Calidad visual en pacientes con implante bilateral y simétrico de lentes intraoculares multifocales
PURPOSE: This thesis presents the results of a prospective, double-blind and randomized clinical trial conducted at the Hospital de Sant Pau i la Santa Creu ofBarcelona.lts main objective was to assess and compare visual qualityofpatients implanted with different designs of multifocal intraocular le...
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| Tipo de recurso: | tesis doctoral |
| Fecha de publicación: | 2016 |
| País: | España |
| Institución: | Universitat Politècnica de Catalunya (UPC) |
| Repositorio: | UPCommons. Portal del coneixement obert de la UPC |
| Idioma: | español |
| OAI Identifier: | oai:upcommons.upc.edu:2117/107047 |
| Acceso en línea: | https://hdl.handle.net/2117/107047 https://dx.doi.org/10.5821/dissertation-2117-107047 |
| Access Level: | acceso abierto |
| Palabra clave: | Cataract surgery Chromatic aberration Contrast sensitivity Multifocal intraocular lenses Quality of life Subjective quality of vision Stereo-acuity Visual acuity Àrees temàtiques de la UPC::Ciències de la visió |
| Sumario: | PURPOSE: This thesis presents the results of a prospective, double-blind and randomized clinical trial conducted at the Hospital de Sant Pau i la Santa Creu ofBarcelona.lts main objective was to assess and compare visual qualityofpatients implanted with different designs of multifocal intraocular lenses (MIOLs), as well as a monofocallens as control group. METHOD : The MIOLs used in the studywere the refractive ReZoom NXG, with add power of +3.00D, the aspheric hybrid (apodized diffractive-refractive) AcrySof ReSTOR SN6AD1, with add power of +3.00D, the spherical hybrid (apodized diffractive-refractive) AcrySof ReSTOR SN60D3, with add power of +4.00D and the aspheric diffractive Tecnis ZMAOO, with add power of +4.00D. The monofocallens was the aspheric Tecnis ZA9003. All clinical measurements were conducted under best post-operative optical correction. One and three months after the intervention visual acuity (VA) was as ses sed at far (VF), intermediate (60 cm) (VI) and near (33 and 40 cm), (VN) distances. The SIFFI-MAVtest, which is the standard test in this type of clinical trials , was used for VF and the test ofthe Departament de Treball de la Generalitat de Catalunya for VN. At three months patients were administered two questionnaires to investigate subjective qualityofvision and qualityoflife and at six months contras!sens itivity (CS) and stereoacuity were assessed. Contras!sensitivity was explored at distance under photopic, mesopic and mesopic with glare conditions with the CSV-1000 and at near in photopic conditions with the VCTS 6000 test. Two tests were employed to meas ure stereoacuity: the polarized Titmus test and the anaglyphic TNO. RESULTS: No statistically significan!differences (p>0.05) were found in VF amongst the MIOL under study. For VI, the ReZoom , SN6AD1 and Tecnis offered the bes!performance, without differences amongst them . M. 33 cm, the best VN was obtained with the aspheric MIOLs, withoutdifferences amongstthem , and at40 cm, the bestVN was obtained with the monofocallens . Regarding CS at far, no differences were found amongst the MIOLs under any of the illum ination conditions. Alnear, the aspheric lenses offered the best results in terms of CS. However, the best CS at any distance and illumination was obtained with the monofocallens . No difference was found amongst the MIOLs in stereoacuity as meas ured with the Titmus test, although with the TNO test the refractive ReZoom offered the best outcome. In terms of subjective visual quality, patients im planted with MIOLs reported good vis ion with and without best optical correction at all distances , al so presenting with spectacle independence at all distances . Photic phenom ena were found to occur in patients im planted with MIOLs , albeit less in apodized designs . Patient satisfaction with MIOL designs was high and they did not report any problems when conducting daily activities . With the monofocallens there was less spectacle independence, less occurrence of photic phenomena and good visual satisfaction. CONCLUSION: the present findings may assist practitioners when selecting the best intraocular lens design for each patient, particularlythose with high visual demands at VP and VI. |
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