Laser interferometric assessment of pilocarpine-induced movement of an accommodating intraocular lens - A randomized trial
Laser interferometric assessment of pilocarpine-induced movement of an accommodating intraocular lens - A randomized trial
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DOI：
10.1016/j.ophtha.2003.12.057
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发表时间：
2004-08-01
期刊：
影响因子：
13.7
通讯作者：
Drexler, W
中科院分区：
文献类型：
--
作者：
Findl, O;Kriechbaum, K;Drexler, W
目的：目的：测量应用毛果芸香碱后，由睫状肌收缩引起的可调节性人工透镜（IOL）轴向移动。设计：随机、对照、患者和检查者设盲的试验，并进行患者内比较。首先，将调节性IOL（1 CU）与作为对照的3件式开环丙烯酸IOL进行比较。在第二项研究中，为了评估囊膜纤维化对可调节IOL潜在调节性能的影响，将使用狭缝套管对前囊膜进行广泛抛光与标准手术进行了比较。在第三项研究中，将后囊撕囊术的效果与标准手术的效果进行了比较。在局部应用2%毛果芸香碱前后，用部分相干干涉测量法评估前房深度（ACD），并在术后3个月评估近视力（VA）。主要结果测量：毛果芸香碱诱导的ACD变化。结果：可调节IOL在毛果芸香碱下显示向前移动，移动幅度中位数为-314 mum（95%置信区间[CI]：-148至-592），而开环对照IOL向后移动63 gm（95% CI：161至-41）（P = 0.001）。晶状体囊抛光和后囊撕囊术对调节性IOL的IOL移动没有影响。经远视力矫正的近视力中位数为20/60。结论：匹鲁卡品可使可调节人工晶状体向前移动，但幅度较小。然而，计算出的移动量导致屈光变化为
Purpose: To measure the axial movement of an accommodating intraocular lens (IOL) induced by ciliary muscle contraction after application of pilocarpine.Design: Randomized, controlled, patient- and examiner-masked trial with intrapatient comparison.Participants and Controls: One hundred ten eyes of 55 patients with age-related bilateral cataract.Methods: This study was divided into 3 parts. In the first, the accommodating IOL (1 CU) was compared with a 3-piece open-loop acrylic IOL that served as the control. In the second, to assess the effect of capsule fibrosis on the potential accommodating performance of the accommodating IOL, extensive polishing of the anterior capsule with a slit cannula was compared with standard surgery. In the third, the effect of a posterior capsulorhexis was compared with that of standard surgery. Anterior chamber depth (ACD) was assessed with partial coherence interferometry, measured before and after topical application of pilocarpine 2%, and near visual acuity (VA) was evaluated 3 months after surgery.Main Outcome Measure: Pilocarpine-induced change in ACD.Results: The accommodating IOL showed a forward movement under pilocarpine with a median amplitude of movement of -314 mum (95% confidence interval [CI]: -148 to -592), compared with the backward movement of 63 gm (95% CI: 161 to -41) for the open-loop control IOL (P = 0.001). Capsule polishing and a posterior capsulorhexis had no effect on IOL movement with the accommodating IOL. The median near VA with distance correction was 20/60.Conclusion: Pilocarpine induced a small but significant forward movement of the accommodating IOL. However, the amount of movement was calculated to result in a refractive change of