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Singh B, Sharma S, Bharti N, Samantrey D, Paandey DJ, Bharti S. Visual and refractive outcomes of new intraocular lens implantation after cataract surgery. Sci Rep 2022; 12:14100. [PMID: 35982071 PMCID: PMC9388624 DOI: 10.1038/s41598-022-14315-6] [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: 12/07/2021] [Accepted: 06/06/2022] [Indexed: 11/25/2022] Open
Abstract
To report the visual and refractive outcomes of new aspheric hydrophobic acrylic monofocal intraocular lens (IOL). Retrospective case series. This study included eyes of patients who underwent routine cataract surgery for uncomplicated age-related cataract with implantation of a Aktis SP (NS-60YG; Nidek Co. Ltd., Japan) IOL and attended regular follow ups at 1 week, 1 month, 3 months, and 12 months. At each post-operative visit, ophthalmological evaluation included measurement Uncorrected (UCVA) and Best corrected visual acuity (BCVA), contrast sensitivity, posterior capsular opacification (PCO), optical aberrations, analysis of point spread function (PSF) and modulation transfer function (MTF). The study included 2102 eyes of 1358 patients aged 45 to 75 years (mean age 62.6 years ± 5.6 SD). The mean preoperative BCVA was 0.56 ± 0.26 logMAR. At 1 year follow up, the mean postoperative UCVA and BCVA were 0.11 ± 0.09 and 0.02 ± 0.03 logMAR, respectively. At the end of 6 months, around 1487 (93%) eyes had BCVA of 20/20 and better than 20/30 in 100% of the eyes. Mild posterior capsule opacification (PCO) was observed in 56 patients, but none required Nd YAG laser capsulotomy. There was reduction in ocular spherical aberration and Higher order aberrations (HOAs) as compared to pre operative. This explains better contrast sensitivity obtained by MTF and PSF values. The study shows that the Aktis SP IOL is safe, effective, and stable lens that could be inserted through 2.2 mm incision with satisfactory visual and refractive outcomes, even in late post-operative period.
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Affiliation(s)
| | | | - Neha Bharti
- Bharti Eye Center and Foundation, New Delhi, India
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Clinical and Aberrometric Evaluation of a New Monofocal IOL with Intermediate Vision Improvement. J Ophthalmol 2022; 2022:4119698. [PMID: 35847352 PMCID: PMC9282993 DOI: 10.1155/2022/4119698] [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: 08/19/2021] [Revised: 05/22/2022] [Accepted: 05/25/2022] [Indexed: 11/22/2022] Open
Abstract
Purpose The aim of the study was to evaluate the visual outcomes, aberrometric results, and subjective and objective optical qualities 12 months after implantation of a new monofocal intraocular lens (Physiol IsoPure 1.2.3) in comparison with a standard monofocal intraocular lens (Tecnis PCB00). Materials and Methods Cataract patients without ocular comorbidities had bilateral implantation of the IsoPure IOL or the PCB00 IOL. One month after eye surgery, the visual acuity and monocular defocus curve were assessed. Twelve months after surgery, the visual acuity, binocular defocus curve, contrast sensitivity, and subjective/objective optical quality were assessed. Furthermore, wavefront analysis was performed. The primary endpoint was the best distance correct/uncorrected visual acuity at intermediate and far distances. The secondary endpoint was an aberration evaluation of the IOLs and contrast sensitivity. Results The study comprised a total of 42 patients (84 eyes). Monocular and binocular uncorrected and corrected distance were similar between groups, and uncorrected intermediate visual acuity was significantly higher in the IsoPure group. There was no difference in contrast sensitivity and subjective and objective optical qualities. The optical aberrations at 3.0 and 5.0 mm aperture diameters were similar in both groups. Conclusion The IsoPure IOL, based on greater depth of focus than the aspheric monofocal IOL, may offer a good option for the distance and intermediate vision without increasing optical aberrations and any photic phenomena.
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Liu Y, Zhao J, Hu Y, Li B, Wang J, Zhang J. Comparison of the Visual Performance after Implantation of Three Aberration-correcting Aspherical Intraocular Lens. Curr Eye Res 2020; 46:333-340. [PMID: 32935593 DOI: 10.1080/02713683.2020.1798467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To compare the visual performance after implantation of three aberration-correcting aspherical intraocular lens (IOL). MATERIALS AND METHODS Seventy-seven eyes of 77 cataract patients were divided into three groups: 26 eyes implanted with a non-constant aberration IOL (LUCIA 601P IOL, Zeiss Company, Germany); 26 eyes implanted with a spherical aberration -0.18μm IOL (CT ASPHINA 509M, Zeiss Company, Germany) and 27 eyes implanted with a spherical aberration -0.27μm IOL (AMO Tecnis ZCB00, Johnson & Johnson Surgical Vision, USA). Three months after operation, the distance visual acuity, wavefront aberrometry, contrast sensitivity, intraocular stray light, IOL decentration, and tilt were evaluated. RESULTS Three months postoperatively, no statistically significant differences were found in uncorrected distance visual acuity and corrected distance visual acuity (p≥.83). The RMS for total ocular coma was statistically significantly lower in the Lucia group (p=.03) and spherical aberration was statistically significantly lower in the Tecnis group (p<.01). No statistically significant differences were observed among the three lenses in higher order aberration (p=.85) and in contrast sensitivity under both photopic and mesopic lighting conditions (p≥.05). The intraocular stray light was statistically significantly better in the Lucia group (p=.04). No statistically significant differences were observed with respect to IOL decentration (p=.75) and tilt (p=.89). CONCLUSIONS Cataract surgery with non-constant aberration IOL resulted in lower coma and better intraocular stray light than with the spherical aberration -0.18μm and -0.27μm IOLs despite equivalent postoperative levels of visual acuity and contrast sensitivity.
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Affiliation(s)
- Yuqi Liu
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University and the Key Lenticular Laboratory of Liaoning Province , Shenyang, China
| | - Jiangyue Zhao
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University and the Key Lenticular Laboratory of Liaoning Province , Shenyang, China
| | - Yiping Hu
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University and the Key Lenticular Laboratory of Liaoning Province , Shenyang, China
| | - Bowen Li
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University and the Key Lenticular Laboratory of Liaoning Province , Shenyang, China
| | - Jing Wang
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University and the Key Lenticular Laboratory of Liaoning Province , Shenyang, China.,Department of Ophthalmology, Shenyang Aier Excellence Eye Hospital , Shenyang, China
| | - Jinsong Zhang
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University and the Key Lenticular Laboratory of Liaoning Province , Shenyang, China.,Department of Ophthalmology, Shenyang Aier Excellence Eye Hospital , Shenyang, China
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Abstract
AIM To review the use of clinical corneal sealants for the closure of full thickness corneal wounds. METHODS A systematic review was conducted across CENTRAL, Medline, PubMed, Embase, Scopus, mRCT and ICTRP for the keywords of 'cornea', 'full-thickness wound', 'sealant' and their synonyms. Only evidence level 2 of higher as graded by Oxford Centre of Evidence-based Medicine were included for this review. RESULTS Seven studies were included; three randomized controlled trials investigated ReSure® sealant, 2 OcuSeal®, 1 human fibrin glue vs cyanoacrylate and 1 human fibrin glue as an adjunct to sutures vs sutures alone in penetrating keratoplasty. ReSure® was superior to suture for sealing leaking corneal incisions after cataract surgery despite provocation. ReSure® sealant has not been tested on complex full thickness corneal wounds, perforated ulcers or penetrating keratoplasty. OcuSeal® was also able to seal full thickness cornea wound post-cataract surgery to prevent ingress of Trypan blue dye. Human fibrin glue and cyanoacrylate were similarly effective in treating corneal perforations <3 mm of mixed etiologies. CONCLUSION There are limited high-level evidence for corneal sealants. The currently available sealants with human data are ReSure®, OcuSeal®, human fibrin glue and cyanoacrylates. While ReSure® and OcuSeal® are effective post-cataract surgery, there are no data for perforations from other etiologies. Post-approval data from ReSure® registry report good tolerability and no apparent safety concerns.
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Affiliation(s)
- Jackie Tan
- Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, The University of Sydney , Sydney, New South Wales, Australia
| | - Leslie John Ray Foster
- Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, The University of Sydney , Sydney, New South Wales, Australia.,Bio/polymers Research Group, Department of Chemistry, The University of Alabama in Huntsville , Huntsville, USA
| | - Stephanie Louise Watson
- Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, The University of Sydney , Sydney, New South Wales, Australia
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He Q, Huang J, Xu Y, Han W. Changes in total, anterior, and posterior corneal surface higher-order aberrations after 1.8 mm incision and 2.8 mm incision cataract surgery. J Cataract Refract Surg 2019; 45:1135-1147. [DOI: 10.1016/j.jcrs.2019.02.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 12/02/2018] [Accepted: 02/23/2019] [Indexed: 11/29/2022]
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Cavallini GM, Verdina T, De Maria M, Fornasari E, Torlai G, Volante V, Donati S, Cagini C. Bimanual microincision cataract surgery with implantation of the new Incise ® MJ14 intraocular lens through a 1.4 mm incision. Int J Ophthalmol 2017; 10:1710-1715. [PMID: 29181315 DOI: 10.18240/ijo.2017.11.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 07/18/2017] [Indexed: 11/23/2022] Open
Abstract
AIM To analyze the visual outcomes and the posterior capsule opacification (PCO) with the new Incise® MJ14 intraocular lens (IOL) implanted through a 1.4 mm clear corneal incision (CCI) in patients who underwent bimanual microincision cataract surgery (B-MICS). METHODS Eighty eyes which underwent cataract surgery using B-MICS technique performed by the same experienced surgeon were included in the study: 40 eyes were implanted with an Incise® MJ14 IOL through a 1.4 mm CCI (group A) without enlargement of the main CCI, while 40 eyes were implanted with an Akreos® MI60 IOL with enlargement of the main CCI to 1.8 mm (group B). Best corrected visual acuity (BCVA), astigmatism and endothelial cell loss were evaluated before and after surgery at 7, 30d and 6mo. Anterior segment-optical coherence tomography (AS-OCT) of CCI was performed at 1, 3, 7, 30d, 6 and 18mo. PCO incidence was evaluated at 18mo using EPCO 2000 Software. RESULTS Mean BCVA improvement and endothelial cell loss were statistically significant at 18mo in both groups with no difference between the two groups; no statistically significant difference in surgically induced astigmatism (SIA) was noticed in the two groups. At AS-OCT the only significant alterations in the CCI were endothelial gaping and local detachment of Descemet's membrane at 1 and 7d after surgery; no statistically significant alterations were found at 1, 6 and 18mo. PCO score at 18mo was 0.03±0.07 for group A and 0.08±0.18 for group B (P=0.11) with no sign of central optic plate invasion in both groups. CONCLUSION The implant of the new Incise® MJ14 IOL through a 1.4 mm CCI and B-MICS technique appeared to be a safe and effective procedure with rapid visual recovery. PCO rate resulted very low and the CCI presented few morphological alterations which were only detectable in the first days postoperatively and achieved fast corneal healing during the long-term follow-up.
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Affiliation(s)
| | - Tommaso Verdina
- Institute of Ophthalmology, University of Modena, Modena 41100, Italy
| | - Michele De Maria
- Institute of Ophthalmology, University of Modena, Modena 41100, Italy
| | - Elisa Fornasari
- Institute of Ophthalmology, University of Modena, Modena 41100, Italy
| | - Giulio Torlai
- Institute of Ophthalmology, University of Modena, Modena 41100, Italy
| | - Veronica Volante
- Institute of Ophthalmology, University of Modena, Modena 41100, Italy
| | - Simone Donati
- Department of Surgical and Morphological Sciences, Section of Ophthalmology, University of Insubria, Varese-Como 21100, Italy
| | - Carlo Cagini
- Department of Surgical and Biomedical Sciences, University of Perugia, S. Maria della Misericordia Hospital, Perugia 06123, Italy
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Jin C, Chen X, Law A, Kang Y, Wang X, Xu W, Yao K. Different-sized incisions for phacoemulsification in age-related cataract. Cochrane Database Syst Rev 2017; 9:CD010510. [PMID: 28931202 PMCID: PMC5665700 DOI: 10.1002/14651858.cd010510.pub2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Age-related cataract is the principal cause of blindness and visual impairment in the world. Phacoemulsification is the main surgical procedure used to treat cataract. The comparative effectiveness and safety of different-sized incisions for phacoemulsification has not been determined. OBJECTIVES The aim of this systematic review was to assess the effectiveness and safety of smaller versus larger incisions for phacoemulsification in age-related cataract. The primary outcome of this review was surgically induced astigmatism at three months after surgery. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 10), MEDLINE Ovid (1946 to 28 October 2016), Embase Ovid (1947 to 28 October 2016), PubMed (1948 to 28 October 2016), LILACS (Latin American and Caribbean Health Sciences Literature Database) (1982 to 28 October 2016), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com; last searched 13 May 2013), ClinicalTrials.gov (www.clinicaltrials.gov; searched 28 October 2016), and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp; searched 28 October 2016). We did not use any date or language restrictions in the electronic searches for trials. SELECTION CRITERIA We included randomized controlled trials (RCTs) comparing different-sized incisions in people with age-related cataract undergoing phacoemulsification. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS We included 26 RCTs with a total of 2737 participants (3120 eyes). These trials were conducted in Bosnia and Herzegovina, China, France, India, Italy, Korea, Spain, Switzerland, and Turkey. Half of the 26 trials were conducted in China. We judged all trials as mostly at unclear to low risk of bias. The included RCTs compared four different-sized incisions:<= 1.5 mm, 1.8 mm, 2.2 mm, and approximately 3.0 mm. These incisions were performed using three different techniques: coaxial and biaxial microincision phacoemulsification (C-MICS and B-MICS) and standard phacoemulsification. Not all studies provided data in a form that could be included in this review. Five studies had three arms.Fifteen trials compared C-MICS (2.2 mm) with standard phacoemulsification (about 3.0 mm). Very low-certainty evidence suggested less surgically induced astigmatism in the C-MICS group at three months compared with standard phacoemulsification (mean difference (MD) -0.19 diopters (D), 95% confidence interval (CI) -0.30 to -0.09; 996 eyes; 8 RCTs). There was low-certainty evidence that both groups achieved similar best-corrected visual acuity (MD 0.00 logMAR, 95% CI -0.02 to 0.02; 242 eyes; 3 RCTs). There was low-certainty evidence of little or no difference in endothelial cell loss and central corneal thickness comparing C-MICS with standard phacoemulsification (MD -7.23 cells/mm2, 95% CI -78.66 to 64.20; 596 eyes; 4 RCTs) and (MD -0.68 μm, 95% CI -3.26 to 1.90; 487 eyes; 5 RCTs).Nine trials compared C-MICS (1.8 mm) with standard phacoemulsification (about 3.0 mm). Very low-certainty evidence suggested less astigmatism at three months in the C-MICS group compared with standard phacoemulsification group (MD -0.23 D, 95% CI -0.34 to -0.13; 561 eyes; 5 RCTs). Low-certainty evidence suggested little or no difference in best-corrected visual acuity, endothelial cell loss, and central corneal thickness in the two groups at three months (MD -0.02 logMAR, 95% CI -0.03 to -0.00; 192 eyes; 3 RCTs), (MD 7.56 cells/mm2, 95% CI -67.65 to 82.77; 380 eyes; 5 RCTs), and (MD -1.52 μm, 95% CI -6.29 to 3.25; 245 eyes; 3 RCTs).Six studies compared C-MICS (1.8 mm) with C-MICS (2.2 mm). There was low-certainty evidence that astigmatism, visual acuity, and central corneal thickness were similar in the two groups at three months (MD 0.04 D, 95% CI -0.09 to 0.16; 259 eyes; 3 RCTs), (MD 0.01 logMAR, 95% CI -0.01 to 0.04; 200 eyes; 3 RCTs), and (MD 0.45 μm, 95% CI -2.70 to 3.60; 100 eyes; 1 RCT). Very low-certainty evidence suggested higher endothelial cell loss in the 1.8 mm group (MD 213.00 cells/mm2, 95% CI 11.15 to 414.85; 70 eyes; 1 RCT).Four studies compared B-MICS (<= 1.5 mm) with standard phacoemulsification (about 3.0 mm). Astigmatism was similar in the two groups at three months (MD -0.01 D, 95% CI -0.03 to 0.01; 368 eyes; 2 RCTs; moderate-certainty evidence). There was low-certainty evidence on visual acuity, suggesting little or no difference between the two groups (MD -0.02 logMAR, 95% CI -0.04 to -0.00; 464 eyes; 3 RCTs). Low-certainty evidence on endothelial cell loss and central corneal thickness also suggested little or no difference between the two groups (MD 55.83 cells/mm2, 95% CI -34.93 to 146.59; 280 eyes; 1 RCT) and (MD 0.10 μm, 95% CI -14.04 to 14.24; 90 eyes; 1 RCT).None of the trials reported on quality of life. One trial reported that no participants experienced endophthalmitis or posterior capsule rupture; they also reported little or no difference between incision groups regarding corneal edema (risk ratio 1.02, 95% CI 0.40 to 2.63; 362 eyes). AUTHORS' CONCLUSIONS Phacoemulsification with smaller incisions was not consistently associated with less surgically induced astigmatism compared with phacoemulsification with larger incisions. Coaxial microincision phacoemulsification may be associated with less astigmatism than standard phacoemulsification, but the difference was small, in the order of 0.2 D, and the evidence was uncertain. Safety outcomes and quality of life were not adequately reported; these should be addressed in future studies.
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Affiliation(s)
- Chongfei Jin
- Eye Center of the Second Affiliated Hospital, Medical College of Zhejiang University88 Jiefang RoadHangzhouChina310009
- National Eye Institute, National Institutes of HealthOphthalmic Genetics and Visual Function Branch5635 Fishers LaneRockvilleMarylandUSA20852
- Brookdale University Hospital and Medical CenterDepartment of Internal MedicineOne Brookdale PlazaBrooklynNew YorkUSA11212
| | - Xinyi Chen
- Eye Center of the Second Affiliated Hospital, Medical College of Zhejiang University88 Jiefang RoadHangzhouChina310009
| | - Andrew Law
- Johns Hopkins Bloomberg School of Public HealthDepartment of Epidemiology615 N. Wolfe StreetBaltimoreMarylandUSA21205
| | - Yunhee Kang
- Johns Hopkins Bloomberg School of Public HealthInternational Health DepartmentBaltimoreMarylandUSA
| | - Xue Wang
- Johns Hopkins Bloomberg School of Public HealthDepartment of Epidemiology615 N. Wolfe StreetBaltimoreMarylandUSA21205
| | - Wen Xu
- Eye Center of the Second Affiliated Hospital, Medical College of Zhejiang University88 Jiefang RoadHangzhouChina310009
| | - Ke Yao
- Eye Center of the Second Affiliated Hospital, Medical College of Zhejiang University88 Jiefang RoadHangzhouChina310009
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Bimanual Microincision Cataract Surgery versus Coaxial Microincision Cataract Surgery: A Meta-Analysis of Randomized Controlled Trials and Cohort Studies. J Ophthalmol 2017; 2017:3737603. [PMID: 28912968 PMCID: PMC5587976 DOI: 10.1155/2017/3737603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 07/24/2017] [Indexed: 11/17/2022] Open
Abstract
PURPOSE This meta-analysis was conducted to compare the intraoperative and postoperative outcomes of bimanual microincision cataract surgery (B-MICS) and coaxial microincision cataract surgery (C-MICS). METHODS Three databases were searched for papers that compared B-MICS and C-MICS from inception to June 2016. The following intraoperative and postoperative outcomes were included in the final meta-analysis: ultrasound time (UST), effective phacoemulsification time (EPT), balanced salt solution use (BSS use), mean surgery time, best-corrected visual acuity (BCVA), central corneal thickness (CCT), and increased CCT. RESULTS There were no statistically significant differences in mean surgery time, UST, BSS use, BCVA, CCT, or increased CCT (one subgroup at postoperative day 7-8 and another subgroup at postoperative day 30). However, there was less EPT needed during surgery (p < 0.01) and lower levels of increased CCT at postoperative day 1 (p = 0.02) in the B-MICS group compared with the C-MICS group. CONCLUSIONS The EPT was shorter and increased CCT was less at postoperative day 1 in the B-MICS group. There were no statistically significant differences in other intraoperative and postoperative outcomes between the B-MICS group and the C-MICS group. B-MICS is an efficient and safe cataract surgery procedure.
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Lubiński W, Kirkiewicz M, Podborączyńska-Jodko K. Clinical results after microincision biaxial cataract surgery and implantation of an Incise intraocular lens. Int Ophthalmol 2017; 38:1977-1983. [PMID: 28803418 PMCID: PMC6153898 DOI: 10.1007/s10792-017-0686-0] [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: 04/18/2017] [Accepted: 08/07/2017] [Indexed: 10/30/2022]
Abstract
PURPOSE To evaluate clinical outcomes after uncomplicated microincision biaxial cataract surgery and implantation of Incise intraocular lens (IOL). METHODS This study included 47 eyes of 29 patients (mean age 62.2 ± 8.6 years), who underwent 1.4-mm biaxial cataract surgery with implantation of the Incise IOL (Bausch and Lomb). At third month, surgically induced astigmatism (SIA) was calculated. Three, 6 and 12 months postoperatively, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), corrected near visual acuity (CNVA) LogMAR ETDRS, spherical equivalent refraction (SER), photopic distance corrected contrast sensitivity (CS) with and without glare (85 cd/m2) (CSV-1000) were assessed. One year after surgery, late complications were assessed and subjects were questioned for subjective symptoms. RESULTS Mean of SIA was equal 0.29 ± 0.16 D. Three months postoperatively: mean UDVA improved from 0.83 to 0.04 (p < 0.001), CDVA from 0.58 to -0.05 (p < 0.001) and CNVA from 0.58 to -0.02 (p < 0.001) and all were stable during 1-year follow-up. Three months postoperatively, the mean SER was equal 0.07 ± 0.61 D and was within ±0.5 D in 79%, and within 1 D in 88% of eyes. During follow-up period, corrected CS with and without glare for distance was found to be within normal limits. The only late complication was posterior capsule opacification (PCO). Subjective quality of vision was very high; none of patients complained about glare. CONCLUSIONS Biaxial cataract surgery with implantation of the Incise IOL provided excellent clinical outcomes by minimizing SIA, stable refraction and low incidence of PCO.
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Affiliation(s)
- Wojciech Lubiński
- Clinic of Ophthalmology, Pomeranian Medical University, al. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland.
| | - Marta Kirkiewicz
- Clinic of Ophthalmology, Pomeranian Medical University, al. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland
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Corneal Higher-Order Aberrations after Phacoemulsification: A Comparison of 3 Different Incision Sizes. Eur J Ophthalmol 2016; 27:402-406. [DOI: 10.5301/ejo.5000881] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2016] [Indexed: 11/20/2022]
Abstract
Purpose To analyze the impact of different incision sizes for phacoemulsification on corneal higher-order aberrations (HOA). Methods Patients seeking cataract surgery were randomly assigned to one of the following groups: 1.4 mm with biaxial microincision phacoemulsification (25 eyes), 1.8 mm with coaxial phacoemulsification (27 eyes), and 2.2 mm with coaxial phacoemulsification (62 eyes). Inclusion criteria were a minimum age of 18 years and uncomplicated cataract. Exclusion criteria were history of ocular trauma or intraocular surgery, any sign of inflammation or infection, pseudoexfoliation syndrome, glaucoma, optic atrophy, diabetic retinopathy, lens dislocation, cataracta intumescens, cataracta matura, and corneal diseases. Patients underwent phacoemulsification with implantation of an intraocular lens. Aberrometry was performed using an iTrace aberrometer with a pupil scan size of 5.0 mm preoperatively and at postoperative follow-up visits after 1 month. The paired sample t test and analysis of covariance were used for statistical analysis. Results Ninety patients (114 eyes) were enrolled (mean age 73.7 ± 8.9 years). In all groups, an increase of total HOAs could be measured. The strongest increase was seen in the 2.2 mm group (mean difference 0.031 [95% confidence interval (CI) 0.006-0.056], p = 0.014) and in the 1.4 mm group (mean difference 0.035 [95% CI -0.007 to 0078], p = 0.097). No important difference was found in the 1.8 mm group. Conclusions The 2.2 mm and the 1.4 mm incisions seem to have a higher impact on corneal HOAs in comparison to the 1.8 mm incision.
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Toygar B, Yabas Kiziloglu O, Toygar O, Hacimustafaoglu AM. Early clinical outcome with a new monofocal microincision intraocular lens. Int Ophthalmol 2016; 36:657-64. [PMID: 26780097 DOI: 10.1007/s10792-016-0178-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 01/05/2016] [Indexed: 10/22/2022]
Abstract
The purpose of this study was to evaluate the early visual and refractive outcomes of a new aspheric monofocal microincision intraocular lens (IOL). This retrospective case series included eyes of patients who underwent implantation of a microincision IOL following 1.8 mm manual coaxial microincision cataract surgery and who attended regular postoperative follow-up visits on the first week and first, third, and sixth months. The postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refraction and predictability, intraoperative and postoperative complications, posterior capsule opacification (PCO), IOL centration, and surgically induced astigmatism (SIA) were evaluated. Sixty-three eyes of 38 patients ranging in age from 51 to 86 were included in the study. The mean preoperative BCVA was 0.52 ± 0.42 logMAR. At the postoperative sixth month, the mean postoperative UCVA and BCVA were 0.12 ± 0.11 and 0.01 ± 0.03 logMAR, respectively. The mean postoperative spherical equivalent refraction (SER) was -0.30 ± 0.49 D. The SER was within ± 1.00 D of the attempted correction in 95.2 % of the eyes. The mean SIA measured with vector analysis was 0.45 ± 0.28 D. Mild PCO was observed in 9 eyes (14.7 %) with none requiring Nd:Yag laser capsulotomy. On centration analysis, the IOL was found to be 0.26 mm on average to the supero-nasal position. The aspheric microincision IOL was safely implanted and provided satisfactory visual and refractive outcomes in the early postoperative period.
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Affiliation(s)
- Baha Toygar
- Faculty of Medicine, Department of Ophthalmology, Bahcesehir University, Sahrayı Cedid Mahallesi Batman Sokak No: 66 - 68 Yenisahra/Kadıköy, Istanbul, Turkey
| | - Ozge Yabas Kiziloglu
- Faculty of Medicine, Department of Ophthalmology, Bahcesehir University, Sahrayı Cedid Mahallesi Batman Sokak No: 66 - 68 Yenisahra/Kadıköy, Istanbul, Turkey.
| | - Okan Toygar
- Faculty of Medicine, Department of Ophthalmology, Bahcesehir University, Sahrayı Cedid Mahallesi Batman Sokak No: 66 - 68 Yenisahra/Kadıköy, Istanbul, Turkey
| | - Ali Murat Hacimustafaoglu
- Department of Ophthalmology, Medical Park Göztepe Hospital, E-5 üzeri, 23 Nisan sok. No: 17 Merdivenkoy/Kadikoy, Istanbul, Turkey
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Toygar B, Kiziloglu ÖY, Toygar O, Aykan Ü. Spontaneous Haptic Flexion and Misalignment of a New Microincisional Aspheric Intraocular Lens in the Early Postoperative Period in Two Patients. J Refract Surg 2015; 31:558-60. [PMID: 26248349 DOI: 10.3928/1081597x-20150728-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 06/17/2015] [Indexed: 01/19/2023]
Abstract
PURPOSE To present two cases of spontaneous haptic flexion and misalignment of a new single-piece microincisional aspheric intraocular lens (IOL) following uneventful microincisional phacoemulsification surgery and IOL implantation. METHODS Case reports. RESULTS Both patients had decreased visual acuity and significant myopia and astigmatism in their operated eye at the postoperative first month visit. On dilated biomicroscopic examination, flexion of one haptic was observed in both cases. In one of the cases, the misaligned IOL was explanted and a different posterior chamber IOL was implanted. In the other case, the misaligned IOL was repositioned. CONCLUSIONS Cataract surgeons should be aware of the risk for haptic flexion and misalignment of this new IOL, causing decreased visual acuity and significant refractive error in the early postoperative period. Satisfactory results can be achieved by either IOL exchange or repositioning the IOL.
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