 시력을 제공하지 못하며 눈부심과 빛 번짐의 시각적 불편감이 나타나는 것으로 사료된다.

Keywords

References

  1. Zhao G, Zhang J, Zhou Y, Hu L, Che C, Jiang N. Visual function after monocular implantation of apodized diffractive multifocal or single-piece monofocal intraocular lens Randomized prospective comparison. J Cataract Refract Surg. 2010;36(2):282-285. https://doi.org/10.1016/j.jcrs.2009.08.037
  2. Vingolo EM, Grenga P, Iacobeli L, Grenga R. Visual acuity and contrast sensitivity: AcrySof ReSTOR apodized diffractive versus AcrySof SA60AT monofocal intraocular lenses. J. Cataract Refract. Surg. 2007;33(7):1244-1247. https://doi.org/10.1016/j.jcrs.2007.03.052
  3. Rocha KM, Soriano ES, Chamon W, Chalita MR, Nose W. Spherical aberration and depth of focus in eyes implanted with aspheric and spherical intraocular lenses: a prospective randomized study. Ophthalmology. 2007;114(11):2050- 2054. https://doi.org/10.1016/j.ophtha.2007.01.024
  4. Franchini A. Compromise between spherical and chromatic aberration and depth of focus in aspheric intraocular lenses. J. Cataract Refract. Surg. 2007;33(3):497-509. https://doi.org/10.1016/j.jcrs.2006.11.018
  5. Leyland, M, Zinicola E. Multifocal versus monofocal intraocular lenses in cataract surgery: a systematic review. Ophthalmology. 2003;110(9):1789-1798. https://doi.org/10.1016/S0161-6420(03)00722-X
  6. Alio JL, Pinero DP, Plaza-Puche AB, Amparo F, Jimenez R, Rodrizuez-Prats JL, et al. Visual and optical performance with two different diffractive multifocal intraocular lenses compared to a monofocal lens. J Refract Surg. 2011;27(8):570-581. https://doi.org/10.3928/1081597X-20101223-01
  7. Zelichowska B, Rekas M, Stankiewicz A, Cervino A, Montes- Mico R. Apodized diffractive versus refractive multifocal intraocular lenses: optical and visual evaluation. J Cataract Refract Surg. 2008;34(12):2036-2042. https://doi.org/10.1016/j.jcrs.2008.06.045
  8. Chiam PT, Chan JH, Haider SI, Karia N, Kasaby H, Aggarwal RK. Functional vision with bilateral ReZoom and ReSTOR intraocular lenses 6 months after cataract surgery. J cataract Refract. Surg. 2007;33(12):2057-2061. https://doi.org/10.1016/j.jcrs.2007.07.029
  9. Souza CE, Muccioli C, Soriano ES, Chalita MR, Oliveira F, Freitas LL, et al. Visual performance of AcrySof ReSTOR apodized diffractive IOL: a prospective comparative trial. Am J Ophthalmol. 2006;141(5):827-832. https://doi.org/10.1016/j.ajo.2005.12.031
  10. Chiam PJ, Chan JH, Aggarwal RK, Kasaby S. ReSTOR intraocular lens implantation in cataract surgery: quality of vision. J cataract Refract Surg. 2006;32(9):1459-1463. https://doi.org/10.1016/j.jcrs.2006.04.015
  11. Cionni RJ, Chang DF, Donnenfeld ED, Lane SS, McCulley JP, Solomon KD Clinical outcomes and functional visual performance: comparison of the ReSTOR apodised diffractive intraocular lens to a monofocal control. Br J Ophthalmol. 2009;93(9):1215-1219. https://doi.org/10.1136/bjo.2008.146647
  12. Alio JL, Plaza-Puche AB, Pinero DP, Amparo F, Rodriguez- Prats JL, Ayala MJ. Quality of life evaluation after implantation of 2 multifocal intraocular lens models and a monofocal model. J Cataract Refract. Surg. 2011;37(4): 638-648. https://doi.org/10.1016/j.jcrs.2010.10.056
  13. Hofmann T, Zuberbuhler B, Cervino A, Montes-Mico R, Haefliger E. Retinal straylight and complaint scores 18 months after implantation of the AcrySof monofocal and ReSTOR diffractive intraocular lenses. J Refract Surg. 2009;25(6):485-492.
  14. de Vries NE, Webers CA, Touwslager WR, Bauer NJ, Brabander JD, Berendschot TT, et al. Dissatisfaction after implantation of multifocal intraocular lenses. J Cataract Refract Surg. 2011;37(5):859-865. https://doi.org/10.1016/j.jcrs.2010.11.032
  15. Woodward MA, Randleman JB, Stulting RD. Dissatisfaction after multifocal intraocular lens implantation. J Cataract Refract Surg. 2009;35(6):992-997. https://doi.org/10.1016/j.jcrs.2009.01.031
  16. Montes-Mico R, Espana E, Bueno I, Charman WN, Menezo JL. Visual performance with multifocal intraocular lenses: mesopic contrast sensitivity under distance and near conditions. Ophthalmology 2004;111(1):85-96. https://doi.org/10.1016/S0161-6420(03)00862-5
  17. Schmitz S, Dick HB, Krummenauer F, Schwenn O, Krist R. Contrast sensitivity and glare disability by halogen light after monofocal and multifocal lens implantation. Br J Ophthalmol. 2000;84(10):1109-1112. https://doi.org/10.1136/bjo.84.10.1109
  18. 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(10):1882-1886.
  19. Chalita MR, Chavala S, Xu M, Krueger RR. Wavefront analysis in post-LASIK eyes and its correlation with visual symptoms, refraction, and topography. Ophthalmology 2004; 111(3):447-453. https://doi.org/10.1016/j.ophtha.2003.06.022
  20. Ortiz D, Alio JL, Bernabeu G, Ponqo V. Optical performance of monofocal and multifocal intraocular lenses in the human eye. J Cataract Refract. Surg. 2008;34(5):755- 762. https://doi.org/10.1016/j.jcrs.2007.12.038
  21. Yoon JU, Chung JL, Hong JP, Ha BJ, Kim EK, Kim TI. Comparison of wavefront analysis and visual function between monofocal and multifocal aspheric intraocular lenses. J Korean Ophthalmol Soc. 2009;50(2):195-201. https://doi.org/10.3341/jkos.2009.50.2.195
  22. Kim SM, Kim CH, Chung ES, Chung TY. Visual outcome and patient satisfaction after implantation of multifocal IOL: three-month follow-up results. J Korean Ophthalmol Soc. 2012;53(2):230-237. https://doi.org/10.3341/jkos.2012.53.2.230
  23. Zhang F, Sugar A, Jacobsen G, Collins M. Visual function and spectacle independence after cataract surgery: bilateral diffractive multifocal intraocular lenses versus monovision pseudophakia. J Cataract Refract Surg. 2011;37(5): 853-858. https://doi.org/10.1016/j.jcrs.2010.12.041
  24. Dowski ER Jr, Cathey WT. Extended depth of field through wave-front coding. Appl Opt. 1995;34(11):1859-1866. https://doi.org/10.1364/AO.34.001859
  25. Kim SG, Park, SC. Prediction of visual performance using contrast sensitivity function and modulation transfer function. Korean J Optics Photonics. 2004;15(5):461-468. https://doi.org/10.3807/KJOP.2004.15.5.461
  26. McLellan JS, Prieto PM, Marcos S, Burns SA. Effects of interactions among wave aberrations on optical image quality. Vision Res. 2006;46(18):3009-3016. https://doi.org/10.1016/j.visres.2006.03.005
  27. Artal, P, Ferro, M, Miranda, I, Navarro R. Effects of aging in retinal image quality. J Opt Soc Am A. 1993; 10(7):1656-1662. https://doi.org/10.1364/JOSAA.10.001656
  28. Diaz-Douton F, Benito A, Pujol J, Arjona M, Guell JL, Artal P. Comparison of the retinal image quality with a Hartmann-Shack wavefront sensor and a double-pass instrument. Invest Ophthalmol Vis Sci. 2006;47(4): 1710-1716. https://doi.org/10.1167/iovs.05-1049
  29. Castro JJ, Jimenez JR, Hita E, Ortiz C. Influence of interocular differences in the Strehl ratio on binocular summation. Ophthal Physiol Opt. 2009;29(6):370-374. https://doi.org/10.1111/j.1475-1313.2009.00643.x
  30. Ortiz D, Alio, JL, Ruiz-Colecha J, Oser U. Grading nuclear cataract opacity by densitometry and objective optical analysis. J Cataract Refract Surg. 2008;34(8): 1345-1352. https://doi.org/10.1016/j.jcrs.2008.04.022
  31. Vilaseca M, Arjona M, Pujol J, Issolio L, Guell JL. Optical quality of foldable monofocal intraocular lenses before and after injection: comparative evaluation using a double- pass system. J Cataract Refract Surg. 2009;35(8): 1415- 1423. https://doi.org/10.1016/j.jcrs.2009.03.022
  32. Gunenc U, Celik L. Long-term experience with mixing and matching refractive array and diffractive CeeOn multifocal intraocular lenses. J Refract Surg. 2008;24(3):233- 242.
  33. Goes FJ. Visual results following implantation of a refractive multifocal IOL in one eye and a diffractive multifocal IOL in the contralateral eye. J Refract Surg. 2008;24(3): 300-305.
  34. Ito M, Shimizu K. Reading ability with pseudophakic monovision and with refractive multifocal intraocular lens: Comparative study. J cataract Refract Surg. 2009; 35(9): 1501-1504. https://doi.org/10.1016/j.jcrs.2009.03.051
  35. Leyland MD, Langan L, Goolfee F, Lee N, Bloom PA. Prospective randomized double-masked trial of bilateral multifocal, bifocal or monofocal intraocular lenses. Eye. 2002;16(4):481-490. https://doi.org/10.1038/sj.eye.6700077
  36. 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(12): 2483- 2493. https://doi.org/10.1016/j.jcrs.2004.04.049
  37. Kim JY, Lee KJ. Optical performance after monofocal intraocular lens implantation evaluated using a OQAS. Korean J Vis Sci. 2013;15(2):173-182.
  38. Piers PA, Weeber HA, Artal P, Norrby S. Theoretical comparison of aberration-correcting customized and aspheric intraocular lenses. J Refract Surg 2007;23(4): 374-384.
  39. Pandita D, Raj SM, Vasavada VA, Kazi NS, Vasavada AR. Contrast sensitivity and glare disability after implantation of AcrySof IQ natural aspheric intraocular lens: prospective randomized masked clinical trial. J Cataract Refrat Surg. 2007;33(4):603-610. https://doi.org/10.1016/j.jcrs.2007.01.009
  40. Kasper T, Buhren J, Kohnen T. Intraindividual comparison of higher-order aberrations after implantation of aspherical and spherical intraocular lenses as a function of pupil diameter. J Cataract Refract Surg. 2006;32(1):78-84. https://doi.org/10.1016/j.jcrs.2005.11.018
  41. Caporossi A, Martone G, Casprini F, Rapisarda L. Prospective randomized study of clinical perfomance of 3 aspheric and 2 spherical intraocular lenses in 250 eyes. J Refract Surg. 2007;23(7):639-648.
  42. Artal P, Benito A, Perez GM, Alcon E, Casas AD, Pujol J et al. An objective scatter index based on double-pass retinal images of a point source to classify cataracts. PLoS One. 2011;6(2):e16823. doi:10.1371. https://doi.org/10.1371/journal.pone.0016823
  43. Van den Berg TJ, Van Rijn LJ, Michael R, Heine C, Coeckelbergh T, Nischler C, et al. Straylight effects with aging and lens extraction. Am J Ophthalmol. 2007;144(3): 358-363. https://doi.org/10.1016/j.ajo.2007.05.037
  44. Shahidi M. Yang Y. Measurement of ocular aberrations and light scatter in healthy subjects. Optom Vis Sci 2004; 81(11):853-857. https://doi.org/10.1097/01.OPX.0000145022.74296.45
  45. de Vries NE, Franssen L. Webers CA, Tahzib NG, Cheng YY, Hendrikse F et al. Intraocular straylight after implantation of the multifocal AcrySof ReSTOR SA60D3 diffractive intraocular lens. J Cataract Refract Surg. 2008; 34(6):957-962. https://doi.org/10.1016/j.jcrs.2008.02.016
  46. Kim JH, Lee JW, Chung JL, Kim EK, Kim TI. Combined Implantation of Monofocal and Multifocal Intraocular lenses in senile cataract surgery. J Korean Ophthalmol Soc. 2009;50(11):1632-1638. https://doi.org/10.3341/jkos.2009.50.11.1632
  47. Cheon MH, Lee JE, Kim JH, Kim KH, Lee HG, Kim JY et al. One-year outcome of monocular implant of aspheric multifocal IOL. J Korean Ophthalmol Soc. 2010;51(6): 822-828. https://doi.org/10.3341/jkos.2010.51.6.822

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