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Halkiadakis I, Ntravalias T, Kollia E, Chatzistefanou K, Kandarakis SA, Patsea E. Screening for multifocal intraocular lens implantation in cataract patients in a public hospital. Int Ophthalmol 2024; 44:151. [PMID: 38507136 DOI: 10.1007/s10792-024-03088-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 02/23/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE To identify the rate and characteristics of cataract surgery candidates suitable for multifocal intraocular lens implantation among patients undergoing preoperative evaluation in a public hospital. MATERIALS AND METHODS Screening was performed based on the patient's medical records, comprehensive ophthalmic examination, optical biometry (Zeiss, IOL Master 700) and optical coherence tomography (OCT) (Heidelberg, OCT Spectralis) in accordance with the relevant indications and contraindications mentioned in the pertinent literature. Patients were included in the present study if they were eligible for bilateral cataract surgery. The exclusion criteria were the presence of central nervous system or motility issues, prior refractive surgery, the presence of astigmatism greater than 1 dioptre and/or the presence of important ocular comorbidities in either eye. RESULTS The study evaluated 1200 consecutive patients. Four hundred thirty-two patients (36%) were not eligible for bilateral surgery and were excluded from the study. Of the 768 patients included in the present study, 346 (45.1%) were considered suitable candidates. Four hundred twenty-two patients (54.9%) were excluded for one or both eyes. Among them, 121 (28.7%) were excluded because of retinal disease, 120 (28.4%) because of regular astigmatism (> 1.0 D of corneal astigmatism), 32 (7.5%) because of pseudoexfoliation or zonular instability, and 30 (7.1%) because of glaucoma or ocular hypertension; in addition, 90 (21.3%) patients were excluded for multiple reasons. Suitable candidates were significantly younger (70 and 75 years, respectively) (p < 0.001). After being informed about the potential risks and benefits of MOIL implantation, 212 of 346 (83.8%) eligible patients provided consent. CONCLUSION Close to half of cataract patients in a public hospital were eligible for MOIL implantation, and the majority of patients would proceed to surgery. The most prevalent contraindication was macular disease.
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Affiliation(s)
- Ioannis Halkiadakis
- Ophthalmiatrion Athinon, Athens Eye Hospital, Sarantaporou 7 Agios Stephanos, 145 65, Athens, Greece.
| | - Thomas Ntravalias
- Ophthalmiatrion Athinon, Athens Eye Hospital, Sarantaporou 7 Agios Stephanos, 145 65, Athens, Greece
| | - Elpida Kollia
- Ophthalmiatrion Athinon, Athens Eye Hospital, Sarantaporou 7 Agios Stephanos, 145 65, Athens, Greece
| | - Klio Chatzistefanou
- First Department of Ophthalmology, National and Kapodistrian University of Athens, General Hospital "G. Gennimatas", Athens, Greece
| | - Stylianos A Kandarakis
- First Department of Ophthalmology, National and Kapodistrian University of Athens, General Hospital "G. Gennimatas", Athens, Greece
| | - Eleni Patsea
- Ophthalmiatrion Athinon, Athens Eye Hospital, Sarantaporou 7 Agios Stephanos, 145 65, Athens, Greece
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Huang H, Yan J, Li B, Huang M, Guo S, Fan A, Liu W. Tear Film Stability Affects Visual Acuity After Implantations of Monofocal and Multifocal Intraocular Lenses: An Evaluation by Objective Scatter Index. Transl Vis Sci Technol 2023; 12:15. [PMID: 37847201 PMCID: PMC10584023 DOI: 10.1167/tvst.12.10.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/14/2023] [Indexed: 10/18/2023] Open
Abstract
Purpose To assess the impact of tear film on postoperative visual acuity after cataract surgery to implant an intraocular lens (IOL). Methods Tear break-up time (TBUT), Schirmer I test, objective scatter index (OSI), and uncorrected distance visual acuity (UCDVA), intermediate visual acuity (UCIVA), and near visual acuity (UCNVA) were collected 6 months after cataract surgery. Results Fifteen eyes with monofocal (Mo-) IOLs and 15 eyes with multifocal (Mu-) IOLs from 30 subjects were included. The Mu-IOL group exhibited higher baseline OSI (1.92 ± 0.69, P < 0.001). Negative correlations-both groups: tear film-related OSI (TF-OSI) and TBUT/Schirmer I test; Mo-IOL: TBUT and logMAR UCDVA-and positive correlations-both groups: TF-OSI and baseline OSI, baseline OSI/TF-OSI and logMAR UCDVA; Mu-IOL: baseline OSI/TF-OSI and logMAR UCIVA/UCNVA-were found. Linear regression showed associations between TF-OSI and TBUT (Mo-IOL: R2 = 0.455, P = 0.006; Mu-IOL: R2 = 0.454, P = 0.006)/Schirmer I test (Mo-IOL: R2 = 0.527, P = 0.002; Mu-IOL: R2 = 0.266, P = 0.049). Multiple regression showed associations between baseline OSI (Mo-IOL: R2 = 0.309, P = 0.032; Mu-IOL: R2 = 0.305, P = 0.033)/TF-OSI (Mo-IOL: R2 = 0.332, P = 0.025; Mu-IOL: R2 = 0.523, P = 0.002)/TBUT (Mo-IOL only: R2 = 0.315, P = 0.029) and logMAR UCDVA. Conclusions TF-OSI reflects the UCDVA performance in eyes with IOLs and facilitates a better understanding of the effects of the tear film. Translational Relevance TF-OSI offers a developmental and objective approach to assessing the changing visual performance caused by tear film after cataract surgery and IOL implantation in clinical practices.
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Affiliation(s)
- Hao Huang
- Department of Ophthalmology, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou, China
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science; Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Jianjun Yan
- Department of Ophthalmology, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou, China
| | - Bowen Li
- Eye Center of Xiangya Hospital, Central South University, Changsha, China
| | - Mansha Huang
- Guangzhou Aier Eye Hospital, Jinan University, Guangzhou, China
| | - Shuanglin Guo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science; Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Aifang Fan
- Department of Ophthalmology, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou, China
| | - Wei Liu
- Department of Ophthalmology, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou, China
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Ozturkmen C, Kesim C, Gunel Karadeniz P, Sahin A. Comparative Analysis of a New Hybrid EDOF-Multifocal Diffractive Intraocular Lens with a Trifocal Diffractive Intraocular Lens. Eur J Ophthalmol 2021; 32:2961-2966. [PMID: 34905987 DOI: 10.1177/11206721211067643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To compare visual acuity, defocus curve and visual quality of life performances of a new hybrid refractive-diffractive intraocular lens (IOL) and a trifocal diffractive IOL. METHODS Patients who underwent cataract surgery with bilateral implantation of ZFR00V or TFNT00 IOLs were enrolled in this study. The main outcomes were defined as uncorrected distant, intermediate and near visual acuities (UDVA, UIVA and UNVA, respectively), defocus curve and VF-14 questionnaire aimed for visual performance. RESULTS Fifty patients, of whom 30 had bilateral ZFR00V implantation, were enrolled in the study. Patients with ZFR00V had significantly better UIVA than patients with TFNT00 (0.05 ± 0.03 vs. 0.07 ± 0.04 logMAR, P = 0.02). Defocus curve showed significantly higher visual acuity in intermediate range for ZFR00V IOL between -1.00 and -1.50 dioptres (all P < 0.05). All patients had good visual performance with mean VF-14 scores above 3 points with no significant difference between two IOL models. Spectacle independence was 100% for both distant and near vision in both group of patients. CONCLUSION Bilateral implantation of ZFR00V in cataract patients shows better intermediate visual acuity scores and similar daily visual performance when compared with trifocal TFNT00 IOL.
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Affiliation(s)
| | - Cem Kesim
- Department of Ophthalmology, 52979Koc University School of Medicine, Istanbul, Turkey
| | - Pinar Gunel Karadeniz
- Department of Biostatistics, Gaziantep SANKO University School of Medicine, Gaziantep, Turkey
| | - Afsun Sahin
- Department of Ophthalmology, 52979Koc University School of Medicine, Istanbul, Turkey.,52979Koc University Research Center for Translational Medicine, Istanbul, Turkey
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Binocular visual function after unilateral versus bilateral implantation of segmented refractive multifocal intraocular lenses: a pilot study. Graefes Arch Clin Exp Ophthalmol 2021; 260:1205-1213. [PMID: 34825956 DOI: 10.1007/s00417-021-05496-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 11/07/2021] [Accepted: 11/10/2021] [Indexed: 10/19/2022] Open
Abstract
PURPOSE To evaluate binocular visual function after unilateral and bilateral implantation of segmented refractive multifocal intraocular lenses (MIOLs). METHODS This prospective comparative pilot study included patients who underwent SBL-3 (Lenstec; + 3.00 D) implantation at Peking University Third Hospital. Patients were divided into two groups (monocular or binocular surgery). Thirty-two patients with emmetropic presbyopic contralateral eyes and 49 patients with bilateral SBL-3 implantation within a week between eyes were included in the unilateral SBL-3 and bilateral groups, respectively. At 3-month follow-up, the main outcomes were binocular uncorrected distant, intermediate, and near visual acuity (UDVA, UIVA, and UNVA). Secondary outcomes included binocular best-corrected visual acuity at all distances, defocus curve, contrast sensitivity, photic phenomena, spectacle independence, patient satisfaction, and National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) score. The essential perceptual phenomena constituting binocular vision, simultaneous perception, fusion, and stereopsis were also evaluated. RESULTS Both groups showed similar binocular UDVA and UIVA, but UNVA was significantly better in the bilateral group (0.07 ± 0.07 versus 0.12 ± 0.07, P = 0.008). Better binocular defocus curve at intermediate to near focal points, higher percentage of spectacle independence at near distance, and NEI-VFQ-25 near activity scores were observed in the bilateral group. No significant differences in contrast sensitivity, photic phenomena, overall satisfaction, other NEI-VFQ-25 subscales, fusional amplitude, and stereoacuity were found between groups. CONCLUSION Unilateral implantation of segmented refractive MIOL provided desirable distant visual acuity and high patient satisfaction, but inferior intermediate and near visual outcomes compared with bilateral implantation.
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Ozturkmen C, Kesim C, Karadeniz PG, Sahin A. Visual acuity, defocus curve and patient satisfaction of a new hybrid EDOF-multifocal diffractive intraocular lens. Eur J Ophthalmol 2021; 32:2988-2993. [PMID: 34766507 DOI: 10.1177/11206721211057338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Purpose: To evaluate the visual acuity, defocus curve and visual quality of life following bilateral implantation of a new hybrid extended depth of focus (EDOF)-multifocal diffractive intraocular lens (IOL). Methods: Patients who underwent cataract surgery with bilateral implantation of Tecnis Synergy IOL were enrolled in this study. The main outcomes were defined as uncorrected distant, intermediate and near visual acuities (UDVA, UIVA and UNVA, respectively), defocus curve and VF-14 questionnaire aimed for visual performance. Results: The mean ± SD values for binocular UDVA, UIVA and UNVA were -0.01 ± 0.04, 0.05 ± 0.03 and 0.03 ± 0.05 logMAR, respectively. Defocus curve showed a continuous vision above 0.16 logMAR between +0.50 D and -2.50 D. Patients had good visual performance with mean VF-14 scores above 3 points. Driving at night (3.47 ± 0.64) was found to be the most difficult task to perform. Spectacle independence was 100% for both distant and near vision. Conclusion: Bilateral implantation of Tecnis Synergy IOL in cataract patients shows good visual acuity and performance, covering a good visual range without any need of spectacles.
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Affiliation(s)
| | - Cem Kesim
- Department of Ophthalmology, 52979Koc University School of Medicine, Istanbul, Turkey
| | | | - Afsun Sahin
- Department of Ophthalmology, 52979Koc University School of Medicine, Istanbul, Turkey.,Koc University Research Center for Translational Medicine, Istanbul, Turkey
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Undrakonda V, Sahiti TK, Vennesh PS, Kamath YS. A comparative study of stereoacuity in patients with various grades of cataract and bilateral pseudophakia. Indian J Ophthalmol 2020; 67:1834-1837. [PMID: 31638044 PMCID: PMC6836621 DOI: 10.4103/ijo.ijo_401_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose To compare the stereopsis in patients with various grades of cataract and bilateral pseudophakia. Methods A cross-sectional observational study was conducted at a tertiary care center in South India from December 2016 to September 2018, wherein the stereoacuity of patients having bilateral senile cataract or bilateral pseudophakia, was measured using the Titmus Fly chart. Those with any form of squint, glaucoma or retinal pathology were excluded. The patients were divided into three groups based on the severity of cataract, determined by the Lens Opacification Classification System (LOCS)-III. Group 4 included those with bilateral pseudophakia. Statistical analysis was performed using one-way ANOVA test with post hoc analysis using the Bonferroni test, to study the difference of stereoacuity between the groups. Results A total of 200 patients were evaluated. The mean stereoacuity was 65.2 ± 18.2, 114.8 ± 83.42, 402.4 ± 223.7 and 107.2 ± 71.68 arc seconds in groups 1, 2, 3 and 4, respectively (P < 0.001). The mean best corrected visual acuity (BCVA) in LogMAR units was 0.19 ± 0.15, 0.37 ± 0.24, 0.82 ± 0.26 and 0.14 ± 0.13 in groups 1, 2, 3 and 4, respectively (P = 0.01). On comparison between four groups, there was a generalised decrease in BCVA and stereoacuity with increasing grades of cataract except for group 4 which included the bilateral pseudophakics. On post hoc analysis to analyse intergroup variation a statistically significant difference in stereo acuity was noticed when group 3 was compared to other groups. Conclusion Stereoacuity decreases with increasing grades of cataract. Better stereoacuity is seen in patients with bilateral pseudophakia when compared with high grades of cataract.
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Affiliation(s)
- Vivekanand Undrakonda
- Department of Ophthalmology, Alluri Sitaramaraju Academy of Medical Sciences, Malkapuram, Eluru, Andhra Pradesh, India
| | - Thotamasetty Krishna Sahiti
- Department of Ophthalmology, Alluri Sitaramaraju Academy of Medical Sciences, Malkapuram, Eluru, Andhra Pradesh, India
| | - Patchipala Siva Vennesh
- Department of Ophthalmology, Alluri Sitaramaraju Academy of Medical Sciences, Malkapuram, Eluru, Andhra Pradesh, India
| | - Yogish Subraya Kamath
- Department of Ophthalmology, Kasturba Medical College-Manipal, Manipal, Karnataka, India
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Negishi K, Hayashi K, Kamiya K, Sato M, Bissen-Miyajima H, Negishi K, Hayashi K, Kamiya K, Sato M, Bissen-Miyajima H. Nationwide Prospective Cohort Study on Cataract Surgery With Multifocal Intraocular Lens Implantation in Japan. Am J Ophthalmol 2019; 208:133-144. [PMID: 31377282 DOI: 10.1016/j.ajo.2019.07.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/21/2019] [Accepted: 07/26/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE To conduct a nationwide prospective cohort study of multifocal intraocular lens (mfIOL) implantation to determine clinical outcomes and patient satisfaction and assess factors affecting patient satisfaction. DESIGN Prospective, multicenter cohort study. METHODS Setting: institutional; patient population: a total of 1051 consecutive patients (1631 eyes) who underwent cataract surgery with mfIOL implantation at 65 Japanese institutions from January 2017 to June 2018. The inclusion criteria were patient age of 20 years and older and cataract surgery with mfIOL implantation. The exclusion criteria were the absence of informed consent, completed postoperative questionnaires, and no record of the IOL models implanted. OBSERVATION PROCEDURES the uncorrected and corrected distance visual acuities (UDVAs and CDVAs) at 5 m; uncorrected VAs at 50, 40, and 30 cm; and questionnaires regarding subjective visual symptoms, spectacle independence, and surgical satisfaction were assessed 3 months postoperatively. MAIN OUTCOME MEASURE odds ratios for the overall surgical satisfaction were computed for the preoperative/postoperative factors. RESULTS We analyzed data from 1384 eyes of 871 patients. The UDVAs and CDVAs, respectively, improved significantly at 3 months postoperatively. The intermediate and near VAs varied with the IOL models; 68.4% of patients were almost or totally spectacle-independent; 3.9% of patients reported surgical dissatisfaction. In patients implanted bilaterally with the same mfIOLs, postoperative blurred vision and/or decreased contrast was the most important factor in the overall surgical satisfaction. CONCLUSIONS MfIOLs provided good visual outcomes and high satisfaction rates in this large patient cohort. The difference in the outcomes with the extended depth-of-focus IOLs did not differ significantly from the bifocal IOLs. The postoperative blurred vision is important to the overall surgical satisfaction.
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Visual Performance after a Unilateral or Bilateral Implantation of Enlarged Depth-of-Focus Intraocular Lens in Patients with Cataract: A Prospective Clinical Trial. J Ophthalmol 2019; 2019:2163809. [PMID: 30949362 PMCID: PMC6425413 DOI: 10.1155/2019/2163809] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 02/14/2019] [Indexed: 11/29/2022] Open
Abstract
Purpose To investigate visual performances after a unilateral or bilateral implantation of enlarged depth-of-focus intraocular lens in patients with cataract. Methods In this prospective study, uneventful phacoemulsification and TECNIS® Symfony intraocular lens implantation were performed in 20 eyes of 17 patients. At postoperative 1, 4, and 12 weeks, the logarithm of the minimal angle of resolution visual acuity at far, intermediate, and near distances and the spherical equivalent in manifest refraction and automated refraction were measured. A questionnaire was used to investigate glare, spectacle dependency, and satisfaction at 12 weeks. The mean numerical error and mean absolute error were compared between intraocular lens formulas to assess the best-fit formula. Results The logarithm of the minimal angle of resolution visual acuity significantly improved to 0.02 at far, 0.02 at intermediate, and 0.27 at near distances at 12 weeks (p < 0.05). Spherical equivalent was −0.79 D on automated refraction and was significantly lower than −0.26 D measured on manifest refraction. Patients' satisfaction score was 9.06, 8.94, and 6.65 for far, intermediate, and near distances, respectively. Near glasses were required in 5 patients and 2 patients complained of photic phenomenon. Visual performances were not significantly different between bilateral and unilateral implanted patients. No patients reported bilateral imbalance due to unilateral surgery. The mean numerical error was closest to 0 D using the Barrett Universal II formula. The mean absolute error was not significantly different between these formulas. Conclusion Unilateral or bilateral implantation of the enlarged depth-of-focus intraocular lens seems to be equally effective in improving visual performances in patients with cataract.
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Akman A, Asena L, Ozturk C, Gür Güngör S. Evaluation of quality of life after implantation of a new trifocal intraocular lens. J Cataract Refract Surg 2019; 45:130-134. [PMID: 30612749 DOI: 10.1016/j.jcrs.2018.12.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 11/28/2018] [Accepted: 12/03/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the vision-related quality of life (QOL) after implantation of a new trifocal intraocular lens (IOL), by using the National Eye Institute Visual Function Questionnaire-14 (VF-14 QOL questionnaire). SETTING Baskent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey. DESIGN Prospective noncomparative case series. METHODS Consecutive patients who had a new trifocal IOL (PanOptix) bilaterally implanted were included in the study. The vision-related QOL was assessed 3 months after the surgery in the second eye. The VF-14 QOL questionnaire was used, with a grading scale of 0, no difficulty; 1, a little difficulty; 2, moderate difficulty; 3, quite difficult; 4, impossible to perform. A subgroup of 14 patients, with an interval of at least 3 months between the surgery in the first eye and the surgery in the fellow eye, were also interviewed 3 months after the monocular IOL implantation. In this subgroup, the QOL with monocular and binocular implantation was compared. RESULTS The study comprised 48 patients. Reading small print, driving at night, and doing fine handwork were the most difficult tasks to perform, with the mean values of the VF-14 QOL questionnaire being 0.94 ± 0.81 (SD), 0.89 ± 0.68, and 0.64 ± 0.67, respectively. Binocular implantation was associated with improvement in vision-related QOL when compared with monocular implantation, with significant differences in doing fine handwork such as sewing (P = .02) and using a computer (P = .03). CONCLUSIONS With mean values of 1.00 or lower for each question, the results of the VF-14 QOL questionnaire indicated that patients who have the new trifocal IOL bilaterally implanted have an overall high satisfaction rate and a high vision-related QOL.
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Affiliation(s)
- Ahmet Akman
- Baskent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
| | - Leyla Asena
- Baskent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey.
| | - Caner Ozturk
- Baskent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
| | - Sirel Gür Güngör
- Baskent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
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Zhou H, Zhu C, Xu W, Zhou F. The efficacy of accommodative versus monofocal intraocular lenses for cataract patients: A systematic review and meta-analysis. Medicine (Baltimore) 2018; 97:e12693. [PMID: 30290663 PMCID: PMC6200466 DOI: 10.1097/md.0000000000012693] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION We performed a systematic review and meta-analysis to evaluate whether accommodative intraocular lenses (AC-IOLs) are superior for cataract patients compared with monofocal IOLs (MF-IOLs). METHODS Pubmed, Embase, Cochrane library, CNKI, and Wanfang databases were searched through in August 2018 for AC-IOLs versus MF-IOLs in cataract patients. Studies were pooled under either fixed-effects model or random-effects model to calculate the relative risk (RR), weighted mean difference (WMD), or standard mean difference (SMD) and their corresponding 95% confidence interval (CI). Distance-corrected near visual acuity (DCNVA) was chosen as the primary outcome. The secondary outcomes were corrected distant visual acuity (CDVA), pilocarpine-induced IOL shift, contrast sensitivity, and spectacle independence. RESULTS Seventeen studies, involving a total of 1764 eyes, were included. Our results revealed that AC-IOLs improved DCNVA (SMD = -1.84, 95% CI = -2.56 to -1.11) and were associated with significantly greater anterior lens shift than MF-IOLs (WMD = -0.30, 95% CI = -0.37 to -0.23). Furthermore, spectacle independence was significantly better with AC-IOLs than with MF-IOLs (RR = 3.07, 95% CI = 1.06-8.89). However, there was no significant difference in CDVA and contrast sensitivity between the 2 groups. CONCLUSION Our study confirmed that AC-IOLs can provide cataract patients with DCNVA and result in more high levels of spectacle independence than MF-IOLs. Further studies with larger data set and well-designed models are required to validate our findings.
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Affiliation(s)
- Hongwei Zhou
- Department of Ophthalmology, Lianshui County People's Hospital, Lianshui, Huai'an
- Department of Diabetes, School of Medicine, Southeast University, Nanjing
| | - Chongyan Zhu
- Department of Ophthalmology, Lianshui County People's Hospital, Lianshui, Huai'an
| | - Wenya Xu
- Department of Ophthalmology, Lianshui County People's Hospital, Lianshui, Huai'an
| | - Fang Zhou
- Beijing Key Laboratory of Megaregions Sustainable Development Modeling, Capital University of Economics and Business, Beijing, China
- Department of Statistics, Stockholm University, Stockholm, Sweden
- College of Urban Economics and Public Administration, Capital University of Economics and Business, Beijing, China
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Zeng L, Fang F. Advances and challenges of intraocular lens design [Invited]. APPLIED OPTICS 2018; 57:7363-7376. [PMID: 30182957 DOI: 10.1364/ao.57.007363] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 06/29/2018] [Indexed: 06/08/2023]
Abstract
Phacoemulsification technique with intraocular lens implantation has been a common treatment for cataract patients. With rising demand among the public, new technologies for lens design have emerged to minimize intraocular aberrations, improving visual quality to the largest extent. This paper systematically reviews the development of materials applied in lens manufacturing, the different categories of intraocular lenses, and respective design principles. The advantages and potential drawbacks of intraocular lenses are illustrated in the paper, and prospective research to improve the design are presented in the end.
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Fan YY, Sun CC, Chen HC, Ma DHK. Photorefractive keratectomy for correcting residual refractive error following cataract surgery with premium intraocular lens implantation. Taiwan J Ophthalmol 2018; 8:149-158. [PMID: 30294528 PMCID: PMC6169333 DOI: 10.4103/tjo.tjo_51_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE: The aim of this study is to evaluate the effectiveness and predictability of photorefractive keratectomy (PRK) for correcting residual refractive error following cataract surgery with premium intraocular lens (IOL) implantation. METHODS: We conducted a retrospective review of the medical records of patients who received PRK for correcting residual hyperopia, myopia, and/or astigmatism due to unsatisfied uncorrected distance visual acuity (UDVA) after cataract extraction with implantation of aspheric, diffractive multifocal, or toric IOL from September 2011 to December 2017. Pre-cataract surgery, pre- and post-PRK data including UDVA, best-corrected distance visual acuity, and refractive status were analyzed. RESULTS: A total of 18 consecutive eyes in 17 patients were included in this study. The UDVA after PRK improved 1 line or more in 10 eyes, remained unchanged in five eyes, and decreased in three eyes. The overall improvement in the logarithm of minimal angle of resolution (logMAR) UDVA after PRK was significant (P < 0.05). While dividing patients into subgroups based on IOL type, significant improvement in logMAR UDVA was found in patients with aspheric IOL or diffractive multifocal IOL implantation (P < 0.05). No significant improvement of UDVA was found in patients with toric IOL implantation. All eyes achieved ± 1.00 D of the attempted spherical correction, demonstrating good predictability of PRK. CONCLUSIONS: PRK was a safe and effective procedure to correct residual refractive error following cataract extraction with premium IOL implantation. Although satisfactory for all patients, the outcome is better and more predictable in patients with aspheric and diffractive multifocal IOL implantation and is less satisfactory and unpredictable in patients with toric IOL implantation.
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Affiliation(s)
- Yuan-Yao Fan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chi-Chin Sun
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan.,Department of Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hung-Chi Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Ophthalmology, Limbal Stem Cell Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan.,Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - David Hui-Kang Ma
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Ophthalmology, Limbal Stem Cell Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan.,Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Ophthalmology, Xiamen Chang Gung Hospital, Xiamen, China
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Zare Mehrjerdi MA, Mohebbi M, Zandian M. Review of Static Approaches to Surgical Correction of Presbyopia. J Ophthalmic Vis Res 2017; 12:413-418. [PMID: 29090052 PMCID: PMC5644409 DOI: 10.4103/jovr.jovr_162_16] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Presbyopia is the primary cause of reduction in the quality of life of people in their 40s, due to dependence on spectacles. Therefore, presbyopia correction has become an evolving and rapidly progressive field in refractive surgery. There are two primary options for presbyopia correction: the dynamic approach uses the residual accommodative capacity of the eye, and the static approach attempts to enhance the depth of focus of the optical system. The dynamic approach attempts to reverse suspected pathophysiologic changes. Dynamic approaches such as accommodative intraocular lenses (IOLs), scleral expansion techniques, refilling, and photodisruption of the crystalline lens have attracted less clinical interest due to inconsistent results and the complexity of the techniques. We have reviewed the most popular static techniques in presbyopia surgery, including multifocal IOLs, PresbyLASIK, and corneal inlays, but we should emphasize that these techniques are very different from the physiologic status of an untouched eye. A systematic PubMed search for the keywords “presbylasik”, “multifocal IOL”, and “presbyopic corneal inlay” revealed 634 articles; 124 were controlled clinical trials, 95 were published in the previous 10 years, and 78 were English with available full text. We reviewed the abstracts and rejected the unrelated articles; other references were included as needed. This narrative review compares different treatments according to available information on the optical basis of each treatment modality, including the clinical outcomes such as near, intermediate, and far visual acuity, spectacles independence, quality of vision, and dysphotopic phenomena.
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Affiliation(s)
- Mohammad Ali Zare Mehrjerdi
- Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Masomeh Mohebbi
- Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Zandian
- Department of Ophthalmology, Faculty of Medicine, Hamedan University of Medical Sciences, Hamedan, Iran
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Multifocal intraocular lenses: An overview. Surv Ophthalmol 2017; 62:611-634. [DOI: 10.1016/j.survophthal.2017.03.005] [Citation(s) in RCA: 168] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 02/28/2017] [Accepted: 03/03/2017] [Indexed: 01/18/2023]
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Patient-Centered and Visual Quality Outcomes of Premium Cataract Surgery: A Systematic Review. Eur J Ophthalmol 2017; 27:387-401. [DOI: 10.5301/ejo.5000978] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2017] [Indexed: 11/20/2022]
Abstract
Purpose Over 8 million cataract surgeries are performed in the United States and the European Union annually, with many patients choosing to pay out of pocket for premium options including premium intraocular lens implants (IOLs) or laser-assisted cataract surgery (LACS). This report provides a systematic review evaluating patient-centered and visual quality outcomes comparing standard monofocal IOLs to premium cataract surgery options. Methods PubMed and EMBASE were searched for publications published between January 1, 1980, and September 18, 2016, on multifocal, accommodative, and toric IOLs, monovision, and LACS, which reported on 1) dysphotopsias, 2) contrast sensitivity, 3) spectacle independence, 4) vision-related quality of life or patient satisfaction, and 5) IOL exchange. Results Multifocal lenses achieved higher rates of spectacle independence compared to monofocal lenses but also had higher reported frequency of dysphotopsia and worse contrast sensitivity, especially with low light or glare. Accommodative lenses were not associated with reduced contrast sensitivity or more dysphotopsia but had only modest improvements in spectacle independence compared to monofocal lenses. Studies of monovision did not target a sufficiently myopic outcome in the near-vision eye to achieve the full potential for spectacle independence. Patients reported high levels of overall satisfaction regardless of implanted IOL. No studies correlated patient-reported outcomes with patient expectations. Conclusions Studies are needed to thoroughly compare patient-reported outcomes with concomitant patient expectations. In light of the substantial patient costs for premium options, patients and their surgeons will benefit from a better understanding of which surgical options best meet patients’ expectations and how those expectations can be impacted by premium versus monofocal—including monovision—options.
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Lan J, Huang YS, Dai YH, Wu XM, Sun JJ, Xie LX. Visual performance with accommodating and multifocal intraocular lenses. Int J Ophthalmol 2017; 10:235-240. [PMID: 28251082 DOI: 10.18240/ijo.2017.02.09] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 10/11/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To compare the visual functional outcomes with accommodating and multifocal intraocular lenses (IOLs). METHODS Our retrospective comparative study included 51 patients (60 eyes) received implantation of an accommodating IOL (Tetraflex; 16 patients, 20 eyes), a refractive multifocal IOL (ReZoom; 18 patients, 20 eyes), or a diffractive multifocal IOL (ZMA00; 17 patients, 20 eyes). Subjective refraction, visual acuity, contrast sensitivity (CS), intraocular aberration, and subjective photic phenomena were detected at 3mo after surgery. RESULTS The spherical equivalent in the three groups was -0.38±0.54 D, 0.14±0.56 D, and 0.35±0.41 D, respectively. No statistically significant differences were found in uncorrected and corrected distance visual acuity and uncorrected intermediate visual acuity among the groups (P=0.39). The ReZoom group had significantly better distance-corrected intermediate visual acuity than the ZMA00 group (P=0.003). The ZMA00 group had significantly better near visual acuity than the other groups (P<0.05). Better contrast sensitivity values were observed in the Tetraflex group under most of the spatial frequencies conditions (P=0.025). The total aberration was lowest in the ZMA00 group (P=0.000), and the spherical aberration was highest in the Tetraflex group (P=0.000). The three groups had similar frequency of ghosting and glare, and the Tetraflex group had a low rate of halos (P=0.01). CONCLUSION Both accommodating and multifocal IOLs can successfully restore distance and uncorrected intermediate visual acuities. Tetraflex accommodating IOLs perform better in CS and with less halos of photic phenomena. ReZoom refractive multifocal IOLs have better performance in distance-corrected intermediate visual acuity than ZMA00 diffractive multifocal IOLs, and the latter achieved better near visual acuity and efficiently decreased the optical aberration.
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Affiliation(s)
- Jie Lan
- Qingdao University Medical College, Qingdao 266071, Shandong Province, China; Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| | - Yu-Sen Huang
- Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| | - Yun-Hai Dai
- Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| | - Xiao-Ming Wu
- Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| | - Jia-Jun Sun
- Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| | - Li-Xin Xie
- Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
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Chang DH. Visual acuity and patient satisfaction at varied distances and lighting conditions after implantation of an aspheric diffractive multifocal one-piece intraocular lens. Clin Ophthalmol 2016; 10:1471-7. [PMID: 27536061 PMCID: PMC4977080 DOI: 10.2147/opth.s108298] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The aim of the study is to evaluate the visual acuity and patient satisfaction at varied distances under photopic and mesopic lighting conditions in patients bilaterally implanted with aspheric diffractive multifocal one-piece intraocular lenses. METHODS In this retrospective-prospective study, 16 patients with a mean age of 66.2±9.2 years (range: 50-81 years) who had undergone bilateral phacoemulsification surgery with implantation of a Tecnis multifocal one-piece intraocular lens (ZMB00) were evaluated. Monocular and binocular uncorrected and distance-corrected visual acuities were measured at distance (20 ft), intermediate (70-80 cm), and near (35-40 cm) under photopic (85 cd/m(2)) and mesopic (3 cd/m(2)) lighting conditions and were compared using the paired t-test. All patients also completed a subjective questionnaire. RESULTS At a mean follow-up of 9.5±3.9 months, distance, near, and intermediate visual acuity improved significantly from preoperative acuity. Under photopic and mesopic conditions, 93.8% and 62.5% of patients, respectively, had binocular uncorrected intermediate visual acuity of 20/40 or better, and 62.5% and 31.3% of patients had binocular uncorrected near visual acuity of 20/20 or better. All patients were satisfied with their overall vision without using glasses and/or contact lenses when compared with before surgery. A total of 87.5% of patients reported no glare and 68.8% of patients reported no halos around lights at night. CONCLUSION Tecnis multifocal one-piece intraocular lenses provide good distance, intermediate, and near visual acuity under photopic as well as mesopic lighting conditions. High levels of spectacle independence with low levels of photic phenomenon were achieved, resulting in excellent patient satisfaction.
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Sadoughi MM, Einollahi B, Roshandel D, Sarimohammadli M, Feizi S. Visual and Refractive Outcomes of Phacoemulsification with Implantation of Accommodating versus Standard Monofocal Intraocular Lenses. J Ophthalmic Vis Res 2016; 10:370-4. [PMID: 27051480 PMCID: PMC4795385 DOI: 10.4103/2008-322x.176896] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose: To compare distant and near visual function after cataract surgery with implantation of Crystalens HD or Tek-Clear as accommodating intraocular lenses (IOLs), versus SA60AT as a standard IOL. Methods: The study included 62 eyes of 58 patients divided into three groups using three different IOLs: Crystalens HD (Bausch and Lomb, NY, USA), Tek-Clear (Tekia, CA, USA) and SA60AT (Alcon, TX, USA) were implanted in 23, 14 and 25 eyes, respectively. Corrected distant visual acuity (CDVA), uncorrected and distance corrected near visual acuities (UCNVA and DCNVA), near point of accommodation (NPA), spectacle freedom and patient satisfaction were assessed six months postoperatively and compared between the three groups. Results: After 6 months, all patients showed significant improvement in CDVA with no significant difference among the study groups. However, UCNVA and DCNVA were significantly better in patients implanted with accommodating IOLs. NPA was closest in the Crystalens HD group, followed by Tek-Clear and monofocal SA60AT (P < 0.001). Patients with accommodating IOLs were more likely to become spectacle free and satisfied with their near vision as compared to subjects receiving a monofocal IOL. Conclusions: Accommodating IOLs (Crystalens HD and Tek-Clear) effectively reduce the necessity for spectacles after cataract surgery.
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Affiliation(s)
| | - Bahram Einollahi
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Danial Roshandel
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Sepehr Feizi
- Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Esteve-Taboada JJ, Domínguez-Vicent A, Del Águila-Carrasco AJ, Ferrer-Blasco T, Montés-Micó R. Effect of Large Apertures on the Optical Quality of Three Multifocal Lenses. J Refract Surg 2015; 31:666-76. [DOI: 10.3928/1081597x-20150928-01] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 08/05/2015] [Indexed: 11/20/2022]
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Gil-Cazorla R, Shah S, Naroo SA. A review of the surgical options for the correction of presbyopia. Br J Ophthalmol 2015; 100:62-70. [PMID: 25908836 DOI: 10.1136/bjophthalmol-2015-306663] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/04/2015] [Indexed: 11/03/2022]
Abstract
Presbyopia is an age-related eye condition where one of the signs is the reduction in the amplitude of accommodation, resulting in the loss of ability to change the eye's focus from far to near. It is the most common age-related ailments affecting everyone around their mid-40s. Methods for the correction of presbyopia include contact lens and spectacle options but the surgical correction of presbyopia still remains a significant challenge for refractive surgeons. Surgical strategies for dealing with presbyopia may be extraocular (corneal or scleral) or intraocular (removal and replacement of the crystalline lens or some type of treatment on the crystalline lens itself). There are however a number of limitations and considerations that have limited the widespread acceptance of surgical correction of presbyopia. Each surgical strategy presents its own unique set of advantages and disadvantages. For example, lens removal and replacement with an intraocular lens may not be preferable in a young patient with presbyopia without a refractive error. Similarly treatment on the crystalline lens may not be a suitable choice for a patient with early signs of cataract. This article is a review of the options available and those that are in development stages and are likely to be available in the near future for the surgical correction of presbyopia.
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Affiliation(s)
- Raquel Gil-Cazorla
- Ophthalmic Research Group, School of Life and Health Sciences, Aston University, Birmingham, UK Midland Eye, Solihull, UK
| | - Sunil Shah
- Ophthalmic Research Group, School of Life and Health Sciences, Aston University, Birmingham, UK Midland Eye, Solihull, UK Birmingham and Midland Eye Centre, City Hospital, Birmingham, UK
| | - Shehzad A Naroo
- Ophthalmic Research Group, School of Life and Health Sciences, Aston University, Birmingham, UK
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Light-distortion analysis as a possible indicator of visual quality after refractive lens exchange with diffractive multifocal intraocular lenses. J Cataract Refract Surg 2015; 41:613-22. [PMID: 25708210 DOI: 10.1016/j.jcrs.2014.07.033] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 06/11/2014] [Accepted: 07/04/2014] [Indexed: 11/22/2022]
Abstract
PURPOSE To study the perception of light distortion after refractive lens exchange (RLE) with diffractive multifocal intraocular lenses (IOLs). SETTING Clínica Oftalmológica das Antas, Porto, Portugal. DESIGN Retrospective comparative study. METHODS Refractive lens exchange was performed with implantation of an AT Lisa 839M (trifocal) or 909MP (bifocal toric) IOL, the latter if corneal astigmatism was more than 0.75 diopter (D). The postoperative visual and refractive outcomes were evaluated. A prototype light-distortion analyzer was used to quantify the postoperative light-distortion indices. A control group of eyes in which a Tecnis ZCB00 1-piece monofocal IOL was implanted had the same examinations. RESULTS A trifocal or bifocal toric IOL was implanted in 66 eyes. The control IOL was implanted in 18 eyes. All 3 groups obtained a significant improvement in uncorrected distance visual acuity (UDVA) (P < .001) and corrected distance visual acuity (CDVA) (P = .001). The mean uncorrected near visual acuity (UNVA) was 0.123 logMAR with the trifocal IOL and 0.130 logMAR with the bifocal toric IOL. The residual refractive cylinder was less than 1.00 D in 86.7% of cases with the toric IOL. The mean light-distortion index was significantly higher in the multifocal IOL groups than in the monofocal group (P < .001), although no correlation was found between the light-distortion index and CDVA. CONCLUSIONS The multifocal IOLs provided excellent UDVA and functional UNVA despite increased light-distortion indices. The light-distortion analyzer reliably quantified a subjective component of vision distinct from visual acuity; it may become a useful adjunct in the evaluation of visual quality obtained with multifocal IOLs. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Moshirfar M, McCaughey MV, Santiago-Caban L. Corrective Techniques and Future Directions for Treatment of Residual Refractive Error Following Cataract Surgery. EXPERT REVIEW OF OPHTHALMOLOGY 2014; 9:529-537. [PMID: 25663845 DOI: 10.1586/17469899.2014.966817] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Postoperative residual refractive error following cataract surgery is not an uncommon occurrence for a large proportion of modern-day patients. Residual refractive errors can be broadly classified into 3 main categories: myopic, hyperopic, and astigmatic. The degree to which a residual refractive error adversely affects a patient is dependent on the magnitude of the error, as well as the specific type of intraocular lens the patient possesses. There are a variety of strategies for resolving residual refractive errors that must be individualized for each specific patient scenario. In this review, the authors discuss contemporary methods for rectification of residual refractive error, along with their respective indications/contraindications, and efficacies.
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Affiliation(s)
- Majid Moshirfar
- Department of Ophthalmology, Co-Director Cornea and Refractive Surgery Division, Francis I. Proctor Foundation, University of California San Francisco, 10 Koret Way, K101, San Francisco, CA 94143, USA
| | | | - Luis Santiago-Caban
- Ophthalmology Department, University of Puerto Rico School of Medicine, San Juan, PR 00936
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Tomás-Juan J, Piñero DP, Murueta-Goyena AL. Single-optic positional accommodating intraocular lenses: a review. EXPERT REVIEW OF OPHTHALMOLOGY 2014. [DOI: 10.1586/17469899.2014.947275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Venter JA, Pelouskova M, Collins BM, Schallhorn SC, Hannan SJ. Visual outcomes and patient satisfaction in 9366 eyes using a refractive segmented multifocal intraocular lens. J Cataract Refract Surg 2013; 39:1477-84. [PMID: 23860009 DOI: 10.1016/j.jcrs.2013.03.035] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 03/26/2013] [Accepted: 03/28/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To report the effectiveness, patient satisfaction, and complication rate with a zonal refractive intraocular lens (IOL) in a high volume of patients. SETTING Private clinic, London, United Kingdom. DESIGN Case series. METHODS Retrospective data of patients with binocular Lentis Mplus IOLs were analyzed. The main outcome measures were uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), corrected distance visual acuity, manifest refraction, patient satisfaction, and complications. One-month, 3-month, and 6-month data were analyzed. RESULTS The study comprised 9366 eyes of 4683 patients. The mean spherical equivalent changed from +1.73 diopters (D) ± 3.37 (SD) preoperatively to -0.02 ± 0.60 D at 3 months and +0.03 ± 0.60 D at 6 months. Ninety-five percent of patients achieved a binocular UDVA of 6/7.5 (0.1 logMAR) or better 3 months postoperatively. The mean binocular UNVA was 0.155 ± 0.144 logMAR and 0.159 ± 0.143 logMAR at 3 months and 6 months, respectively. Severe dysphotopsia requiring an IOL exchange occurred in 55 eyes. Patient satisfaction was high, with 97.5% of patients willing to recommend the procedure. CONCLUSIONS The zonal refractive IOL provided excellent distance and near visual acuity. The postoperative complication rate was clinically acceptable, and patient satisfaction high. FINANCIAL DISCLOSURE Dr. Schallhorn is a consultant to Abbott Medical Optics, Inc. No author has a financial or proprietary interest in any material or method mentioned.
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Ye PP, Li X, Yao K. Visual outcome and optical quality after bilateral implantation of aspheric diffractive multifocal, aspheric monofocal and spherical monofocal intraocular lenses: a prospective comparison. Int J Ophthalmol 2013; 6:300-6. [PMID: 23826522 DOI: 10.3980/j.issn.2222-3959.2013.03.08] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 04/22/2013] [Indexed: 11/02/2022] Open
Abstract
AIM To evaluate the visual function after bilateral implantation of aspheric diffractive multifocal Tecnis ZMA00, aspheric monofocal ZA9003 versus spherical monofocal Akreos Adapt intraocular lenses (IOLs). METHODS Tecnis ZMA00, Tecnis ZA9003 or Akreos Adapt IOLs were bilaterally implanted in 180 eyes from 90 patients. The following parameters were assessed 3 months postoperatively: monocular and binocular uncorrected visual acuity (UCVA) and distance-corrected visual acuity (DCVA) for distance, intermediate and near, spherical aberration (SA), contrast and glare sensitivity, near point refractive power, uncorrected and best-corrected near stereoscopic acuity (NSA). Patient satisfaction was assessed by a questionnaire. RESULTS Three months postoperatively, the monocular and binocular UCVA and DCVA at near of Tecnis ZMA00 were significantly better than other two groups. The mean SA for 5.0mm optical zone in Tecnis ZMA00 and Tecnis ZA9003 was significantly lower than that in Akreos Adapt. Mean contrast sensitivity and glare sensitivity were better for Tecnis ZA9003 group than for other two groups. Patients with Tecnis ZMA00 had higher monocular and binocular near point refractive power and uncorrected NSA than monofocal groups. The patients in Tecnis ZMA00 had higher mean values for halo compared with other two groups. CONCLUSION Tecnis ZMA00 provided better near VA and uncorrected NSA and higher near point refractive power than monofocal IOLs and patients were spectacle independent. The IOLs with Tecnis aspheric design improved contrast and glare sensitivity. Patients with Tecnis ZMA00 reported more disturbances on visual phenomena of halo.
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Affiliation(s)
- Pan-Pan Ye
- Eye Center, the Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 3100009, Zhejiang Province, China
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Hayashi K, Manabe SI, Yoshimura K, Hirata A. Binocular visual function with a diffractive multifocal intraocular lens in patients with unilateral cataract. J Cataract Refract Surg 2013; 39:851-8. [PMID: 23688871 DOI: 10.1016/j.jcrs.2013.01.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 12/03/2012] [Accepted: 01/01/2013] [Indexed: 11/26/2022]
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Chen W, Zuo C, Chen C, Su J, Luo L, Congdon N, Liu Y. Prevalence of corneal astigmatism before cataract surgery in Chinese patients. J Cataract Refract Surg 2012; 39:188-92. [PMID: 23141077 DOI: 10.1016/j.jcrs.2012.08.060] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Revised: 08/09/2012] [Accepted: 08/17/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE To assess the demographics and distribution of corneal astigmatism before cataract surgery in Chinese patients. SETTING State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. DESIGN Clinic-based cross-sectional study. METHODS From July 2009 to May 2011, preoperative bilateral partial coherence interferometry (IOLMaster) was performed in consecutive patients having cataract surgery. Patient demographics and keratometric data were recorded. RESULTS The mean age of the 2849 patients (4831 eyes) was 70.56 years ± 9.55 (SD); there was a predominance of women patients (64.0%). The mean axial length was 23.58 ± 1.13 mm. The mean corneal astigmatism in this cohort was 1.01 D (range 0.05 to 6.59 D). Corneal astigmatism was between 0.25 D and 1.25 D in 67.7% of eyes, 1.25 D or higher in 27.5% eyes, and less than 0.25 D in 4.8% of eyes. Astigmatism was with the rule in 25.1% of eyes, against the rule (ATR) in 58.2% of eyes, and oblique in 16.7% of eyes. The mean steep keratometry measurement was 44.76 ± 1.56 D. Against-the-rule astigmatism increased significantly with older age. CONCLUSIONS Corneal astigmatism largely fell between 0.25 D and 1.25 D in these predominantly elderly female Chinese patients, and ATR astigmatism increased with age. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Weirong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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Agresta B, Knorz MC, Kohnen T, Donatti C, Jackson D. Distance and Near Visual Acuity Improvement After Implantation of Multifocal Intraocular Lenses in Cataract Patients With Presbyopia: A Systematic Review. J Refract Surg 2012; 28:426-35. [PMID: 22692525 DOI: 10.3928/1081597x-20120518-06] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 05/01/2012] [Indexed: 11/20/2022]
Affiliation(s)
- Blaise Agresta
- Health Economics and Outcomes Research, IMS Health, London, UK.
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Menassa N, Fitting A, Auffarth GU, Holzer MP. Visual outcomes and corneal changes after intrastromal femtosecond laser correction of presbyopia. J Cataract Refract Surg 2012; 38:765-73. [PMID: 22520302 DOI: 10.1016/j.jcrs.2011.11.051] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Revised: 11/13/2011] [Accepted: 11/20/2011] [Indexed: 10/28/2022]
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McAlinden C, Moore JE. Multifocal intraocular lens with a surface-embedded near section: Short-term clinical outcomes. J Cataract Refract Surg 2011; 37:441-5. [DOI: 10.1016/j.jcrs.2010.08.055] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Revised: 08/24/2010] [Accepted: 08/24/2010] [Indexed: 11/28/2022]
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Presbyopic intraocular lenses for monocular cataract. Am J Ophthalmol 2010; 150:593-4. [PMID: 21036205 DOI: 10.1016/j.ajo.2010.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Accepted: 06/16/2010] [Indexed: 11/23/2022]
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