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Łabuz G, Khoramnia R, Yan W, van den Berg TJTP, Auffarth GU, Naujokaitis T, Tandogan T. Characterizing glare effects associated with diffractive optics in presbyopia-correcting intraocular lenses. J Cataract Refract Surg 2024; 50:413-419. [PMID: 38237073 DOI: 10.1097/j.jcrs.0000000000001398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/08/2024] [Indexed: 03/26/2024]
Abstract
PURPOSE To objectively quantify glare of intraocular lenses (IOLs) using a diffractive principle to extend the visual range and to identify models with increased susceptibility to inducing glare. SETTING David J Apple Laboratory, Heidelberg, Germany. DESIGN Laboratory investigation. METHODS Glare was assessed by means of a straylight parameter with a standard C-Quant intended for 7 degrees. In addition, 2 C-Quant modifications were used to test lower angles (ie, 2.5 degrees and 3.5 degrees). The following IOL models were assessed: PanOptix, AT Lisa Tri, Synergy, and Triumf, the latter 2 with chromatic aberration correction at distance. Straylight from trifocal IOLs was compared against a monofocal W-60R lens. The C-Quant test was performed through the studied IOLs by using additional optical components attached to their ocular. RESULTS Straylight (deg 2 sr -1 ) of the control was <1 at all tested angles, with the trifocal models showing comparable straylight at 7 degrees. At 3.5 degrees, Triumf's straylight increased to 15.5 ± 0.6, followed by Synergy (6.2 ± 1.1), PanOptix (4.1 ± 0.3), and AT Lisa Tri (2.0 ± 0.8). The chromatic aberration-correcting models demonstrated correspondingly higher straylight (Synergy: 18.8 ± 1.3; Triumf: 17.3 ± 0.5) at 2.5 degrees compared with PanOptix (4.3 ± 0.4), AT Lisa Tri (2.1 ± 0.1), and monofocal IOLs yielding minimal or no increase. CONCLUSIONS Trifocal IOLs induced increased straylight, but it was limited to lower angles, which may cause difficulties detecting these effects using a standard clinical approach. The latest IOL designs featuring chromatic aberration correction at far focus seem more susceptible than the established trifocal IOLs to inducing a glare phenomenon.
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Affiliation(s)
- Grzegorz Łabuz
- From the The David J Apple Center for Vision Research, Department of Ophthalmology, University Hospital Heidelberg, Heidelberg, Germany (Łabuz, Khoramnia, Yan, Auffarth, Naujokaitis, Tandogan); Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands (van den Berg); Augenklinik Pallas, Olten, Switzerland (Tandogan)
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Kawamura J, Tanabe H, Shojo T, Yamauchi T, Takase K, Tabuchi H. Comparison of visual performance between diffractive bifocal and diffractive trifocal intraocular lenses. Sci Rep 2024; 14:5292. [PMID: 38438495 PMCID: PMC10912743 DOI: 10.1038/s41598-024-55926-5] [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: 04/26/2023] [Accepted: 02/29/2024] [Indexed: 03/06/2024] Open
Abstract
To evaluate the visual performance of a diffractive bifocal intraocular lens (IOL) with + 4.0 D near addition (ZMB00) and a diffractive trifocal IOL with + 2.17 D and + 3.25 D near addition (AcrySof IQ PanOptix TFNT00), we investigated the 10-week postoperative parameters after cataract surgery in which ZMB00 or TFNT00 lenses were implanted bilaterally from 2011 to 2020 (with a 3-month interval between implantation of the right and left lenses). The study included 1448 eyes of 724 patients. The diffractive bifocal group comprised 1326 eyes of 663 patients (aged 67.0 ± 7.8 years; females/males, 518/145), and the diffractive trifocal group comprised 122 eyes of 61 patients (aged 66.6 ± 7.3 years; females/males, 35/26). A linear mixed-effects model using data for both eyes, with strict adjustments for sex, age, subjective refraction spherical equivalent, subjective refraction cylinder, corneal astigmatism, axial length, corneal higher-order aberrations, and pupil diameter, ensured statistical validity. Uncorrected near visual acuity and higher-order aberrations (ocular/internal, scaled to a pupil size of 4 mm) (Wavefront_4mm_postoperative_Ocular/Internal_Spherical) were significantly better in the bifocal group (p < 0.00068, Wald test). Uncorrected intermediate visual acuity, contrast sensitivity (6.3/4.0/2.5/1.6/1.0/0.7 degrees), and contrast sensitivity with glare (4.0/1.6/1.0/0.7 degrees) were significantly better in the trifocal group (p < 0.00068, Wald test).
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Affiliation(s)
- Junya Kawamura
- Department of Ophthalmology, Tsukazaki Hospital, Himeji, Japan
| | - Hirotaka Tanabe
- Department of Ophthalmology, Tsukazaki Hospital, Himeji, Japan.
| | - Tomohiro Shojo
- Department of Ophthalmology, Tsukazaki Hospital, Himeji, Japan
| | | | - Kosuke Takase
- Department of Ophthalmology, Tsukazaki Hospital, Himeji, Japan
| | - Hitoshi Tabuchi
- Department of Ophthalmology, Tsukazaki Hospital, Himeji, Japan
- Department of Technology and Design Thinking for Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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Giglio R, Vinciguerra AL, Presotto M, Jonak K, Rejdak R, Toro MD, Nanavaty MA, Tognetto D. Visual outcomes and patient satisfaction after bilateral implantation of an enhanced monofocal intraocular lens: a single-masked prospective randomized study. Int Ophthalmol 2024; 44:112. [PMID: 38407686 PMCID: PMC10896881 DOI: 10.1007/s10792-024-02946-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 12/04/2023] [Indexed: 02/27/2024]
Abstract
PURPOSE To evaluate and compare the visual outcomes of an enhanced monofocal intraocular lens (IOL) with two different monofocal IOLs. SETTING Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy. DESIGN Prospective, single-center, single-masked, randomized controlled clinical study. METHODS The study included patients undergoing phacoemulsification and IOL implantation. Patients were consecutively randomized by block randomization and assigned in a 1:1:1 allocation ratio to three study arms to bilaterally receive Tecnis Eyhance™ (model ICB00) or Tecnis® monofocal 1-piece (model PCB00) or Clareon® monofocal (model CNA0T0), respectively. Monocular and binocular (both corrected and uncorrected) visual acuities for far, intermediate and near were registered and compared among groups at 3 months. To track changes in patient quality of life, the Catquest-9SF questionnaire was administered to each patient before and after cataract extraction. RESULTS Ninety patients (30 for each group) were enrolled. At 3 months follow-up, statistically significant differences for intermediate visual acuities were found between the three groups. Nonstatistically significant differences were observed for distance visual acuities and the changes in Catquest-9SF scores. CONCLUSION Tecnis Eyhance™ provided better results in intermediate visual outcomes without adverse effects on patients' quality of life.
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Affiliation(s)
- Rosa Giglio
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Ospedale Maggiore, Piazza Ospedale 1, 34129, Trieste, Friuli-Venezia Giulia, Italy
| | - Alex Lucia Vinciguerra
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Ospedale Maggiore, Piazza Ospedale 1, 34129, Trieste, Friuli-Venezia Giulia, Italy.
| | - Marianna Presotto
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Ospedale Maggiore, Piazza Ospedale 1, 34129, Trieste, Friuli-Venezia Giulia, Italy
| | - Kamil Jonak
- Department of Biomedical Engineering, Lublin University of Technology, 20-618, Lublin, Poland
- Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 20-093, Lublin, Poland
| | - Robert Rejdak
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-093, Lublin, Poland
| | - Mario Damiano Toro
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-093, Lublin, Poland
- Eye Clinic, Public Health Department, University of Naples Federico II, 80138, Naples, Italy
| | | | - Daniele Tognetto
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Ospedale Maggiore, Piazza Ospedale 1, 34129, Trieste, Friuli-Venezia Giulia, Italy
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Hong ASY, Ang BCH, Dorairaj E, Dorairaj S. Premium Intraocular Lenses in Glaucoma-A Systematic Review. Bioengineering (Basel) 2023; 10:993. [PMID: 37760095 PMCID: PMC10525961 DOI: 10.3390/bioengineering10090993] [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: 07/06/2023] [Revised: 08/12/2023] [Accepted: 08/16/2023] [Indexed: 09/29/2023] Open
Abstract
The incidence of both cataract and glaucoma is increasing globally. With increasing patient expectation and improved technology, premium intraocular lenses (IOLs), including presbyopia-correcting and toric IOLs, are being increasingly implanted today. However, concerns remain regarding the use of premium IOLs, particularly presbyopia-correcting IOLs, in eyes with glaucoma. This systematic review evaluates the use of premium IOLs in glaucoma. A comprehensive search of the MEDLINE database was performed from inception until 1 June 2023. Initial search yielded 1404 records, of which 12 were included in the final review of post-operative outcomes. Studies demonstrated high spectacle independence for distance and good patient satisfaction in glaucomatous eyes, with positive outcomes also in post-operative visual acuity, residual astigmatism, and contrast sensitivity. Considerations in patient selection include anatomical and functional factors, such as the type and severity of glaucomatous visual field defects, glaucoma subtype, presence of ocular surface disease, ocular changes after glaucoma surgery, and the reliability of disease monitoring, all of which may be affected by, or influence, the outcomes of premium IOL implantation in glaucoma patients. Regular reviews on this topic are needed in order to keep up with the rapid advancements in IOL technology and glaucoma surgical treatments.
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Affiliation(s)
- Ashley Shuen Ying Hong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore;
| | - Bryan Chin Hou Ang
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore 308433, Singapore
- Department of Ophthalmology, National Healthcare Group Eye Institute, Woodlands Health Campus, Singapore 768024, Singapore
| | - Emily Dorairaj
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA;
| | - Syril Dorairaj
- Department of Ophthalmology, Mayo Clinic, Jacksonville, FL 32224, USA;
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Wang Q, Stoakes IM, Moshirfar M, Harvey DH, Hoopes PC. Assessment of Pupil Size and Angle Kappa in Refractive Surgery: A Population-Based Epidemiological Study in Predominantly American Caucasians. Cureus 2023; 15:e43998. [PMID: 37638275 PMCID: PMC10447998 DOI: 10.7759/cureus.43998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 08/29/2023] Open
Abstract
Purpose This retrospective study aims to establish normative values for pupil size, angle kappa, higher-order aberration, and astigmatism type in a largely Caucasian population in Utah, United States, utilizing the NIDEK OPD-Scan III system (Gamagori, Japan). Methods This study included 716 patients (1432 eyes) grouped based on spherical equivalence and age. Measurements were conducted under mesopic and photopic conditions. Statistical analysis involved Pearson's correlation and linear regression using the generalized estimating equation. NIDEK OPD-Scan III measured mesopic and photopic pupil size and angle kappa. The subjects were then grouped based on their spherical equivalence in diopters (D) and age in decades. The spherical equivalence groups were defined: >-6 D, -5.99 to -3 D, -2.99 to -0.25 D, -0.24 to 0.24 D, and >0.25 D (range 0.25-5.75 D). The higher-order aberration groups were based on the reason for the visit: laser-assisted in situ keratomileusis, photorefractive keratectomy, and small incision lenticule extraction as one group; cataract evaluation; and keratoconus. Astigmatism measurements were grouped into with-the-rule (WRT), against-the-rule (ATR), and oblique astigmatism, with further subgrouping into a young cohort (20-40 years) and an old cohort (>65 years). Results Among 716 participants, 49.2% were men; the mean age was 42.1±15.5 (range 7-88 years). The average spherical equivalence for myopia eyes was -3.28±2.34 D, and 1.51±1.46 D for hyperopia eyes. The mean mesopic pupil size was 5.68 ± 1.09 mm; the photopic pupil size was 4.65±1.09 mm. Pearson's correlation coefficient for mesopic pupil size versus age was -0.551, and -0.42 for photopic pupil (p < 0.001); sphere vs mesopic pupil size was -0.200, and -0.173 for photopic pupil (p < 0.001). The regression analysis for mesopic pupil size versus age revealed a 0.39 mm decrease in average pupil size per decade increase in age, and 0.25 mm decrease per decade for photopic pupil. The regression analysis for mesopic pupil size versus sphere revealed a 0.22 mm decrease in average pupil size per 3D increase in sphere, and a 0.16 mm decrease 3 D increase in sphere for the photopic pupil. The mean mesopic angle kappa was 0.33 ± 0.15 mm; photopic angle kappa was 0.31±0.15 mm. Pearson's correlation coefficient for mesopic angle kappa vs spherical equivalence was 0.32, and 0.296 for photopic angle kappa (p <0.001 for both). Regression analysis for mesopic angle kappa vs spherical equivalence demonstrated a 0.051 mm increase in angle kappa per 3 D increase in spherical equivalence, and a 0.048 mm increase for photopic angle kappa (p < 0.001 for both). Among the higher-order aberration groups, the keratoconus group exhibited the highest levels. In terms of astigmatism type, WRT astigmatism was the most common in the young cohort, while ATR astigmatism was most prevalent in the older cohort. Conclusions The results of this study reveal significant associations between pupil size and increasing age, as well as between pupil size and increasingly positive refractive errors. These findings hold particular clinical relevance to older patients and individuals with hyperopia, as they undergo photoablative corneal refractive surgery or multifocal intraocular lens implantation. Understanding the established normative values for pupil size, angle kappa, higher-order aberration, and astigmatism type can aid clinicians in making more informed decisions and improving patient outcomes.
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Affiliation(s)
| | - Isabella M Stoakes
- Osteopathic Medicine, Pacific Northwest University of Health Sciences, Yakima, USA
| | - Majid Moshirfar
- Corneal and Refractive Surgery, Hoopes Vision Research Center, Draper, USA
- Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, USA
- Eye Banking and Corneal Transplantation, Utah Lions Eye Bank, Murray, USA
| | - Devon H Harvey
- Medicine, The Ohio State University College of Medicine, Columbus, USA
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Łabuz G, Yan W, Baur ID, Khoramnia R, Auffarth GU. Comparison of Five Presbyopia-Correcting Intraocular Lenses: Optical-Bench Assessment with Visual-Quality Simulation. J Clin Med 2023; 12:jcm12072523. [PMID: 37048607 PMCID: PMC10095001 DOI: 10.3390/jcm12072523] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/16/2023] [Accepted: 03/22/2023] [Indexed: 03/29/2023] Open
Abstract
Presbyopia correction through implantation of a trifocal intraocular lens (IOL) is a modality offered to both cataract and refractive-lens exchange patients. To maximize postoperative satisfaction, IOL selection needs to be made based on patients’ requirements aligned with the available technology. Five Trifocal IOLs were assessed in this study, and their differentiating features were identified: Triumf POD L GF, AT Lisa Tri, Tecnis Synergy, AcrySof IQ PanOptix, and Acriva Trinova Pro C. The optical quality was assessed using the modulation-transfer-function principle. Simulated defocus curves were derived from a non-linear formula. Far-focus simulated visual acuity (simVA) was 0.03 logMAR or better for all the studied IOLs, showing minimal differences. However, each IOL’s intermediate focus position differed across a range from 61 cm to 80 cm; and for the near focus, it was 36 cm to 44 cm. Triumf demonstrated improved intermediate point at the expense of the near focus resulting in a lower predicted near VA. PanOptix exhibited the shortest range of vision without a clear distinction between intermediate and near-point. The remaining lenses presented three foci of comparable optical quality and, thus, simVA performance. Each model, however, revealed a different aperture-change response. Trinova function improved at intermediate but was worse at near for larger pupils. The opposite was observed for AT Lisa. Synergy’s optical quality change was predominantly associated with lower pupil diameter. In conclusion, the trifocal IOLs can be differentiated according to their secondary-foci position, light-energy distribution, and pupil-size-related behavior. The observed differences may translate directly into a clinical effect showing that the trifocal IOLs vary in their ability to deliver optimal vision at different distances, with some providing improved intermediate while others favor reading distance. The knowledge gained through this objective testing can support IOL selection, postoperative patient counselling and increase the chance of spectacle independence after surgery.
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Bohac M, Jagic M, Biscevic A, Lukacevic S, Mravicic I, Suic SP, Dekaris I. Stereoacuity and Multifocal Intraocular Lenses - a Systematic Review. Acta Inform Med 2023; 31:62-67. [PMID: 37038487 PMCID: PMC10082657 DOI: 10.5455/aim.2023.31.62-67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/10/2023] [Indexed: 04/12/2023] Open
Abstract
Background Among various visual functions, stereoacuity, or the ability to perceive depth, is the most sophisticated binocular function. Many publications discuss the influence of retinal image formation by multifocal intraocular lenses on glare and contrast sensitivity, but only a few present results of testing binocular vision in patients with multifocal intraocular lenses. Objective This article is designed to review the results of testing binocular vision in patients with multifocal intraocular lenses implanted in cataract surgery. Methods This article was performed based on a literature review and Internet search through scientific databases such as PubMed, Scopus, Web of Science, and Google Scholar. Results Some reports found that patients implanted with the monofocal lens, when measured with a near addition, presented statistically significant better stereoacuity scores than those implanted with any of the multifocal intraocular lens types. When the TNO test was used for measurement, statistically significant better stereoacuity was disclosed with the refractive multifocal intraocular lens than with the diffractive-based multifocal intraocular lens design. Stereoacuity scores, even within the same types of lenses, were significantly better with the Titmus test than with the TNO test. Conclusion Stereoacuity is not affected by multifocality-induced retinal blur as it is by other causes of image degradation such as small residual refractive error very early opacification of ocular media or dry eye. Multifocal intraocular lenses do not cause more functional aniseikonia than would be expected with a monofocal intraocular lens. Since stereoacuity is compromised with unilateral multifocal intraocular lens implantation bilateral implantation should be attempted.
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Affiliation(s)
- Maja Bohac
- University Eye Hospital Svjetlost, School of Medicine University of Rijeka, Zagreb, Croatia
| | - Mateja Jagic
- University Eye Hospital Svjetlost, School of Medicine University of Rijeka, Zagreb, Croatia
| | - Alma Biscevic
- University Eye Hospital Svjetlost, School of Medicine University of Rijeka, Zagreb, Croatia
- Eye Clinic Svjetlost, Sarajevo, Bosnia and Herzegovina
| | - Selma Lukacevic
- University Eye Hospital Svjetlost, School of Medicine University of Rijeka, Zagreb, Croatia
| | - Ivana Mravicic
- University Eye Hospital Svjetlost, School of Medicine University of Rijeka, Zagreb, Croatia
| | | | - Iva Dekaris
- University Eye Hospital Svjetlost, School of Medicine University of Rijeka, Zagreb, Croatia
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Tanabe H, Shojo T, Yamauchi T, Takase K, Akada M, Tabuchi H. Comparative visual performance of diffractive bifocal and rotationally asymmetric refractive intraocular lenses. Sci Rep 2022; 12:19394. [PMID: 36371596 PMCID: PMC9653499 DOI: 10.1038/s41598-022-24123-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 11/10/2022] [Indexed: 11/15/2022] Open
Abstract
We compared the visual performance of a diffractive bifocal intraocular lens (IOL) with + 4.0 D near addition (ZMB00 [Johnson & Johnson Surgical Vision]) and a rotationally asymmetric refractive IOL with + 1.5 D near addition (LS-313 MF15 [Teleon Surgical BV]) 10 weeks after cataract patients' last surgery for bilateral ZMB00 or LS-313 MF15 implantation between 2011 and 2020, with the lenses of each eye implanted within 3 months of each other. The ZMB00 and LS-313 MF15 groups comprised 1326 eyes of 663 patients (age: 67.0 ± 7.8 years; females/males, 518/145) and 448 eyes of 224 patients (73.6 ± 7.0 years; females/males, 125/99), respectively. A linear mixed-effects model using data for both eyes, with strict adjustments for sex, age, subjective refraction spherical equivalent, subjective refraction cylinder, corneal astigmatism, axial length, corneal higher-order aberrations, and pupil diameter, ensured statistical validity. Compared to LS-313 MF15, ZMB00 achieved significantly superior uncorrected near visual acuity, reduced higher-order aberrations (ocular/internal, scaled to a 4-mm pupil; Wavefront_4_post_Ocular_Total Higher-Order Aberration/Third/Fourth/Trefoil/Coma/Tetrafoil/Spherical, Wavefront_4_post_Internal_Astigmatism/Total Higher-Order Aberration/Third/Trefoil/Coma/Tetrafoil/Spherical), and superior distance and near spectacle independence (p < 0.00068, Wald test). Contrast sensitivity, measured without (visual angle of the test target: 6.3°/4.0°/2.5°/1.6°/1.0°/0.7°) or with glare (4.0°/2.5°/1.6°/1.0°/0.7°), was significantly better in the LS-313 MF15 than the ZMB00 group (p < 0.00068, Wald test).
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Affiliation(s)
- Hirotaka Tanabe
- Department of Ophthalmology, Tsukazaki Hospital, Himeji, Japan
| | - Tomohiro Shojo
- Department of Ophthalmology, Tsukazaki Hospital, Himeji, Japan
| | | | - Kosuke Takase
- Department of Ophthalmology, Tsukazaki Hospital, Himeji, Japan
| | - Masahiro Akada
- Department of Ophthalmology, Tsukazaki Hospital, Himeji, Japan
| | - Hitoshi Tabuchi
- Department of Ophthalmology, Tsukazaki Hospital, Himeji, Japan ,grid.257022.00000 0000 8711 3200Department of Technology and Design Thinking for Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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Small Aperture IC-8 Extended-Depth-of-Focus Intraocular Lens in Cataract Surgery: A Systematic Review. J Clin Med 2022; 11:jcm11164654. [PMID: 36012888 PMCID: PMC9409955 DOI: 10.3390/jcm11164654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/06/2022] [Accepted: 08/08/2022] [Indexed: 11/17/2022] Open
Abstract
The aim of this paper is to evaluate the visual outcomes and patient satisfaction of small aperture IC-8 IOLs in cataract patients with or without prior ocular events. A systematic review of full-length original English studies reporting the visual results of small aperture IC-8 IOL implantation after cataract surgery in three databases, PubMed, Web of Science and Scopus, was performed according to the PRISMA statement. The Quality Assessment Tool for case series studies from the National Heart, Lung, and Blood Institute was used to analyze the quality of the studies selected. The search provided 543 articles, of which 22 were included in this systematic review. Significant improvements in uncorrected distance visual acuity (UDVA); uncorrected intermediate visual acuity (UIVA); uncorrected near visual acuity (UNVA); perception of photic phenomena; and patient satisfaction have been reported. Unilateral and bilateral small aperture IC-8 IOL implantation reduces photic phenomena and provides good vision for all distances with high patient satisfaction and minimal postoperative complications. Therefore, the implantation of this IOL may be recommended for patients with cataracts, corneal irregularities and ocular trauma with partial aniridia.
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Sievers J, Elsner R, Bohn S, Schünemann M, Stolz H, Guthoff RF, Stachs O, Sperlich K. Method for the generation and visualization of cross-sectional images of three-dimensional point spread functions for rotationally symmetric intraocular lenses. BIOMEDICAL OPTICS EXPRESS 2022; 13:1087-1101. [PMID: 35284182 PMCID: PMC8884235 DOI: 10.1364/boe.446869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/21/2021] [Accepted: 12/30/2021] [Indexed: 06/14/2023]
Abstract
Cross-sectional images of three-dimensional point spread functions of intraocular lenses are used to study their image formation. To obtain those, light sheet-based methods are established. Due to the non-negligible thicknesses of the light sheets, the image quality of the cross-sectional images is constrained. To overcome this hurdle, we present a dedicated evaluation algorithm to increase image quality in the post-processing step. Additionally, we compare the developed- with the light sheet method based on our own investigations of a multifocal diffractive intraocular lens conducted in an in-house designed optical bench. The comparative study showed the clear superiority of the newly developed method in terms of image quality, fine structure visibility, and signal-to-noise ratio compared to the light sheet based method. However, since the algorithm assumes a rotationally symmetrical point spread function, it is only suitable for all rotationally symmetrical lenses.
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Affiliation(s)
- Jan Sievers
- Department of Ophthalmology, Rostock University Medical Center, 18057 Rostock, Germany
- Department Life, Light & Matter, University of Rostock, 18055 Rostock, Germany
- Institute of Physics, Martin–Luther–University Halle–Wittenberg, 06120 Halle (Saale), Germany
| | - Ricardo Elsner
- Department of Ophthalmology, Rostock University Medical Center, 18057 Rostock, Germany
- Department Life, Light & Matter, University of Rostock, 18055 Rostock, Germany
| | - Sebastian Bohn
- Department of Ophthalmology, Rostock University Medical Center, 18057 Rostock, Germany
- Department Life, Light & Matter, University of Rostock, 18055 Rostock, Germany
| | - Melanie Schünemann
- Department of Ophthalmology, Rostock University Medical Center, 18057 Rostock, Germany
- Department Life, Light & Matter, University of Rostock, 18055 Rostock, Germany
| | - Heinrich Stolz
- Department Life, Light & Matter, University of Rostock, 18055 Rostock, Germany
- Institute of Physics, University of Rostock, 18055 Rostock, Germany
| | - Rudolf F. Guthoff
- Department of Ophthalmology, Rostock University Medical Center, 18057 Rostock, Germany
- Department Life, Light & Matter, University of Rostock, 18055 Rostock, Germany
| | - Oliver Stachs
- Department of Ophthalmology, Rostock University Medical Center, 18057 Rostock, Germany
- Department Life, Light & Matter, University of Rostock, 18055 Rostock, Germany
| | - Karsten Sperlich
- Department of Ophthalmology, Rostock University Medical Center, 18057 Rostock, Germany
- Department Life, Light & Matter, University of Rostock, 18055 Rostock, Germany
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Nakajima D, Takahashi H, Kobayakawa S. Clinical Outcome of Lentis Comfort Intraocular Lens Implantation. J NIPPON MED SCH 2021; 88:398-407. [PMID: 32999178 DOI: 10.1272/jnms.jnms.2021_88-504] [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: 11/19/2022]
Abstract
PURPOSE To evaluate visual outcome and patient satisfaction following Lentis Comfort intraocular lens (IOL) implantation. METHOD This retrospective case series examined 68 eyes of 41 patients (mean age 72.0 ± 8.1 years) who underwent Lentis Comfort (LS-313 MF15, Oculentis GmbH, Berlin, Germany; Santen, Osaka, Japan) implantations. Patients were evaluated for visual acuity (VA) at several distances (0.3, 0.5 and 5 meters), refractive error, defocus curve and contrast sensitivity, in addition to answering a questionnaire on photic phenomena, visual discomfort and patient satisfaction. RESULTS Uncorrected visual acuity was 0.05 ± 0.13 (logMAR) for distance, 0.23 ± 0.17 (logMAR) for intermediate, and 0.52 ± 0.20 (logMAR) for near. Defocus curve showed the binocular visual acuity attained was almost 20/20 within the range of +0.5 D to -1.5 D. Contrast sensitivity was within the normal range. The Lentis Comfort IOL tolerated astigmatism to some extent. Patient age could potentially be related to uncorrected visual acuity. Questionnaire results showed almost all patients were satisfied with Lentis Comfort IOL implantation. CONCLUSION Lentis Comfort IOLs provided better visual function at far and intermediate distances.
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Affiliation(s)
- Daisuke Nakajima
- Department of Ophthalmology, Nippon Medical School Musashikosugi Hospital
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12
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Teshigawara T, Meguro A, Mizuki N. The Effect of Age, Postoperative Refraction, and Pre- and Postoperative Pupil Size on Halo Size and Intensity in Eyes Implanted with a Trifocal or Extended Depth-of-Focus Lens. Clin Ophthalmol 2021; 15:4141-4152. [PMID: 34703200 PMCID: PMC8524255 DOI: 10.2147/opth.s327660] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/04/2021] [Indexed: 12/28/2022] Open
Abstract
Purpose Halos are a chief source of patient dissatisfaction after multifocal intraocular lens (IOL) implantation. The primary purpose of this study was to investigate the influence of age, postoperative refraction, and pre- and postoperative pupil size on postoperative halo size with a trifocal diffractive IOL (AcrySof IQ PanOptix) and extended depth-of-focus (EDOF) IOL (TECNIS Symfony) to determine whether these factors could predict postoperative halo size. Patients and Methods This single-center, open-label study conducted between October 2018 and April 2020 in Yokosuka, Japan included 160 patients: 80 with PanOptix and 80 with Symfony IOLs. Size and intensity of the halos were examined binocularly using a computer-based simulator (Eyeland Design Network GmbH) and scored from 0 (minimum) to 10 (maximum) at 1, 3, and 6 months postoperatively, along with the change in each variable for both IOLs. The respective correlations of halo size with age, postoperative refraction, pre- and postoperative pupil size, and discomfort level due to the halo were also investigated 6 months postoperatively. Results Halo size and intensity were significantly mitigated between 1, 3, and 6 months postoperatively. Throughout the observation period, halo size was significantly larger with PanOptix than with Symphony (P < 0.05), and halo intensity was significantly higher with Symphony than with PanOptix (P < 0.05). The pre- and postoperative pupil size correlated positively with halo size, while age and postoperative refraction were negatively correlated, for both IOLs. Conclusion Understanding the features and predictive preoperative factors of halos in different types of multifocal IOLs may be useful in improving patient satisfaction.
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Affiliation(s)
- Takeshi Teshigawara
- Department of Ophthalmology, Yokosuka Chuoh Eye Clinic, Yokosuka, Kanagawa, 238-0008, Japan.,Tsurumi Chuoh Eye Clinic, Yokohama, Kanagawa, 230-0051, Japan.,Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Kanagawa, 236-0004, Japan
| | - Akira Meguro
- Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Kanagawa, 236-0004, Japan
| | - Nobuhisa Mizuki
- Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Kanagawa, 236-0004, Japan
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13
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Bandrakalli P, Rani V, Yogesh RB, Bagrecha NK, Pavan G. Extent of multifocality with corneal manipulation in manual small incision cataract surgery with monofocal posterior chamber intraocular lens implantation. Indian J Ophthalmol 2021; 69:275-278. [PMID: 33463573 PMCID: PMC7933831 DOI: 10.4103/ijo.ijo_2390_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose: To compare the visual outcome in terms of multifocality in Manual Small Incision Cataract Surgery (MSICS) with and without intraoperative manipulation of corneal curvature. Methods: This was a prospective study on 80 subjects (80 eyes) who underwent MSICS with monofocal posterior chamber intraocular lens (PCIOL) implantation between January 2018 and October 2019. Intraoperative manipulation of corneal curvature using viscoelastics was performed during MSICS in 40 subjects (cases) while this intraoperative manipulation was not performed in the remaining 40 subjects (controls). Uncorrected distance visual acuity (UDVA) and uncorrected near visual acuity (UNVA) were compared at day 1, 7, 30 and 180postoperatively. Results: At 1 month and 6 months of follow up, UDVA was comparable in the 2 groups. UNVA was better in cases than controls at 1 month and6 months (P < 0.001). At 6 months of follow up,76% of cases with UDVA of 6/9 or better had UNVA of N8 while only 15% of controls with UDVA of 6/9 or better had UNVA of N8 (P <0.001). Mean near add requirement to achieve a best corrected near vision (BCNV)of N6 at 6 months was significantly lesser (P =0.002) in cases (+2.05 D) compared to controls (+2.43D). Conclusion: MSICS with intra operative manipulation of corneal curvature resulted in better unaided near visual acuity compared to that without intra operative manipulation of corneal curvature, without compromising unaided distant visual acuity.
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Affiliation(s)
- Parasappa Bandrakalli
- Department of Ophthalmology, Vijayanagar Institute of Medical Sciences, Cantonment, Ballari, Karnataka, India
| | - Vidya Rani
- Department of Ophthalmology, Vijayanagar Institute of Medical Sciences, Cantonment, Ballari, Karnataka, India
| | - R B Yogesh
- Department of Ophthalmology, Vijayanagar Institute of Medical Sciences, Cantonment, Ballari, Karnataka, India
| | - Nirmal Kumar Bagrecha
- Department of Ophthalmology, Vijayanagar Institute of Medical Sciences, Cantonment, Ballari, Karnataka, India
| | - G Pavan
- Department of Ophthalmology, Vijayanagar Institute of Medical Sciences, Cantonment, Ballari, Karnataka, India
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14
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Yangzes S, Kamble N, Grewal S, Grewal SPS. Comparison of an aspheric monofocal intraocular lens with the new generation monofocal lens using defocus curve. Indian J Ophthalmol 2021; 68:3025-3029. [PMID: 33229691 PMCID: PMC7856977 DOI: 10.4103/ijo.ijo_985_20] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose: The aim of this study was to compare the visual outcomes of two monofocal intraocular lenses (IOLs), with emphasis on the defocus curve. Methods: A total of 116 consecutive eyes with cataract, undergoing phacoemulsification with IOL implantation were included in the observational case series, and divided into two groups. 71 eyes were implanted with Tecnis Eyhance and 45 with Tecnis 1 monofocal IOL. Eyes with ocular comorbidities, previous ocular surgeries and corneal astigmatism >1 Diopters (D) were excluded from the study. Complete ophthalmic evaluation including uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), corrected intermediate visual acuity (CIVA), uncorrected visual acuity (UNVA), corrected near visual acuity (CNVA) was noted and defocus levels ranging from - 4.00 D to + 1.00 D were plotted postoperatively in both groups. Results: Uncorrected intermediate visual acuity (UIVA) and uncorrected near visual acuity (UNVA) was significantly better in Tecnis Eyhance group compared to Tecnis 1 monofocal. Both the IOLs have similar performance for distance vision but visual acuity at intermediate and near is significantly better with Tecnis Eyhance compared to Tecnis 1 piece IOL. Conclusion: Tecnis Eyhance IOL with its better defocus curve, not only provides good distance, but intermediate vision as well. With significantly better visual acuity across the range of near and intermediate vision, Tecnis Eyhance IOL can prove to be a viable and reasonable option for patients who are more dependent on intermediate vision in daily activities.
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Affiliation(s)
- Sonam Yangzes
- Department of Lens, Cornea and Refractive Services, Grewal Eye Institute, Chandigarh, India
| | - Neha Kamble
- Department of Lens, Cornea and Refractive Services, Grewal Eye Institute, Chandigarh, India
| | - Sartaj Grewal
- Department of Lens, Cornea and Refractive Services, Grewal Eye Institute, Chandigarh, India
| | - Satinder P S Grewal
- Department of Lens, Cornea and Refractive Services, Grewal Eye Institute, Chandigarh, India
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15
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Fernández J, Rodríguez-Vallejo M, Martínez J, Burguera N, Piñero DP. What we have learnt from 30 years living with positive dysphotopsia after intraocular lens implantation?: a review. EXPERT REVIEW OF OPHTHALMOLOGY 2021. [DOI: 10.1080/17469899.2021.1917997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Joaquín Fernández
- Department of Ophthalmology (Qvision, VITHAS Hospital, Almería, Spain
| | | | - Javier Martínez
- Department of Ophthalmology (Qvision, VITHAS Hospital, Almería, Spain
| | - Noemi Burguera
- Department of Ophthalmology (Qvision, VITHAS Hospital, Almería, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- Department of Ophthalmology (Imqo-oftalmar), Vithas Medimar International Hospital, Alicante, Spain
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16
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Fernández J, Rodríguez-Vallejo M, Martínez J, Burguera N, Piñero DP. Pupil Diameter in Patients With Multifocal Intraocular Lenses. J Refract Surg 2020; 36:750-756. [PMID: 33170282 DOI: 10.3928/1081597x-20200813-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 08/05/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE To evaluate the distribution of pupil size in patients implanted with multifocal intraocular lenses (IOLs) and to assess the variations according to age. METHODS A total of 168 eyes that had implantation of several multifocal IOLs and were measured at the 3-month follow-up visit were included in the analysis. The Keratograph 5M (Oculus Optikgeräte) was used to measure the photopic and mesopic pupil size, as well as the average between both (average pupil size). Eyes were stratified in four groups by age: 50 years or younger, 51 to 60 years, 61 to 70 years, and older than 70 years. RESULTS Considering the total sample, 84.5% and 95.8% of eyes had a photopic pupil size of 3 and 3.5 mm or less, respectively. The mesopic pupil size was greater than 4.5 mm in 39.3% and greater than 5 mm in 16.7% of eyes. The average pupil size was 3.5 and 4 mm or less in 54.2% and 85.1% of eyes, respectively. Mesopic pupil size resulted in a steeper decrease with age than photopic pupil size: 0.028 versus 0.015 mm/year, respectively. Statistically significant differences were found among the four age groups (P < .0005). No significant mean differences were found between multifocal IOL models for photopic pupil size, mesopic pupil size, or average pupil size (P > .05). CONCLUSIONS Eyes implanted with multifocal IOLs had a photopic pupil size of 3.5 mm or less and mesopic pupil size of 5 mm or less. Mesopic and photopic pupil size decreased 0.28 and 0.15 mm per decade, respectively. This information can help surgeons to understand the general functioning of multifocal IOLs whose performance varies with pupil size. [J Refract Surg. 2020;36(11):750-756.].
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17
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Tanabe H, Tabuchi H, Shojo T, Yamauchi T, Takase K. Comparison of visual performance between monofocal and multifocal intraocular lenses of the same material and basic design. Sci Rep 2020; 10:15490. [PMID: 32968124 PMCID: PMC7511318 DOI: 10.1038/s41598-020-72473-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 09/02/2020] [Indexed: 02/06/2023] Open
Abstract
To compare the visual performance of a monofocal intraocular lens (IOL) (ZCB00) and a multifocal IOL (ZMB00) of the same material and basic design, we evaluated postoperative parameters at 10 weeks after the last surgery in cataract patients who underwent bilateral ZCB00 or ZMB00 implantation from December 13, 2010, to July 29, 2019, with the right and left lenses implanted within 3 months of each other. The study enrolled 2,230 eyes of 1,115 patients. The monofocal group comprised 904 eyes of 452 patients (72.3 ± 6.8 years; females/males, 268/184), and the multifocal group comprised 1,326 eyes of 663 patients (67.0 ± 7.8 years; females/males, 518/145). Contrast sensitivity (4.0/2.5/1.6/1.0/0.7 degrees), contrast sensitivity with glare (1.6/1.0/0.7 degrees), and the VFQ-25 score for driving at night were significantly better in the monofocal group (p < 0.00068, Wald test). Uncorrected intermediate/near visual acuity and near spectacle independence were significantly better in the multifocal group (p < 0.00068, Wald test). The two IOL groups had different characteristics in terms of contrast sensitivity, night-time driving, uncorrected intermediate/near visual acuity and near spectacle independence.
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Affiliation(s)
- Hirotaka Tanabe
- Department of Ophthalmology, Tsukazaki Hospital, Himeji, Japan.
| | - Hitoshi Tabuchi
- Department of Ophthalmology, Tsukazaki Hospital, Himeji, Japan.,Department of Technology and Design Thinking for Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Tomohiro Shojo
- Department of Ophthalmology, Tsukazaki Hospital, Himeji, Japan
| | | | - Kosuke Takase
- Department of Ophthalmology, Tsukazaki Hospital, Himeji, Japan
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18
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Yao L, Xu Y, Han T, Qi L, Shi J, Zou Z, Zhou X. Relationships Between Haloes and Objective Visual Quality in Healthy Eyes. Transl Vis Sci Technol 2020; 9:13. [PMID: 32974085 PMCID: PMC7488622 DOI: 10.1167/tvst.9.10.13] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 07/15/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose To determine the normal values and relationships between haloes and objective optical quality in healthy eyes. Methods In this cross-sectional study, haloes, pupillary responses to light, and objective optical quality were measured with the optical quality analysis system (OQAS) and a vision monitor (MonCv3) in 138 right eyes of 138 healthy young men with mean spherical equivalent of 0.32 ± 0.47 D. Results The mean disc halo size was 77.17 ± 25.03 arcmin. The mean objective optical quality values were as follows: objective scatter index (OSI), 0.58 ± 0.33; Strehl ratio (SR), 0.21 ± 0.05; modulation transfer function cutoff, 36.27 ± 7.98 cpd; OQAS value (OV)100%, 1.21 ± 0.27; OV20%, 0.91 ± 0.23; and OV9%, 0.59 ± 0.16. Disc halo size correlated independently with OSI (P < 0.001) and minimum pupil size (P = 0.003) by forward stepwise regression analysis (disc halo size = 16.60 + 26.24 × OSI + 11.34 × minimum pupil size; R2 value = 17.7%; F = 14.52; P < 0.001). Conclusions Reference values for disc halo size and objective optical quality in healthy young subjects were established. Eyes with worse objective vision quality exhibited larger haloes. Translational Relevance The study provided the knowledge and the relationships of OQAS and halo measurements from a well-defined group of healthy young subjects. Both measurements are useful in clinical practice to help quantify the vision quality and complement each other.
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Affiliation(s)
- Lu Yao
- Department of Aviation Physical Examination, Air Force Medical Center, Beijing
| | - Ye Xu
- Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China.,NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai 200031, China
| | - Tian Han
- Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China.,NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai 200031, China
| | - Linsong Qi
- Department of Aviation Physical Examination, Air Force Medical Center, Beijing
| | | | - Zhikang Zou
- Department of Aviation Physical Examination, Air Force Medical Center, Beijing
| | - Xingtao Zhou
- Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China.,NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai 200031, China
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19
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Breyer DRH, Beckers L, Ax T, Kaymak H, Klabe K, Kretz FTA. [Current Review: Multifocal Intraocular Lenses and Extended Depth of Focus Intraocular Lenses]. Klin Monbl Augenheilkd 2020; 237:943-957. [PMID: 32797470 DOI: 10.1055/a-1111-9380] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Presbyopia and cataract patients' wish to be increasingly independent of spectacles after surgery and this is one of the main drivers for the development of multifocal intraocular lenses (MIOL) and extended depth of focus (EDOF) intraocular lenses (IOL). As education, biometry, diagnostics, surgical techniques, and MIOL/EDOF IOL designs have improved over the past decade, an increasing number of cataract surgeons have become cataract refractive surgeons to help address this need. There is not one single MIOL/EDOF IOL, however, that suits all patients' needs. The wide variety of MIOL and EDOF IOL, their optics, and their impact on our patients' quality of vision have to be fully understood if we have to choose the appropriate IOL for each individual; MIOL/EDOF IOL surgery has to be customized. This review article looks at the different optical aspects and clinical consequences of MIOL/EDOF IOL, in order to help surgeons find an appropriate solution for each of their individual patients.
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Affiliation(s)
- Detlev R H Breyer
- Breyer, Kaymak und Klabe Augenchirurgie, Düsseldorf.,I. I. O., Internationale Innovative Ophthalmochirurgie, Düsseldorf.,Augenheilkunde, International Vision Correction Research Centre Network (IVCRC.net), Universität Heidelberg
| | - Lena Beckers
- Breyer, Kaymak und Klabe Augenchirurgie, Düsseldorf.,I. I. O., Internationale Innovative Ophthalmochirurgie, Düsseldorf.,Augenheilkunde, International Vision Correction Research Centre Network (IVCRC.net), Universität Heidelberg
| | - Timon Ax
- Breyer, Kaymak und Klabe Augenchirurgie, Düsseldorf.,I. I. O., Internationale Innovative Ophthalmochirurgie, Düsseldorf.,Augenheilkunde, International Vision Correction Research Centre Network (IVCRC.net), Universität Heidelberg
| | - Hakan Kaymak
- Breyer, Kaymak und Klabe Augenchirurgie, Düsseldorf.,I. I. O., Internationale Innovative Ophthalmochirurgie, Düsseldorf.,Augenheilkunde, International Vision Correction Research Centre Network (IVCRC.net), Universität Heidelberg
| | - Karsten Klabe
- Breyer, Kaymak und Klabe Augenchirurgie, Düsseldorf.,I. I. O., Internationale Innovative Ophthalmochirurgie, Düsseldorf.,Augenheilkunde, International Vision Correction Research Centre Network (IVCRC.net), Universität Heidelberg
| | - Florian Tobias Alwin Kretz
- Augenheilkunde, International Vision Correction Research Centre Network (IVCRC.net), Universität Heidelberg.,Augenheilkunde, Precise Vision Augenärzte, PVK Precise Vision GmbH, Rheine
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20
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Kim JH, Eom Y, Park SY, Choi SY, Hwang HS, Kim JH, Song JS, Kim HM. Rainbow halos occur less following implantation of extended range of vision one-piece intraocular lenses vs diffractive bifocal intraocular lenses. Int J Ophthalmol 2020; 13:913-919. [PMID: 32566502 DOI: 10.18240/ijo.2020.06.09] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 01/17/2020] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate clinical outcomes following implantation of an extended range of vision intraocular lens (IOL), the ZXR00, and a diffractive multifocal IOL with +2.75 diopters (D) add power, the ZKB00. METHODS Totally 30 patients who underwent either bilateral implantation of the ZXR00 IOL with intended emmetropia (ZXR00 emmetropia group: 20 eyes) and intended micromonovision (ZXR00 monovision group: 20 eyes), or bilateral implantation of the ZKB00 IOL with intended emmetropia (ZKB00 group: 20 eyes) were included in this study. Visual acuity at 4 m, 80, and 40 cm; and the types of halos (misty, fine, and rainbow) were analyzed at one and three months after surgery. RESULTS There were no significant differences in distance visual acuity among the three groups. The mean uncorrected intermediate visual acuity was better in the ZXR00 emmetropia and monovision groups (0.02 logMAR and 0.02 logMAR, respectively) than in the ZKB00 group (0.14 logMAR). The mean uncorrected near visual acuity was worse in the ZXR00 emmetropia group (0.26 logMAR) than in the ZXR00 monovision and ZKB00 groups (0.12 logMAR and 0.10 logMAR, respectively). There was an increased incidence of rainbow halos in the ZKB00 group vs in either ZXR00 group (P=0.033). CONCLUSION Implantation of the ZXR00 IOL with intended micromonovision provide superior visual acuity than implantation of the ZXR00 IOL with intended emmetropia. The ZXR00 IOLs tend to show a lower incidence of rainbow halos than did the ZKB00 IOL.
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Affiliation(s)
- Jae-Hyung Kim
- Seoul Daabom Eye Center, Cheongju 28568, Republic of Korea
| | - Youngsub Eom
- Department of Ophthalmology, Ansan Hospital, Korea University College of Medicine, Seoul 15355, Republic of Korea
| | - Seo Yeon Park
- Department of Ophthalmology, Ansan Hospital, Korea University College of Medicine, Seoul 15355, Republic of Korea
| | - Soo Youn Choi
- Department of Ophthalmology, Ansan Hospital, Korea University College of Medicine, Seoul 15355, Republic of Korea.,BGN World Tower Eye Clinic, Seoul 05551, Republic of Korea
| | - Ho Sik Hwang
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul 07345, Republic of Korea
| | - Jun-Heon Kim
- Joeunnun Vision Clinic, Seoul 06134, Republic of Korea
| | - Jong Suk Song
- Department of Ophthalmology, Ansan Hospital, Korea University College of Medicine, Seoul 15355, Republic of Korea
| | - Hyo Myung Kim
- Department of Ophthalmology, Ansan Hospital, Korea University College of Medicine, Seoul 15355, Republic of Korea
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Altinkurt E, Muftuoglu O. Comparison of three different diffractıve multifocal intraocular lenses with a +2.5, +3.0, and +3.75 diopter additıon power. Saudi J Ophthalmol 2020; 33:353-362. [PMID: 31933530 PMCID: PMC6950979 DOI: 10.1016/j.sjopt.2019.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 05/27/2019] [Accepted: 09/16/2019] [Indexed: 11/25/2022] Open
Abstract
Purpose To compare the functional outcomes and astigmatic tolerability after implantation of multifocal intraocular lenses (IOLs) with a +2.5, +3.0, and +3.75 diopter (D) addition power. Methods This study included 122 eyes of 61 patients who had bilateral cataract extraction and implantation of diffractive aspheric multifocal acrylic IOLs with +2.5 D (+2.5 group), +3.0 D (+3.0 group), and +3.75 D (+3.75 group) addition powers. 1-year after surgery, distance corrected near (DNVA) and intermediate (DIVA) visual acuities at 32, 40, 45, 50, 55, and 60 cm; and contrast sensitivity measurements under photopic, mesopic and mesopic with glare conditions; spherical and astigmatic defocus testing; distance-intermediate-near vision patient satisfaction levels; spectacle dependance; patient-reported outcomes were assessed binocularly. Results The +2.50 D group had better DIVA than both +3.0 group and +3.75 groups at 45 cm, 50 cm, 55 cm, and 60 cm (p < 0.05). The +3.75 group had better DNVA than both +2.5 and +3.0 IOL groups at 32 cm (p < 0.05). There was no significant difference in mean contrast values at all frequencies between three IOL groups (p > 0.05). The +2.50 D group showed better astigmatic tolerability than +3.00 group (at 2.00 D) and +3.75 group (at 1.50 D, and at 2.00 D) (p < 0.05). Conclusion Multifocal IOLs with +2.5 add power have better intermediate vision, but worse near vision compared to multifocal IOLs with +3.00 D and +3.75 D add power. Multifocal IOLs with +2.50 D add power tend to have better astigmatic defocus tolerability than multifocal IOLs with +3.00 D and +3.75 D add powers.
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Affiliation(s)
- Emre Altinkurt
- Istanbul University, Istanbul Medical School, Department of Ophthalmology, Istanbul, Turkey
- Corresponding author.
| | - Orkun Muftuoglu
- Koc University, School of Medicine, Department of Ophthalmology, Istanbul, Turkey
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22
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Kim BH, Hyon JY, Kim MK. Effects of Bifocal versus Trifocal Diffractive Intraocular Lens Implantation on Visual Quality after Cataract Surgery. KOREAN JOURNAL OF OPHTHALMOLOGY 2019; 33:333-342. [PMID: 31389209 PMCID: PMC6685823 DOI: 10.3341/kjo.2019.0001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/24/2019] [Accepted: 05/08/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare the effects of bifocal versus trifocal diffractive intraocular lens (IOL) implantation on visual quality after phacoemulsification in patients with cataracts. Methods Eighty-eight eyes from 63 patients were analyzed. Trifocal (AT LISA tri 839MP), bifocal (AcrySof IQ ReSTOR) and bifocal (Tecnis MF ZLB00) IOLs were implanted into 53, 18, and 17 eyes, respectively. Uncorrected distance, intermediate and near visual acuity, refractive errors, contrast sensitivity, and patient satisfaction were measured at 1 week and 1 month after surgery. Refractive error was converted to a spherical equivalent and compared to predicted refraction calculated by IOL calculation formulas. Results Uncorrected distance, intermediate, and near visual acuity did not differ significantly between groups. One month after surgery, the mean refractive errors were −0.07 diopters (D) in the AT LISA tri 839MP group, +0.18 D in the AcrySof IQ ReSTOR group, and +0.31 D in the Tecnis MF ZLB00 group (p < 0.001). The predictive accuracy of IOL calculation formulas did not differ between groups. Contrast sensitivity, satisfaction, and spectacle independence in the trifocal group were comparable with those of the two bifocal groups. Conclusions Trifocal IOL and two different types of bifocal IOL implantation were all effective for improving visual quality, although refractive error in patients with trifocal IOL shows myopic tendencies.
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Affiliation(s)
- Bo Hee Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Joon Young Hyon
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Mee Kum Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.,Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea.
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Cao K, Friedman DS, Jin S, Yusufu M, Zhang J, Wang J, Hou S, Zhu G, Wang B, Xiong Y, Li J, Li X, He H, Chai L, Wan XH. Multifocal versus monofocal intraocular lenses for age-related cataract patients: a system review and meta-analysis based on randomized controlled trials. Surv Ophthalmol 2019; 64:647-658. [DOI: 10.1016/j.survophthal.2019.02.012] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 02/21/2019] [Accepted: 02/25/2019] [Indexed: 11/16/2022]
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Srinivasan S, Khoo LW, Koshy Z. Posterior Segment Visualization in Eyes With Small-Aperture Intraocular Lens. J Refract Surg 2019; 35:538-542. [PMID: 31393993 DOI: 10.3928/1081597x-20190710-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 07/09/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the posterior segment visualization in patients with small-aperture intraocular lens (IOL) implantation. METHODS In this prospective, comparative case series, 15 patients who had unilateral implantation of the small-aperture IOL in their non-dominant eyes were recruited. Their fellow eyes were pseudophakic with a monofocal IOL in 14 patients and phakic in 1 patient. All underwent bilateral posterior segment clinical investigations including fundus photography, threshold perimetry, and optical coherence tomography of the posterior pole including optic nerve head. The results from these investigations were graded by a clinician masked to the laterality and type of IOL. Patient 11 developed postoperative endophthalmitis 4 weeks following cataract surgery with implantation of a small-aperture IOL and underwent pars plana vitrectomy. The intraoperative view of the posterior segment was subjectively evaluated by the retinal surgeon. RESULTS All 15 patients had successful image captures with all clinical investigative tools with no differences in image quality detected between the images obtained from the monofocal pseudophakic and small-aperture IOL eyes. The small-aperture IOL did not subjectively obstruct the intraoperative view for the retinal surgeon during pars plana vitrectomy. CONCLUSIONS Standard posterior segment investigations including non-mydriatic fundus photography, optical coherence tomography, and automated perimetry can be safely and effectively performed in eyes with small-aperture IOLs. There is no difference in the image quality. [J Refract Surg. 2019;35(8):538-542.].
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Visualization of Light Propagation with Multifocal Intraocular Lenses Using the Ouzo Effect. BIOMED RESEARCH INTERNATIONAL 2019; 2019:6425040. [PMID: 31346522 PMCID: PMC6620854 DOI: 10.1155/2019/6425040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/28/2019] [Accepted: 06/04/2019] [Indexed: 01/07/2023]
Abstract
The number of presbyopia correcting intraocular lenses (IOLs) is increasing and new technologies are constantly emerging with the aim of correcting the loss of accommodation after cataract surgery. Various optical designs have been proposed to implement multifocality or an extended depth of focus (EDOF). Depending on the optical principle of an implanted lens, the visual performance often is deteriorated by superposition of individual image planes and halos of varying intensity. This experimental study presents a concept to visualize the light fields and especially the halos of mono- and multifocal IOLs using the well known alcoholic beverage “ouzo” in order to obtain qualitative data on the imaging characteristics. We conclude that ouzo is a useful, cost effective, and nonpolluting medium for beam visualization and an alternative to fluorescein or milk, which could find an application for educational purposes.
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Al-Shymali O, Alió JL. Multifocal Intraocular Lenses: Neuroadaptation Failure Corrected by Exchanging with a Different Multifocal Intraocular Lens. ESSENTIALS IN OPHTHALMOLOGY 2019. [DOI: 10.1007/978-3-030-21282-7_11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Sachdev GS, Ramamurthy S, Sharma U, Dandapani R. Visual outcomes of patients bilaterally implanted with the extended range of vision intraocular lens: A prospective study. Indian J Ophthalmol 2018; 66:407-410. [PMID: 29480252 PMCID: PMC5859596 DOI: 10.4103/ijo.ijo_813_17] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose: The aim of this study was to analyze the objective and subjective visual outcomes of patients bilaterally implanted with the extended range of vision intraocular lens (EROV IOL), the Tecnis Symfony. Methods: This was a prospective interventional case series conducted at a tertiary eye care hospital in South India. The study included patients with bilateral implantation of EROV IOLs. The uncorrected and corrected visual acuity for distance, intermediate, and near vision was recorded at 6 weeks and 6 months’ postoperative visit. A subjective questionnaire was administered to assess spectacle independence, photic phenomenon, and overall satisfaction. All data were recorded using Microsoft Excel worksheet. The analyses were performed using SPSS for windows software. Results: Our study included fifty patients with bilateral implantation of EROV IOLs. The mean age was 59.84 ± 11.68 years. The mean uncorrected binocular distance, intermediate, and near visual acuity (in standard decimal equivalent) was 0.89,0.99 and 0.99 respectively, at 6 months’ postoperative visit. Ninety-six percent of the patients did not require spectacles for distance and 98% of the patients were free from spectacles for intermediate and near vision. 94% of our patients perceived no or minimal photic phenomena such as glare and halos. The mean subjective patient satisfaction score (out of 10) for distance, intermediate, and near was 9, 10, and 9, respectively. Conclusion: The EROV IOLs demonstrated high levels of spectacle independence for distance, intermediate, and near vision. The incidence of photic phenomena observed was minimal with a high level of patient satisfaction.
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Affiliation(s)
| | | | - Umesh Sharma
- The Eye Foundation, Coimbatore, Tamil Nadu, India
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Zhao F, Han T, Chen X, Chen Z, Zheng K, Wang X, Zhou X. Minimum pupil in pupillary response to light and myopia affect disk halo size: a cross-sectional study. BMJ Open 2018; 8:e019914. [PMID: 29643157 PMCID: PMC5898290 DOI: 10.1136/bmjopen-2017-019914] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To evaluate the relationship between pupillary response to light, myopia and disk halo size. DESIGN Cross-sectional study. SETTING Single refractive surgery centre. PARTICIPANTS In this study, 197 right eyes of 197 patients between 20 and 35 years of age were evaluated for disk halo size and pupillary response to light with a vision monitor. PRIMARY AND SECONDARY OUTCOME MEASURES Halo radius, age, spherical equivalent (SE), axial length (AL), initial diameter, amplitude of contraction, latency of contraction, duration of contraction, velocity of contraction, latency of dilation, duration of dilation, velocity of dilation, maximum pupil, minimum pupil, average pupil and dark pupil. RESULTS Significant associations were found between disk halo size and SE (r=-0.219, P=0.002), AL (r=0.152, P=0.033) and minimum pupil (r=0.149, P=0.037). There were no associations between disk halo size and initial diameter, amplitude of contraction, latency of contraction, duration of contraction, velocity of contraction, latency of dilation, duration of dilation, velocity of dilation, maximum pupil, average pupil, dark pupil and age (P>0.05). A significant difference in disk halo size was detected between the low-moderate and high myopia (SE< -6 D) groups (P=0.002) and between the small and large (minimum pupil≥4 mm) minimum pupil size groups (P=0.014). CONCLUSIONS Patients with a high SE and large minimum pupil size (minimum pupil ≥4 mm) suffered more disability glare than those with a low SE and small minimum pupil size.
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Affiliation(s)
- Feng Zhao
- Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai, China
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Tian Han
- Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai, China
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Xun Chen
- Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai, China
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Zhi Chen
- Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai, China
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Ke Zheng
- Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai, China
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Xiaoying Wang
- Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai, China
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Xingtao Zhou
- Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai, China
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
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Chow SSW, Chan TCY, Ng ALK, Kwok AKH. Outcomes of presbyopia-correcting intraocular lenses after laser in situ keratomileusis. Int Ophthalmol 2018; 39:1199-1204. [DOI: 10.1007/s10792-018-0908-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 03/22/2018] [Indexed: 10/17/2022]
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Carson D, Lee S, Alexander E, Wei X, Lee S. Comparison of two laboratory-based systems for evaluation of halos in intraocular lenses. Clin Ophthalmol 2018; 12:385-393. [PMID: 29503526 PMCID: PMC5826305 DOI: 10.2147/opth.s152201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Multifocal intraocular lenses (IOLs) can be associated with unwanted visual phenomena, including halos. Predicting potential for halos is desirable when designing new multifocal IOLs. Halo images from 6 IOL models were compared using the Optikos modulation transfer function bench system and a new high dynamic range (HDR) system. Materials and methods One monofocal, 1 extended depth of focus, and 4 multifocal IOLs were evaluated. An off-the-shelf optical bench was used to simulate a distant (>50 m) car headlight and record images. A custom HDR system was constructed using an imaging photometer to simulate headlight images and to measure quantitative halo luminance data. A metric was developed to characterize halo luminance properties. Clinical relevance was investigated by correlating halo measurements to visual outcomes questionnaire data. Results The Optikos system produced halo images useful for visual comparisons; however, measurements were relative and not quantitative. The HDR halo system provided objective and quantitative measurements used to create a metric from the area under the curve (AUC) of the logarithmic normalized halo profile. This proposed metric differentiated between IOL models, and linear regression analysis found strong correlations between AUC and subjective clinical ratings of halos. Conclusion The HDR system produced quantitative, preclinical metrics that correlated to patients’ subjective perception of halos.
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Affiliation(s)
| | | | | | - Xin Wei
- Alcon Research, Ltd., Fort Worth, TX, USA
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Through-Focus Vision Performance and Light Disturbances of 3 New Intraocular Lenses for Presbyopia Correction. J Ophthalmol 2018; 2018:6165493. [PMID: 29651343 PMCID: PMC5831879 DOI: 10.1155/2018/6165493] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 12/07/2017] [Accepted: 12/14/2017] [Indexed: 12/13/2022] Open
Abstract
Purpose To compare the through-focus visual performance in a clinical population of pseudophakic patients implanted with two new trifocal intraocular lenses (IOLs) and one extended depth of focus IOL. Methods Prospective, nonrandomized, examiner-masked case series. Twenty-three patients received the FineVision® and seven patients received the PanOptix™ trifocal IOLs. Fifteen patients received the Symfony extended depth of focus IOL. Mean age of patients was 63 ± 8 years. Through-focus visual acuity was measured from –3.00 to +1.00 D vergences. Contrast sensitivity was measured with and without a source of glare. Light disturbances were evaluated with the Light Distortion Analyzer. Results Though-focus evaluation showed that trifocal IOLs performed significantly better at near distance (33 and 40 cm), and extended depth of focus performed significantly better at intermediate distance (1.0 m). Contrast sensitivity function with glare and dysphotopsia was similar between the three IOLs and subjective response to questionnaire showed a significantly higher score (worse performance) for the extended depth of focus IOL compared to both trifocal IOLs in the bothersome subscale (p < 0.05). Conclusions Trifocal IOLs grant better performance at near distance while extended depth of focus IOL performs better at intermediate distance. Objective dysphotopsia measured with the Light Distortion Analyzer is not reduced in extended depth of focus IOL compared to trifocal IOLs.
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Alba-Bueno F, Garzón N, Vega F, Poyales F, Millán MS. Patient-Perceived and Laboratory-Measured Halos Associated with Diffractive Bifocal and Trifocal Intraocular Lenses. Curr Eye Res 2017; 43:35-42. [PMID: 29161162 DOI: 10.1080/02713683.2017.1379541] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To examine and assess the halos generated in distance vision by multifocal intraocular lenses (IOLs) using both in vitro objective and in vivo subjective methods. SETTING The objective method was carried out in the optics laboratory of the Applied Optics and Image Processing Group (Universitat Politècnica de Catalunya -Barcelona). The psychophysical and subjective methods were carried out in the Instituto de Oftalmología Avanzada Madrid Innova Ocular. DESIGN Optical bench results and prospective evaluation of consecutive cases. METHODS The IOLs examined were TECNIS®one-piece bifocals with addition powers of +4.00 D, +3.25 D, and +2.75 D and the trifocals AT-LISA-tri® and FineVision®. In the objective assessment, we examined halos around the far focus images of a pinhole formed by each IOL in an optical bench. For the in vivo study, we recruited 100 patients who had been bilaterally implanted one month earlier with the IOLs under study. Participants were subjected to psychophysical halometry (Halo v1.0) on the eye with better, distance-corrected, visual acuity and were required to subjectively grade halos by responding to the question "How much do halos bother you?" RESULTS The objective method revealed that the halo size increased with addition power and that the two trifocals gave rise to a double-halo pattern. Scores in the halometry also indicated a direct relationship between the halo size and addition power. The subjective results indicated fewer complaints about halos associated with the trifocal than bifocal IOLs. CONCLUSIONS The addition power of the tested IOLs affected both laboratory-measured and patient-perceived halos. Trifocal lenses generated fewer complaints about halos. Precise: Multifocal intraocular lenses (MIOLs) give rise to halos observed by patients under conditions of dim lighting. This study compares laboratory characterized halos generated by five MIOLs with patient-perceived halos.
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Affiliation(s)
- Francisco Alba-Bueno
- a Valles Ophthalmology Research (VOR) , Institute of Medical and Surgical Ophthalmology (OMIQ) , Barcelona , Spain.,b Applied Optics and Image Processing Group (GOAPI) , Universitat Politècnica de Catalunya (UPC BARCELONATECH) , Barcelona , Spain
| | | | - Fidel Vega
- b Applied Optics and Image Processing Group (GOAPI) , Universitat Politècnica de Catalunya (UPC BARCELONATECH) , Barcelona , Spain
| | | | - María S Millán
- b Applied Optics and Image Processing Group (GOAPI) , Universitat Politècnica de Catalunya (UPC BARCELONATECH) , Barcelona , Spain
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Abstract
PURPOSE The objective of this study was to evaluate, by halometry and under low illumination conditions, the effects of short-wavelength light absorbance filters on visual discrimination capacity in retinitis pigmentosa patients. METHODS This was an observational, prospective, analytic, and transversal study on 109 eyes of 57 retinitis pigmentosa patients with visual acuity better than 1.25 logMAR. Visual disturbance index (VDI) was determined using the software Halo 1.0, with and without the interposition of filters which absorb (totally or partially) short-wavelength light between 380 and 500 nm. RESULTS A statistically significant reduction in the VDI values determined using filters which absorb short-wavelength light was observed (p < 0.0001). The established VDIs in patients with VA logMAR <0.4 were 0.30 ± 0.05 (95% CI, 0.26-0.36) for the lens alone, 0.20 ± 0.04 (95% CI, 0.16-0.24) with the filter that completely absorbs wavelengths shorter than 450 nm, and 0.24 ± 0.04 (95% CI, 0.20-0.28) with the filter that partially absorbs wavelengths shorter than 450 nm, which implies a 20 to 33% visual discrimination capacity increase. In addition, a decrease of VDI in at least one eye was observed in more than 90% of patients when using a filter. CONCLUSIONS Short-wavelength light absorbance filters increase visual discrimination capacity under low illumination conditions in retinitis pigmentosa patients. Use of such filters constitutes a suitable method to improve visual quality related to intraocular light visual disturbances under low illumination conditions in this group of patients.
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Quality of vision, patient satisfaction and long-term visual function after bilateral implantation of a low addition multifocal intraocular lens. Int Ophthalmol 2017; 38:1709-1716. [PMID: 28718041 DOI: 10.1007/s10792-017-0652-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 07/06/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of the current study was to compare the quality of vision, contrast sensitivity and patient satisfaction with a biaspheric, segmented, rotationally asymmetric IOL (Lentis Comfort LS-313 MF 15-Oculentis GmbH, Berlin, Germany) as opposed to those of a monofocal IOL. METHODS This prospective single-blind comparative study included two groups of patients affected by bilateral senile cataract who underwent lens extraction and IOL implantation. The first group received a bilateral implantation of a monofocal IOL, and the second group received a bilateral implantation of the Comfort IOL. Twelve months after surgery uncorrected and corrected visual acuity at different distances (30, 50, 70 cm and 4 m), defocus curve and contrast sensitivity were assessed. Patient's satisfaction and spectacle independence were evaluated by mean of the NEI RQL-42 questionnaire. RESULTS No significant differences were found between the groups in terms of near vision. The group of patients implanted with a Comfort IOL obtained the best results at intermediate distances (50 and 70 cm P < .001). Both groups showed an excellent uncorrected distance visual acuity (4 m). No statistically significant differences were found in terms of corrected near, intermediate and distance visual acuity. Concerning contrast sensitivity, no statistically significant differences between the groups were observed at any cycles per degree. The NEI RQL-42 questionnaire showed statistically significant differences between the group for "near vision" (P = .015), "dependence on correction" (P = .048) and "suboptimal correction" (P < .001) subscales. CONCLUSION Our findings indicated that the Comfort IOL +1.5 D provides a good intermediate spectacle independence together with a high quality of vision, with a low amount of subjective symptoms and a contrast sensitivity similar to those obtained with a monofocal IOL.
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Breyer DRH, Kaymak H, Ax T, Kretz FTA, Auffarth GU, Hagen PR. Multifocal Intraocular Lenses and Extended Depth of Focus Intraocular Lenses. Asia Pac J Ophthalmol (Phila) 2017; 6:339-349. [PMID: 28780781 DOI: 10.22608/apo.2017186] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 07/26/2017] [Indexed: 12/18/2022] Open
Abstract
Presbyopia and cataract patients' desire for increased spectacle independence after surgery is one of the main drivers for the development of multifocal intraocular lenses (MIOLs) and extended depth of focus (EDOF) intraocular lenses (IOLs). As education, biometry, diagnostics, surgical techniques, and MIOL/EDOF IOL designs have improved over the past decade, an increasing number of cataract surgeons have become cataract-refractive surgeons to help address this need. There is not 1 single MIOL/EDOF IOL, however, that suits all patients' needs. The wide variety of MIOLs and EDOF IOLs, their optics, and their respective impact on our patients' quality of vision have to be fully understood to choose the appropriate IOL for each individual; MIOL/EDOF IOL surgery has to be customized. This review article looks at the different optical aspects and clinical consequences of MIOLs/EDOF IOLs to help surgeons find an appropriate solution for each of their individual patients.
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Affiliation(s)
| | - Hakan Kaymak
- Breyer, Kaymak, Klabe Augenchirurgie, Düsseldorf, Germany
| | - Timon Ax
- Breyer, Kaymak, Klabe Augenchirurgie, Düsseldorf, Germany
| | | | | | - Philipp R Hagen
- Internationale Innovative Ophthalmochirurgie GbR, Düsseldorf, Germany
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Nuzzi R, Tridico F. Comparison of visual outcomes, spectacles dependence and patient satisfaction of multifocal and accommodative intraocular lenses: innovative perspectives for maximal refractive-oriented cataract surgery. BMC Ophthalmol 2017; 17:12. [PMID: 28196497 PMCID: PMC5309975 DOI: 10.1186/s12886-017-0411-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 02/10/2017] [Indexed: 11/16/2022] Open
Abstract
Background The aim of this study was to evaluate visual outcomes for different working distances (far, 60 cm and 33 cm) and impact on vision quality of multifocal IOLs AcrySof ResTOR SN6AD1 and SN6AD3 (Alcon, Inc., Fort Worth, Texas, USA) as well as REVIEW FIL611PV multifocal and OPTOFLEX FIL618 accommodative IOLs (Soleko, Ltd., Rome, Italy) in patients undergoing bilateral phacoemulsification. Methods In this observational prospective study 63 patients undergoing binocular cataract surgery were divided into four groups for implantation of one of the IOLs under evaluation. Visual outcomes were evaluated at 1 day, 7 days, 1 month, 3 months and 6 months after surgery. Patients’ satisfaction and spectacle independence were evaluated with questionnaires administered at the 6-months follow-up. Results Improvements in visual acuity for the three working distances were statistically significant in all cases compared to the preoperative status, especially after binocular implantation. The AcrySof ReSTOR SN6AD1 multifocal IOL provided the best visual acuity results and tolerability for all working distances. While performing worse than SN6AD1, FIL611PV and FIL618 provided better uncorrected visual acuity and spectacles independence for intermediate/close-up and far distances respectively, in comparison with the SN6AD3 group. Conclusions SN6AD1 was confirmed the best choice for all working distances. However, FIL611PV IOL may represent a valid and more cost-effective alternative, especially if surgeons intend to prioritize spectacle independence and patient autonomy at intermediate and close-up distances, in accordance to specific needs and requests. Trial registration Trial retrospectively registered in ISRCTN Registry on 02/02/2017. TRN: ISRCTN14145737.
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Affiliation(s)
- Raffaele Nuzzi
- Institute of Ophthalmology, Department of Surgical Sciences, University of Turin, Via Juvarra 19, 10100, Turin, Italy. .,Unit of Ophthalmology, San Luigi Gonzaga University Hospital, University of Turin, Regione Gonzole 10, Orbassano, 10043, Turin, Italy.
| | - Federico Tridico
- Institute of Ophthalmology, Department of Surgical Sciences, University of Turin, Via Juvarra 19, 10100, Turin, Italy
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Das Lesevermögen nach Katarakt-Operation: Wie lesen Patienten mit multifokalen, akkommodierenden und monofokalen Intraokularlinsen? SPEKTRUM DER AUGENHEILKUNDE 2016. [DOI: 10.1007/s00717-016-0308-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Intraokulare Multifokallinsen. SPEKTRUM DER AUGENHEILKUNDE 2016. [DOI: 10.1007/s00717-016-0319-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Comparison of visual function after implantation of inferior sector-shaped intraocular lenses: low-add +1.5 D vs +3.0 D. Eur J Ophthalmol 2016; 26:607-611. [PMID: 27646332 DOI: 10.5301/ejo.5000771] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare visual function after implantation of multifocal Lentis comfort LS-313 MF 15 (group 1) or Lentis M plus LS-313 MF 30 (group 2) intraocular lenses (IOLs). METHODS Patients between 49 and 76 years of age who received monocular cataract surgery with multifocal IOL implantation were analyzed. Patients were evaluated preoperatively and for 5 months postoperatively for distance, intermediate, and near visual acuities, and static photopic and mesopic contrast sensitivity. A satisfaction questionnaire was administered 5 months after surgery. RESULTS Group 1 comprised 21 eyes and group 2 contained 34 eyes. Both groups had a statistically significant improvement in uncorrected and corrected distance visual acuities postoperatively (p<0.01). Uncorrected visual near acuity at 40 cm was better in group 2 (1 month: p = 0.013; 5 months: p = 0.051). Uncorrected intermediate visual acuity at 70 cm was better in group 1 (1 month: p = 0.060; 5 months: p = 0.044). No significant differences in contrast sensitivity were observed between the groups. Glare and halo symptoms were better in group 1 (glare: p = 0.044; halo: p = 0.029). CONCLUSIONS Inferior sector-shaped, near-addition IOLs with lower add powers (+1.5 D) provide good vision over longer working distances and show fewer glare and halo symptoms.
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Abstract
PURPOSE To evaluate whether an induced astigmatism influences the subjective depth of focus. METHODS Fifty-one participants aged 18 to 35 years and with a mean spherical equivalent refractive error of -0.51 ± 2.35 DS participated in the study. The accommodation was blocked with three drops of 1% cyclopentolate. Refractive errors were corrected after subjective refraction with a 4-mm artificial pupil. To evaluate the depth of focus (DoF), defocus curves with a spherical range of ±1.5 DS were assessed. The DoF was calculated as the horizontal distance at a threshold level of +0.1 logMAR from the maximum visual acuity (VA). Defocus curves were estimated binocularly during distance (500 cm) and a near vision (40 cm) for two induced axis (ATR in 0° and WTR in 90°) and for a fixed amount of astigmatic defocus of -0.5 DC. RESULTS The mean natural DoF was 0.885 ± 0.316 D for far vision and 0.940 ± 0.400 D for near vision. With induced astigmatism, the DoF for far vision was significantly increased to 1.095 ± 0.421 D (p = 0.006, ANOVA) for the WTR astigmatism but not for the ATR astigmatism (1.030 ± 0.395 D; p = 0.164, ANOVA). The induced WTR astigmatism enhanced the DoF for near vision significantly to 1.144 ± 0.338 D (p = 0.04, ANOVA), and DoF with induced ATR astigmatism (0.953 ± 0.318 D) was not significantly different (p = 1.00, ANOVA). ATR-astigmatism reduced VA by +0.08 ± 0.08 logMAR (p < 0.01, t-test). CONCLUSIONS With an induced WTR astigmatism of -0.5 DC, the DoF can be enhanced in the near viewing distance with a marginal loss in binocular VA. The approach of using induced WTR astigmatism can lead to novel optical treatments for presbyopia.
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Lee S, Choi M, Xu Z, Zhao Z, Alexander E, Liu Y. Optical bench performance of a novel trifocal intraocular lens compared with a multifocal intraocular lens. Clin Ophthalmol 2016; 10:1031-8. [PMID: 27330273 PMCID: PMC4898421 DOI: 10.2147/opth.s106646] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [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 purpose of this study is to compare the optical characteristics of the novel PanOptix presbyopia-correcting trifocal intraocular lens (IOL) and the multifocal ReSTOR +3.0 D IOL, through in vitro bench investigations. Methods The optical characteristics of AcrySof® IQ PanOptix™ (PanOptix) and AcrySof® IQ ReSTOR +3.0 D (ReSTOR +3.0 D) IOLs were evaluated by through-focus Badal images, simulated headlight images, and modulation transfer function (MTF) measurements which determine resolution, photic phenomena, and image quality. Through-focus Badal images of an Early Treatment of Diabetic Retinopathy Study chart were recorded at both photopic and mesopic pupil sizes. Simulated headlight images were taken on an MTF bench with a 50-μm pinhole target and a 5.0 mm pupil at the distance focus of the IOL. MTF curves were measured with a 3.0 mm pupil, and spatial frequencies equivalent to 20/40 and 20/20 visual acuities were recorded to illustrate the through-focus MTF curves. Far-, intermediate-, and near-focus MTF values were obtained. Results Bench Badal image testing and MTF measurements showed that PanOptix has a near focus at a distance of 42 cm and an additional intermediate focus at a distance of about 60 cm. The near focus for ReSTOR +3.0 D is at 45 cm. PanOptix and ReSTOR +3.0 D have comparable photopic distances and near MTF values. Additionally, PanOptix provided a substantial continuous range of vision from distance to intermediate and to near compared with ReSTOR +3.0 D. The halo propensity for PanOptix was slightly higher than that for ReSTOR +3.0 D. Conclusion Laboratory-based in vitro simulations showed that PanOptix trifocal IOL has comparable resolution and image quality performance in distance and near foci compared with ReSTOR +3.0 D IOL. PanOptix showed better resolution and image quality performance at the intermediate focus than ReSTOR +3.0 D IOL.
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Affiliation(s)
| | | | - Zaiwei Xu
- Alcon Research, Ltd., Fort Worth, TX, USA
| | - Zeyu Zhao
- Alcon Research, Ltd., Fort Worth, TX, USA
| | | | - Yueai Liu
- Alcon Research, Ltd., Fort Worth, TX, USA
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Alio JL, Simonov A, Plaza-Puche AB, Angelov A, Angelov Y, van Lawick W, Rombach M. Visual Outcomes and Accommodative Response of the Lumina Accommodative Intraocular Lens. Am J Ophthalmol 2016; 164:37-48. [PMID: 26829595 DOI: 10.1016/j.ajo.2016.01.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 01/08/2016] [Accepted: 01/23/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare visual acuity, accommodation, and contrast sensitivity of the AkkoLens Lumina accommodative intraocular lens (AkkoLens Clinical b.v., Breda, The Netherlands) with a standard monofocal intraocular lens (IOL). DESIGN Randomized clinical trial. METHODS The study enrolled 86 eyes with cataract that all required cataract surgery and IOL implantation. The study group included 61 eyes that were implanted with the Lumina. The control group included 25 eyes that were implanted with an Acrysof SA60AT (Alcon, Fort Worth, TX, USA) monofocal IOL. The distance and near visual acuities, contrast sensitivity, and accommodation were measured over a 1-year follow-up period. Accommodation was measured subjectively, using defocus curves, and objectively, with an open-field autorefractor. RESULTS Uncorrected (UDVA) and corrected (CDVA) distance visual acuities did not differ significantly between the groups (P ≥ .21) over the 12 months. However, the uncorrected near visual acuity (UNVA) was 0.07 ± 0.08 logRAD for the Lumina group and 0.37 ± 0.19 logRAD for the control group (P < .01) and the corrected distance near visual acuity (CDNVA) was 0.11 ± 0.12 LogRAD for the Lumina group and 0.41 ± 0.15 LogRAD for the control group (P < .01). Defocus curves showed a statistically significant difference between groups for defocus ranging from -4.50 to -0.50 diopters (D) (P < .01) with significantly higher visual acuities for the Lumina group. Subjective accommodation, as determined from defocus curves, was 3.05 ± 1.06, 3.87 ± 1.27, and 5.59 ± 1.02 D for the Lumina group and 1.46 ± 0.54, 2.00 ± 0.52, and 3.67 ± 0.75 D for the control group at visual acuities of 0.10, 0.20, and 0.4 logMAR for both groups, respectively. The objective accommodation, measured by an open-field autorefractor, was 0.63 ± 0.41, 0.69 ± 0.45, 0.91 ± 0.51, and 1.27 ± 0.76 D for the Lumina group and 0.10 ± 0.15, 0.12 ± 0.15, -0.06 ± 0.09 and 0.07 ± 0.10 D for the control group at accommodation stimuli of 2.0, 2.5, 3.0, and 4.0 D, respectively. Contrast sensitivity was the same for both groups (P ≥ .26). CONCLUSIONS The Lumina accommodative IOL effectively restores the visual function, accommodation, and contrast sensitivity after cataract surgery with no influence on the postoperative contrast sensitivity.
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Whitman J, Dougherty PJ, Parkhurst GD, Olkowski J, Slade SG, Hovanesian J, Chu R, Dishler J, Tran DB, Lehmann R, Carter H, Steinert RF, Koch DD. Treatment of Presbyopia in Emmetropes Using a Shape-Changing Corneal Inlay: One-Year Clinical Outcomes. Ophthalmology 2016; 123:466-75. [PMID: 26804761 DOI: 10.1016/j.ophtha.2015.11.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 10/02/2015] [Accepted: 11/06/2015] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To report 1-year safety and efficacy clinical outcomes of a shape-changing corneal inlay for the treatment of presbyopia. DESIGN Prospective, nonrandomized, multicenter United States Food and Drug Administration Investigational Device Exemption clinical trial (clinicaltrials.gov identifier, NCT01373580). PARTICIPANTS Nondominant eyes (N = 373) of emmetropic presbyopic subjects were implanted at 11 sites with the Raindrop Near Vision Inlay (ReVision Optics, Lake Forest, CA); 340 eyes underwent the 1-year follow-up visit. METHODS The corneal inlay was implanted under a corneal flap at the center of the light-constricted pupil created with a femtosecond laser. MAIN OUTCOME MEASURES For subjects completing the 1-year follow-up, monocular and binocular uncorrected and corrected visual acuity, refractive stability, contrast sensitivity (CS; photopic and mesopic), symptom and satisfaction questionnaire results, and adverse events. RESULTS At 1 year in the treated eye, on average, uncorrected near visual acuity (UNVA) improved by 5.1 lines, uncorrected intermediate visual acuity (UIVA) improved by 2.5 lines, and uncorrected distance visual acuity (UDVA) decreased by 1.2 lines. From 3 months through 1 year, 93% of subjects achieved UNVA of 20/25 or better, 97% achieve UIVA of 20/32 or better, and 95% achieved UDVA of 20/40 or better. Binocularly, the mean UDVA exceeded 20/20 from 3 months through 1 year. Contrast sensitivity loss occurred only at the highest spatial frequencies, with no loss binocularly. Absent or mild scores were reported in 96% of subjects for visual symptoms (glare, halos, double vision, and fluctuations in vision), in 99% for ocular symptoms (pain, light sensitivity, and discomfort), and in 95% for dryness. Adverse events were treatable and resolved. Eighteen inlays were replaced, usually soon after implantation because of decentration, but UNVA was little affected in this group thereafter. In the 11 cases requiring inlay explantations, 100% achieved a corrected distance visual acuity of 20/25 or better by 3 months after explant. CONCLUSIONS The Raindrop Near Vision Inlay provides significant improvement in near and intermediate visual performance, with no significant change in binocular distance vision or CS. Subject satisfaction is improved significantly with minimal ocular or visual symptoms.
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Affiliation(s)
| | | | | | | | | | | | - Ralph Chu
- Chu Vision Institute, Bloomington, Minnesota
| | - Jon Dishler
- Dishler Laser Institute, Greenwood Village, Colorado
| | - Dan B Tran
- Coastal Vision Laser Eye Center, Orange, California
| | | | | | - Roger F Steinert
- Gavin Herbert Eye Institute, University of California, Irvine, California
| | - Douglas D Koch
- Department of Ophthalmology, Baylor College of Medicine, Houston, Texas
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The Small-Aperture IC-8 Intraocular Lens: A New Concept for Added Depth of Focus in Cataract Patients. Am J Ophthalmol 2015; 160:1176-1184.e1. [PMID: 26299536 DOI: 10.1016/j.ajo.2015.08.017] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 08/13/2015] [Accepted: 08/13/2015] [Indexed: 11/21/2022]
Abstract
PURPOSE To evaluate visual performance of subjects implanted monocularly with a small-aperture hydrophobic intraocular lens (IC-8 IOL). DESIGN A prospective, noncomparative, multicenter case series. METHODS A series of 12 patients, presenting for cataract surgery, were implanted monocularly with a single-piece hydrophobic acrylic intraocular with a centrally located opaque annular mask measuring 3.23 mm in total diameter with a 1.36 mm central aperture. Uncorrected distance, intermediate, and near visual acuities (UDVA, UIVA, and UNVA); depth of focus; and subjective symptoms were evaluated for 12 months after implantation. Mean ± standard deviation visual acuity is reported in logMAR. RESULTS The mean monocular UDVA, UIVA, and UNVA improved significantly from 0.42 ± 0.18, 0.52 ± 0.22 and 0.66 ± 0.23 preoperatively to 0.06 ± 0.08 (P < .0001), 0.07 ± 0.11 (P < .0001), and 0.11 ± 0.15 (P < .0001) at 1 month, respectively, and remained stable until 12 months. At 12 months, 100%, 100%, and 92% of patients achieved 20/32 or better binocularly for UDVA, UIVA, and UNVA, respectively. One hundred percent of eyes maintained 20/40 or better visual acuity over a range of +0.50 diopter to -1.50 diopters of defocus. Subjects implanted with the IC-8 IOL perceived a small magnitude of visual symptoms and rated their symptoms on the lower end of the severity scale. CONCLUSION Early results demonstrate that monocular IC-8 intraocular lens implantation provides a continuous, broad range of vision and excellent acuity across all focal distances.
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Kim JS, Jung JW, Lee JM, Seo KY, Kim EK, Kim TI. Clinical Outcomes Following Implantation of Diffractive Multifocal Intraocular Lenses With Varying Add Powers. Am J Ophthalmol 2015. [PMID: 26209232 DOI: 10.1016/j.ajo.2015.07.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To compare clinical outcomes after implantation of TECNIS diffractive multifocal intraocular lenses (IOLs) with different add powers. DESIGN Prospective, comparative, interventional case series. METHODS Subjects underwent cataract extraction and diffractive multifocal IOL implant. Subjects had an additional add power of +2.75 diopters (D) (Group 1, 23 eyes), +3.25 D (Group 2, 21 eyes), or +4.00 D (Group 3, 21 eyes). Evaluations were performed 1 and 3 months following cataract surgery, including measurement of monocular uncorrected distance visual acuity (UDVA), refractive error (manifest refraction [MR]), and monocular uncorrected near visual acuity (UNVA) at 33, 40, and 50 cm. At 3 months, internal aberrations and contrast sensitivity were evaluated and subjects completed a questionnaire on outcomes satisfaction, visual symptoms, and spectacle use. RESULTS Sixty-five eyes (43 subjects) were included. After surgery, no significant differences between groups were observed in UDVA and MR values. UNVA at 33 cm was best in Group 3 (1 month: P = .032; 3 months: P = .031). Three months after surgery, UNVA was best in Group 1 at 50 cm (P = .017). No significant differences in internal aberration and contrast sensitivity were observed between groups and surgical satisfaction was worst in Group 3 (P = .001). A total of 87.0%, 85.7%, and 76.9% had spectacle independence in Groups 1, 2, and 3, respectively (P = .080). CONCLUSIONS TECNIS diffractive multifocal IOLs with lower add powers provide good vision over longer working distances and excellent distant vision. Subjects with lower add power had greater satisfaction, more spectacle independence, and fewer visual symptoms than those with +4.00 D add.
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Ferreira-Neves H, Macedo-de-Araújo R, Rico-Del-Viejo L, da-Silva AC, Queirós A, González-Méijome JM. Validation of a method to measure light distortion surrounding a source of glare. JOURNAL OF BIOMEDICAL OPTICS 2015; 20:75002. [PMID: 26146877 DOI: 10.1117/1.jbo.20.7.075002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 05/04/2015] [Indexed: 06/04/2023]
Abstract
Our objective was to validate a new device dedicated to measure the light disturbances surrounding bright sources of light under different sources of potential variability. Twenty subjects were involved in the study. Light distortion was measured using an experimental prototype (light distortion analyzer, CEORLab, University of Minho, Portugal) comprising twenty-four LED arrays panel at 2 m. Sources of variability included: intrasession and intersession repeated measures, pupil size (3 versus 6 mm), defocus (+0.50 ) correction for the working distance, angular resolution (15 deg versus 30 deg), temporal stimuli presentation, and pupil size. Size, shape, location, and irregularity parameters have been obtained. At a low speed of presentation of the stimuli, changes in angular resolution did not have an effect on the results of the parameters measured. Results did not change with pupil size. Intensity of the central glare source significantly influenced the outcomes. Examination time was reduced by 30% when a 30 deg angular resolution was explored instead of 15 deg. Measurements were fast and repeatable under the same experimental conditions. Size and shape parameters showed the highest consistency, whereas location and irregularity parameters showed lower consistency. The system was sensitive to changes in the intensity of the central glare source but not to pupil changes in this sample of healthy subjects
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Plaza-Puche AB, Alió JL, MacRae S, Zheleznyak L, Sala E, Yoon G. Correlating Optical Bench Performance With Clinical Defocus Curves in Varifocal and Trifocal Intraocular Lenses. J Refract Surg 2015; 31:300-7. [DOI: 10.3928/1081597x-20150423-03] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 02/24/2015] [Indexed: 11/20/2022]
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Hayashi K, Ogawa S, Manabe SI, Hirata A. Visual outcomes in eyes with a distance-dominant diffractive multifocal intraocular lens with low near addition power. Br J Ophthalmol 2015; 99:1466-70. [DOI: 10.1136/bjophthalmol-2014-306476] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 03/27/2015] [Indexed: 11/04/2022]
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Implantation of refractive multifocal intraocular lens with a surface-embedded near section for cataract eyes complicated with a coexisting ocular pathology. Eye (Lond) 2015; 29:649-55. [PMID: 25744442 DOI: 10.1038/eye.2015.12] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 12/24/2014] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To evaluate the postoperative outcomes of cataract eyes complicated with coexisting ocular pathologies that underwent implantation of a refractive multifocal intraocular lens (MIOL) with a surface-embedded near section. METHODS LENTIS MPlus (Oculentis GmbH) refractive MIOLs were implanted in 15 eyes with ocular pathologies other than cataract (ie, six high-myopia eyes with an axial length longer than 28 mm, two fundus albipunctatus eyes, two branch retinal-vein occlusion eyes, four glaucoma eyes (one with high myopia), and two keratoconus eyes). Uncorrected or corrected distance and near visual acuity (VA) (UDVA, UNVA, CDVA, and CNVA), contrast sensitivity, and defocus curve were measured at 1 day and 6 months postoperatively, and each patient completed a 6-month postoperative questionnaire regarding vision quality and eyeglass use. RESULTS Thirteen eyes (87%) registered 0 or better in CDVA and 12 eyes (73%) registered better than 0 in CNVA. Contrast sensitivity in the eyes of all patients was comparable to that of normal healthy subjects. No patient required eyeglasses for distance vision, but three patients (20%) required them for near vision. No patient reported poor or very poor vision quality. CONCLUSION With careful case selection, sectorial refractive MIOL implantation is effective for treating cataract eyes complicated with ocular pathologies.
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Oh JJ, Choi JS. Clinical Results and Optical Quality of Diffractive Multifocal Intraocular Lens. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.12.1867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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