ophthalmologyОфтальмологияOphthalmology in Russia1816-50952500-0845Ophthalmology10.18008/1816-5095-2023-4-683-687ophthalmology-2237Research ArticleОФТАЛЬМОХИРУРГИЯOPHTHALMOSURGERYСравнительная оценка кривой дефокусировки монофокальной ИОЛ, ИОЛ с расширенной глубиной фокуса и трифокальной ИОЛComparative Evaluation of the Defocus Curve of Monofocal IOL, Extended Depth of Focus IOL, and Trifocal IOLКоноваловМ. Е.KonovalovM. E.

Коновалов Михаил Егорович доктор медицинских наук, доцент, профессор кафедры офтальмологии

Волоколамское шоссе, 91, Москва, 125371

Konovalov Mikhail E. MD, Associate Professor, Professor of the Department of ophthalmology

Volokolamskoe highway, 91, Moscow, 125371

МоренкоА. В.MorenkoA. V.

Моренко Алексей Валерьевич главный врач

ул. Карла Либкнехта, 13, Мурманск, 183038

Morenko Alexey V. chief physician

Karla Liebknechta str., 13, Murmansk, 183038

Академия постдипломного образования ФГБУ «Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий Федерального медико-биологического агентства»РоссияAcademy of Postgraduate Education of the Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies of the Federal Medical and Biological AgencyRussian FederationООО «Офтальмологический центр Мурманской области»РоссияOphthalmological Center of the Murmansk RegionRussian Federation202327122023204683687Copyright © Коновалов М.Е., Моренко А.В., 20232023Коновалов М.Е., Моренко А.В.Konovalov M.E., Morenko A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ophthalmojournal.com/opht/article/view/2237

Цель: сравнительная оценка кривой дефокусировки (КД) монофокальной ИОЛ (МИОЛ), ИОЛ с расширенной глубиной фокуса (ЭДОФ) и трифокальной ИОЛ (ТИОЛ). Пациенты и методы. Под нашим наблюдением находились 90 пациентов (средний возраст 57,8 ± 1,8 года), которым была выполнена стандартная бинокулярная факоэмульсификация катаракты на обоих глазах с эмметропической рефракцией «цели» и послеоперационной монокулярной некорригированной остротой зрения вдаль (НКОЗ) — не менее 1,0 отн. ед. Все пациенты были разделены на три равнозначные по количеству пациентов, возрасту, гендерному признаку и состоянию зрения группы, соответствующие трем вариантам имплантируемых ИОЛ: МИОЛ («RayOne Aspheric», модель RAO600C), ЭДОФ («RayOne EMV», модель RAO200E) и ТИОЛ («RayOne Trifocal»). Проведение КД выполнялось бинокулярно на основании стандартного измерения НКОЗ с оптической нагрузкой для дефокусировки от +3,0 до -4,0 дптр с «шагом» +1,0 и -0,5 дптр. Результаты. В условиях оптической дефокусировки положительными линзами (1,0; 2,0; 3,0 дптр) при наличии всех трех видов ИОЛ сохранялась практически одинаковая средняя НКОЗ (при +1,0 дптр диапазон НКОЗ составлял 0,72–0,76 отн. ед.; при +2,0 дптр — 0,66–0,72 отн. ед.; при +3,0 дптр — 0,52–0,56 отн. ед.). Применительно к анализу НКОЗ в условиях дефокусировки отрицательными линзами установлено, что острота зрения была значительно лучше с ЭДОФ, чем с МИОЛ, при нагрузке от -1,0 до -4,0 дптр, при этом данные различия были статистически значимыми и составляли от 0,14 до 0,27 отн. ед. (р < 0,01). Наряду с этим определено, что НКОЗ была значительно лучше в группе с ТИОЛ, чем в группе с ЭДОФ, при нагрузке от -2,5 до -4,0 дптр; данные различия были статистически значимыми и составляли от 0,09 до 0,14 отн. ед. (р < 0,01). Заключение. Конструктивные особенности ИОЛ позволяют рассматривать имплантацию ЭДОФ как вариант индивидуального подхода к выбору ИОЛ, особенно с учетом возможности применения у пациентов, профессиональная деятельность которых связана с длительной зрительной работой на промежуточных расстояниях (например, пользователи персональных компьютеров).

Purpose. Comparative evaluation of the defocus curve (DC) of monofocal IOLs (MIOLs), extended depth of focus IOLs (EDОF) and trifocal IOLs (TIOLs). Patients and methods. We observed 90 patients (average age 57.8 ± 1.8 years) who underwent standard binocular phacoemulsification of cataracts in both eyes with emmetropic “target” refraction and postoperative monocular uncorrected distance visual acuity (UCVA) of at least 1.0 rel. units. All patients were divided into three groups equal in number of patients, age, gender and visual status, corresponding to three options of implantable IOLs: MIOL (“RayOne Aspheric”, model RAO600C); EDOF (RayOne EMV, model RAO200E) and THYOL (RayOne Trifocal). DC was performed binocularly based on a standard BCVA measurement with an optical load for defocusing from +3.0 D to -4.0 D with a “step” of +1.0 D and -0.5 D. Results. Under conditions of optical defocusing with positive lenses (1.0; 2.0; 3.0 D), all three types of IOLs maintained almost the same average BCVA (at +1.0 D, the BCVA range was 0.72–0.76 rel. units; at +2.0 diopters — 0.66–0.72 relative units; at +3.0 diopters — 0.52–0.56 relative units). In relation to the analysis of BCVA in conditions of defocusing with negative lenses, it was found that visual acuity was significantly better with EDOF than with MIOL, with a load from -1.0 to -4.0 diopters, while these differences were statistically significant and ranged from 0.14 to 0.27 relative units (p < 0.01). Along with this, it was determined that UCVA was significantly better in the group with TIOL than in the group with EDOF, with a load from -2.5 to -4.0 D. Moreover, these differences were statistically significant and ranged from 0.09 to 0.14 rel. units (p < 0.01). Conclusion. The design features of IOLs make it possible to consider implantation of EDOF as an option for an individual approach to the selection of IOLs, especially taking into account the possibility of use in patients whose professional activities involve long-term visual work at intermediate distances (for example, users of personal computers).

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The authors declare that there are no conflicts of interest present.