Astigmatic correction with implantation of a light adjustable vs monofocal lens: a single site analysis of a randomized controlled trial
Astigmatic correction with implantation of a light adjustable vs monofocal lens: a single site analysis of a randomized controlled trial
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DOI：
10.18240/ijo.2019.07.08
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发表时间：
2019-07-18
影响因子：
1.4
通讯作者：
Hoopes, Phillip C., Jr.
中科院分区：
文献类型：
--
作者：
Moshirfar, Majid;Wagner, William D.;Hoopes, Phillip C., Jr.
目的：评价光可调晶状体（LAL）与标准单焦点晶状体在实现目标散光屈光度和改善术后未矫正距离视力（UDVA）方面的效果。方法：本随机对照临床试验纳入40例既往散光伴明显白内障患者。28例患者接受LAL， 12例对照患者在同一机构接受单焦点人工晶状体（IOL）。LAL患者术后接受紫外线（UV）光调整和随后的锁定程序，所有患者在6、9和12个月时返回诊所随访研究参数。每次就诊均记录明显屈光、远视力和不良事件。结果：双眼LAL调整前平均柱形为-0.89 +/- 0.58 D (-2.00 ~ 0.00 D)，锁定后平均柱形为-0.34 +/- 0.34 D (-1.25 ~ 0.00 D) （P=1.68 × 10(-8)）。单焦点晶状体患者术后17-21d平均晶状体为-1.00 +/- 0.32 D (-1.50 ~ -0.50 D)，与LAL晶状体柱锁定组差异有统计学意义（P=1.43 × 10(-6)）。锁定后，LAL组79%的患者UDVA为20/20或更好，在12个月内具有良好的稳定性，而对照组的UDVA为20/20或更好的患者为33%。结论：这些结果表明，与标准单焦点晶状体相比，LAL在实现目标屈光和改善角膜散光患者术后UDVA方面更有效。
AIM: To evaluate the light adjustable lens (LAL) vs a standard monofocal lens in achieving target astigmatic refraction and improving postoperative uncorrected distance visual acuity (UDVA).METHODS: This randomized controlled clinical trial included 40 patients with pre-existing astigmatism and visually significant cataract. Twenty-eight patients received the LAL and 12 control patients received a monofocal intraocular lens (IOL) after cataract extraction at a single institution. The patients with the LAL underwent adjustment by ultraviolet (UV) light postoperatively plus subsequent lock-in procedures and all patients returned to clinic for follow up of study parameters at 6, 9, and 12mo. Manifest refraction, distance visual acuity, and adverse events were recorded at each visit.RESULTS: The mean cylinder before adjustment in eyes with the LAL was -0.89 +/- 0.58 D (-2.00 to 0.00 D) and -0.34 +/- 0.34 D (-1.25 to 0.00 D) after lock-in (P=1.68x10(-8)). The mean cylinder in patients with the monofocal lens was -1.00 +/- 0.32 D (-1.50 to -0.50 D) at 17-21d postoperatively, which was statistically different from the LAL cylinder post lock-in (P=1.43x10(-6)). UDVA in the LAL group was 20/20 or better in 79% of patients post lock-in with good stability over 12mo compared with 33% of the control patients with UDVA of 20/20 or better.CONCLUSION: These results demonstrate that the LAL is more effective in achieving target refractions and improving postoperative UDVA in patients with pre-existing corneal astigmatism than a standard monofocal lens.