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Hisai T, Takada K, Tokuda S, Nejima R, Mori Y, Minami K, Miyata K. Visual function in eyes with diffractive extended depth-of-focus and monofocal intraocular lenses: 2-year comparison. Graefes Arch Clin Exp Ophthalmol 2023; 261:2567-2573. [PMID: 37071152 DOI: 10.1007/s00417-023-06051-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/15/2023] [Accepted: 03/24/2023] [Indexed: 04/19/2023] Open
Abstract
PURPOSE To compare long-term visual function after implantation of diffractive extended depth-of-focus (EDF) intraocular lenses (IOLs) using echelett optics and monofocal IOLs with the same platform. METHODS In this prospective comparative case series, diffractive EDF or monofocal IOLs were implanted binocularly and followed up for 2 years. At the last visit, distance-corrected binocular visual acuities were measured at distances of 0.3, 0.5, 0.7, 1, 2, 3, and 5 m. Photopic and mesopic contrast sensitivity was also examined. Dynamic visual function was evaluated in terms of functional visual acuity (FVA), standard deviation of visual acuity (SDVA), visual maintenance ratio (VMR), mean response time, and number of blinks. The outcomes were compared between the two IOLs, and the influence of posterior capsule opacification (PCO) on contrast sensitivity and FVA was examined. RESULTS Binocular visual acuity of eyes with EDF IOLs was better at distances of 0.5 and 0.7 m than that of eyes with monofocal IOL (P < 0.026). There were no differences in binocular visual acuity at other distances, contrast sensitivities, or dynamic visual functions. The influence of PCO on the visual functions was not found in eyes with EDF IOLs. CONCLUSION Up to 2 years postoperatively, eyes with diffractive EDF IOLs sustained superior intermediate visual acuity together with visual function comparable to that of eyes with monofocal IOLs.
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Affiliation(s)
- Takahiro Hisai
- Miyata Eye Hospital, 6-3 Kurahara-cho, Miyakonojyo, Miyazaki, 885-0051, Japan
| | - Keita Takada
- Miyata Eye Hospital, 6-3 Kurahara-cho, Miyakonojyo, Miyazaki, 885-0051, Japan
| | - Shota Tokuda
- Miyata Eye Hospital, 6-3 Kurahara-cho, Miyakonojyo, Miyazaki, 885-0051, Japan
| | - Ryohei Nejima
- Miyata Eye Hospital, 6-3 Kurahara-cho, Miyakonojyo, Miyazaki, 885-0051, Japan
| | - Yosai Mori
- Miyata Eye Hospital, 6-3 Kurahara-cho, Miyakonojyo, Miyazaki, 885-0051, Japan
| | - Keiichiro Minami
- Miyata Eye Hospital, 6-3 Kurahara-cho, Miyakonojyo, Miyazaki, 885-0051, Japan.
| | - Kazunori Miyata
- Miyata Eye Hospital, 6-3 Kurahara-cho, Miyakonojyo, Miyazaki, 885-0051, Japan
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Effect of Photochromic Contact Lens Wear on Indoor Visual Performance and Patient Satisfaction. Ophthalmol Ther 2022; 11:1847-1855. [PMID: 35908148 PMCID: PMC9437160 DOI: 10.1007/s40123-022-00552-5] [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: 06/10/2022] [Accepted: 07/19/2022] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION To quantitatively assess visual performance and patient satisfaction during photochromic contact lens (CL) wear in an indoor environment. METHODS This observational study comprised 82 eyes of 41 healthy subjects (mean age ± standard deviation, 21.7 ± 0.7 years) who had no ophthalmic diseases except for refractive errors at Kitasato University in 2021. We prospectively compared visual acuity, kinetic visual acuity, functional (time-dependent) visual acuity, the maintaining rate of visual acuity, the response time, contrast sensitivity function, higher-order aberrations, and patient satisfaction score for overall vision in such subjects during photochromic and non-photochromic CL wear in such an environment. RESULTS The kinetic visual acuity at 30 km/h was 0.32 ± 0.21 and 0.41 ± 0.24 in the photochromic and non-photochromic CL groups, respectively (p = 0.008). The kinetic visual acuity at 60 km/h was 0.32 ± 0.21 and 0.41 ± 0.24, respectively (p = 0.034). The functional visual acuity was 0.00 ± 0.21 and 0.05 ± 0.25, respectively (p = 0.030). The average response time was 1.19 ± 0.15 s and 1.23 ± 0.15 s, respectively (p = 0.029). The patient satisfaction score for overall visual performance was 4.22 ± 0.11 and 3.59 ± 0.68, respectively (p < 0.001). Otherwise, we found no significant differences in visual acuity, the maintaining rate, higher-order aberrations, or contrast sensitivity function (p = 0.116, p = 0.053, p = 0.371, or p = 0.943). We found no apparent complications such as ocular discomfort, superficial punctate keratitis, conjunctival injection, or infectious keratitis during the observation period. CONCLUSIONS According to our experience, the photochromic CL showed good visual quality, especially in terms of kinetic and functional visual acuities and subsequent high patient satisfaction, even in an indoor environment, suggesting its viability of visual correction not only in daily activities but also in indoor sports activities.
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Sakisaka T, Minami K, Takada K, Mori Y, Miyata K. Functional visual acuity after implantation of diffractive extended depth-of-focus intraocular lenses using an echelett optics. BMC Ophthalmol 2021; 21:418. [PMID: 34863126 PMCID: PMC8645128 DOI: 10.1186/s12886-021-02189-7] [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: 06/10/2021] [Accepted: 11/17/2021] [Indexed: 11/30/2022] Open
Abstract
Background The prospective comparative case series aimed to evaluate all-distance visual acuity, contrast sensitivity, and functional visual acuity (FVA) of eyes with diffractive extended depth-of-focus (EDOF) intraocular lenses (IOLs) using an echelett optics and monofocal IOLs with the same platform. Methods Diffractive EDOF and monofocal IOLs were implanted in 27 eyes of 27 patients each. At 3 months after implantation, all-distance visual acuities at distances of 0.3, 0.5, 0.7, 1, 2, 3, and 5 m were measured under distance-corrected. Static visual function was also examined using photopic contrast sensitivity and area under the logarithmic contrast sensitivity function (AULCSF). Dynamic visual function was examined with FVA, and mean FVA value, visual maintenance ratio (VMR), mean response time, and number of blinks were evaluated. These outcomes were compared between the two IOLs. Results The mean distance-corrected visual acuities were better at distances of 0.7 m or nearer in eyes with EDOF IOLs. There was no difference in the contrast sensitivities (P > 0.22). In the FVA results, no difference was found in mean FVA and VMR (P > 0.68). Conclusion The static and dynamic evaluations of postoperative visual functions demonstrated that the visual function of eyes with EDOF IOLs under photopic and distance-corrected conditions was comparable to eyes with monofocal IOLs. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-021-02189-7.
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Affiliation(s)
| | | | - Keita Takada
- Miyata Eye Hospital, Miyakonojyo, Miyazaki, Japan
| | - Yosai Mori
- Miyata Eye Hospital, Miyakonojyo, Miyazaki, Japan
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Tabernero J, Garcia-Porta N, Artal P, Pardhan S. Intraocular Scattering, Blinking Rate, and Tear Film Osmolarity After Exposure to Environmental Stress. Transl Vis Sci Technol 2021; 10:12. [PMID: 34379094 PMCID: PMC8362624 DOI: 10.1167/tvst.10.9.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Dry environments, such as those in offices or aircraft cabins, can potentially generate ocular discomfort and alter the tear film. We compare light scatter, blinking rate, and tear osmolarity in young and older subjects after exposure to low humidity using a controlled environmental chamber. Methods Two groups of healthy subjects were recruited; younger (N = 13, 27 ± 6 years) and older (N = 23, 71 ± 7 years). Measurements were carried out before and after 90-minute exposure to low relative humidity (5%) and constant temperature (23 degrees). Ocular light scatter was measured using a double-pass instrument (OQAS, Visiometrics, Spain). Blinking rate was monitored using an infrared video camera. Tear osmolarity was measured using the TearLab system (Escondido, CA, USA). Results Ocular light scatter increased by a factor of 10% after exposure to low humidity in the older group (P = 0.03) but did not change significantly in the younger group. Blinking rate increased significantly (40% more blinks) in both groups but there was no difference between the groups. No significant differences in osmolarity were shown between two age groups or as result of environmental stress. Conclusions Exposure to dry environment increased light scatter in older subjects. Although more blinks were triggered in both younger and older groups to prevent corneal dehydration, there was no difference between the groups. Blink rate and osmolarity are not associated with the difference in light scatter. Translational Relevance Our work approaches a clinical care problem using basic research methods (measuring ocular scatter and blink ratio).
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Affiliation(s)
- Juan Tabernero
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK.,Departamento de Electromagnetismo y Electrónica, Universidad de Murcia, Spain
| | - Nery Garcia-Porta
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK.,Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Pablo Artal
- Laboratorio de Óptica, Universidad de Murcia, Murcia, Spain
| | - Shahina Pardhan
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK
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Kanclerz P, Yildirim TM, Khoramnia R. Microscopic Characteristics of Late Intraocular Lens Opacifications. Arch Pathol Lab Med 2021; 145:759-767. [PMID: 33091924 DOI: 10.5858/arpa.2019-0626-ra] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2020] [Indexed: 11/06/2022]
Abstract
CONTEXT.— The increases in overall life expectancy and in lens surgeries performed on younger patients have resulted in a significant increase in the anticipated duration of artificial intraocular lenses (IOLs) in the eye. Thus, the physicochemical properties of the IOL become a critical issue, and several types of postoperative IOL opacifications have been reported. OBJECTIVE.— To describe the microscopic characteristics of opacified IOLs. Glistenings and subsurface nanoglistenings are fluid-related phenomena developing mainly in hydrophobic acrylic IOLs and are associated with aqueous influx into the IOL matrix. Calcification presents in hydrophilic acrylic or silicone IOLs as deposits of hydroxyapatite or other phases of calcium. Snowflake degeneration is less common, and it manifests in older polymethyl methacrylate IOLs. DATA SOURCES.— PubMed and ScienceDirect databases were searched for the following keywords: intraocular lens, IOL, cataract surgery, phacoemulsification, opacification, glistening, subsurface nanoglistenings, calcification, snowflake degeneration. English-language articles published up to October 15, 2019 were included in the study. The manuscript contains mainly a literature review; however, it was supplemented with original investigations from the David J. Apple International Laboratory for Ocular Pathology. CONCLUSIONS.— Glistenings and subsurface nanoglistenings should be evaluated in a hydrated state and at room temperature; they manifest as microvacuoles sized from 1.0 to greater than 25.0 μm and less than 200 nm, respectively. Calcification deposits are situated on or underneath the surface of the IOL and can be stained with a 1% alizarin red solution or with the von Kossa method. Snowflake degeneration manifests as "particles" or "crystals," causing whitish IOL discoloration. Scanning electron microscopy or energy dispersive X-ray spectroscopy may improve the diagnostic accuracy.
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Affiliation(s)
- Piotr Kanclerz
- From the Department of Ophthalmology, Hygeia Clinic, Gdańsk, Poland (Kanclerz)
| | - Timur Mert Yildirim
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Germany (Yildirim, Khoramnia)
| | - Ramin Khoramnia
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Germany (Yildirim, Khoramnia)
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Surface light scattering from 1-piece hydrophobic acrylic intraocular lenses with hydroxyethyl methacrylate: contralateral observation for 7 years. J Cataract Refract Surg 2021; 47:702-705. [PMID: 33769764 DOI: 10.1097/j.jcrs.0000000000000621] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/11/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To quantitatively and intraindividually compare surface light scattering for 7 years after implantation of Clareon and AcrySof intraocular lenses (IOLs). SETTING Miyata Eye Hospital, Miyazaki, Japan. DESIGN Retrospective comparative case series. METHODS Clinical records of eyes that had contralateral implantation of SN60WF and SY60WF IOLs were reviewed. Light scattering on the anterior surface of IOLs, corrected distance visual acuity (CDVA), and mesopic and photopic contrast sensitivities were examined at 1 year, 3 years, and 7 years postoperatively, and they were intraindividually compared. RESULTS 34, 19, and 16 patients visited at 1 year, 3 years, and 7 years postoperatively, respectively. Surface light scattering in eyes with SY60WF IOL was significantly reduced, and the rate of increase was 2.74 computer compatible tapes per year. Although there were prominent increases in eyes with SN60WF IOL, no statistically significant difference was found in their CDVA and contrast sensitivities. CONCLUSIONS In eyes with Clareon IOLs, the development of surface light scattering was suppressed up to 7 years. The increase rate demonstrated that the visual acuity would be least deteriorated up to 12 years postoperatively, whereas the influence of straylight induced should be investigated.
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Yildirim TM, Schickhardt SK, Wang Q, Friedmann E, Khoramnia R, Auffarth GU. Quantitative evaluation of microvacuole formation in five intraocular lens models made of different hydrophobic materials. PLoS One 2021; 16:e0250860. [PMID: 33930084 PMCID: PMC8087009 DOI: 10.1371/journal.pone.0250860] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 04/15/2021] [Indexed: 11/29/2022] Open
Abstract
In this laboratory study, we assessed the resistance to microvacuole (glistening) formation in hydrophobic intraocular lenses (IOLs). Glistenings were induced in five lenses each of five different hydrophobic acrylic IOL models, using an established in vitro laboratory model: 800C (Rayner, Worthing, UK), AcrySof SN60WF (Alcon, Fort Worth, USA), Tecnis ZCB00 (Johnson & Johnson Vision, Santa Ana, USA), Vivinex XY1 (Hoya, Tokyo, Japan) and CT Lucia 611P (Zeiss, Oberkochen, Germany). We evaluated the number of microvacuoles per square millimeter (MV/mm2) in the central part of each IOL. Results were analyzed statistically, and mean glistening numbers were ranked, with the highest in the SN60WF which had 66.0 (±45.5) MVs/mm, followed by the 611P with 30.7 (±8.4) MVs/mm2. The 800C and XY1 showed comparable values of 2.0 (±3.6) and 2.7 (±2.4) MVs/mm2, respectively. ZCB00 had the lowest number with 0.9 (±0.6) MVs/mm2. This study shows that the resistance to glistening formation differs depending on the hydrophobic acrylic copolymer composition of the IOL material. Some IOLs from current clinical use are still prone to develop glistenings whereas others, including the ZCB00, 800C and XY1 show high resistance to microvacuole formation.
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Affiliation(s)
- Timur M. Yildirim
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Sonja K. Schickhardt
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Qiang Wang
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
- Department of Ophthalmology, The Third Affiliated Hospital of Wenzhou Medical University, Rui’an, Zhejiang, China
| | - Elfriede Friedmann
- Faculty of Mathematics and Natural Sciences, University of Kassel, Kassel, Germany
| | - Ramin Khoramnia
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Gerd U. Auffarth
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
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Abstract
PURPOSE OF REVIEW Phacoemulsification cataract surgery is one of the most commonly performed surgical procedure worldwide. In the majority of cases, intraocular lenses (IOLs) are implanted. Due to the increasing life expectancy and the fact that cataract surgery is performed in earlier stages, the anticipated IOL duration in the eye has increased over the last decades. The aim of this study was to review the types and describe the characteristics of late intraocular lens opacifications. RECENT FINDINGS Calcification was the most commonly reported type of opacification in hydrophilic IOLs; it usually negatively impacted the visual function and required IOL explantation. Glistening manifested in hydrophobic acrylic lenses and was frequent in some IOL models. In most cases glistening and subsurface nanoglistenigs do not lead to a decline in visual acuity or require IOL exchange. Current studies indicate that fluid-related phenomena may induce straylight, leading to a decrease of comfort and quality of vision. SUMMARY Several reports on late IOL opacifications have been published in recent years. In some cases, particularly in glistening, the development of the opacifications might be related to IOL aging. The influence of the fluid-related microvacuoles on the quality of vision requires further research.
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Affiliation(s)
- Piotr Kanclerz
- Department of Ophthalmology, Hygeia Clinic, Gdańsk, Poland
| | - Timur M Yildirim
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Ramin Khoramnia
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
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Lee J, Mori Y, Nejima R, Minami K, Miyata K. Influence of implantations of extended depth-of-focus on standard automated perimetry. Sci Rep 2020; 10:20153. [PMID: 33214642 PMCID: PMC7678857 DOI: 10.1038/s41598-020-77214-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 11/06/2020] [Indexed: 01/19/2023] Open
Abstract
This prospective study aimed to investigate the influence of an extended depth-of-focus intraocular lens (EDOF IOL) on standard automated perimetry. Ninety eyes of 90 patients who had undergone cataract surgery from February 2018 to December 2018 were included. No patients had any diseases that might affect the visual field. ZMB00 (+ 4.00 D add), ZXR00V (+ 1.75 D add), and ZCB00V (Johnson & Johnson Surgical Vision, Santa Ana, CA, USA) were used as multifocal, EDOF, and monofocal IOLs, respectively. Humphrey Visual Field 10–2 testing was performed 2–3 months after cataract surgery, acceptable reliability indices were measured, and mean deviation (MD), pattern standard deviation (PSD), foveal sensitivity and mean sensitivity (MS) were compared. Seventy-one eyes (ZXR00V: 24 eyes, ZMB00: 25 eyes, ZCB00V: 22 eyes) were used for the analyses. The MD and MS of the EDOF and monofocal groups were significantly higher than those of the multifocal group (P < 0.0051). However, the MD and MS of the EDOF and monofocal groups were not different (P > 0.23). The PSD and foveal sensitivity were not different among the groups. In non-glaucomatous patients, the MD and MS of the EDOF IOL were comparable to those of the monofocal IOL and better than those of the multifocal IOL.
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Affiliation(s)
- Jinhee Lee
- Miyata Eye Hospital, 6-3, Kurahara-cho, Miyakonojo, Miyazaki, 885-0051, Japan
| | - Yosai Mori
- Miyata Eye Hospital, 6-3, Kurahara-cho, Miyakonojo, Miyazaki, 885-0051, Japan
| | - Ryohei Nejima
- Miyata Eye Hospital, 6-3, Kurahara-cho, Miyakonojo, Miyazaki, 885-0051, Japan
| | - Keiichiro Minami
- Miyata Eye Hospital, 6-3, Kurahara-cho, Miyakonojo, Miyazaki, 885-0051, Japan.
| | - Kazunori Miyata
- Miyata Eye Hospital, 6-3, Kurahara-cho, Miyakonojo, Miyazaki, 885-0051, Japan
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Grzybowski A, Markeviciute A, Zemaitiene R. A narrative review of intraocular lens opacifications: update 2020. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1547. [PMID: 33313292 PMCID: PMC7729367 DOI: 10.21037/atm-20-4207] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The opacifications of intraocular lenses (IOLs) can significantly impact patients visual quality. Despite the identification of specific risk factors, manufacturing changes, opacifications are not eliminated. Likewise, more attention in recent studies was paid to possible new risk factors, however one of the most important purposes of the studies remains opacifications effect on visual performance, which could be disturbed in different aspects. The aim of this review is to discuss the main risk factors of IOLs opacification in particular IOL types, and its impact on vision quality. Different risk factors were discussed in the study, including the material of IOLs, the impact of the breakdown of blood-aqueous barrier (BAB), and certain surgeries that can be associated with opacification formation. Glistenings occur more often in a hydrophobic material, however, the changes in water content of the IOLs can significantly reduce the formation of glistenings. The studies showed a significant effect of intraocular injection of exogenous air or gas during Descemet-stripping endothelial keratoplasty, Descemet-stripping automated endothelial keratoplasty, Descemet membrane endothelial keratoplasty, and pars plana vitrectomy on calcification formation. It raises a concern, as the incidence of these surgeries is increasing. Visual acuity decreases significantly after the calcification in IOLs occurs, and it usually causes IOLs exchange. However, disability glare seems to be more affected in patients with IOLs, which were affected by glistenings than visual acuity. Disability glare is associated with increased levels of straylight, which was widely evaluated in recent studies and it was reported to be a susceptible measurement to detect the presence of IOLs pathology. For future researches, it should be noticed that disability glare and straylight are more appropriate in evaluating IOLs opacification effect on visual quality than visual acuity. While reviewing the main risk factors of IOLs opacifications particular attention must be paid on calcification occurrence in hydrophilic acrylic IOLs after surgeries with intraocular injection of exogenous air or gas.
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Affiliation(s)
- Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland.,Institute for Research in Ophthalmology, Poznan, Poland
| | - Agne Markeviciute
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Reda Zemaitiene
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Argay A, Vamosi P. The assessment of the impact of glistening on visual performance in relation to tear film quality. PLoS One 2020; 15:e0240440. [PMID: 33044979 PMCID: PMC7549795 DOI: 10.1371/journal.pone.0240440] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 09/25/2020] [Indexed: 11/24/2022] Open
Abstract
Background The aim of our case control study was to evaluate the impact of glistening and tear film quality on visual performance after implantation of two different hydrophobic acrylic intraocular lenses (IOLs). Materials and methods In our retrospective study we included cataract patients operated between January 1, 2011 and December 31, 2012, with follow-up controls between January 2016 and December 2019. Z-Flex 860FAB (Medicontur) and AcrySof IQ SN60WF (Alcon) monofocal IOLs were implanted during standard phacoemulsification. Best corrected distance visual acuity (BCDVA) and contrast sensitivity were monitored over the post-operative period of up to 6 years. Glistening was evaluated semi-quantitatively with slit-lamp biomicroscopy and quantitatively using Pentacam HR (Oculus). Using HD Analyzer OQAS (Visiometrics), total intraocular light diffusion was interpreted with the objective scatter index (OSI) and tear film quality was evaluated with the tear film related objective scatter index (TF-OSI). Results 26 eyes implanted with the Z-Flex and 25 eyes with the AcrySof IQ IOLs were included in the analysis. The slit-lamp evaluation of patients with the Z-Flex IOL (0.57 ± 0.60) revealed significantly less glistening (p<0.0001), compared to the AcrySof IQ group (1.82 ± 0.90), and these observations were confirmed by the Pentacam HR analyses, as well (Z-Flex group: 35.1 ± 1.63, Acrysof IQ: 39.6 ± 3.69, p<0.0001). TF-OSI differed between the two sets of patients remarkably (1.53 ± 1.03 vs. 2.51 ± 1.76 for AcrySof IQ and Z-Flex groups, respectively, p = 0.043). Both groups of patients provided similar results of BCDVA and contrast sensitivity. Conclusion Glistening and tear film quality both contribute to visual performance outcomes after cataract surgery. In our study the advantage of less glistening in the Z-Flex IOL might have been masked by the adverse effects of the more pronounced tear film insufficiency of these patients, compared to the AcrySof IQ group. Among other factors, tear film quality should also be taken into consideration when comparing the impact of glistening on visual quality of patients implanted with different IOLs.
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Affiliation(s)
- Amanda Argay
- Department of Ophthalmology, Péterfy Sándor Hospital and Traumatology Center, Budapest, Hungary
| | - Peter Vamosi
- Department of Ophthalmology, Péterfy Sándor Hospital and Traumatology Center, Budapest, Hungary
- * E-mail:
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12
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Mid-term and long-term clinical assessments of a new 1-piece hydrophobic acrylic IOL with hydroxyethyl methacrylate. J Cataract Refract Surg 2020; 46:682-687. [DOI: 10.1097/j.jcrs.0000000000000142] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Spiezio V, Walker BN, Calogero D, Ilev IK. Experimental and analytical quantification of light scattering from vacuoles in intraocular lenses. J Cataract Refract Surg 2020; 46:762-773. [PMID: 32358273 PMCID: PMC10824253 DOI: 10.1097/j.jcrs.0000000000000167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To develop an advanced test methodology for quantification of scattered light from intraocular lenses (IOLs) and to evaluate the correlation between IOL vacuole characteristics and measured scattered light. SETTING U.S. Food and Drug Administration, Optical Therapeutics and Medical Nanophotonics Laboratory, Silver Spring, Maryland, USA. DESIGN Experimental and analytical study. METHODS Twenty-four IOLs containing vacuoles were evaluated using a digital microscopy approach for identifying and characterizing the vacuoles present. A scanning light scattering profiler (SLSP) was used to evaluate and quantify the amount of scattered light from each IOL and from a 25th control IOL without any vacuoles. A variety of IOLs and vacuoles were also modeled in a Zemax simulation of the SLSP, and the simulated scattered light was modeled. RESULTS The scattered light as measured with SLSP was well correlated with vacuole characteristics, specifically density and size, as measured under the digital microscope for the 24 vacuole-containing IOLs. Additional correlations were found between vacuole sizes, orientations, and the angle at which light was scattered most severely. These correlations were also present in the Zemax model. CONCLUSIONS Vacuole optical characteristics can be well correlated with measured scatter, demonstrating an ability to predict scattered light based solely on microscope evaluation. Furthermore, the quantitative amount of scatter predicted with Zemax simulations trended closely with the experimentally measured trends.
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Affiliation(s)
- Vincent Spiezio
- From the Optical Therapeutics and Medical Nanophotonics Laboratory, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health (Spiezio, Ilev), and Office of Device Evaluation, Center for Devices and Radiological Health (Walker, Calogero), U.S. Food and Drug Administration, Silver Spring, Maryland, USA
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Quantitative Multiparameter Evaluation of Vacuoles in Intraocular Lenses Employing a High-Magnification Digital Microscopy Method. J Ophthalmol 2019; 2019:7929014. [PMID: 31467695 PMCID: PMC6701293 DOI: 10.1155/2019/7929014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/23/2019] [Accepted: 07/09/2019] [Indexed: 11/17/2022] Open
Abstract
As small imperfections with micrometric sizes, fluid-filled vacuoles, also referred to as glistenings, in intraocular lenses (IOLs) have been known to induce significant unwanted light scattering that in several cases presumably cause complaints and sometimes lead to IOL explantation and replacement. This unwanted scatter is of particular concern for patients viewing bright light in reduced-light conditions such as when driving at night, as the scattered light toward the retina can cause temporary blindness. In this study, we have developed and implemented an accurate test methodology based on a high-magnification digital microscopy approach for quantitative multiparameter evaluation and classification of IOL vacuoles depending on their critical optical characteristics including vacuole size, density, shape, and orientation within the IOL material. Using the multiparameter database developed by evaluating vacuole characteristics, we established a classification grading system that can be used to evaluate vacuole effects on light scattering.
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Correction: Influence of intraocular lens subsurface nanoglistenings on functional visual acuity. PLoS One 2017; 12:e0176318. [PMID: 28414790 PMCID: PMC5393863 DOI: 10.1371/journal.pone.0176318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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