[特殊眼内透镜光学台式评估]。

Die Ophthalmologie Pub Date : 2024-09-01 Epub Date: 2024-07-08 DOI:10.1007/s00347-024-02064-y
Grzegorz Łabuz, Ramin Khoramnia, Tadas Naujokaitis, Gerd U Auffarth
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引用次数: 0

摘要

具有复杂光学设计的眼内透镜(IOL)在了解其性能方面可能会带来挑战,这可能会妨碍在为患者选择合适的透镜时做出明智的决定。因此,收集并提供人工晶体的光学质量数据就显得尤为重要。采用台式系统对人工晶体进行测试,不仅能深入了解各种人工晶体解决方案的设计特点,还能提供一个平台,对特殊光学设计进行客观比较,包括了解它们对光现象的敏感性。人工晶体测试的最新进展提高了从客观光学质量指标预测对视力和对比敏感度的功能性影响的能力。例如,这可用于研究单焦点镜片、非球面对视力的影响以及人工晶体对错位的耐受性。在光学工作台和临床环境中进行测试时,单焦点加人工晶体始终只显示出聚焦深度的轻微改善。虽然这种技术中的瞳孔依赖性可能会限制单焦增强型人工晶体在扩大视力范围方面相对于标准单焦技术的优势,但它却是减少光现象的关键。屈光性和衍射性延伸焦深(EDOF)人工晶体可有效增强中间视力,后者可提供稍宽的焦深,但可能会增加视力障碍的风险。不过,EDOF 人工晶体的局限性在于,它们往往无法在阅读时独立配戴眼镜,而三焦点技术可以克服这一问题。不过,现有的三焦点人工晶体在中焦和近焦的位置以及产生眩光效应的易感性方面仍存在差异。因此,从人工晶体光学台式测试中获得的知识可以帮助优化人工晶体的选择,使患者的视觉需求与人工晶体的特性相一致,设定正确的期望值,并评估发生眩光现象的风险概况,从而改进决策。
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[Optical benchtop evaluation of special intraocular lens optics].

Intraocular lenses (IOL) featuring complex optical designs can pose a challenge in understanding their performance, which may hinder making an informed decision when selecting suitable lenses for patients. This underlines the importance of collecting optical quality data of IOLs and making them available. The deployment of benchtop systems for IOL testing offers not only insights into the design features of various IOL solutions but also provides a platform for objective comparisons of special optics designs, including information about their susceptibility to photic phenomena. Recent advances in IOL testing have improved the ability to predict functional effects on visual acuity and contrast sensitivity from objective optical quality metrics. This, for instance, can be used to study monofocal lenses and the impact of asphericity on vision and IOLs tolerance to misalignment. Monofocal-plus IOLs consistently show only a slight improvement in the depth of focus when tested on the optical bench and in clinical settings. Although the pupil dependence found in this technology may limit the advantages of monofocal-plus over standard monofocal technology to extend the range of vision, it is the key to reduce photic phenomena. Refractive and diffractive extended depth of focus (EDOF) IOLs can effectively enhance intermediate vision, with the latter offering a slightly broader depth of focus but potentially increasing the risk of dysphotopsia. However, the limitation of EDOF IOLs is that they often fail to deliver spectacle independence for reading, which can be overcome by trifocal technology. Still, the available trifocal IOLs differ in their location of intermediate and near foci and the susceptibility to produce glare effects. Therefore, the knowledge from optical benchtop testing of IOLs can support optimizing the IOL selection by aligning the patient's visual needs with the IOL's properties, setting the right expectations, and assessing the risk profile for the occurrence of photic phenomena, potentially leading to improved decision-making.

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