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Hida WT, Moscovici BK, Cortez CM, Colombo-Barboza GN, Tzelikis PFDM, Motta AFP, De Medeiros AL, Nose W, Carricondo PC. Comparison of visual outcomes of bilateral dual-technology diffractive intraocular lens vs blended enhanced monofocal with dual-technology intraocular lens. J Cataract Refract Surg 2024; 50:401-406. [PMID: 38085244 DOI: 10.1097/j.jcrs.0000000000001374] [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: 08/29/2023] [Accepted: 11/21/2023] [Indexed: 03/26/2024]
Abstract
PURPOSE To compare clinical outcomes after implantation of TECNIS Synergy (ZFR00V) intraocular lenses (IOLs) in both eyes and implantation of the TECNIS Synergy and TECNIS Eyhance (ICB00) combination in patients undergoing cataract surgery. SETTING Department of Cataract, Hospital Oftalmológico de Brasilia (HOB), Brasília, Brazil. DESIGN Prospective, interventional, randomized, parallel-group study. METHODS Patients were categorized into 2 groups: Group 1: ZFR00V IOL was implanted in both eyes. Group 2: An ICB00 IOL was implanted in the dominant eye, and a ZFR00V IOL was implanted in the nondominant eye. RESULTS Visual acuity was similar between the 2 groups (95% CI <0.1 logMAR). A superior visual acuity of ≥ 20/25 (at -2.00 to -2.50 diopters [D]) was achieved in Group 1 (bilateral ZFR00V) than in Group 2 (combination of ZFR00V/ICB00). The binocular defocus curve demonstrated better visual acuity at 40 cm (-2.00 D) and 50 cm (-2.50 D) in Group 1 than in Group 2 ( P < .05). Similar contrast sensitivity values were observed between the 2 groups. Patients in Group 1 reported higher satisfaction (completely satisfied) than those in Group 2 ( P < .05). However, halos and glare were more pronounced in Group 1 than in Group 2 ( P < .05). CONCLUSIONS Both presbyopia-correcting IOL combinations showed similar binocular visual acuity results. Group 1 demonstrated enhanced visual acuity in the defocus curve at 40 cm (-2.00 D) and 50 cm (-2.50 D). Comparable contrast sensitivity outcomes were observed in both groups. Patients were more completely satisfied in Group 1 than in Group 2, despite the higher frequency of postoperative nighttime halos and glare.
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Affiliation(s)
- Wilson Takashi Hida
- From the Department of Ophthalmology, Hospital Oftalmológico de Brasília (HOB), Brasília, Brazil (Hida, Cortez, Tzelikis); Department of Ophthalmology, University of Sao Paulo (HC-FMUSP), Sao Paulo, Brazil (Hida, Carricondo); Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil (Moscovici, Nose); Department of Ophthalmology, Hospital Visão Laser, Santos, Brazil (Moscovici, Colombo-Barboza, Tzelikis); Department of Ophthalmology, Renato Ambrosio Research Center (CEORA), Brasília, Brazil (Cortez, Tzelikis, Motta, De Medeiros)
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Gabrić K, Gabrić N, Piñero DP, Gabrić I. Comparative Analysis of the Clinical Outcomes of Two Toric Presbyopia-Correcting Intraocular Lenses. Ophthalmol Ther 2024; 13:775-790. [PMID: 38240999 PMCID: PMC10853117 DOI: 10.1007/s40123-023-00878-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 12/20/2023] [Indexed: 02/10/2024] Open
Abstract
INTRODUCTION To evaluate and compare the clinical outcomes of two toric presbyopia-correcting intraocular lenses (IOLs). METHODS Non-randomized prospective comparative study including 86 eyes of 51 patients (age 43-83 years) that underwent cataract surgery with implantation of one of the following two IOLs: TECNIS Toric Synergy (Johnson & Johnson Vision) (Synergy group) or AT LISA tri toric 939MP (Carl Zeiss Meditec) (ATLISA group). Visual and refractive outcomes were evaluated during a 6-month follow-up. RESULTS At 6 months after surgery, all eyes achieved uncorrected distance visual acuity 20/25 or better in both groups, whereas 96.2% and 100% of eyes achieved uncorrected near visual acuity (UNVA) 20/25 or better in the ATLISA and Synergy groups, respectively. All eyes achieved postoperative mesopic UNVA 20/30 or better in both IOL groups; 96.2% and 100% of eyes had a manifest cylinder ≤ 0.50 D at 6 months in ATLISA and Synergy groups, respectively. Mean magnitude of error was 0.04 ± 0.20 and - 0.04 ± 0.09 D in ATLISA and Synergy groups, respectively (p = 0.05). In the defocus curve, significant differences were found between IOL groups for most of distance-corrected visual acuities, except those corresponding to defocus of 0 D (p = 0.268) and - 1 D (p = 0.361). CONCLUSIONS The two toric presbyopia-correcting IOLs evaluated provide an efficacious astigmatic correction combined with a successful distance, intermediate and near visual rehabilitation. The visual performance seems to be better for most visual demands with the TECNIS Toric Synergy IOL, especially for distances closer than 40 cm.
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Affiliation(s)
- Krešimir Gabrić
- University Eye Clinic Svjetlost, Heinzelova Ul. 39, 10000, Zagreb, Croatia
| | - Nikica Gabrić
- University Eye Clinic Svjetlost, Heinzelova Ul. 39, 10000, Zagreb, Croatia
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - Ivan Gabrić
- University Eye Clinic Svjetlost, Heinzelova Ul. 39, 10000, Zagreb, Croatia.
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Chang JSM, Liu SCT, Ma NTC, Ng JCM. Comparative Analysis of Tolerance to Experimentally Induced Astigmatism with Three Types of Multifocal Intraocular Lenses. Clin Ophthalmol 2024; 18:139-149. [PMID: 38235488 PMCID: PMC10793118 DOI: 10.2147/opth.s429630] [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: 07/08/2023] [Accepted: 11/02/2023] [Indexed: 01/19/2024] Open
Abstract
Purpose The effect of residual astigmatism and its axis on distance and near visual acuities (VAs) with multifocal intraocular lenses (IOLs) has not been studied extensively. This study compared the tolerance to experimentally induced residual astigmatism among bifocal, trifocal, and extended depth-of-focus (EDOF) IOLs. Patients and Methods This retrospective, comparative study included 70 eyes of 70 patients implanted with bifocal, trifocal, or EDOF IOLs. Distance and near VAs were assessed with experimentally induced astigmatism by placing positive cylindrical lenses in increments of 0.50 diopters to 2.00 diopters at 90° and 180° axes over the best distance correction. Results Both distance and near VAs worsened with increasing magnitudes of experimentally induced astigmatism except in the EDOF group, in which the near VA remained within a clinically acceptable limit, ie, within one line from the best corrected VA under all ranges of experimentally induced astigmatism. Furthermore, the EDOF group showed the highest astigmatic threshold for losing VA lines following experimental astigmatic induction at both distance and near. The distance VA was generally better at with-the-rule (WTR) than against-the-rule (ATR) astigmatism for all three IOL groups. On the other hand, the near VA was generally better at WTR than ATR astigmatism in the bifocal group, comparable between WTR and ATR astigmatism in the trifocal group, and generally better at ATR than WTR astigmatism in the EDOF group. Conclusion The EDOF IOL demonstrated the highest tolerance to experimentally induced astigmatism at both distance and near. VA was generally less affected by WTR astigmatism than ATR astigmatism, especially at distance. We proposed the residual astigmatism thresholds for clinically acceptable VA reduction in all three IOL groups.
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Affiliation(s)
- John So Min Chang
- Department of Ophthalmology, Hong Kong Sanatorium & Hospital, Hong Kong
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De la Paz M, Tsai LM. Outcomes and predictive factors in multifocal and extended depth of focus intraocular lens implantation. Curr Opin Ophthalmol 2024; 35:28-33. [PMID: 37910172 DOI: 10.1097/icu.0000000000001013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
PURPOSE OF REVIEW Options for addressing presbyopia with intraocular lens (IOL) implantation have become more varied and sophisticated. We reviewed recent literature on multifocal and extended depth of focus (EDOF) IOLs in order to provide insight on their respective advantages, with emphasis on the visual outcomes of each design. RECENT FINDINGS Increased patient age, spectral domain optical coherence tomography (SD-OCT) abnormalities, abnormal optical axis measurements, and better preoperative visual acuity have been implicated as predictors of worse postoperative vision or visual quality in multifocal IOLs. Despite differences in objective outcomes, patient-reported outcomes such as satisfaction are consistently similar between multifocal and EDOF IOLs. EDOFs may have slightly lower rates of spectacle independence than trifocals, but there is more support for their use in the setting of with other ocular conditions. SUMMARY Multifocal and EDOF IOLs are both viable options for patients who wish to preserve near vision. Given their similar objective performance in many aspects, enabling patients to make informed decisions based on their expectations and visual requirements is critical to postoperative satisfaction. Evidence for advanced technology IOL implantation in pediatric patients remains inconclusive.
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Affiliation(s)
- Matthew De la Paz
- Department of Ophthalmology, Washington University School of Medicine, St. Louis, Missouri, USA
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Nomura Y, Ota Y, Fujita Y, Nishimura T, Bissen-Miyajima H, Minami K. Clinical outcomes in eyes with diffractive continuous depth-of-focus intraocular lenses enhanced for near vision: comparison with trifocal intraocular lenses. BMC Ophthalmol 2023; 23:475. [PMID: 37990206 PMCID: PMC10664304 DOI: 10.1186/s12886-023-03207-6] [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: 09/08/2023] [Accepted: 11/07/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND To prospectively evaluate visual functions and patient satisfaction after bilateral implantation of diffractive continuous depth-of-focus intraocular lens (CDF IOL) compared with trifocal IOLs. METHODS This investigator-initiated study was approved by a certified local review board (registered: jRCTs032210305). CDF IOL (Synergy, J&J, group S) and trifocal IOL (AcrySof PanOptix, Alcon, group P) were implanted bilaterally in 30 patients each. Three months postoperatively, binocular outcomes of uncorrected (BUCVA) and distance-corrected (BDCVA) visual acuities at distances of 0.3, 0.4, 0.5, 0.7, and 5 m were measured. Contrast sensitivities were binocularly measured using CSV-1000 (2.5 m) and Pelli-Robson charts at distances of 0.4 and 1 m. Symptoms of glare, halo, starburst, and waxy vision, and satisfaction for near, intermediate, and far visions were assessed with questionnaires. Differences between the two groups were examined. RESULTS Twenty-seven patients each completed the follow-up. The mean age of the group S was lower than that of the group P (P < 0.001). The BUCVA at 0.4 m was better in the S group, while the mean manifest refraction of the P group showed a significant hyperopic shift (P < 0.001). BDCVA was significantly better in the S group. The contrast sensitivity results at three distances showed no discernible differences. Although more patients in the S group reported significant glare and halo, their satisfaction with near vision was higher. CONCLUSIONS The binocular visual function of patients with CDF IOLs was comparable to or better than that of patients with trifocal IOLs. The patients were satisfied with near vision, despite the enhanced glare and halo. Understanding the differences between the two types of presbyopia-correcting IOLs is important to ensure patient satisfaction. TRIAL REGISTRATION This clinical trial was registered in the Japan Registry for Clinical Research (identifier: jRCTs032210305) on September 13, 2021.
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Affiliation(s)
| | - Yuka Ota
- Department of Ophthalmology, Tokyo Dental College Suidobashi Hospital, Tokyo, Japan
| | | | | | | | - Keiichiro Minami
- Department of Ophthalmology, Tokyo Dental College Suidobashi Hospital, Tokyo, Japan.
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Moshirfar M, Stoakes IM, Theis JS, Porter KB, Santos JM, Martheswaran T, Payne CJ, Hoopes PC. Assessing Visual Outcomes: A Comparative Study of US-FDA Premarket Approval Data for Multifocal and EDOF Lens Implants in Cataract Surgery. J Clin Med 2023; 12:4365. [PMID: 37445400 DOI: 10.3390/jcm12134365] [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: 06/05/2023] [Revised: 06/21/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
This study compares the efficacy, safety, and patient-reported outcomes of three intraocular implants (IOL): Tecnis Synergy IOL, AcrySof IQ PanOptix Trifocal, and Tecnis Symfony EDOF IOL. Participants achieving 20/20 or better uncorrected binocular visual acuity were as follows: Synergy-67% distance, 64% intermediate, and 47% near; PanOptix-73% distance, 73% intermediate, and 50% near; and Symfony-63% distance, 75% intermediate, and 22% near. Symfony demonstrated superior intermediate visual acuity compared to Synergy (p = 0.0182) for those achieving 20/25 or better. Both Synergy and PanOptix showed superiority over Symfony for near visual acuity (p < 0.0001). Halos were statistically more common in Synergy participants compared to PanOptix (p = 0.0013) and Symfony (p < 0.0001). Each trial lens outperformed its monofocal IOL in terms of independence from glasses or contacts, with Synergy and PanOptix showing statistical significance over Symfony. Comparing contrast sensitivities and defocus curves was challenging due to data variance and as such, standardization of United States Food and Drug Administration (US-FDA) data reporting is key for better comparison of outcomes among different IOL platforms.
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Affiliation(s)
- Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA
- John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
- Utah Lions Eye Bank, Murray, UT 84107, USA
| | - Isabella M Stoakes
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA
- Pacific Northwest University of Health Sciences, College of Osteopathic Medicine, Yakima, WA 98901, USA
| | - Joshua S Theis
- University of Arizona School of Medicine, Phoenix, AZ 85004, USA
| | - Kaiden B Porter
- University of Arizona School of Medicine, Phoenix, AZ 85004, USA
| | - Jordan M Santos
- University of Arizona School of Medicine, Phoenix, AZ 85004, USA
| | | | - Carter J Payne
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA
- Case Western Reserve School of Medicine, Cleveland, OH 44106, USA
| | - Phillip C Hoopes
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA
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Sahin V, Unal M, Ayaz Y. Outcomes after bilateral implantation of AcrySof IQ PanOptix trifocal intraocular lens: a prospective interventional study. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2023; 12:36-45. [PMID: 37641668 PMCID: PMC10445311 DOI: 10.51329/mehdiophthal1468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 05/26/2023] [Indexed: 08/31/2023]
Abstract
Background Implantation of multifocal intraocular lenses (IOLs) is becoming increasingly popular for the treatment of visual demands at various distances in patients undergoing phacoemulsification cataract surgery. We aimed to assess the visual performance and rates of photic phenomena, posterior capsule opacification (PCO), and spectacle independence in patients with bilateral implantation of the AcrySof® IQ PanOptix® multifocal IOL model TFNT00 at one and six months postoperatively. Methods This prospective interventional cohort study included adult patients who underwent uneventful phacoemulsification cataract surgery with bilateral implantation of AcrySof® IQ PanOptix® IOL. Uncorrected and corrected visual acuities at far, intermediate, and near distances were measured preoperatively and at the one- and six-month postoperative follow-up examinations. The rates of photic phenomena, postoperative need for near and distance spectacles, and PCO were also recorded. Results We included 164 eyes of 82 patients with a male-to-female ratio of 38 (46.3%) to 44 (53.7%) and a mean (standard deviation [SD]) age of 52.37 (7.62) years. There were statistically significant improvements in the visual acuities of both eyes across all distances at the one- and six-month follow-up examinations compared to the preoperative values (all P < 0.001), except for corrected near visual acuity in the right eye (P > 0.05) at six-month. We also detected significant postoperative improvements in visual acuities of both eyes across all distances at the six-month follow-up compared to values at the one-month follow-up (all P < 0.05), except for corrected near visual acuity in the right eye (P > 0.05). The photic phenomenon was reported by 12 (14.6%) of the 82 patients at the six-month postoperative follow-up. Five (6.1%) and eight (9.8%) of the 82 patients reported using spectacles for distance and near, respectively. Additionally, PCO developed in 19 (11.6%) of the 164 included eyes, although it was not clinically significant at six months. Conclusions The AcrySof® IQ PanOptix® IOL model TFNT00 is recommended for use, given its excellent performance in all ranges of vision, a high rate of spectacle independence, and a good safety profile. Future comparative studies with longer follow-up periods are warranted to verify superiority of its performance over that of other available multifocal IOLs.
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Affiliation(s)
- Vedat Sahin
- Department of Ophtalmology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Mustafa Unal
- Department of Ophtalmology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Yusuf Ayaz
- Department of Ophtalmology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
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Yim CK, Dave A, Strawn A, Chan J, Zhou I, Zhu DC. Visual Outcomes and Patient Satisfaction After Bilateral Refractive Lens Exchange with a Trifocal Intraocular Lens in Patients with Presbyopia. Ophthalmol Ther 2023; 12:1757-1773. [PMID: 37052874 PMCID: PMC10164213 DOI: 10.1007/s40123-023-00708-x] [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: 02/24/2023] [Accepted: 03/28/2023] [Indexed: 04/14/2023] Open
Abstract
INTRODUCTION Refractive lens exchange (RLE) patients represent a unique population with a different baseline and set of expectations compared to their cataract counterparts. Visual outcomes and patient satisfaction following RLE with bilateral implantation of a trifocal intraocular lens (IOL) were assessed in a cohort of patients with presbyopia and without cataract. METHODS Charts of patients with presbyopia who underwent femtosecond laser-assisted RLE with bilateral implantation of the PanOptix trifocal IOL (toric and non-toric) at a single-surgeon, private practice center from September 2019 to August 2020 were retrospectively reviewed. Eyes with prior keratorefractive surgery, amblyopia, or underlying pathology were excluded. Primary endpoints included corrected and uncorrected visual acuity at distance (CDVA and UDVA), intermediate (DCIVA and UIVA), and near (DCNVA and UNVA) at 6 months. Secondary endpoints included residual refractive error, patient-reported satisfaction, spectacle independence, and visual disturbance profile as assessed by a validated questionnaire at 6 months. RESULTS Seventy-eight eyes of 39 patients (mean age 56 ± 6 years; 79% female) were included. Most eyes were hyperopic (mean SE 2.35 ± 1.81). Postoperatively, 100% and 92% of eyes were within ± 1.00 D and ± 0.50 D of emmetropia, respectively. One hundred percent, 97%, and 97% of patients achieved UDVA, UNVA, and UIVA of logMAR 0.1 or better. Starbursts were the most frequent (67%) and bothersome (41%) visual disturbance cited, but nearly half (41%) of patients rated them as absent or "not bothersome at all." Overall, 77% of patients reported achieving complete spectacle independence with 87% and 90% of patients stating they were satisfied with their vision and would recommend the same procedure to others, respectively. CONCLUSIONS RLE with bilateral implantation of the PanOptix IOL is a safe and effective procedure with good patient satisfaction. Because of their relatively clear native lenses and visually demanding needs compared to their cataract counterparts, surgeons should take extra precautions to counsel RLE patients on the limitations of trifocal technology.
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Affiliation(s)
- Cindi K Yim
- Department of Ophthalmology, Keck School of Medicine, USC Roski Eye Institute, University of Southern California, Los Angeles, CA, 90033, USA.
- LAC+USC Medical Center, Los Angeles, CA, 90033, USA.
- , 1450 San Pablo Street, #4400, Los Angeles, CA, 90033, USA.
| | - Amisha Dave
- University of Connecticut School of Medicine, Farmington, CT, 06032, USA
| | - Alyx Strawn
- Sackler School of Medicine American Program, New York, NY, 10065, USA
| | - Jeffrey Chan
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ, 85308, USA
| | - Irene Zhou
- University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Dagny C Zhu
- Medical Director and Partner, NVISION Eye Centers, Rowland Heights, Los Angeles, CA, 91748, USA
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Nemet A, Kanclerz P, Tuuminen R. Should Multifocal Intraocular Lenses Become a Standard in Phacoemulsification Cataract Surgery? J Clin Med 2023; 12:jcm12051983. [PMID: 36902768 PMCID: PMC10004625 DOI: 10.3390/jcm12051983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 02/26/2023] [Indexed: 03/06/2023] Open
Abstract
Cataracts impair daily activities such as reading, outdoor sports, and driving, which may not match best-corrected visual acuity at optimal room light conditions, but can be just as important to patients [...].
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Affiliation(s)
- Achia Nemet
- Department of Ophthalmology, Assuta Ashdod University Medical Center, Ashdod 7747629, Israel
| | - Piotr Kanclerz
- Helsinki Retina Research Group, University of Helsinki, 00290 Helsinki, Finland
- Hygeia Clinic, 80-286 Gdańsk, Poland
| | - Raimo Tuuminen
- Helsinki Retina Research Group, University of Helsinki, 00290 Helsinki, Finland
- Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka Hygeia Clinic, 48210 Gdańsk, Finland
- Correspondence: ; Tel.: +358-50-411-3870; Fax: +358-9-2411-227
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