当院におけるPanOptix®とTECNIS Synergy®の術後成績の検討

Postoperative outcomes of Clareon PanOptix® and TECNIS Synergy®

要約　目的：3焦点眼内レンズ（AcrySof^® IQ PanOptix^® TrifocalおよびClareon^® PanOptix^® Trifocal）と連続焦点型多焦点眼内レンズ（TECNIS Synergy^®）の術後視力および屈折値の変化を比較検討した。

対象と方法：2021年8月〜2024年12月に当院でPanOptix^®（以下，P群），TECNIS Synergy^®（以下，S群）を挿入し，白内障以外の眼科疾患および術中・術後合併症がなく，術後3か月以上経経過観察が可能であったP群54例81眼（68.4±8.5歳），S群19例34眼（67.5±8.3歳）を対象とした。術後3か月の遠方（5m）・中間（70cm）・近方（30cm）裸眼logMAR視力，自覚屈折値等を後ろ向きに調査した。

結果：術後裸眼logMAR視力はP群とS群で，どの距離でも両群間で有意差はなかった。術後3か月の自覚屈折値は，P群0.05±0.28D，S群−0.06±0.30，予想屈折値との差はP群0.06±0.29D，S群−0.04±0.32Dであり，P群はS群より統計学的に有意に差が小さかった（p＝0.04）。重回帰分析では年齢と群の交互作用は有意ではなかった（p＝0.27）。回帰線の傾きに群間差はなかったが，視覚的にはS群において高齢になるに従い近視寄りの屈折誤差が生じる傾向がみられた。

結論：P群，S群ともに良好な裸眼視力を得られ，高齢で近視に傾く傾向を認めた。P群はS群より屈折誤差が有意に小さく，年齢と群の交互作用は統計的には有意ではなかったが，S群において高齢で近視に傾く傾向が示唆された。

Abstract　Purpose：This study compared the postoperative visual acuity and refractive changes between trifocal intraocular（AcrySof^® IQ PanOptix^® Trifocal） and continuous-focus multifocal intraocular（TECNIS Synergy^®） lens.

Methods：The study included patients who underwent cataract surgery using trifocal intraocular lens（PanOptix^®, P group, n＝81 and TECNIS Synergy^®, S group, n＝34） between August 2021 and December 2024, had no other ocular diseases or intra- or postoperative complications, and were followed for at least three months after postoperatively. Three months postoperatively, unaided logMAR visual acuity（VA） at distance, intermediate, near refraction, and subjective refraction were retrospectively investigated.

Results：The postoperative uncorrected logMAR visual acuity was not significantly different between the two groups at any distance. Three months postoperatively, subjective refraction in the P and S groups were 0.05±0.28D and −0.06±0.30D, respectively. The difference from predicted refraction in the P and S groups were 0.06±0.29D and −0.04±0.32D, respectively. Multiple regression analysis did not reveal a significant interaction between age and group（p＝0.27）. However, in a model excluding the interaction, a significant difference in the preoperative predicted and postoperative refractions was observed between the two groups（p＝0.04）. There was no significant difference in the regression line slope between both groups；however, the slope was slightly higher in the S group.

Conclusion：Both groups achieved good uncorrected visual acuity, and a tendency toward myopia was observed with age. The P group had a significantly smaller refractive error than the S group. Although the interaction between age and group was not statistically significant, a tendency toward myopia at older ages was observed in the S group.