회절성 삼중초점인공수정체와 회절성 연속초점인공수정체의 임상 결과 비교
Visual and Refractive Outcomes of Diffractive Trifocal Versus Hybrid Multifocal-extended Depth of Focus Intraocular Lenses
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목적: 양안에 회절성 삼중초점인공수정체 AcrySof® IQ Panoptix TFNT00 (Alcon, Fort Worth, TX, USA) 또는 회절성 연속초점인공수정체 TECNIS® Synergy ZFR00V (Johnson & Johnson Vision, Santa Ana, CA, USA)를 삽입한 후 단기 임상 결과를 보고하고자한다. 대상과 방법: 회절성 삼중초점인공수정체를 삽입한 환자 13명 26안(A군)과 회절성 연속초점인공수정체를 삽입한 환자 12명 24안(B군) 의 수술 1개월째 logarithm of the minimal angle of resolution 시력으로 표기한 단안 및 양안 원거리, 중간거리, 근거리 나안시력, 탈초점곡선과 수술 3개월째 대비감도 및 시력 만족도를 비교하였다. 결과: 수술 1개월째 단안 원거리, 근거리 및 양안 근거리 나안시력은 A군 0.13 ± 0.09, 0.33 ± 0.14, 0.29 ± 0.11, B군 0.07 ± 0.07, 0.24 ± 0.16, 0.18 ± 0.15로 B군에서 유의하게 높았다(모두 p<0.05). 단안 탈초점곡선의 +1.00 diopters (D), -3.00 D, -3.50 D 및 양안 탈초점곡선의 +1.00 D에서 B군의 시력이 유의하게 높았다(모두 p<0.05). 0.00 D부터 -3.00 D 구간의 양안 탈초점곡선에서 두 군 모두 0.2 이상의 연속적인 시력을 보였다. 수술 3개월째 대비감도 및 시력 만족도는 두 군 간 유의한 차이가 없었다(p>0.05). 결론: 회절성 연속초점인공수정체가 회절성 삼중초점인공수정체보다 근거리에서 더 높은 시력을 보일 수 있으며 두 인공수정체 모두우수한 원거리, 중간거리, 근거리 시력을 보인다.
Abstract
Purpose: We compared the clinical outcomes of patients who received AcrySof IQ Panoptix TFNT00 (Alcon, Fort Worth, TX, USA), a diffractive trifocal intraocular lens (IOL), or TECNIS Synergy ZFR00V (Johnson & Johnson Vision, Santa Ana, CA, USA), a hybrid multifocal-extended depth of focus (EDOF) IOL. Methods: In total, 26 eyes of 13 patients who underwent bilateral implantation of the diffractive trifocal IOL (group A) and 24 eyes of 12 patients who underwent bilateral implantation of the hybrid multifocal-EDOF IOL (group B) were included. We assessed visual acuity using the logarithm of the minimal angle of resolution (logMAR) scale and evaluated the visual performance of both groups, including uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA) and the defocus curve at 1 month postoperatively. In addition, we measured contrast sensitivity and administered a satisfaction questionnaire at 3 months postoperatively. Results: At 1 month postoperatively, group B demonstrated significantly better monocular UDVA, UNVA and binocular UNVA compared to group A (0.07 ± 0.07, 0.24 ± 0.16, and 0.18 ± 0.15 vs. 0.13 ± 0.09, 0.33 ± 0.14, and 0.29 ± 0.11; p < 0.05). In addition, group B exhibited higher visual acuities in the monocular and binocular defocus curves at +1.00 diopters (D), -3.00 D, -3.50 D, and +1.00 D (p < 0.05). Notably, the binocular defocus curves of both groups demonstrated excellent logMAR visual acuities (better than 0.2) in the range of 0.00 to -3.00 D. However, no significant differences were observed between the groups in contrast sensitivity or satisfaction questionnaire responses for visual acuity at 3 months postoperatively (p > 0.05). Conclusions: The hybrid multifocal-EDOF IOL demonstrates superior near visual acuity compared to the diffractive trifocal IOL. However, both IOLs exhibit excellent visual acuity at distant, intermediate, and near distances.
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