Prelex Dotaz Zobrazit nápovědu
Autoři referují o svých zkušenostech s chirurgickou korekcí presbyopie metodou Prelex (presbyopic lens exchange). Do studie byli zařazeni pacienti, kteří podstoupili tento typ refrakční operace s cílem omezit svou závislost na brýlové korekci jak na dálku, tak do blízka (12 pacientů, 23 očí) a 1 mladá pacientka (2 oči) s juvenilní kataraktou a vysokou hypermetropií. Průměrný věk v době operace byl 51,0 ± 5,5 let (rozmezí 19–77 let). Průměrná sledovací doba celého souboru je 9,8 měsíce (rozmezí 1–13 měsíců). Podle typu implantované nitrooční čočky je soubor rozdělen na skupinu A, kde jsme použili akomodační čočku 1 CU firmy Human Optics a skupinu B s akomodační čočkou Kellan TetraFlex KH 3500 firmy LensTec. Ve skupině A je zahrnuto 8 pacientů (15 očí) s průměrnou předoperační refrakcí +2,35 ± 3,45 D. Průměrný nekorigovaný vizus této skupiny byl 0,24 ± 0,18 a průměrný korigovaný vizus 0,77 ± 0,22 v době před operací. Průměrná hodnota brýlové korekce do blízka byla +4,1 D a nekorigovaný vizus do blízka Jaeger (J) 13. Skupinu B tvoří 5 pacientů (10 očí). Průměrná předoperační refrakce byla +2,23 ± 0,93 D. Průměrná hodnota nekorigované zrakové ostrosti (NZO) před operací byla 0,43 ± 0,28 a průměrná hodnota korigované zrakové (KZO) ostrosti byla 0,82 ± 0,25. Hodnota brýlové korekce do blízka byla +5,25 D a naturální J 13. Výsledná průměrná pooperační refrakce v době poslední kontroly byla ve skupině A +0,06 ± 1,17 D. Průměrná NZO byla 0,69 ± 0,24 a průměrná KZO byla 0,96 ± 0,12. Pacienti této skupiny viděli do blízka bez korekce průměrně J 3. V skupině B jsme při poslední kontrole zaznamenali průměrnou výslednou hodnotu pooperační refrakce -0,2 ± 0,72 D. Průměrná NZO byla 0,57 ± 0,22 a průměrná KZO 0,95 ± 0,12. Naturální vizus do blízka byl průměrně J 5. Nezaznamenali jsme žádnou vážnější peri- ani pooperační komplikaci tohoto výkonu.
The authors refer about their experience with the surgical correction of the presbyopia by means of the Prelex (presbyopic lens exchange) method. Patients, who underwent this type of refractive surgery procedure to decrease their dependency on glasses correction for far as well as for near vision (12 patients, 23 eyes) and 1 young female patient (2 eyes) with juvenile cataract and high hyperopia, were included in the study. The average age at the time of the surgery was 51.0 ± 5.5 years (range, 19–77 years). The average follow up period of the whole group of patients is 9.8 months (range, 1–13 months). Depending on the type of the lens implanted, the group was divided into subgroup A with the accommodative lens 1 CU produced by Human Optics Company implanted, and subgroup B with the accommodative lens Kellan TetraFlex KH 3500 produced by LensTec Company implanted. The subgroup A consists of 8 patients (15 eyes) with the average preoperative refractive error +2.35 ± 3.45 diopters. The average uncorrected visual acuity of this group was 0.24 ± 0.18, and the average best-corrected visual acuity was 0.77 ± 0.22 at the time before the surgery. The average glasses correction for near was +4.1 dioptres, and the uncorrected vision for near was Jaeger’s table Nr. (J) 13. The B subgroup consists of 5 patients (10 eyes). The average preoperative refractive error was +2.23 ± 0.93 diopters. The average value of the uncorrected visual acuity before the surgery was 0.43 ± 0.28, and the average corrected visual acuity was 0.82 ± 0.25. The average value of the glasses correction for near was +5.25 and uncorrected vision for near J 13. The final average postoperative error at the time of the last visit was in the A subgroup +0.06 ±1.17 dioptres. The average uncorrected visual acuity was 0.69 ± 0.24, and the average best-corrected visual acuity 0.96 ± 0.12. The average vision of the patients of this subgroup for near was J 3. In the B subgroup we found at the last visit the average final value of the postoperative refractive error –0.2 ± 0.72 dioptres. The average uncorrected visual acuity 0.57 ± 0.22 and the average corrected visual acuity 0.95 ± 0.12. Average uncorrected vision for near was J 5. We did not notice any serious per- or postoperative complication of this procedure.
PURPOSE: To compare the visual and refractive outcomes obtained with the implantation of a rotationally asymmetric refractive multifocal IOL after femtosecond laser-assisted cataract surgery (FLACS) and conventional lens extraction (CLE). METHODS: A total of 78 eyes of 58 patients that had undergone conventional phacoemulsification (36 eyes, CLE group) or FLACS (37 eyes, FLACS group) with the implantation of the toric multifocal IOL LU-313 MF30T (Oculentis, Germany) were enrolled in this retrospective study. Mean age was 57.0 years at the time of surgery, ranging from 44 to 69 years. Visual and refractive outcomes were evaluated during a 12-month follow-up. Likewise, contrast sensitivity was assessed at the end of the follow-up. RESULTS: Significant improvements were observed in both groups in uncorrected distance (UDVA) and near visual acuity (UNVA) at 1 month postoperatively (p < 0.001). Differences between groups in these parameters as well as in sphere and cylinder did not reach statistical significance during the whole follow-up (p ≥ 0.079), except for UNVA only at 12 months postoperatively (p = 0.018). Concerning corrected near visual acuity, only significant differences between groups were found preoperatively (p = 0.020). Furthermore, only a minimal but significant difference between groups was found at 12 months postoperatively in contrast sensitivity for the spatial frequency of 18 cycles/° (p = 0.029). CONCLUSIONS: The rotationally asymmetric toric multifocal IOL LU-313 MF 30T provides good visual rehabilitation for near and distance vision after presbyopic lens extraction in eyes with preexisting astigmatism, independently whether the cataract surgery is performed with the FLACS or conventional technique.
- MeSH
- citlivost na kontrast MeSH
- dospělí MeSH
- fakoemulzifikace * metody MeSH
- implantace nitrooční čočky * MeSH
- lidé středního věku MeSH
- lidé MeSH
- multifokální intraokulární čočky * MeSH
- refrakce oka * MeSH
- retrospektivní studie MeSH
- senioři MeSH
- zraková ostrost MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Klíčová slova
- Prelex,
- MeSH
- implantace nitrooční čočky metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- presbyopie * chirurgie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
The leading topic of this particular paper is dedicated to available surgical options for refractive eye disorders treatment including surgery of cornea and intraocular surgery. Corneal Surgery includes laser refractive surgery - LASIK (Laser-Assisted In Situ Keratomileusis), FemtoLASIK (Femtosecond laser-assisted LASIK), PRK (Photorefractive keratectomy). This article describes relevant principles of particular procedures, indications and possible contraindications. The chapter dedicated to corneal implants provides information about ICRS (Intrastromal Corneal Rings Segment) and Inlays (corneal implants for presbyopia correction). Corneal interventions also include incision methods for astigmatism correction AK (Astigmatic Keratotomy) and LRI (Limbal relaxing Incisions). Intraocular refractive interventions preserving natural human lens also include phakic lenses. Relevant categorization, examples, indications and contraindications are listed in particular chapter of this paper. Intraocular refractive surgery which replaces the original human lens is also called RLE (Refractive Lens Exchange) or PRELEX (Presbyopic Lens Exchange). These interventions are usually accompanied with the multifocal intraocular lens implantation. This chapter provides the list of specific lens types, indications and contraindications related to this type of intervention. The last chapter describes Bioptics--the combination of corneal and intraocular surgery.
