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Inoue M, Itoh Y, Bissen-Miyajima H, Koto T. Retinal Image Quality Through an Operating Microscope With Wavefront Shaping Extended Depth of Focus Intraocular Lens in Model Eye. Am J Ophthalmol 2024; 265:117-126. [PMID: 38701877 DOI: 10.1016/j.ajo.2024.04.028] [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: 03/20/2024] [Revised: 04/27/2024] [Accepted: 04/27/2024] [Indexed: 05/05/2024]
Abstract
PURPOSE To compare the quality of images of gratings placed in a model eye viewed through an extended depth of focus (EDoF) intraocular lens (IOL) to that of diffractive bifocal IOL or monofocal IOL. DESIGN Experimental laboratory investigation. METHODS Nondiffractive wavefront shaping EDoF (CNAET0, Alcon Laboratories), echelette-designed EDoF (ZXR00V, Johnson & Johnson Vision), diffractive bifocal IOL with low power addition (SV25T, Alcon Laboratories), or monofocal IOL (CNA0T0, Alcon Laboratories) was placed in a fluid-filled model eye. A United States Air Force Resolution Grating Target was glued to the posterior surface of the model eye and viewed through a flat or a wide-angle contact lens. The contrast of the gratings viewed through the EDoF or multifocal IOLs was compared to that through the monofocal IOL. A wavefront analyzer was used to measure the spherical power of the central 4.5 mm optics of the EDoF, multifocal, and monofocal IOLs. The distribution of the dioptric power and the dioptric power map were compared. RESULTS The gratings observed through the flat contact lens with CNAET0, ZXR00V, or SV25T were slightly blurred when viewed through the multifocal optics. The blurred area was in the circumferential area of CNAET0, the central area of SV25T, and the peripheral area of ZXR00V. The mean contrast was 0.258 ± 0.020 for CNAET0, 0.227 ± 0.025 for ZXR00V, and 0.221 ± 0.020 for SV25T for the 16.0 cyc/mm grating. The contrast was significantly lower for ZXR00V (P = .004) and SV25T (P = .004) than 0.303 ± 0.015 for CNA0T0 but the differences were not significant for CNAET0. For the wide-angle contact lens, the contrast for CNAET0 was 0.182 ± 0.009, for ZXR00V was 0.162 ± 0.011, and for SV25T was 0.163 ± 0.007 for the 16.0 cyc/mm grating, and none was significantly different from 0.188 ± 0.012 for CNA0T0. The dioptric variations of CNAET0 indicated a ring-shaped area of higher power corresponding to the circumferential blurred zone observed through the flat contact lens. CONCLUSIONS The wavefront shaping and echelette-designed EDoF-IOLs reduce the contrast of the grating more than the monofocal IOL when viewed through the flat contact lens. The degree of reduction depended on the design of the extended-focus optics. The difference was less through the wide-angle contact lens.
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Affiliation(s)
- Makoto Inoue
- From the Kyorin Eye Center (MI, YI, TK), Kyorin University School of Medicine, Mitaka, Tokyo, Japan; Department of Ophthalmology (MI, HBM), Tokyo Dental College Suidobashi Hospital, Tokyo, Japan.
| | - Yuji Itoh
- From the Kyorin Eye Center (MI, YI, TK), Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Hiroko Bissen-Miyajima
- Department of Ophthalmology (MI, HBM), Tokyo Dental College Suidobashi Hospital, Tokyo, Japan
| | - Takashi Koto
- From the Kyorin Eye Center (MI, YI, TK), Kyorin University School of Medicine, Mitaka, Tokyo, Japan
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Termote K, Van Schoor R, Krolo I, Oellerich S, Cools W, Delbeke H, Ni Dhubhghaill S. Combination of a monofocal and one type of extended depth-of-focus (zonal refractive) intraocular lens (COMEDI) in bilateral cataract surgery protocol: a monocentric, randomised, parallel group trial in cataract surgery. BMJ Open Ophthalmol 2024; 9:e001572. [PMID: 39103234 PMCID: PMC11308891 DOI: 10.1136/bmjophth-2023-001572] [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: 11/11/2023] [Accepted: 06/28/2024] [Indexed: 08/07/2024] Open
Abstract
INTRODUCTION Modern intraocular lens (IOL) designs for cataract treatment can be broadly classified into three focal range categories; monofocal, extended depth-of-focus (EDOF) and multifocal IOLs.Monofocal IOLs allow spectacle independence for one focus, typically distance. In contrast, EDOF IOLs provide a greater range of vision, extending spectacle independence to intermediate distance, while multifocal IOLs enable spectacle independence at all distances with the drawback of positive dysphotopsias and reduced contrast perception.EDOF lenses are an attractive compromise with fewer dysphotopic side effects than multifocals. The purpose of this study is to assess whether implanting an EDOF IOL in the second eye of a patient who received a monofocal IOL in the first eye can improve spectacle independence while maintaining the same optical quality as bilateral monofocal IOL implantation. METHODS AND ANALYSIS This study compares combined monofocal and EDOF IOL implantation versus bilateral monofocal IOL implantation in terms of clinical and patient-reported outcomes in a monocentric, randomised, patient-masked and assessor-masked, parallel group trial in 88 bilateral cataract patients. The primary outcome measure is binocular photopic distance corrected intermediate visual acuity. The secondary outcome measures include (un)corrected distance and near visual acuity, reading speed at intermediate distance, quality of visual function assessments, patient-reported spectacle independence, contrast sensitivity, aberrometry, stereopsis and straylight measurement at the 3-month follow-up. ETHICS AND DISSEMINATION The protocol was approved by the ethical committee of the University Hospital of Brussels (BUN 23219_EDOF). TRIAL REGISTRATION NUMBER NCT06002399.
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Affiliation(s)
- Karolien Termote
- Department of Ophthalmology, University Hospital Brussels, Jette, Belgium
- Department of Medicine and Pharmacology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Roger Van Schoor
- Department of Ophthalmology, University Hospital Brussels, Jette, Belgium
- Department of Medicine and Pharmacology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Iva Krolo
- Department of Ophthalmology, University Hospital Brussels, Jette, Belgium
- Department of Medicine and Pharmacology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Silke Oellerich
- Department of Ophthalmology, University Hospital Brussels, Jette, Belgium
- Department of Medicine and Pharmacology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Wilfried Cools
- Interfaculty Center for Data Processing and Statistics, Vrije Universiteit Brussel, Brussels, Belgium
| | - Heleen Delbeke
- Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium
- Department of Neurosciences, Research Group Ophthalmology, Biomedical Sciences Group, KU Leuven, Leuven, Belgium
| | - Sorcha Ni Dhubhghaill
- Department of Ophthalmology, University Hospital Brussels, Jette, Belgium
- Department of Medicine and Pharmacology, Vrije Universiteit Brussel, Brussels, Belgium
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Rua Amaro D, Bertelmann E, von Sonnleithner C. Clinical outcomes and optical performance of a new segmental refractive extended depth-of-focus intraocular lens. BMC Ophthalmol 2024; 24:320. [PMID: 39090592 PMCID: PMC11293127 DOI: 10.1186/s12886-024-03586-4] [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: 01/10/2024] [Accepted: 07/22/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND The visual performance and the optical quality of a segmental refractive extended depth-of-focus (EDoF) intraocular lens (IOL) were evaluated in a prospective, single-arm, single-center study. METHODS A total of 20 patients (40 eyes) after bilateral implantation of the refractive segmental EDoF Acunex Vario AN6V were included. Assessment procedure: refraction outcome, monocular and binocular uncorrected (UCVA) and distance-corrected visual acuity (DCVA), defocus curve, contrast sensitivity (CS), higher-order aberrations (HOAs) and patient satisfaction were evaluated 1 and 3 months after surgery. RESULTS At 3-month follow-up, mean spherical equivalent was - 0.23 ± 0.32 D. Binocular uncorrected distance visual acuity (VA) at distance, intermediate and near was - 0.08 ± 0.06 logMAR at 4 m, -0.03 ± 0.06 logMAR at 66 cm and 0.16 ± 0.06 logMAR at 40 cm, respectively. The binocular defocus curve showed a VA better than 0.20 logMAR over a range from + 1.50 to - 2.45 D. Contrast sensitivity aligned with monofocal lenses, highlighting the lens's clinical value. Aberrometry showed minimal changes in corneal aberrations. NEI-RQL-42-Questionnaire showed a high patient satisfaction for daily activities and revealed reduced dependence on glasses, particularly for near and intermediate vision. The Acunex Vario AN6V demonstrated minimal dysphotopsias, making it a promising option for those seeking spectacle independence. CONCLUSION This segmental refractive EDoF IOL provides a high degree of spectacle independence for far and intermediate distances with functional near VA. Although inducing residual coma aberrations, it showed subjectively good results with little dysphotopsias. TRIAL REGISTRATION This study protocol was reviewed and approved by ethics committee of Charité University, Berlin, Germany, with approval number EA4/126/20.
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Affiliation(s)
- David Rua Amaro
- Department of Ophthalmology, Charité Medical University, Campus Virchow, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Eckart Bertelmann
- Department of Ophthalmology, Charité Medical University, Campus Virchow, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Christoph von Sonnleithner
- Department of Ophthalmology, Charité Medical University, Campus Virchow, Augustenburger Platz 1, 13353, Berlin, Germany.
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Chen L, Sun L, Tang Y, Sui W, Bian A, Zhang X, Wang Z, Zhong Y, Zhang S. Visual performance, safety, and patient satisfaction after binocular clear lens extraction and trifocal intraocular lens implantation in Chinese presbyopic patients. BMC Ophthalmol 2024; 24:305. [PMID: 39044126 PMCID: PMC11264366 DOI: 10.1186/s12886-024-03573-9] [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: 04/11/2024] [Accepted: 07/12/2024] [Indexed: 07/25/2024] Open
Abstract
BACKGROUND Addressing presbyopia in the aging population, particularly in non-cataractous patients, remains a challenge. This study evaluates the outcomes of refractive lens exchange (RLE) with AT LISA tri 839MP trifocal intraocular lens (IOL) implantation in a Chinese presbyopic population without cataracts. METHODS The study included 164 eyes from 82 patients undergoing bilateral RLE at Peking Union Medical College Hospital. Comprehensive evaluations encompassed visual acuities, refraction, ocular aberrometry, and subjective outcomes via the VF-14 questionnaire. The focus was on postoperative visual performance, refractive outcomes, safety, objective optical quality, and patient satisfaction. RESULTS 100%, 90.2%, and 89.0% of patients achieved binocular UDVA, UNVA, and UIVA of logMAR 0.1 or better at 6 months postoperatively. 97.6% of eyes were within ± 1.00 D of emmetropia postoperatively. Optical quality assessments showed increases in modulation transfer function and Strehl ratios (p < 0.05). High-order aberrations decreased significantly (p < 0.05). Despite the high incidence of posterior capsule opacification (83.2%), managed with early Nd: YAG capsulotomy, no other severe complications were reported. Patient-reported outcomes indicated high satisfaction, with an average VF-14 score of 94.3 ± 10.2 and 93.5% achieving complete spectacle independence. Halo (66.2%) was the most commonly reported optical phenomena, followed by glare (18.2%), and starburst (7.8%) after surgery. CONCLUSIONS Bilateral RLE with trifocal IOLs in presbyopic patients without cataracts significantly improves visual acuity and reduces ocular aberrations in presbyopic patients. The procedure offers high patient satisfaction and spectacle independence, though it requires careful patient selection and management of expectations regarding potential photic phenomena.
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Affiliation(s)
- Lulu Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1, Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Lu Sun
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1, Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Yongxiang Tang
- Department of Ophthalmology, The Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Wenda Sui
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1, Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Ailing Bian
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1, Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Xia Zhang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1, Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Zaowen Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1, Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Yong Zhong
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1, Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Shunhua Zhang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1, Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
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Petelczyc K, Bolek J, Kakarenko K, Krix-Jachym K, Kołodziejczyk A, Rękas M. Use of the perceptual point-spread function to assess dysphotopsias. PLoS One 2024; 19:e0306331. [PMID: 39028737 PMCID: PMC11259305 DOI: 10.1371/journal.pone.0306331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 06/14/2024] [Indexed: 07/21/2024] Open
Abstract
Nowadays many patients are choosing EDOF or multifocal lenses for replacement of natural lens in cataract surgery. This can result in issues such as presence of dysphotopsias, namely halo and glare. In this work, we propose a new perimetry method to describe dysphotopsias in far-field region in a presence of bright, point-like light source. We constructed a custom device and designed measurement procedure for quantitative measurement of dysphotopias in the center of visual field and used it to examine patients with mild cataracts or implanted IOLs. Our approach may help in establishing an objective method to study and compare dysphotopsias.
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Affiliation(s)
| | - Jan Bolek
- Faculty of Physics, Warsaw University of Technology, Warsaw, Poland
| | - Karol Kakarenko
- Faculty of Physics, Warsaw University of Technology, Warsaw, Poland
| | | | | | - Marek Rękas
- Ophthalmology Department, Military Institute of Medicine, Warsaw, Poland
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Reitblat O, Velleman DA, Levy A, Assia EI, Kleinmann G. Performance of Extended Depth of Focus Intraocular Lens in Eyes with Preexisting Retinal Disease. Ophthalmologica 2024:1-10. [PMID: 39004074 DOI: 10.1159/000540187] [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: 02/27/2024] [Accepted: 06/30/2024] [Indexed: 07/16/2024]
Abstract
INTRODUCTION Extended depth of focus (EDOF) intraocular lens (IOL) offers improved near and intermediate vision, aiming to reduce spectacle dependence in cataract patients. This research aimed to evaluate the performance of EDOF IOL in patients with retinal pathologies following cataract surgery. METHODS The medical charts of thirty-three eyes with retinal pathologies and 100 healthy eyes that underwent cataract extraction with implantation of an EDOF IOL and had at least 3 weeks of postoperative follow-up were retrospectively included. Patients' overall satisfaction, spectacle dependence, visual perception, and side effects were evaluated with a self-reported questionnaire. RESULTS Mean uncorrected visual acuities (LogMAR) were significantly better in the healthy eyes compared with the eyes with retinal pathologies: 0.05 and 0.10, p = 0.011 (distance), 0.06 and 0.16, p = 0.001 (intermediate), and 0.20 and 0.28, p = 0.026 (near), respectively. No or rare use of spectacles for any distance was reported by 71% and 38% of patients, respectively (p = 0.004). Haloes/glare were reported by 17% and 23%, respectively (p = 0.556); only in 7% and 4% it was clinically disturbing (p > 0.999). The same IOL would be chosen again in 77% and 73% of patients, respectively, (p = 0.550). CONCLUSION Patients with retinal pathologies who were implanted with an EDOF IOL demonstrated excellent distant uncorrected visual results with reasonable intermediate and near uncorrected visual results alongside high satisfaction; however, results were inferior to those of the control healthy eyes.
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Affiliation(s)
- Olga Reitblat
- Ein-Tal Eye Center, Tel Aviv, Israel,
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel,
- Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel,
| | | | - Adi Levy
- Ein-Tal Eye Center, Tel Aviv, Israel
| | - Ehud I Assia
- Ein-Tal Eye Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Guy Kleinmann
- Ein-Tal Eye Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Goldschleger Eye Institute, Sheba Medical Center, Ramat Gan, Israel
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Soscia WL, DeRojas JO, Mathews PM, Brutsky A, Solomon KD, Potvin R, Sandoval HP. Clinical performance after implantation of an EDOF intraocular lens in the dominant eye and a presbyopia-correcting intraocular lens in the nondominant eye. J Cataract Refract Surg 2024; 50:578-584. [PMID: 38305420 PMCID: PMC11146179 DOI: 10.1097/j.jcrs.0000000000001412] [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: 08/25/2023] [Revised: 01/09/2024] [Accepted: 01/29/2024] [Indexed: 02/03/2024]
Abstract
PURPOSE To evaluate subjective and objective outcomes after combined implantation of an extended depth-of-focus (EDOF) intraocular lens (IOL) and a combined technology multifocal lens (CT-IOL). SETTING 2 clinical practices (Carolina Eyecare Physicians, Center For Sight) in the United States. DESIGN Prospective, unmasked, multicenter, nonrandomized bilateral eye study. METHODS Patients interested in reducing their dependence on spectacles were implanted with an EDOF IOL in the dominant eye and a CT-IOL in the nondominant eye. Refractive and visual acuity (VA) data at various distances (4 m, 66 cm, 40 cm, and 33 cm) were collected 3 months postsurgery, along with the distance-corrected binocular defocus curve and responses to questionnaires related to spectacle independence, visual disturbances, and overall visual function. RESULTS Data from 37 participants were analyzed. The distance-corrected binocular defocus curve showed a mean VA better than 0.1 logMAR (20/25) at all vergences from +1.00 to -2.50 diopters (D). 36 participants (97%) had an uncorrected binocular VA of 0.3 logMAR or better, at all test distances. 70% of participants (26/37) reported never wearing spectacles at any distance, and 84% (31/37) were "completely" or "mostly" satisfied with their overall vision after surgery. Halos were the disturbance reported most frequently and reported as most bothersome, with difficulty driving at night the most common visual function issue. Difficulty reading was the next most reported issue. Overall eyesight was rated as "excellent" or "good" by 92% (34/37) of participants. CONCLUSIONS This combined EDOF/CT-IOL approach was well-tolerated by participants and provided some potential benefits relative to bilateral implantation of either lens.
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Affiliation(s)
- William L. Soscia
- From the Center For Sight/US Eye, Sarasota, Florida (Soscia, DeRojas, Mathews, Brutsky); Carolina Eyecare Physicians/US Eye, Mt. Pleasant, South Carolina (Solomon, Sandoval); Science in Vision, Frisco, Texas (Potvin)
| | - Joaquin O. DeRojas
- From the Center For Sight/US Eye, Sarasota, Florida (Soscia, DeRojas, Mathews, Brutsky); Carolina Eyecare Physicians/US Eye, Mt. Pleasant, South Carolina (Solomon, Sandoval); Science in Vision, Frisco, Texas (Potvin)
| | - Priya M. Mathews
- From the Center For Sight/US Eye, Sarasota, Florida (Soscia, DeRojas, Mathews, Brutsky); Carolina Eyecare Physicians/US Eye, Mt. Pleasant, South Carolina (Solomon, Sandoval); Science in Vision, Frisco, Texas (Potvin)
| | - Amy Brutsky
- From the Center For Sight/US Eye, Sarasota, Florida (Soscia, DeRojas, Mathews, Brutsky); Carolina Eyecare Physicians/US Eye, Mt. Pleasant, South Carolina (Solomon, Sandoval); Science in Vision, Frisco, Texas (Potvin)
| | - Kerry D. Solomon
- From the Center For Sight/US Eye, Sarasota, Florida (Soscia, DeRojas, Mathews, Brutsky); Carolina Eyecare Physicians/US Eye, Mt. Pleasant, South Carolina (Solomon, Sandoval); Science in Vision, Frisco, Texas (Potvin)
| | - Richard Potvin
- From the Center For Sight/US Eye, Sarasota, Florida (Soscia, DeRojas, Mathews, Brutsky); Carolina Eyecare Physicians/US Eye, Mt. Pleasant, South Carolina (Solomon, Sandoval); Science in Vision, Frisco, Texas (Potvin)
| | - Helga P. Sandoval
- From the Center For Sight/US Eye, Sarasota, Florida (Soscia, DeRojas, Mathews, Brutsky); Carolina Eyecare Physicians/US Eye, Mt. Pleasant, South Carolina (Solomon, Sandoval); Science in Vision, Frisco, Texas (Potvin)
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Won YK, Choi SH, Chung TY, Lim DH. Clinical Outcomes after Bilateral Implantation of a Wavefront-Shaping Extended Depth of Focus (EDOF) IOL with Mini-Monovision. J Clin Med 2024; 13:3225. [PMID: 38892936 PMCID: PMC11172505 DOI: 10.3390/jcm13113225] [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: 03/25/2024] [Revised: 05/12/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
Background: To compare the visual outcomes and optical quality of patients who underwent bilateral implantation of EDOF (AcrySof® IQ Vivity IOL, DFT015) for mini-monovision, trifocal (AcrySof® IQ PanOptix, TNFT00), or monofocal (AcrySof® IQ IOL, SN60WF) IOL. Methods: The monocular-corrected and uncorrected distance visual acuities (CDVA and UDVA, respectively) were evaluated postoperatively at 1 and 3 months. The binocular visual acuity by distance, the binocular defocus curve, contrast sensitivity, and patient satisfaction were examined 3 months postoperatively. All patients were asked to complete questionnaires regarding their satisfaction, visual symptoms, and spectacle dependency. Results: This study included 178 eyes from 89 patients. The postoperative binocular UDVA did not differ significantly among the three groups. In the defocus curve, the Vivity group showed better visual acuity over a range of far and intermediate (60 cm) than the other two IOLs groups. In near-vision, the PanOptix group showed the best near-vision, and the Vivity group showed significantly better vision than the IQ group. The Vivity group showed contrast sensitivity and optical quality comparable to the IQ group. Conclusions: The bilateral implantation of AcrySof® IQ Vivity IOL with the mini-monovision approach provided excellent distance and intermediate visual acuity with good near-vision, resulting in high satisfaction.
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Affiliation(s)
- Yeo Kyoung Won
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
| | - Sung Ho Choi
- First Samsung Eye Clinic, Seoul 06621, Republic of Korea
| | - Tae-Young Chung
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
- Renew Seoul Eye Center, Seoul 06181, Republic of Korea
| | - Dong Hui Lim
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
- Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul 06351, Republic of Korea
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Guo S, Huang H, Li B, Huang M, Gao L, Chen J, Zeng Y, Yang Y, Liu L, Cheng L, Yao S, Cheng H. Comparatively analysing the postoperative optical performance of different intraocular lenses: a prospective observational study. BMC Ophthalmol 2024; 24:198. [PMID: 38671381 PMCID: PMC11046961 DOI: 10.1186/s12886-024-03439-0] [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: 01/24/2023] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Postoperative performance, including best corrected distance visual acuity (BCDVA) and optical metrics (from the OQAS and iTrace devices), was compared among 4 different intraocular lenses (IOLs). METHODS This prospective observational study included 104 eyes from 104 subjects who underwent cataract surgery combined with implantation of 4 different IOLs: monofocal (Mon) IOLs, segmental refractive (SegRef) IOLs, diffractive (Dif) IOLs and extended depth of focus (EDoF) IOLs. Postoperative BCDVA and optical metrics were collected at the 6th month. The OQAS optical metrics included the objective scattering index (OSI), Strehl ratio (SR), modulation transfer function (MTF) cut-off frequency, and predicted visual acuity (PVA); the iTrace optical metrics included blur/double vision, glare/halo, starburst, mixed focus, night myopia, and night hyperopia. RESULTS There was no significant difference in BCDVA among the 4 groups (P = 0.059; power = 70.3%). Differences were observed in all OQAS optical metrics among the groups (all P < 0.001). Overall, Mon IOLs and EDoF IOLs exhibited better performance than Dif IOLs and SegRef IOLs. Starburst was the only iTrace optical metric that differed among the groups (P < 0.001): SegRef IOLs caused more starbursts than Mon IOLs (P = 0.001), Dif IOLs (P = 0.006) and EDoF IOLs (P < 0.001). Spearman rank correlation analysis was used to determine the relationships among the iTrace optical metrics, OQAS optical metrics and BCDVA: starburst was negatively correlated with BCDVA, PVA at contrasts of 100% and 20%, OSI, and MTF cut-off frequency (all P ≤ 0.001); mixed focus was positively correlated with BCDVA, PVA at contrasts of 100% and 20%, OSI, and MTF cut-off frequency (all P ≤ 0.001). CONCLUSIONS Postoperative BCDVA and optical metrics varied among the different IOLs, which should be taken into account in the selection and management of IOLs for cataract patients. TRIAL REGISTRATION This study was approved by the First Affiliated Hospital of Guangzhou Medical University Ethical Review Board (No. 50 2022).
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Affiliation(s)
- Shuanglin Guo
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China
| | - Hao Huang
- Department of Ophthalmology, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, #116, Changjiang South Road, Zhuzhou, Hunan, 412000, China.
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
| | - Bowen Li
- Eye Center of Xiangya Hospital, Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, 410008, China
| | - Mansha Huang
- Department of Ophthalmology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, 510240, China
| | - Lu Gao
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China
| | - Jingyi Chen
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China
| | - Yuying Zeng
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China
| | - Ye Yang
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China
| | - Lin Liu
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China
| | - Lu Cheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China
| | - Siyang Yao
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China
| | - Hao Cheng
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China.
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Kim JW, Eom Y, Bae SH, Jeon HS, Kim SJ, Kim DH, Song JS. Visual Outcomes According to Age After Bilateral Implantation of Trifocal Intraocular Lenses. J Refract Surg 2024; 40:e270-e277. [PMID: 38593255 DOI: 10.3928/1081597x-20240314-03] [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: 04/11/2024]
Abstract
PURPOSE To investigate the effect of age on visual outcomes after the bilateral implantation of trifocal intraocular lenses (IOLs). METHODS A total of 290 patients (580 eyes) who underwent bilateral implantation of a trifocal IOL were enrolled in this retrospective case-control study. Patients were divided into five age groups: 45 to 49, 50 to 54, 55 to 59, 60 to 64, and 65 years and older. Postoperative monocular uncorrected and corrected distance visual acuity (UDVA and CDVA, respectively), uncorrected near visual acuity (UNVA), binocular distance-corrected defocus curve, spectacle dependence for near and distance vision, and patient satisfaction scores were compared among the five groups. RESULTS The 45 to 49 years group had significantly better mean UDVA (0.02 ± 0.05 logMAR) and UNVA (0.02 ± 0.04 logMAR) than the 65 years and older group (0.06 ± 0.09 and 0.09 ± 0.09 logMAR; P = .029 and P < .001; respectively). However, no significant differences were observed in the mean CDVA among the groups. Binocular visual performance of the 45 to 49 years group was better than that of the 65 years and older age group at defocuses of +1.00, +0.50, -1.00, and -3.00 D. No significant differences were observed in spectacle dependence for near and distance vision or in patient satisfaction scores among the five groups. CONCLUSIONS Bilateral implantation of trifocal IOLs can provide excellent near and distance vision in both young and older patients. However, UDVA and UNVA revealed considerably worse results in the older group, although no significant difference was observed in CDVA and postoperative refractive errors by age. [J Refract Surg. 2024;40(4):e270-e277.].
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Kim J, Kim T, Tchah H, Koh K. Long-term Results after Bilateral Implantation of Extended Depth of Focus Intraocular Lenses with Mini-Monovision. KOREAN JOURNAL OF OPHTHALMOLOGY 2024; 38:129-136. [PMID: 38414249 PMCID: PMC11016687 DOI: 10.3341/kjo.2023.0139] [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: 12/14/2023] [Revised: 02/12/2024] [Accepted: 02/26/2024] [Indexed: 02/29/2024] Open
Abstract
PURPOSE To assess long-term clinical results following bilateral Tecnis Symfony ZXR00 intraocular lens implantation with mini-monovision. METHODS The medical records of cataract patients who underwent bilateral implantation of ZXR00 with intended mini-monovision (target refraction of -0.3 diopters [D] in dominant eye and -0.6 D in nondominant eye) between April 2019 and March 2021 were assessed. Postoperative uncorrected distance visual acuity (UDVA), corrected distance VA (CDVA), uncorrected intermediate VA (UIVA), uncorrected near VA (UNVA), and rate of spectacle dependence for near distance were investigated at 3 months and 2 years after surgery. RESULTS This study included 61 patients (122 eyes) with average age of 61.8 ± 7.7 years. At 2 years postoperatively, binocular logarithm of the minimum angle of resolution UDVA, UIVA, UNVA, and CDVA were 0.086 ± 0.094, 0.056 ± 0.041, 0.140 ± 0.045, and 0.012 ± 0.024, respectively. The monocular manifest refraction spherical equivalent was -0.31 ± 0.38 in the dominant eye and -0.53 ± 0.47 in the nondominant eye at 3 months postoperatively, and -0.38 ± 0.43 in the dominant eye and -0.61 ± 0.54 in the nondominant eye at 2 years postoperatively. Eight out of 61 patients (13.1%) needed glasses 3 months after surgery, and nine out of 61 patients (14.8%) needed glasses 2 years after surgery. CONCLUSIONS The bilateral implantation of ZXR00s with mini-monovision allows for a good VA at wide range of distance from far to near, thereby resulting in high rate of spectacle independence. These results have held up well even after 2 years after surgery.
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Affiliation(s)
- Jeongmin Kim
- Department of Ophthalmology, Kim’s Eye Hospital, Konyang University College of Medicine, Seoul,
Korea
| | - Taeeun Kim
- Crean Lutheran High School, Irvine, CA,
USA
| | - Hungwon Tchah
- Department of Ophthalmology, Kim’s Eye Hospital, Konyang University College of Medicine, Seoul,
Korea
| | - Kyungmin Koh
- Department of Ophthalmology, Kim’s Eye Hospital, Konyang University College of Medicine, Seoul,
Korea
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Moore J, Østergaard J, Kretz F. Visual performance and patient preference with bilateral implantation of an extended depth of focus or combined implantation of an extended depth of focus/trifocal intraocular lens. Int Ophthalmol 2024; 44:80. [PMID: 38356027 PMCID: PMC10866775 DOI: 10.1007/s10792-024-03030-y] [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: 05/31/2023] [Accepted: 01/11/2024] [Indexed: 02/16/2024]
Abstract
PURPOSE Evaluate postoperative visual performance in patients with bilaterally implanted AT LARA or AT LARA/AT LISA tri (Carl Zeiss AG, Jena, Germany) intraocular lenses. METHODS Multicentered, comparative, open-label, retrospective/prospective study. Post-IOL implantation, patients were prospectively enrolled into this study; preoperative patient data were collected retrospectively. Follow-up was at 2-4 and 5-8 months post-surgery. The primary endpoint was binocular best corrected distance visual acuity (CDVA). The study was retrospectively registered on clinicaltrials.gov (#NCT05462067). RESULTS Seventy-one patients (142 eyes) were enrolled; 67 patients (134 eyes) have 5-8 months data. The mean binocular CDVA at 2-4 months was -0.10 ± 0.06 logMAR in the bilateral AT LARA group ("bilateral") and -0.11 ± 0.09 logMAR in the combined implantation AT LARA/ AT LISA tri group ("combined implantation"); (P = 0.4856). At 5-8 months, mean binocular CDVA was -0.13 ± 0.06 logMAR in the bilateral group and -0.11 ± 0.09 in the combined implantation group (P = 0.4003). At 5-8 months, more eyes in the bilateral group attained 0.2 logMAR or better binocular uncorrected intermediate VA (UIVA; 67 cm) than those in the combined implantation group (100% vs. 94%, respectively). The bilateral group achieved a mean of 0.24 ± 0.11 logMAR in uncorrected near VA (UCNVA), compared to a mean of 0.16 ± 0.12 logMAR in the combined implantation group at 5-8 months (P = 0.0041). CONCLUSIONS A combined implantation approach (AT LARA in the distance dominant eye/AT LISA tri in the non-dominant eye) produced similar CDVA outcomes but better UCNVA as bilateral implantation with the AT LARA. UIVA was comparable between groups. No new safety concerns were reported.
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Affiliation(s)
| | | | - Florian Kretz
- Augentagesklinik Rheine, Osnabrücker Straße 233 -235, 48429, Rheine, Germany.
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13
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Bilbao-Calabuig R, Ortega-Usobiaga J, Mayordomo-Cerdá F, Beltrán-Sanz J, Fernández-García J, Cobo-Soriano R. Trifocal versus monofocal intraocular lens implantation in eyes previously treated with laser in situ keratomileusis (LASIK) for myopia. Indian J Ophthalmol 2024; 72:S254-S259. [PMID: 38271420 DOI: 10.4103/ijo.ijo_1844_23] [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: 07/13/2023] [Accepted: 10/31/2023] [Indexed: 01/27/2024] Open
Abstract
PURPOSE To assess visual and refractive outcomes of trifocal intraocular lens (IOL) implantation in eyes that had previously undergone laser in situ keratomileusis (LASIK) for myopia and to compare them with those recorded after implantation of a monofocal IOL. DESIGN Retrospective comparative cases series. METHODS This study evaluated uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), safety, and efficacy after the implantation of two comparable trifocal IOL models and one monofocal IOL model in patients who had previously undergone myopic LASIK. Patients were classified according to the implanted IOL (monofocal or trifocal). RESULTS A total of 211 eyes from 170 patients received a monofocal IOL, and 211 eyes from 161 patients received a trifocal IOL. At the end of the study, after lensectomy, there was a higher myopic residual spherical equivalent in the monofocal group because some eyes had been targeted for slight myopia to achieve monovision; therefore, UDVA was better in the trifocal group. CDVA was comparable in both groups. As expected, both monocular and binocular UNVA were significantly better in the trifocal group. Although the percentage of eyes that lost ≥1 line of CDVA did not differ between the groups, the safety index was slightly better in the monofocal group. CONCLUSION Although implantation of monofocal and trifocal IOLs after myopic LASIK yielded excellent distance visual outcomes, UNVA was significantly better for the trifocal IOL, with a minimally worse safety profile. Trifocal IOLs can be considered after previous LASIK for myopia, with an appropriate patient selection.
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Affiliation(s)
- Rafael Bilbao-Calabuig
- Department of Cataract and Refractive Surgery, Clínica Baviera (Aier Eye Hospital Group), Madrid, Spain
| | - Julio Ortega-Usobiaga
- Department of Cataract and Refractive Surgery, Clínica Baviera (Aier Eye Hospital Group), Bilbao, Spain
| | - Fernando Mayordomo-Cerdá
- Department of Cataract and Refractive Surgery, Clínica Baviera (Aier Eye Hospital Group), Valencia, Spain
| | - Jaime Beltrán-Sanz
- Research and Development, Clínica Baviera (Aier Eye Hospital Group), Valencia, Spain
| | - Javier Fernández-García
- Department of Cataract and Refractive Surgery, Clínica Baviera (Aier Eye Hospital Group), Valencia, Spain
| | - Rosario Cobo-Soriano
- Department of Cataract and Refractive Surgery, Clínica Baviera (Aier Eye Hospital Group), Madrid, Spain
- Francisco de Vitoria University, Madrid, Spain
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14
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Ansari E. The BVI ISOPURE ® 123 intraocular lens: a new hydrophobic preloaded extended monofocal IOL with intermediate vision correction. FRONTIERS IN OPHTHALMOLOGY 2024; 3:1330335. [PMID: 38983008 PMCID: PMC11182318 DOI: 10.3389/fopht.2023.1330335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/29/2023] [Indexed: 07/11/2024]
Abstract
The BVI ISOPURE® intraocular lens (IOL) (PhysIOL, Liege, Belgium) is a fully refractive, aspherical, monofocal lens based on isofocal technology. Isofocal technology provides cataract patients distance vision quality combined with improved unaided intermediate vision by accentuating the extended depth of field/focus (EDOF) effect whilst inducing minimal photic phenomena. Methods PubMed, Web of Science, Scopus, and Google Scholar searches were conducted for published research articles featuring the ISOPURE 123 IOL. Results Excellent uncorrected and corrected binocular distance visual acuity of at least 20/25 can be achieved; uncorrected binocular intermediate vision of 20/25 or better in 81% and 50% at 80 cm and 66 cm, respectively, and 42% binocular near vision of 20/40 or better can be achieved. The defocus curve showed good visual acuity at far and intermediate distances with a depth of focus value of 1.50 D. Photic phenomena are minimal compared to other EDOF IOLs. Excellent contrast sensitivity was maintained compared to a standard monofocal IOL. Conclusion Studies show that this isofocal optic design IOL provides excellent visual performance for far vision and functional intermediate vision with an increased range of vision with few photic phenomena. This lens is an effective option for providing functional intermediate vision and correcting aphakia.
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Affiliation(s)
- Ejaz Ansari
- Eye Ear and Mouth Unit, Maidstone & Tunbridge Wells Hospitals, Kent, United Kingdom
- Institute of Medical Sciences, Canterbury Christ Church University, Kent, United Kingdom
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15
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Fernández J, Ribeiro F, Rocha-de-Lossada C, Rodríguez-Vallejo M. Functional Classification of Intraocular Lenses Based on Defocus Curves: A Scoping Review and Cluster Analysis. J Refract Surg 2024; 40:e108-e116. [PMID: 38346117 DOI: 10.3928/1081597x-20231212-01] [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: 02/15/2024]
Abstract
PURPOSE To explore a potential functional classification of intraocular lenses (IOLs) based on monocular visual acuity defocus curves (VADCs) as a primary end-point. METHODS A systematic literature search was conducted using PubMed. Two independent reviewers screened the literature for inclusion and data extraction. Inclusion criteria were full-text primary clinical studies of IOLs, published in English from 2010 onward, involving patients undergoing cataract or refractive lens exchange. A cluster analysis was conducted to explore similarities in the range of field (RoF) and increase of visual acuity from intermediate to near (ΔVA). RESULTS A total of 107 studies were ultimately included from the 436 identified in the systematic search, with an additional 5 studies added through the snowballing technique search. The cluster analysis was conducted using 69 reports that included monocular VADCs. Two main categories were identified based on the achieved RoF for 0.2 and 0.3 logMAR: full (FRoF) and partial (PRoF) RoF IOLs. Three subcategories were identified for FRoF depending on ΔVA: continuous (FRoF-C), smooth (FRoF-Sm), and steep (FRoF-St). On the other hand, PRoF IOLs shared the characteristic of monotonous decrease in visual acuity and were subclassified into two subcategories depending on the achieved RoF: narrowed (PRoF-N) and extended (PRoF-Ex). An additional subcategory was added to PRoF, enhanced (PRoF-En), for 7 reports alternating between PRoF-N and PRoF-Ex depending on the use of 0.2 or 0.3 logMAR as a cut-off for calculating the RoF. CONCLUSIONS IOLs can be functionally classified into six types depending on the RoF and shape of the monocular VADC. [J Refract Surg. 2024;40(2):e108-e116.].
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16
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Pershin KB, Pashinova NF, Tsygankov AY, Antonov EA, Kosova IV, Korneeva EA. [Outcomes of extended depth of focus intraocular lenses implantation]. Vestn Oftalmol 2024; 140:40-46. [PMID: 38742497 DOI: 10.17116/oftalma202414002140] [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] [Indexed: 05/16/2024]
Abstract
Extended depth of focus (EDOF) intraocular lenses (IOLs) are the latest IOL designs. In recent years, several models of EDOF IOLs have become available in Russia, two of which (Tecnis Symfony and Acrysof IQ Vivity) are implanted in our clinic. Comparative studies devoted to the results of implantation of the new EDOF IOLs are rare in the available literature. PURPOSE This article compares the outcomes of implantation of two EDOF IOLs in patients with presbyopia and/or cataract. MATERIAL AND METHODS The prospective study included 60 patients (81 eyes) after implantation of EDOF IOL Tecnis Symfony (32 patients, 45 eyes; group 1) or EDOF IOL AcrySof IQ Vivity (28 patients, 36 eyes; group 2). The mean follow-up period was 3.9±1.3 months. RESULTS All groups showed a significant (p<0.05) increase in uncorrected near visual acuity (UCNVA), intermediate visual acuity (UCIVA), and distance visual acuity (UCDVA) at the maximum follow-up time compared to preoperative values. In group 1, the best corrected near visual acuity (BCNVA) increased from 0.61±0.10 to 0.82±0.16 at the maximum follow-up time, and in group 2 - from 0.58±0.08 to 0.67±0.12 (p>0.05). Both groups showed a significant increase in best corrected intermediate and distance visual acuity (BCIVA and BCDVA) at the maximum follow-up time. The increase in the indicator compared to the preoperative period was not significant in both groups (p>0.05). The frequency of side optical phenomena was low in both groups. No significant differences were found between the groups (p>0.05). CONCLUSION This study presents a comparative analysis of the results of implantation of two different EDOF IOLs. Both lenses were comparable in most of the studied parameters, including providing good distance and intermediate vision, functional near vision, as well as a low frequency of side optical phenomena. In all cases the patients were satisfied with the results of the surgical intervention.
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Affiliation(s)
- K B Pershin
- Excimer Eye Centre, Moscow, Russia
- Academy of Postgraduate Education of the Federal Scientific and Practical Center for Specialized Types of Medical Care and Medical Technologies of the Federal Medical-Biological Agency, Moscow, Russia
| | - N F Pashinova
- Excimer Eye Centre, Moscow, Russia
- Academy of Postgraduate Education of the Federal Scientific and Practical Center for Specialized Types of Medical Care and Medical Technologies of the Federal Medical-Biological Agency, Moscow, Russia
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Wendelstein JA, Casazza M, Reifeltshammer S, Riaz K, Pantanelli S, Mariacher S, Seiler TG, Kohnen T, Bolz M. Unilateral intraindividual comparison and bilateral performance of a monofocal spherical and diffractive extended depth of field intraocular lens mix-and-match approach. Clin Exp Ophthalmol 2024; 52:31-41. [PMID: 38050340 DOI: 10.1111/ceo.14315] [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: 06/22/2023] [Revised: 10/04/2023] [Accepted: 10/08/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND To evaluate the intraindividual visual performance of a spherical and extended depth of field (EDOF) IOL used in a mix-and-match approach. METHODS Single centre (tertiary care centre), retrospective consecutive case series. Included patients had uneventful cataract surgery with implantation of a spherical monofocal IOL (CT Spheris 204) in the dominant eye and a diffractive EDOF IOL (AT LARA 829) in the non-dominant eye. Monocular and binocular defocus curves and visual acuity at various distances were assessed. In addition, binocular reading speed, contrast sensitivity, and patient satisfaction using QOV, Catquest 9SF, and glare/halo questionnaires are reported. RESULTS A total of 29 patients (58 eyes) were included. We observed significant intra-individual differences for monocular DCIVA, DCNVA, UIVA, and UNVA. There were no differences in monocular BCDVA or UDVA. The monocular defocus curves for the two IOLs significantly differed at defocus steps between -1.0 and -3.5 D. 93.10% of patients reported they would opt for the same combination of IOLs. CONCLUSION Excellent uncorrected and corrected distance visual acuity was demonstrated in both groups. The mix-and-match approach described in this study yielded good intermediate vision and improved near vision with high-patient satisfaction.
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Affiliation(s)
- Jascha A Wendelstein
- Medical Faculty, Johannes Kepler University Linz, Linz, Austria
- Department of Ophthalmology and Optometry, Kepler University Hospital GmbH, Johannes Kepler University Linz, Linz, Austria
- Institute of Experimental Ophthalmology, Saarland University, Homburg, Germany
- IROC-Institut für Refraktive und Ophthalmo-Chirurgie, Zürich, Switzerland
| | - Marina Casazza
- Medical Faculty, Johannes Kepler University Linz, Linz, Austria
- Department of Ophthalmology and Optometry, Kepler University Hospital GmbH, Johannes Kepler University Linz, Linz, Austria
| | - Sophia Reifeltshammer
- Medical Faculty, Johannes Kepler University Linz, Linz, Austria
- Department of Ophthalmology and Optometry, Kepler University Hospital GmbH, Johannes Kepler University Linz, Linz, Austria
| | - Kamran Riaz
- Dean A. McGee Eye Institute, University of Oklahoma, Oklahoma City, Oklahoma, USA
| | - Seth Pantanelli
- Department of Ophthalmology, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Siegfried Mariacher
- Medical Faculty, Johannes Kepler University Linz, Linz, Austria
- Department of Ophthalmology and Optometry, Kepler University Hospital GmbH, Johannes Kepler University Linz, Linz, Austria
| | - Theo G Seiler
- IROC-Institut für Refraktive und Ophthalmo-Chirurgie, Zürich, Switzerland
- Klinik für Augenheilkunde, Universitätsklinikum Düsseldorf, Duesseldorf, Germany
- Universitätsklinik für Augenheilkunde, Bern, Switzerland
| | - Thomas Kohnen
- Department of Ophthalmology, Goethe University, Frankfurt, Germany
| | - Matthias Bolz
- Medical Faculty, Johannes Kepler University Linz, Linz, Austria
- Department of Ophthalmology and Optometry, Kepler University Hospital GmbH, Johannes Kepler University Linz, Linz, Austria
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18
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Narang R, Agarwal A. Refractive cataract surgery. Curr Opin Ophthalmol 2024; 35:23-27. [PMID: 37962881 DOI: 10.1097/icu.0000000000001005] [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: 11/15/2023]
Abstract
PURPOSE OF REVIEW The aim of this study to provide an overview of recent publications and opinions in refractive cataract surgery. RECENT FINDINGS With the advent of intraocular lenses (IOLs) on different platforms, the surgeon has a wide arena of types of IOL to choose, depending on the patient's visual requirement. Optimization of the tear film, integrating tomography and topography devices for appropriate keratometry values, biometry, use of advanced formulas for IOL power calculation and application of newer IOLs can help achieve target refraction in cases scheduled for cataract surgery. Intraoperative aberrometry can be a useful aid for cataract surgery in postrefractive cases and can help minimize residual postoperative astigmatism. SUMMARY Evolvement and rapid advancement of technology allows to impart desired refractive outcomes in most of the cases postcataract surgery. Appropriate preoperative and intraoperative factors should be considered to achieve the desired postoperative outcome.
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Affiliation(s)
- Rhea Narang
- SMT. NHL Medical College, Ahmedabad, Gujarat
| | - Ashvin Agarwal
- Dr Agarwal's Eye Hospital & Research Centre, Chennai, Tamil Nadu, India
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Madhivanan N, Nivean PD, Madanagopalan VG, Priya S, Madhivanan N, Arthi M. Clinical results after binocular implantation of a unique nondiffractive enhanced monofocal intraocular lens designed for enhanced monovision to increase the depth of focus. Indian J Ophthalmol 2024; 72:63-65. [PMID: 38131571 PMCID: PMC10841775 DOI: 10.4103/ijo.ijo_447_23] [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: 02/12/2023] [Revised: 07/16/2023] [Accepted: 08/05/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE To provide the reports of a pilot study to assess the visual acuity (VA) and contrast sensitivity with RayOne enhanced monovision (EMV), a unique nondiffractive enhanced monofocal intraocular lens (IOL) to increase the range of focus. METHODS A retrospective case series study was conducted by analyzing 25 patients (50 eyes) who had bilateral implantation of EMV IOL after cataract surgery. Data collected included biometry, spherical equivalent (SE), and VA for near, intermediate, and distance. Patients were reviewed at 1 day, 1 week, and 1 month after surgery. Contrast sensitivity (CS) was checked at 1 month. RESULTS The study included 14 males (56%). Age of participants was 61.4 ± 7.4 years. Uniocular uncorrected near and distance VA improved from 0.33 ± 0.13 to 0.05 ± 0.07 and from 0.63 ± 0.31 to 0.05 ± 0.10 log of minimum angle of resolution (logMAR) at 1 month (P < 0.001 for both). Binocular uncorrected near and distance VA improved from 0.09 ± 0.18 and 0.14 ± 0.27 to 0.05 ± 0.06 and 0.00 ± 0.09 logMAR, respectively (P < 0.001). SE changed from - 0.23 ± 2.55 to - 0.33 ± 0.46. CS at 3 months was 1.74 ± 0.21. At 1 month, 48 eyes (96%) achieved uncorrected intermediate VA 6/15 (0.4 logMAR) or better. When comparing eyes that had uncorrected intermediate vision of ≥ 0.2 (6/9 or better) to eyes that had < 0.2 logMAR at 1 month, there was no difference between groups with respect to baseline parameters. CONCLUSION The pilot study shows that the nondiffractive EMV IOL is safe, effective, and stable, providing excellent distance and intermediate vision and good near vision.
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Affiliation(s)
- Nivean Madhivanan
- Cataract and Vitreoretinal Services, MN Eye Hospital, Chennai, Tamil Nadu, India
| | | | - V G Madanagopalan
- Cataract and Vitreoretinal Services, JB Eye Hospital, Salem, Tamil Nadu, India
| | - Shanmuga Priya
- Department of Comprehensive Ophthalmology, MN Eye Hospital, Chennai, Tamil Nadu, India
| | | | - M Arthi
- Cataract and Vitreoretinal Services, JB Eye Hospital, Salem, Tamil Nadu, India
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Jiang M, Zhang J, Ding Y, Huang Y. Multifocal intraocular lens implantation in children with unilateral congenital cataracts. J Cataract Refract Surg 2024; 50:18-23. [PMID: 37702521 DOI: 10.1097/j.jcrs.0000000000001308] [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: 07/04/2023] [Accepted: 08/31/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE To evaluate the vision recovery, reconstruction of binocular visual function, and influencing factors after multifocal intraocular lens implantation in children with unilateral congenital cataracts. SETTING University hospital. DESIGN Prospective clinical study. METHODS In the prospective clinical study, 55 children aged 3 to 14 with unilateral congenital cataracts received multifocal intraocular lenses (TECNIS ZMB00) posterior optic capture from 2019 to 2022. Corrected distance visual acuity (CDVA; 5 m), distance-corrected intermediate visual acuity (DCIVA; 66 cm), distance-corrected near visual acuity (DCNVA; 33 cm), stereoscopic vision, visual quality (objective scatter index [OSI] and modulation transfer function [MTF]), axial length (AL), keratometry (K), and contrast sensitivity (CS), as well as postoperative occlusion compliance were evaluated before and after surgery. RESULTS At the final follow-up, 90.91% (50/55) patients showed significant improvement in visual acuity (VA) after surgery. CDVA, DCIVA and DCNVA were 0.23 ± 0.17, 0.39 ± 0.15, and 0.44 ± 0.15 logMAR, respectively. 69.09% (38/55) patients achieved good VA (better than 0.3 logMAR).52.76% (25/48) patients had a positive Titmus test. OSI and MTF were 1.24 ± 0.91 and 42.45 ± 12.30, respectively. 73.68% (28/38) of the patients (better than 0.3 logMAR) underwent strict occlusion therapy. Postoperative VA is correlated with preoperative CDVA ( r = -0.829, P < .001), corneal astigmatism ( r = 0.384, P = .036), △AL (difference between the cataract eyes and contralateral eyes, r = -0.490, P = .006), and occlusion compliance ( r = -0.806, P < .001). CONCLUSIONS Multifocal intraocular lens implantation could obtain relatively satisfactory VA (CDVA, DCIVA and DCNVA) and the binocular visual function of children with unilateral congenital cataracts. Postoperative VA is related to preoperative VA, corneal astigmatism, △AL, and occlusion compliance.
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Affiliation(s)
- Mingming Jiang
- From the Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology; School of Ophthalmology, Shandong First Medical University, Qingdao, Shandong Provence, China
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Bafna S, Gu X, Fevrier H, Merchea M. IRIS ® Registry (Intelligent Research In Sight) Analysis of the Incidence of Monovision in Cataract Patients with Bilateral Monofocal Intraocular Lens Implantation. Clin Ophthalmol 2023; 17:3123-3129. [PMID: 37877114 PMCID: PMC10591682 DOI: 10.2147/opth.s424195] [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: 06/23/2023] [Accepted: 10/06/2023] [Indexed: 10/26/2023] Open
Abstract
Purpose To determine the incidence of pseudophakic monovision among patients bilaterally implanted with monofocal intraocular lenses (IOLs) and to characterize the distribution of myopic offsets achieved. Patients and Methods This retrospective database study included data on patients receiving care from ophthalmologists who contributed to the Academy IRIS® (Intelligent Research In Sight) Registry. Anonymized data were collected, including patient age, ethnicity, procedure data (CPT code, date, laterality), and postoperative manifest refractive spherical equivalent (MRSE) in both eyes implanted with monofocal or monofocal toric IOLs. No data regarding IOL manufacturer, model, or power were collected. One primary outcome measure was the percentage of patients achieving monovision (defined as emmetropia within ±0.25 diopters [D] in one eye and a myopic offset of ≥0.50 D in the fellow eye) among all patients receiving bilateral monofocal IOLs at the time of cataract surgery between January 1, 2016, and September 1, 2019, with at least 90 days of follow-up. Other primary outcomes included the distribution and frequency of myopic offsets (anisometropia) between eyes. Results Of the 16,765 people receiving bilateral monofocal IOLs within the study period, 4796 (28.6%) achieved emmetropia in at least one eye, as defined by an MRSE within ± 0.25 D. The incidence of monovision among these patients was 34.2% (1638/4796). One-quarter (24.7%; 405/1638) of patients who achieved monovision had a myopic offset between 0.50 and 0.74 D, with more than one-third (35.2%; 576/1638) falling within 0.75-1.24 D and 18.0% within 1.25-1.74 D. A myopic offset ≥1.75 D was observed in 22.1% (362/1638) of patients who achieved monovision. Conclusion Pseudophakic monovision for presbyopia correction was achieved in ~34% of patients in the IRIS Registry bilaterally implanted with monofocal IOLs, with myopic offsets typically ranging from 0.5 to 1.24 D.
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Khoramnia R, Baur ID, Łabuz G, Köppe MK, Hallak MK, Auffarth GU. Functional outcomes after bilateral refractive lens exchange with a continuous-range-of-vision intraocular lens. J Cataract Refract Surg 2023; 49:1011-1017. [PMID: 37464558 DOI: 10.1097/j.jcrs.0000000000001265] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 07/12/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE To clinically evaluate a diffractive continuous-range-of-vision intraocular lens (IOL) that combines bifocal and extended depth-of-focus technologies in refractive lens exchange (RLE) patients. SETTING University eye clinic. DESIGN Prospective interventional clinical study. METHODS Bilateral implantation of the TECNIS Synergy IOL was performed during a RLE procedure in 28 patients. At 3 months postoperatively, uncorrected (UDVA) and corrected (CDVA) distance visual acuities, uncorrected (UIVA) and distance-corrected (DCIVA) intermediate visual acuities at 80 cm, and uncorrected (UNVA) and distance-corrected (DCNVA) near visual acuities at 40 cm were assessed. Defocus curve testing and contrast sensitivity testing were also performed. RESULTS Binocular UDVA and CDVA of 56 eyes (28 patients) were -0.06 ± 0.07 logMAR and -0.13 ± 0.05 logMAR, respectively. UIVA and DCIVA were -0.06 ± 0.05 logMAR and -0.08 ± 0.06 logMAR, and UNVA and DCNVA were -0.01 ± 0.07 logMAR and -0.04 ± 0.07 logMAR. The defocus curve revealed a visual acuity of 0.10 logMAR or better from +0.50 to -3.00 diopters (D). Photopic contrast sensitivity at spatial frequencies 3.0, 6.0, 12.0, and 18.0 was 1.68 ± 0.20, 1.77 ± 0.19, 1.45 ± 0.18, and 1.02 ± 0.19 log units, respectively. Mesopic contrast sensitivity at the same frequencies was 1.56 ± 0.20, 1.44 ± 0.25, 0.92 ± 0.38, and 0.44 ± 0.37, respectively. CONCLUSIONS The Synergy IOL provided very good distance, intermediate, and near visual outcomes. A visual acuity of 0.10 logMAR or better was achieved from +0.50 to -3.0 D. Contrast sensitivity was within the normal range.
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Affiliation(s)
- Ramin Khoramnia
- From the International Vision Correction Research Center, University Eye Clinic of Heidelberg, Heidelberg, Germany
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McNeely RN, Stewart SA, Moore JE. Visual performance and subjective experience 3 months and 12 months after combined implantation of 2 new complementary continuous phase multifocal intraocular lenses. J Cataract Refract Surg 2023; 49:921-928. [PMID: 37291750 DOI: 10.1097/j.jcrs.0000000000001236] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/05/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE To assess the 3-month and 12-month postoperative visual performance and subjective quality of vision (QoV) after combined implantation of complementary continuous phase multifocal intraocular lenses (IOLs). SETTING Private practice, United Kingdom. DESIGN Case series. METHODS The study enrolled 44 patients undergoing phacoemulsification with implantation of an Artis Symbiose Mid in the dominant eye and an Artis Symbiose Plus in the nondominant eye. Refraction, uncorrected distance visual acuity (UDVA), corrected distance visual acuity, uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), electronic reading desk, and a QoV questionnaire were evaluated at 3 months and 12 months postoperatively. RESULTS The mean binocular UDVA was -0.06 ± 0.08 logMAR and -0.07 ± 0.06 logMAR at 3 months and 12 months ( P = .097), respectively. The mean binocular UIVA was 0.03 ± 0.13 logMAR and 0.03 ± 0.10 logMAR ( P = 1.0), respectively. The mean binocular UNVA was 0.07 ± 0.10 logMAR and 0.07 ± 0.08 logMAR ( P = .875), respectively. There was a significant improvement in QoV for both day and night between 3 and 12 months, with a significant reduction in halos at 12 months. Spectacle independence was reported in 93.2% of cases at 12 months. CONCLUSIONS The Artis Symbiose Mid and Plus IOL combined implantation provided an excellent range of uncorrected vision at 3 and 12 months. There was a significant improvement in QoV and less halos at 12 months. This IOL combination provided very high rates of complete spectacle independence.
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Affiliation(s)
- Richard N McNeely
- From the Cathedral Eye Clinic, Belfast, Northern Ireland, United Kingdom (McNeely, Stewart, Moore); School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland, United Kingdom (Stewart); College of Health and Life Sciences, Aston University, Birmingham, United Kingdom (Moore); Tianjin Medical University, Tianjin, China (Moore)
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Fernandez-Bueno I, Olcina LI, Andrés-Iglesias C, Puertas-Neyra K, Fernández-Martínez I, Usategui-Martín R, Maldonado-López MJ. Safety, biocompatibility, and potential functionality of a new accommodative intraocular lens: An experimental study in rabbits. Heliyon 2023; 9:e19604. [PMID: 37810139 PMCID: PMC10558835 DOI: 10.1016/j.heliyon.2023.e19604] [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: 01/11/2023] [Revised: 08/21/2023] [Accepted: 08/28/2023] [Indexed: 10/10/2023] Open
Abstract
This study aims to evaluate the safety, biocompatibility, and functionality of a new accommodative intraocular lens (IOL) (LUZ, patent PCT/ES2016/070,813) after implantation in rabbit eyes. LUZ (Study) and EyeCee® plus a capsular ring (Control) were implanted in rabbits (n = 8 each) after phacoemulsification. Intraoperative follow-up, long-term clinical follow-up, and functional IOL studies were carried out periodically for up to 180 days. A macroscopic examination of the eyeballs to reveal abnormalities and determine the implant centering and a microscopic examination to semi-quantify cell and tissue response were performed. Statistical analysis of the collected data was finally achieved. During follow-up, no significant changes in the general condition nor the clinical evaluation were observed between both groups. However, Study IOL remained centered throughout the study and did not present severe complications as observed in the Control group. Functional studies did not reveal significant differences between both materials. Study showed better centering, fewer adhesions, and maintenance of an opening capsular bag compared to the Control. Local biological effects caused by Study implantation are minimal and comparable to the Control. Therefore, LUZ showed no clinical signs or histological response of adverse reaction to the implanted material, according to UNE-EN ISO 11979-5 and 10993-6. Functionality must be confirmed in another animal species with greater lens accommodation capacity than the rabbit. LUZ keeps the capsular bag open, favoring its centering and avoiding fibrosis and adherence to the bag; this allows potential accommodation of this IOL and theoretically enables the patient to focus dynamically.
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Affiliation(s)
- Ivan Fernandez-Bueno
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Retina Group, Universidad de Valladolid, 47011 Valladolid, Spain
- RICORS Inflamación e inmunopatología de órganos y sistemas (RD21/0002/0017), National Institute of Health Carlos III, Madrid, Spain
| | | | - Cristina Andrés-Iglesias
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Retina Group, Universidad de Valladolid, 47011 Valladolid, Spain
| | - Kevin Puertas-Neyra
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Retina Group, Universidad de Valladolid, 47011 Valladolid, Spain
| | - Itziar Fernández-Martínez
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Retina Group, Universidad de Valladolid, 47011 Valladolid, Spain
- CIBER BBN, National Institute of Health Carlos III, Madrid, Spain
| | - Ricardo Usategui-Martín
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Retina Group, Universidad de Valladolid, 47011 Valladolid, Spain
- RICORS Inflamación e inmunopatología de órganos y sistemas (RD21/0002/0017), National Institute of Health Carlos III, Madrid, Spain
- Departamento de Biología Celular, Histología y Farmacología, Universidad de Valladolid, 47005 Valladolid, Spain
| | - Miguel José Maldonado-López
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Retina Group, Universidad de Valladolid, 47011 Valladolid, Spain
- RICORS Inflamación e inmunopatología de órganos y sistemas (RD21/0002/0017), National Institute of Health Carlos III, Madrid, Spain
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De Rojas JO, Sandoval HP, Potvin R, Solomon KD. Visual Outcomes, Quality of Vision, Patient Satisfaction and Spectacle Independence After Bilateral Implantation of the Synergy™ Intraocular Lens. Clin Ophthalmol 2023; 17:2277-2285. [PMID: 37581096 PMCID: PMC10423583 DOI: 10.2147/opth.s421185] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 06/26/2023] [Indexed: 08/16/2023] Open
Abstract
Purpose To evaluate vision, visual quality, patient satisfaction and spectacle independence after bilateral implantation of the TECNIS Synergy™ intraocular lens. Setting Two clinical practices in the USA. Design Ambispective unmasked non-randomized clinical trial. Methods Patients with a history of uneventful bilateral femtosecond laser assisted cataract surgery with the study IOL implanted, targeted for emmetropia, at least 3 months prior to the study visit were enrolled. Monocular and binocular visual acuity (VA) were measured at distance, intermediate and near, along with binocular mesopic VA. Low contrast binocular VA and reading speed in mesopic and photopic conditions were also measured. Patient satisfaction, spectacle independence, visual symptoms, and functional vision questionnaires were completed. Results Results from 52 subjects were available for analysis. Mean binocular unaided visual acuity was ~0.1 logMAR (20/20) from distance to 33 cm, with 81% of subjects having 0.2 logMAR (20/25) vision or better at all test distances and 92% reporting never needing glasses at any distance. Average reading speed at 40 cm was only 10 words/minute slower in dim light (p = 0.03). Mesopic and low contrast acuity appeared good. Halos were the most frequent and bothersome visual disturbances, with the greatest effect on driving at night. Eighty-eight percent of subjects reported being "completely" or "mostly" satisfied with their overall unaided vision. Conclusion This hybrid technology IOL provided a range of binocular visual acuity from distance to 33 cm and good functional vision, even in dim light. Patients should be advised of the likelihood of visual disturbances, particularly halos.
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Baur ID, Labuz G, Yildirim TM, Auffarth GU, Khoramnia R. Reversible Multifocality Achieved Through Polypseudophakia. Klin Monbl Augenheilkd 2023; 240:981-988. [PMID: 37391182 DOI: 10.1055/a-2079-1692] [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: 07/02/2023]
Abstract
Simultaneous implantation of a monofocal or monofocal toric intraocular lens (IOL) into the capsular bag and a multifocal IOL into the ciliary sulcus, referred to as duet procedure, allows us to create multifocality that is more easily reversible than the implantation of a capsular bag-fixated multifocal IOL. The optical quality and results after the duet procedure are equivalent to those of a capsular bag-fixated multifocal IOL. Patients who cannot tolerate the side effects of multifocal optics or who develop an ocular condition leading to loss of function such as age-related macular degeneration (AMD) or glaucoma in the course of their lives may benefit from the reversibility of the procedure.
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Affiliation(s)
- Isabella Diana Baur
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Univ.-Augenklinik Heidelberg, Deutschland
| | - Grzegorz Labuz
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Univ.-Augenklinik Heidelberg, Deutschland
| | - Timur Mert Yildirim
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Univ.-Augenklinik Heidelberg, Deutschland
| | - Gerd U Auffarth
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Univ.-Augenklinik Heidelberg, Deutschland
| | - Ramin Khoramnia
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Univ.-Augenklinik Heidelberg, Deutschland
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Shemesh R, Reitblat O, Rodov L, Levy A, Assia EI, Kleinmann G. Results of an Extended Depth-of-Focus Intraocular Lens Implantation in the Second Eye of Monofocal Pseudophakic Patients: A Pilot Study. Asia Pac J Ophthalmol (Phila) 2023; 12:349-354. [PMID: 37523425 DOI: 10.1097/apo.0000000000000622] [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: 03/05/2023] [Accepted: 05/14/2023] [Indexed: 08/02/2023] Open
Abstract
PURPOSE The purpose of this study was to investigate the visual results and patient satisfaction after implantation of an extended depth-of-focus (EDOF) intraocular lens (IOL) in the second eye of patients implanted previously with a monofocal IOL in the first eye. METHODS The medical records and self-reported questionnaires from patients who were implanted with monofocal IOLs in the first eye and EDOF IOLs in the second eye (group A) and from patients implanted bilaterally with EDOF IOLs (group B) were compared for visual acuity (VA), spectacle independence, patient satisfaction, and photic phenomena. RESULTS Group A (23 eyes of 23 patients) had similar distance uncorrected VA and intermediate uncorrected VA compared with group B (72 eyes of 36 patients) (0.03±0.05 vs. 0.04±0.16; P =0.136 and 0.660, respectively). There was a tendency toward a better near uncorrected VA in group A compared with group B (0.15±0.14 vs. 0.23±0.17; P =0.074). Patients' perception of their VA was similar between groups. Spectacle independence for distance vision was reported by 16/17 (94.1%) and 35/36 (97.2%) patients ( P =0.543), 13/17 (76.5%) and 32/36 (88.9%) patients ( P =0.252) for intermediate vision, and 4/17 (23.6%) and 22/36 (61.1%) patients for near vision ( P =0.011), in groups A and B, respectively. There was no difference in complaints of photic phenomena between groups. CONCLUSIONS Patients previously implanted with a monofocal IOL in 1 eye who are interested in improving their spectacle independence can be considered for an EDOF IOL implantation in the second eye and may have similar results to those implanted bilaterally with EDOF IOLs.
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Affiliation(s)
- Rachel Shemesh
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Ein-Tal Eye Center, Tel Aviv, Israel
- Sheba Medical center, Tel-Hashomer, Israel
| | - Olga Reitblat
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Ein-Tal Eye Center, Tel Aviv, Israel
- Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
| | | | - Adi Levy
- Ein-Tal Eye Center, Tel Aviv, Israel
| | - Ehud I Assia
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Ein-Tal Eye Center, Tel Aviv, Israel
- Department of Ophthalmology, Meir Medical Center, Kfar Sava, Israel
| | - Guy Kleinmann
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Ein-Tal Eye Center, Tel Aviv, Israel
- Department of Ophthalmology, E. Wolfson Medical Center, Holon, Israel
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Mastropasqua L, Pedrotti E, Ruggeri ML, Vecchiarino L, Bonacci E, Guarini D, Falconio G, Toto L, Marchini G. Two-surgeon, two-center evaluation of a new combined EDOF intraocular lens approach. J Cataract Refract Surg 2023; 49:512-517. [PMID: 36700935 DOI: 10.1097/j.jcrs.0000000000001145] [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: 05/04/2022] [Accepted: 01/12/2023] [Indexed: 01/27/2023]
Abstract
PURPOSE To evaluate visual performance and quality of life after bilateral implantation of 2 extended depth-of-focus intraocular lenses (EDOF IOLs). SETTING Ophthalmology Clinic, Department of Medicine and Science of Ageing, University "G. d'Annunzio" Chieti-Pescara, Italy, and Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy. DESIGN Prospective clinical study. METHODS 60 eyes of 30 patients with senile cataract were enrolled in this study. Patients underwent phacoemulsification and bilateral implantation of the Mini WELL IOL in the dominant eye and the Mini WELL PROXA IOL in the nondominant eye within a month. The main outcome measures over a 3-month follow-up period were uncorrected and corrected visual acuity at different distances (33 cm, 60 cm, and 4 m), defocus curve, contrast sensitivity, and patient satisfaction (evaluated by mean of the National Eye Institute Refractive Error Quality-of-Life instrument-42 questionnaire). RESULTS Binocular uncorrected visual acuity at 90 days was 0.03 ± 0.11 logMAR for long distance, 0.05 ± 0.10 logMAR for intermediate distance, 0.03 ± 0.08 logMAR at 40 cm, and 0.06 ± 0.08 logMAR at 33 cm. Statistically significant differences between the 2 EDOF IOLs in favor of Mini WELL PROXA IOL were observed for uncorrected near visual acuity at 40 and 33 cm ( P < .001 and P < .001, respectively) and for distance-corrected near visual acuity at 40 cm ( P < .001). Significant differences between the 2 IOLs in the defocus curves were reported. CONCLUSIONS In this small pilot study, bilateral implantation of Mini WELL IOL and Mini WELL PROXA IOL achieved good quantity and quality of vision.
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Affiliation(s)
- Leonardo Mastropasqua
- From the Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy (Mastropasqua, Ruggeri, Vecchiarino, Guarini, Falconio, Toto); Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy (Pedrotti, Bonacci, Marchini)
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Tinner C, Eppenberger L, Golla K, Mohanna S, Schmid MK, Thiel M. Use of Spectacles after Cataract Surgery. Klin Monbl Augenheilkd 2023; 240:408-414. [PMID: 37164399 DOI: 10.1055/a-2034-6365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
PURPOSE The goal of this study was to investigate the use of spectacles in everyday life after bilateral cataract surgery with a preoperative refractive target of emmetropia in both eyes. In addition, we analyzed the total cost of spectacles and the patient's visual satisfaction at least 6 months after surgery. METHODS Patients after bilateral cataract surgery with implantation of an aspheric monofocal IOL (Tecnis 1, Johnson & Johnson) with a preoperative refractive target of emmetropia in both eyes and a documented refractive outcome were included in this prospective observational study. In a phone interview ≥ 6 months after surgery, the following items were assessed: type of spectacles purchased and overall cost, type of activity with and duration of spectacle wear, and satisfaction with the visual situation. RESULTS Seventy patients were included in this study. Depending on their postoperative refraction, patients were divided into group A (n = 27) with perfect emmetropia in both eyes (i.e., spherical equivalent [SE] of ≥ - 0.25 D to ≤ + 0.25 D), group B (n = 21) with achieved emmetropia in one eye (i.e., SE of ≥ - 0.25 D to ≤ + 0.25 D) and a myopic refraction in the other eye (< - 0.25 D), and group C (n = 22) with bilateral myopic results (SE of < - 0.25 D). Overall, 84% of patients had purchased new spectacles, mostly varifocals (59%) or reading glasses (24%) at the median cost of 980 Swiss Francs (mean: CHF 912 ± 746). Despite patients' initial reasoning for their lens choice to require reading glasses only, varifocal glasses were worn for more than 50% or all of awake time by 48% of patients in group A, 43% in group B, and 68% in group C. Despite their regular spectacles use, patients' visual satisfaction was very high in all three groups. CONCLUSIONS Most patients who achieve perfect bilateral emmetropia after implantation of monofocal aspheric lenses buy varifocal spectacles within 6 months, and more than half of all patients use their varifocal spectacles for more than 50% of their awakening time. The costs for such spectacles are high.
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Affiliation(s)
- Chiara Tinner
- Eye Clinic, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | | | - Kathrin Golla
- Eye Clinic, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Safa Mohanna
- Eye Clinic, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | | | - Michael Thiel
- Eye Clinic, Lucerne Cantonal Hospital, Lucerne, Switzerland
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Visual performance of patients with trifocal toric and new nondiffractive EDOF toric intraocular lenses. J Cataract Refract Surg 2023; 49:323-324. [PMID: 36867473 DOI: 10.1097/j.jcrs.0000000000001125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 12/12/2022] [Indexed: 03/04/2023]
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Al-Amri SAJ, Alió JL, Milán-Castillo R, D'Oria F, Martinez-Abad A, Yebana P, Subirana N, Al-Harbi Z, Plaza-Puche AB, Alió Del Barrio JL. Clinical Retinal Image Quality of a Non-diffractive Wavefront-Shaping Extended Depth of Focus (Vivity) Intraocular Lens. J Refract Surg 2023; 39:103-110. [PMID: 36779465 DOI: 10.3928/1081597x-20221130-04] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
PURPOSE To evaluate clinical retinal optical image quality following implantation of an extended depth of focus intraocular lens (EDOF IOL) (Vivity; Alcon Laboratories, Inc), and to compare it with a monofocal and a trifocal IOL. METHODS This prospective, comparative, case-control study included 88 eyes implanted with: (1) 19 monofocal IOLs (AcrySof SA60AT; Alcon Laboratories, Inc); (2) 38 EDOF IOLs (AcrySof IQ Vivity); and (3) 31 trifocal IOLs (AT LISA tri 839MP; Carl Zeiss Meditec AG). Total root mean square, ocular lower (LOA) and higher (HOA) order aberrations, point spread function (PSF) Strehl ratio (PSF with LOA), and PSF Strehl ratio excluding LOA (PSF without LOA) were analyzed using a Pyramidal WaveFront-based sensor aberrometer Osiris (Costruzione Strumenti Oftalmici) at two different pupil sizes (3 and 4 mm). RESULTS The trifocal IOL showed the highest PSF without LOA at both pupil sizes (0.52 ± 0.12 and 0.31 ± 0.07, respectively), followed by the AcrySof SA60AT (0.39 ± 0.10 and 0.27 ± 0.07) and AcrySof IQ Vivity (0.34 ± 0.11 and 0.24 ± 0.09) (P < .001). The AcrySof IQ Vivity and monofocal IOLs were comparable (P > .05). Despite the comparable postoperative low spherical equivalent among the IOL groups, the AT LISA tri 839MP retinal image quality (PSF with LOA) was the most severely affected by such residual refractive errors (dropped to 0.26 ± 0.06 at 3 mm; P < .001) compared to the monofocal AcrySof SA60AT (0.24 ± 0.07 at 3 mm) and EDOF Acrysof IQ Vivity (0.23 ± 0.06 at 3 mm) groups. The PSF with LOA was comparable (P > .05) among the three groups at both the 3-and 4-mm pupil size. CONCLUSIONS Although trifocal IOLs provided significantly better retinal image quality if influence of LOA is excluded, they also demonstrated to be the most sensitive to residual refractive errors. Both the EDOF Acrysof IQ Vivity and mono-focal AcrySof SA60AT IOLs showed a comparable retinal image quality, and they are also comparable with trifocal IOLs when considering the clinically real PSF (PSF with LOA). [J Refract Surg. 2023;39(2):103-110.].
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Clinical Evaluation of Reading Performance in Refractive Lens Exchange With a Diffractive Continuous-Range-of-Vision Intraocular Lens. Am J Ophthalmol 2023; 250:25-37. [PMID: 36669611 DOI: 10.1016/j.ajo.2023.01.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/19/2023]
Abstract
PURPOSE Evaluation of reading performance with a novel presbyopia correcting intraocular lens (IOL) in refractive lens exchange using an electronic reading desk. DESIGN Prospective interventional before-and-after clinical study. METHODS In total, 56 eyes of 28 patients were included. Bilateral implantation of the TECNIS Synergy IOL (Johnson & Johnson Surgical Vision) during a bilateral delayed sequential refractive lens exchange procedure. Uncorrected and distance corrected reading acuity, reading distance, reading speed, and the smallest print size that could be read effectively at a set (40 cm/80 cm) and subjectively chosen near and intermediate distance were assessed using the Salzburg Reading Desk preoperatively and 6 months after surgery. RESULTS Uncorrected near reading acuity increased from 0.61 ± 0.16 logarithm of the minimum angle of resolution (logMAR) preoperatively to 0.05 ± 0.09 logMAR postoperatively at the set near distance (40 cm) and from 0.60 ± 0.11 logMAR to 0.07 ± 0.08 logMAR at the subjectively preferred distance (39.6 ± 5.3 cm and 37.7 ± 4.3 cm). Uncorrected intermediate reading acuity was 0.39 ± 0.19 logMAR preoperatively and 0.08 ± 0.07 logMAR postoperatively at the set intermediate distance (80 cm) and 0.43 ± 0.21 logMAR preoperatively and 0.07 ± 0.08 logMAR postoperatively at the preferred intermediate distance (73.5 ± 9.5 cm and 73.3 ± 5.9 cm). CONCLUSIONS Uncorrected intermediate and near reading function considerably improved after bilateral implantation of the TECNIS Synergy IOL. Patients preferred a closer near and intermediate distance to the set distances. However, reading function was comparable for the set and subjectively preferred distances.
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Clinical outcomes of presbyopia-correcting intraocular lenses in patients with Fuchs endothelial corneal dystrophy. Sci Rep 2023; 13:786. [PMID: 36646806 PMCID: PMC9842705 DOI: 10.1038/s41598-023-27830-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 01/09/2023] [Indexed: 01/18/2023] Open
Abstract
Fuchs endothelial corneal dystrophy (FECD) is considered a contraindication for the implantation of presbyopia-correcting IOLs, without sufficient corroborating evidence. A Retrospective, case-control study. Nineteen eyes of ten patients with grade 2-5 FECD (study group) and 57 healthy eyes of 57 patients (control group) who underwent cataract surgery with implantation of presbyopia-correcting IOLs, at the Ein-Tal Eye Center, Tel Aviv, Israel, were included. The target refraction was emmetropia for both groups. Two subgroups of IOLs were analyzed separately: extended depth of focus (EDOF), (9 eyes of FECD patients and 27 eyes of control patients) and multifocal IOLs (10 eyes of FECD patients and 30 eyes of control patients). Main outcome measures were visual acuity and refraction 6 weeks after the surgery. Secondary outcomes were patient perceptions of visual acuity, spectacle independence, photic phenomena and satisfaction scores, reported in a self-assessment questionnaire. FECD patients in the EDOF IOL subgroup had inferior uncorrected distance visual acuity (P = 0.007) and better uncorrected near visual acuity (P = 0.001) compared to the controls. They had less spectacle independence for the intermediate range (P = 0.01) and overall (P = 0.006). However, they did not have more photic phenomena. In the multifocal IOL subgroup, no significant differences were found between the FECD and the control group in visual acuity for all ranges and in spectacle independence. FECD patients had more photic phenomena than the controls (P = 0.006), but it did not interfere with daily life activities. There was no difference in post-operative mean spherical equivalent, patient reported visual perception, and general satisfaction between FECD and control patients in both groups. Our results suggest that presbyopia-correcting IOLs can be carefully considered in patients with grade 2-5 FECD, with slightly inferior results compared with healthy eyes.
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Tomagova N, Elahi S, Vandekerckhove K. Clinical Outcomes of a New Non-Diffractive Extended Depth-of-Focus Intraocular Lens Targeted for Mini-Monovision. Clin Ophthalmol 2023; 17:981-990. [PMID: 37007049 PMCID: PMC10053890 DOI: 10.2147/opth.s405267] [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: 02/06/2023] [Accepted: 03/13/2023] [Indexed: 04/04/2023] Open
Abstract
Purpose To assess visual acuity, binocular defocus curve, spectacle independence, and photic phenomena after bilateral same-day cataract surgery with implantation of an extended depth-of-focus intraocular lens (IOL) with mini-monovision. Methods Single-center retrospective study including 124 eyes from 62 patients who underwent bilateral implantation of an isofocal EDOF lens [Isopure® (BVI)] with mini-monovision (-0.50 D). Refraction, visual acuity at different distances, binocular defocus curves, spectacle independence, and subjective ratings of picture-referenced photic phenomena were assessed one to two months postoperatively. Results The mean postoperative refractive spherical equivalent was -0.15±0.41D in the dominant eyes and -0.46±0.35D in the mini-monovision eyes (p<0.01). Overall, 98.4% and 87.7% of the eyes were within ±1.00D and ±0.50D of the target refraction, respectively. Postoperative monocular corrected distance visual acuity was -0.04±0.07 logMAR. Binocular uncorrected visual acuity was -0.02±0.07, 0.13±0.11and 0.40±0.20 logMAR for far, intermediate and near, respectively. At the visual acuity threshold of 0.20 logMAR (or better) the defocus curve ranged from -1.6D to +0.9D. Reported spectacle-independence was 96% for far distance, 95% for intermediate, and 34% for near. Five percent of patients reported halos, 16% starburst, and 16% glare. Only 7% of all patients considered them bothersome. Conclusion In patients undergoing same-day bilateral cataract surgery, an isofocal EDOF lens provided an extended range of functional vision, up to 63 cm, resulting in useful uncorrected near vision, good uncorrected intermediate vision, and excellent uncorrected distance vision. Subjective patient satisfaction in terms of spectacle independence and photic phenomena was high.
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Affiliation(s)
- Nikola Tomagova
- Clinical Study Department, Vista Alpina Eye Clinic, Visp, Switzerland
| | - Sina Elahi
- Clinical Study Department, Vista Alpina Eye Clinic, Visp, Switzerland
| | - Kristof Vandekerckhove
- Clinical Study Department, Vista Alpina Eye Clinic, Visp, Switzerland
- Correspondence: Kristof Vandekerckhove, Clinical Study Department, Vista Alpina Eye Clinic, Bahnhofplatz 1a, Visp, 3930, Switzerland, Tel +41279467000, Email
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Megiddo-Barnir E, Alió JL. Latest Development in Extended Depth-of-Focus Intraocular Lenses: An Update. Asia Pac J Ophthalmol (Phila) 2023; 12:58-79. [PMID: 36706334 DOI: 10.1097/apo.0000000000000590] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/06/2022] [Indexed: 01/28/2023] Open
Abstract
In recent years, there has been an overwhelming influx of different types of intraocular lenses (IOLs) as treatment for presbyopia. The extended depth-of-focus (EDOF) technology creates a single elongated focal point to enhance depth of focus, in contrast to the multiple foci of multifocal (MF) lenses. In this way, the EDOF lenses aim to reduce photic phenomena, glare, and halos, which have been reported in MF IOLs. A potential disadvantage of this is a blur due to decreased retinal image quality when the amount of the aberrations is increased excessively. Multifocality and EDOF characteristics are not exclusive of each other. Frequently, EDOF IOLs are combined with MF optical designs, a bifocal IOL may exhibit EDOF characteristics, likewise an aspheric monofocal IOL or a diffractive or refractive trifocal IOL. Thus, EDOF lenses are commonly subjected to confusion. A wide range of different types of EDOF lenses are available on the market to surgeons. In this practical update, we aim to clarify what is a true EDOF lens, classify the different types of the EDOF lenses based on their optical principle and review their recently reported outcomes. Comprehensive patient examination and selection, combined with knowledge of the most updated options and adequate patient counseling, can avoid dissatisfaction and yield the desired outcomes.
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Affiliation(s)
| | - Jorge L Alió
- Cornea, Cataract & Refractive Surgery Unit, VISSUM (Miranza Group), Alicante, Spain
- Department of Ophthalmology, Miguel Hernandez University, Alicante, Spain
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Rementería-Capelo LA, Contreras I, García-Pérez JL, Blázquez V, Ruiz-Alcocer J. Visual performance and impact of residual refractive errors with trifocal intraocular lenses of different aspheric design. Eur J Ophthalmol 2022; 33:11206721221144928. [PMID: 36529873 DOI: 10.1177/11206721221144928] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
BACKGROUND To assess the visual quality and the tolerance to low refractive errors of two trifocal intraocular lenses (IOL) with different amounts of spherical aberration (SA). METHODS The study included patients having bilateral implantation of the AcrySof® IQ PanOptixTM (aberration-correcting) or the RayOneTM (aberration-free) Trifocal IOL. Three months after the surgery patients underwent: monocular/binocular and uncorrected/corrected distance visual acuity (VA) and binocular defocus curves. Binocular contrast sensitivity (CSF) and subjective halo perception were assessed with the best distance correction (CDVA), with a positive defocus of + 0.50D and with a negative defocus of -0.50D. Patient's satisfaction was evaluated with the Catquest9-SF questionnaire. RESULTS This study included 54 eyes (28 with PanOptix and 26 with RayOne) of 27 patients. Both groups achieved corrected/uncorrected and monocular/binocular distance VA values better than 0.0 logMAR (1.0 decimal) with no statistically significant differences between them (p > 0.05 for all cases). Defocus curves showed a VA of 0.1 logMAR or better between -2.5 and + 1.0D with no differences between groups (p > 0.05 at all distances). Overall CSF values remained stable under the induced residual refractions for both groups. The halo effect remained stable for the PanOptix group but increased with myopization in the RayOne group (p = 0.02). The questionnaire showed high rates of patient's satisfaction with no differences between groups. CONCLUSION Both lenses showed overall good visual outcomes and offered high rates of patient's satisfaction. Moreover, in normal patients with trifocal IOLs, the combination of residual refractive errors and certain amounts of SA may increase some visual disturbances.
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Affiliation(s)
| | - Inés Contreras
- Clínica Rementería, Madrid, Spain
- 537490IRYCIS Grupo Oftalmología, Madrid, Spain
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Shen J, Lou H, Yu Q, Yao H, Yuan J. The Connection between High Myopia Patients and MiR-708a or MiR-148 Expression Levels in Aqueous Studies of Visual Acuity. BIOMED RESEARCH INTERNATIONAL 2022; 2022:3363830. [PMID: 36277877 PMCID: PMC9584676 DOI: 10.1155/2022/3363830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 08/13/2022] [Accepted: 08/20/2022] [Indexed: 11/17/2022]
Abstract
Myopia goes far beyond the inconvenience it brings. It is a prevailing and vision-threatening eye disease, especially in Asia. Aberrantly expressed miR-708a and miR-148 are critical for accurate diagnosis, good prognosis, and precise response prediction of myopia. In this paper, we aim to examine the potential contributions of miR-708a, miR-148a, and PAX6 to high myopia (HM). First, aqueous samples were taken from 25 exclusively HM eyes and 25 exclusively cataract eyes. For next-generation sequencing and bioinformatics analysis, RNA from sample 30one was used. Twenty more samples were used for RT-qPCR. 341 miRNAs in total were found in HM eyes; 249 mature miRNAs and 17 new miRNAs showed differential expression. The expression of hsa-miR-127-3p, hsa-let-7i-5p, and hsa-miR-98-5p was identified using RT-qPCR. MiR-708a and miR-148, which may be linked to the development of myopia and serve as possible biomarkers, are notably highly expressed in atrial tissues of HM patients. Our findings may help deepen the understanding of the mechanisms behind the high expression of miR-708a and miR-148 in atrial tissues of patients with HM.
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Affiliation(s)
- Jiang Shen
- Department of Ophthalmology, Ningbo Eye Hospital, Ningbo, 315040 Zhejiang, China
| | - Hong Lou
- Department of Ophthalmology, Ningbo Eye Hospital, Ningbo, 315040 Zhejiang, China
| | - Qihua Yu
- Department of Ophthalmology, Ningbo Eye Hospital, Ningbo, 315040 Zhejiang, China
| | - Hongyan Yao
- Department of Ophthalmology, Ningbo Eye Hospital, Ningbo, 315040 Zhejiang, China
| | - Jianshu Yuan
- Department of Ophthalmology, Ningbo Eye Hospital, Ningbo, 315040 Zhejiang, China
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Borkenstein AF, Borkenstein EM, Schmid R. Evaluating Optical Quality of a New Hydrophilic Enhanced Monofocal Intraocular Lens and Comparison to the Monofocal Counterpart: An Optical Bench Analysis. Ophthalmol Ther 2022; 11:2045-2056. [PMID: 36040648 DOI: 10.1007/s40123-022-00561-4] [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: 07/14/2022] [Accepted: 08/12/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The aim of the study was to analyze the optical properties of a new hydrophilic enhanced monofocal intraocular lens (IOL) using optical bench analysis and compare it with its monofocal counterpart. METHODS This laboratory study investigates the enhanced monofocal intraocular lens (L-333) and the monofocal counterpart (L-313) IOL by Teleon Surgical, Spankeren, Netherlands on the optical bench, using OptiSpheric IOL PRO2 (Trioptics, Germany) in order to assess the optical quality according to ISO 11979 with ISO-2 Cornea. IOLs (power 22.0 D) were evaluated regarding through frequency modulation transfer function (MTF), Strehl ratio (SR), and through focus MTF at 50 lp/mm using a 3.0-mm and a 4.5-mm aperture. Tilt and decentration were applied. In addition, wavefront measurements were obtained using WaveMaster® IOL 2 device (Trioptics, Germany) and analyzed. RESULTS Centered: The MTF (mean) at 50 lp/mm (L-333/L-313) with 3.0 mm aperture was 0.606/0.724 and with 4.5 mm aperture 0.330/0.409. The SR (mean) with 3.0 mm aperture was 0.586/0.809 and with 4.5 mm aperture 0.330/0.348. Decentered by 1 mm: The MTF (mean) at 50 lp/mm (L-333/L-313) with 3.0 mm aperture was 0.485/0.705 and with 4.5 mm aperture 0.255/0.374. The SR (mean) with 3.0 mm aperture was 0.457/0.739 and with 4.5 mm aperture 0.185/0.268. Tilted by 5 degrees: The MTF (mean) at 50 lp/mm (L-333/L-313) with 3.0 mm aperture was 0.577/0.657 and with 4.5 mm aperture 0.345/0.336. The SR (mean) with 3.0 mm aperture was 0.583/0.702 and with 4.5 mm aperture 0.269/0.237. In through focus MTF and aperture of 3.0 mm, the L-333 showed a peak of 0.41 with some enlarged depth of power of about 2 D. For the aperture of 4.5 mm, the MTF values of L-313 and L-333 were slightly reduced; L-333 showed an MTF peak of 0.23 and some reduced depth of power of about 1.5 D. Wavefront measurements showed no major aberrations for the L-313, while a combination of moderate increase in Z 4-0 and Z 6-0 with opposite sign was revealed for the L-333. CONCLUSION The enhanced monofocal Lentis Quantum (L-333) produces some enlarged depth of focus by combining spherical aberration of different order and opposite sign. The Lentis Quantum performs very well in comparison to the aspherical monofocal counterpart owing to its optical design. Results with large apertures were sufficient too, suggesting that the lens is a good option in eyes with a wide pupil and thus in refractive surgeries of young patients.
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Affiliation(s)
- Andreas F Borkenstein
- Borkenstein and Borkenstein Private Practice, Privatklinik der Kreuzschwestern Graz, Kreuzgasse 35, 8010, Graz, Austria.
| | - Eva-Maria Borkenstein
- Borkenstein and Borkenstein Private Practice, Privatklinik der Kreuzschwestern Graz, Kreuzgasse 35, 8010, Graz, Austria
| | - Ruediger Schmid
- Accuratis, Practice for Refractive Eye Surgery, Hirschstrasse 1, 89073, Ulm, Germany
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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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Wan KH, Au ACK, Kua WN, Ng ALK, Cheng GPM, Lam NM, Chow VWS. Enhanced Monofocal Versus Conventional Monofocal Intraocular Lens in Cataract Surgery: A Meta-analysis. J Refract Surg 2022; 38:538-546. [PMID: 35947003 DOI: 10.3928/1081597x-20220707-01] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare different outcomes of an enhanced monofocal intraocular lens (IOL) versus a conventional monofocal IOL implantation after cataract surgery. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline was used for abstracting data and assessing quality. Comparative studies between enhanced monofocal versus conventional monofocal IOL implantations reporting outcomes in monocular and binocular visual acuities at various distances, spectacle independence, contrast sensitivity, optical quality, and adverse effects were identified from three databases. Meta-analysis, sensitivity analysis, and subgroup analysis were performed. RESULTS A total of 680 eyes implanted with an enhanced monofocal IOL (Tecnis Eyhance ICB00; Johnson & Johnson) and 647 eyes with a conventional monofocal IOL from 3 randomized controlled trials and 9 comparative studies were included. The enhanced monofocal IOL showed better monocular uncorrected intermediate visual acuity (UIVA) (mean difference [MD]: -0.11 logMAR; 95% CI: -0.12 to -0.09), binocular UIVA (MD: -0.17 logMAR; 95% CI: -0.23 to -0.11), and binocular uncorrected near visual acuity performance (MD: -0.17 logMAR; 95% CI: -0.29 to -0.04) than the conventional monofocal IOL. More patients were spectacle free at intermediate distance with the enhanced monofocal IOL (odds ratio: 12.9; 95% CI: 6.2 to 27.0). Both monocular (MD: -0.002 logMAR; 95% CI: -0.01 to 0.01) and binocular (MD: 0.01 logMAR; 95% CI: -0.02 to 0.03) uncorrected distance visual acuity revealed non-significant differences between the IOL designs. Contrast sensitivity, photic phenomenon, and adverse effects were comparable. CONCLUSIONS Enhanced monofocal IOLs effectively improved unaided intermediate vision with similar distance performance relative to conventional monofocal IOLs. This was achieved without compromising the contrast sensitivity or inducing photic phenomena. [J Refract Surg. 2022;38(8):538-546.].
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Knecht VA, Colosi HA, Hassenstein A. Partial monovision achieved by unilateral implantation of a multifocal add-on lens with bilateral pseudophakia: evaluation and results. Graefes Arch Clin Exp Ophthalmol 2022; 260:2753-2762. [PMID: 35175409 PMCID: PMC9325843 DOI: 10.1007/s00417-022-05584-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/04/2022] [Accepted: 02/01/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To assess the results of partial monovision (PMV) in comparison to a bilateral monofocal implantation (MMV). METHODS The PMV group was treated bilaterally with a monofocal intraocular lens (IOL) implantation, followed 3 months later by the implantation of a multifocal AddOn® lens (+ 3.00 D) into the non-dominant eye. The MMV group received a bilateral monofocal IOL implantation intending to achieve a slight anisometropia (0.0 D/ - 0.50 D). The near visual acuity (UNVA), intermediate visual acuity (UIVA), distance visual acuity (UDVA), defocus curve, and Lang-Stereotest II were conducted uncorrected, binocular, and minimum 3 months after the last operation. For the contrast sensitivity test, the patients were refractively corrected. The Quality of Vision Questionnaire (QoV), Visual Function Questionnaire (VF-14), spectacle independence, and general satisfaction were also assessed. RESULTS A total of 27 PMV patients and 28 MMV patients without ocular diseases relevant to visual acuity were examined. The PMV group was significantly better at UNVA (0.11 ± 0.08 logMAR vs 0.56 ± 0.16 logMAR) and between - 2.00 and - 4.00 D in the defocus curve (p < 0.001). At the UIVA, the PMV group was slightly better (0.11 ± 0.10 logMAR vs 0.20 ± 0.18 logMAR) but not significant (p = 0.054). The UDVA (- 0.13 ± 0.09 logMAR vs - 0.09 ± 0.14 logMAR) (p = 0.315) and contrast sensitivity (p = 0.667) revealed no differences between the groups. The stereo vision was in favor of PMV (p = 0.008). Spectacle independence was statistically better for PMV at distance, intermediate, and near (distance p = 0.012; intermediate p < 0.001; near p < 0.001). In the VF-14 Questionnaire, the PMV was statistically superior (p < 0.001). The QoV Questionnaire showed no differences regarding frequency and severity of visual disturbances. Both groups were highly satisfied (p = 0.509). CONCLUSION Patients with PMV are more independent of glasses and are able to read without disadvantages in distance vision, due to halos and glare. The concept of PMV is well suited for the desire of eyeglass independence, without optical side effects.
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Affiliation(s)
- Vitus André Knecht
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- Department of Ophthalmology, Charité University Medicine Berlin, Mittelallee 4, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Horaţiu Alexandru Colosi
- Department of Medical Education, Division of Medical Informatics and Biostatistics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andrea Hassenstein
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Tahmaz V, Siebelmann S, Koch KR, Cursiefen C, Langenbucher A, Hoerster R. Evaluation of a Novel Non-Diffractive Extended Depth of Focus Intraocular Lens - First Results from a Prospective Study. Curr Eye Res 2022; 47:1149-1155. [PMID: 35642558 DOI: 10.1080/02713683.2022.2074046] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To evaluate a novel hydrophobic, non-diffractive, extended depth of focus (EDOF) intraocular lens (IOL) design in comparison to two monofocal aspheric lenses. METHODS Inclusion criteria for this prospective, monocentric cohort study were opacification of the crystalline lens and patients' wishes for surgery. In the case of the EDOF IOL, patients asked for a presbyopia correction. All patients received surgery on both eyes. Corrected and uncorrected distance visual acuity (CDVA, UCDVA), uncorrected and distance corrected intermediate visual acuity (UIVA, DCIVA) and defocus curves (all monocular and binocular) were compared three months postoperatively. RESULTS Fifty-six eyes were implanted with an EDOF IOL (LuxSmartTM, Bausch & Lomb GmbH, Berlin, Germany), 50 eyes with a monofocal aspheric IOL: 32 eyes with a clear IOL (Polylens® AS 61, Polytech Domilens, Roßdorf, Germany), 16 eyes with a yellow IOL (iSert® 251, Hoya Surgical Optics GmbH, Frankfurt, Germany). Three months postoperatively, UCDVA was comparable with the EDOF IOL, versus the monofocal IOL (P > 0.9). Binocular DCIVA in the EDOF IOL was significantly higher than in the monofocal IOL (P = 0.001). Monocular DCIVA better than 20/23 Snellen was achieved in 10% with the monofocal IOL and in 68% (P < 0.0001) with the EDOF IOL. Defocus curves showed a depth of focus at 20/23 Snellen of 1.6 vs. 0.83 diopters (D) in the EDOF IOL, vs. the monofocal IOL. No patient reported halos or starbursts in non-standardized questioning. CONCLUSION This non-diffractive EDOF IOL provided comparably high UCDVA and significantly higher DCIVA than the mono-focal lenses, causing only mild optical phenomena.
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Affiliation(s)
- Volkan Tahmaz
- Center of Ophthalmology, University of Cologne, Cologne, Germany
| | - Sebastian Siebelmann
- Center of Ophthalmology, University of Cologne, Cologne, Germany.,MVZ ADTC Moenchengladbach-Erkelenz, Erkelenz, Germany
| | - Konrad R Koch
- MVZ ADTC Moenchengladbach-Erkelenz, Erkelenz, Germany
| | - Claus Cursiefen
- Center of Ophthalmology, University of Cologne, Cologne, Germany
| | - Achim Langenbucher
- Department of Experimental Ophthalmology, Saarland University, Homburg, Germany
| | - Robert Hoerster
- Center of Ophthalmology, University of Cologne, Cologne, Germany.,MVZ ADTC Moenchengladbach-Erkelenz, Erkelenz, Germany
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Gundersen KG, Potvin R. Refractive and Visual Outcomes After Implantation of a Secondary Sulcus Intraocular Lens with an Extended Depth of Focus. Clin Ophthalmol 2022; 16:1861-1869. [PMID: 35711970 PMCID: PMC9192784 DOI: 10.2147/opth.s366145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 05/31/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose To evaluate the range of vision, visual function, and quality of vision after implantation of a secondary extended depth of focus intraocular lens (EDOF IOL) implanted in the sulcus. Setting One clinical practice in Haugesund, Norway. Design Prospective single arm non-interventional study. Methods Eligible subjects presenting for surgery, or who had previous successful primary cataract or refractive lens exchange surgery in both eyes were subsequently implanted with the AddOn® secondary EDOF IOL in the sulcus. Manifest refraction and visual acuity at distance, intermediate and near were measured 3 months after surgery, along with the monocular defocus curve. Subjects also completed a visual function and a quality of vision questionnaire. Results The study included 32 eyes of 16 subjects. At 3 months postoperative, the mean refraction spherical equivalent (MRSE) was −0.16 ± 0.30 D, with a residual cylinder of 0.29 ± 0.27 D. The mean monocular uncorrected VA was 0.1 logMAR (20/25) or better at all test distances. The monocular defocus curves showed a depth of focus of 2.0 D. For every category except reading fine print, all but one subject (94%) had no difficulty or little difficulty with near tasks. Glare and halos were the most common visual disturbances, with no reports of starbursts. There was no evidence of any intralenticular opacification in any of the eyes, and no evidence of iris chafing/depigmentation. Conclusion This secondary EDOF IOL provided excellent distance and intermediate vision, and very good near vision to subjects. Subject reported near visual function was also very good and visual disturbances were limited. This lens appears to be a good option for patients who would like to improve their range of vision. Results appear as good or better than those reported for primary EDOF lenses.
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Affiliation(s)
- Kjell Gunnar Gundersen
- IFocus Øyeklinikk AS, Haugesund, Norway
- Correspondence: Kjell Gunnar Gundersen, IFocus Øyeklinikk AS, Sørhauggata 111, Haugesund, 5527, Norway, Tel +47 808900, Email
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Kim JW, Eom Y, Park W, Song JS, Jeong JW, Park SK, Kim HM. Comparison of visual outcomes after two types of mix-and-match implanted trifocal extended-depth-of-focus and trifocal intraocular lenses. Graefes Arch Clin Exp Ophthalmol 2022; 260:3275-3283. [PMID: 35633381 DOI: 10.1007/s00417-022-05710-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 05/03/2022] [Accepted: 05/14/2022] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To compare visual outcomes between two types of mix-and-match implanted trifocal extended-depth-of-focus (EDoF) and trifocal intraocular lenses (IOLs). METHODS A total of 212 eyes of 106 subjects with mix-and-match implanted FineVision Triumf and FineVision HP IOLs (Triumf-HP group) and 212 eyes of 106 subjects with mix-and-match implanted Zeiss AT LARA and AT LISA IOLs (AT LARA-LISA group) were enrolled in this retrospective case-control study. Uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), and binocular distance-corrected defocus curves were measured between 6 and 10 weeks after cataract surgery. RESULTS There was no significant difference in UDVA among the four IOLs. UNVA was the best in eyes with the FineVision HP IOL (0.04 ± 0.06 logMAR), followed by eyes with the AT LISA IOL (0.07 ± 0.07 logMAR), the FineVision Triumf IOL (0.09 ± 0.09 logMAR), and the AT LARA IOL (0.11 ± 0.08 logMAR), respectively. The AT LARA-LISA group had better visual acuity than the Triumf-HP group between - 1.00 D and - 1.50 D of defocus, and the Triumf-HP group had better visual acuity than the AT LARA-LISA group between - 3.00 D and - 4.00 D of defocus. CONCLUSION Mix-and-match implantation of trifocal EDoF and trifocal IOLs provided good visual outcomes in far, intermediate, and near distances. The mix-and-match implantation of Triumf-HP IOLs led to better visual outcomes in near vision, while that of the AT LARA-LISA IOLs led to better visual outcomes in intermediate vision.
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Affiliation(s)
- Jung Wan Kim
- BGN Jamsil Lotte Tower Eye Clinic, Seoul, South Korea
| | - Youngsub Eom
- Department of Ophthalmology, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, South Korea. .,Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea.
| | - Wonkyung Park
- Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea
| | - Jong Suk Song
- Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea
| | - Ji Won Jeong
- BGN Jamsil Lotte Tower Eye Clinic, Seoul, South Korea
| | | | - Hyo Myung Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea
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Baur ID, Auffarth GU, Łabuz G, Khoramnia R. [Implantation of a Toric IOL with Enhanced Depth of Focus for Unilateral Traumatic Cataract]. Klin Monbl Augenheilkd 2022. [PMID: 35580622 DOI: 10.1055/a-1809-5187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Isabella Diana Baur
- Universitäts-Augenklinik Heidelberg, Universitätsklinikum Heidelberg, Deutschland
| | - Gerd U Auffarth
- Universitäts-Augenklinik Heidelberg, Universitätsklinikum Heidelberg, Deutschland
| | - Grzegorz Łabuz
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg, Deutschland
| | - Ramin Khoramnia
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg, Deutschland
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Baur ID, Auffarth GU, Łabuz G, Khoramnia R. Clinical outcomes in patients after duet procedure for reversible trifocality using a supplementary trifocal IOL. Am J Ophthalmol 2022; 241:217-226. [PMID: 35526588 DOI: 10.1016/j.ajo.2022.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE We report the clinical outcomes of patients who had primary lens implantation in the capsular bag and subsequently a supplementary trifocal lens implanted in the ciliary sulcus (duet procedure) to create reversible trifocality. DESIGN Retrospective interventional case series. METHODS Twenty-five patients were included in this single center clinical study, who had undergone either refractive lens exchange for presbyopia correction or cataract surgery. All had lens removal by phacoemulsification and duet procedure to achieve reversible trifocality. Preoperatively and three months postoperatively, uncorrected (UDVA) and corrected distance visual acuity (CDVA) were assessed, as well as uncorrected (UNVA), distance corrected (DCNVA) and corrected near visual acuity (CNVA). At the postoperative examination, uncorrected (UIVA), distance corrected (DCIVA) and corrected intermediate visual acuity (CIVA), defocus curve testing and dysphotopsia evaluation were also performed. RESULTS Monocular UDVA and CDVA improved from 0.71 ± 0.43 logMAR and 0.12 ± 0.16 logMAR preoperatively to 0.04 ± 0.10 logMAR and -0.01 ± 0.09 logMAR postoperatively. Monocular UNVA and DCNVA were both 0.06 ± 0.08 logMAR and UIVA and DCIVA 0.00 ± 0.10 logMAR and -0.02 ± 0.10 logMAR postoperatively. Monocular defocus curve testing revealed a visual acuity of 0.2 logMAR or better from +0.75 to -3.5 diopters. CONCLUSIONS Duet procedure using a trifocal supplementary IOL provided excellent results for far, near and intermediate distance, comparable to those reported for capsular bag fixated trifocal IOLs. The duet procedure offers the advantage of an exit-strategy in cases with a future loss of function or side effects associated with the optics.
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Nowik KE, Nowik K, Kanclerz P, Szaflik JP. Clinical Performance of Extended Depth of Focus (EDOF) Intraocular Lenses – A Retrospective Comparative Study of Mini Well Ready and Symfony. Clin Ophthalmol 2022; 16:1613-1621. [PMID: 35651536 PMCID: PMC9150758 DOI: 10.2147/opth.s341698] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/14/2022] [Indexed: 11/27/2022] Open
Abstract
Purpose Extended depth of focus intraocular (EDOF) IOLs form a bridge between single- and multifocal IOL design. This study aimed to compare clinical outcomes obtained after implanting two different optical designs of EDOF IOLs: the Mini Well Ready (SIFI Medtech, Catania, Italy) and Tecnis Symfony (Abbott Laboratories, Illinois, USA). Methods The retrospective observational study included 61 patients (122 eyes) who underwent bilateral implantation of the Mini Well Ready IOL (32 patients) or the Tecnis Symfony IOL (29 patients). The following preoperative and postoperative parameters were evaluated: spherical equivalent, anterior astigmatism, pupil size, monocular and binocular uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), monocular and binocular uncorrected intermediate visual acuity (UIVA) and distance-corrected intermediate visual acuity (DCIVA), monocular and binocular uncorrected near visual acuity (UNVA) and distance-corrected near visual acuity (DCNVA). In the 6 months postoperative period, defocus curve, contrast sensitivity, photopic phenomena, and posterior capsule opacification were assessed. Results The patients receiving the Tecnis Symfony had slightly better monocular and binocular UDVA and CDVA than with the Mini Well Ready IOL, the differences were not statistically significant. Whereas the UIVA, DCIVA, UNVA, DCNVA, UNVA and DCNVA values were higher in the Mini Well Ready group, the differences were not significant. There were no significant between-group differences regarding the defocus curve for the vast majority of tested vergences. Dysphotopsias postoperatively were assessed at 6 months. Conclusion Patients receiving both the Mini Well Ready and Symfony IOLs had excellent visual acuity outcomes and spectacle independence.
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Affiliation(s)
- Katarzyna Ewa Nowik
- Department of Ophthalmology, Public Ophthalmic Clinical Hospital (SPKSO), Medical University of Warsaw, Warsaw, Poland
- Correspondence: Katarzyna Ewa Nowik, Tel +48 509 873 680, Email
| | - Kamil Nowik
- Department of Ophthalmology, Public Ophthalmic Clinical Hospital (SPKSO), Medical University of Warsaw, Warsaw, Poland
| | - Piotr Kanclerz
- Department of Ophthalmology, Hygeia Clinic, Gdańsk, Poland
- Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland
| | - Jacek Paweł Szaflik
- Department of Ophthalmology, Public Ophthalmic Clinical Hospital (SPKSO), Medical University of Warsaw, Warsaw, Poland
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Shin DE, Lee H, Kim TI, Koh K. Comparison of visual results and optical quality of two presbyopia-correcting intraocular lenses: TECNIS symfony versus TECNIS synergy. Eur J Ophthalmol 2022; 32:3461-3469. [PMID: 35410507 DOI: 10.1177/11206721221093024] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE This study compared the extended depth of focus (EDOF) intraocular lens (IOL) (ZXR00; Tecnis® Symfony®, Johnson & Johnson Vision, Santa Ana, CA, USA) and a new presbyopia-correcting IOL that combines EDOF and multifocal profiles (ZFR00; Tecnis® Synergy®, Johnson & Johnson Vision, Santa Ana, CA, USA) with the same material. METHODS The medical records of patients undergoing cataract surgery with ZXR00 or ZFR00 implantation between March 2021 and July 2021 and with the data available for the 3-month visit were reviewed. The uncorrected near, intermediate, and distance visual acuity (VA), corrected distance VA, defocus curves, refractive errors (RE), optical quality parameters, and patient-reported visual performance parameters were the main outcome measures. RESULTS Among the twenty-three enrolled patients, twelve patients (21 eyes) received ZXR00 and nine patients (17 eyes) received ZFR00. The mean age of the patients was 59.6 ± 10.6 (range: 49 to 70) and 65.2 ± 8.2 (range: 45 to 82) years in ZXR00 and ZFR00 groups, respectively, without significant difference. There was not a significant difference between the two groups in terms of baseline parameters and postoperative RE. The ZFR00 group showed markedly superior intermediate and near VA (p < 0.001 for all) at 3 months postoperatively. In terms of optical quality, ZXR00 was significantly better than ZFR00 (p < 0.001). CONCLUSIONS Both IOLs had comparable distance VA. ZFR00 IOL was superior for intermediate and near visual acuity, but ZXR00 IOL was better for optical quality. Research with more participants is needed to support this finding.
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Affiliation(s)
- Da Eun Shin
- Department of Opthalmology, 224183Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Republic of Korea
| | - Hun Lee
- Department of Ophthalmology, Asan Medical Center, 571440University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Tae-Im Kim
- Department of Opthalmology, Severance Eye Hospital, 37991Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyungmin Koh
- Department of Opthalmology, 224183Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Republic of Korea
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Nov E, Rubowitz A, Dar N, Sharon T, Assia EI. Visual Performance of a Novel Optical Design of a New Multifocal Intraocular Lens. J Refract Surg 2022; 38:150-157. [PMID: 35275007 DOI: 10.3928/1081597x-20220105-01] [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: 11/20/2022]
Abstract
PURPOSE To evaluate the optical performance and quality of vision of a novel optical design of a new trifocal intraocular lens (IOL) using a proprietary modified algorithm. METHODS In this prospective, non-randomized, single-armed, single-center, open-label study, a total of 20 patients (40 eyes) who were candidates for multifocal lens implantation were recruited for implantation with the multifocal Intensity SL IOL (Hanita Lenses). Evaluation performed at 1 and 7 to 10 days and 1 and 3 months after implantation included corrected and uncorrected distance visual acuities at far, intermediate (80 cm), and near (40 cm). Monocular and binocular visual acuities, defocus curves, and contrast sensitivity were measured and questionnaires for grading subjective visual quality, satisfaction, and visual function were provided. RESULTS Three months postoperatively, monocular uncorrected visual acuity for distance, intermediate, and near averaged 0.03 ± 0.11, 0.09 ± 0.09, and -0.22 ± 0.09 logMAR, respectively (Snellen 20/21.4, 20/24.6, and 20/12). Corrected monocular visual acuity for distance, intermediate, and near averaged -0.07 ± 0.06, 0.03 ± 0.09, and -0.25 ± 0.07 logMAR (20/17, 20/21.4, and 20/11.2), respectively. Binocular corrected visual acuity for distance, intermediate, and near was -0.1 ± 0.06, -0.02 ± 0.09, and -0.28 ± 0.04 logMAR (20/15.8, 20/19, and 20/10.5), respectively. Contrast sensitivity was similar to the normal population in photopic and mesopic conditions. Defocus curves showed that this IOL provided visual acuity of 20/28.9 or better between a defocus of +1.00 and -3.50 diopters. The Visual Function Index-14 questionnaire showed that patients reported high satisfaction. Patients specifically noted good quality of vision at near and intermediate distances. CONCLUSIONS The Intensity SL IOL can provide good quality distance, intermediate, and particularly strong near vision after cataract surgery and independence from spectacles with good patient satisfaction. [J Refract Surg. 2022;38(3):150-157.].
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Comparison of Patient Outcomes following Implantation of Trifocal and Extended Depth of Focus Intraocular Lenses: A Systematic Review and Meta-Analysis. J Ophthalmol 2022; 2021:1115076. [PMID: 35003788 PMCID: PMC8731298 DOI: 10.1155/2021/1115076] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/17/2021] [Indexed: 01/19/2023] Open
Abstract
Purpose The purpose is to compare the outcomes of implantation of trifocal intraocular lenses (TIOLs) and extended depth of focus (EDOF) intraocular lenses (IOLs). Methods A comprehensive search of PubMed, Cochrane Library, EMBASE, and ClinicalTrial.gov was conducted in March 2020 to identify relevant studies. A meta-analysis of the results was performed. Patients implanted with EDOF IOLs or TIOLs in previous studies were included. The primary outcomes of the study were uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), and defocus curve. Results TIOLs and EDOF IOLs provided comparable binocular UDVA (MD = -0.01, 95% CI: -0.04, 0.03, logMAR). However, EDOF IOLs provided better UIVA (MD: -0.08, 95% CI: -0.14, -0.01, logMAR) and worse UNVA (MD: 0.10, 95% CI: 0.06, 0.14, logMAR) than TIOLs. Fewer patients achieved spectacle independence after implantation of EDOF IOLs (RR: 0.74, 95% CI: 0.63, 0.87) than after implantation of TIOLs, especially for near vision (RR = 0.82, 95% CI: 0.68, 0.99). There was no statistically significant difference in contrast sensitivity (CS) under photopic or mesopic conditions with both IOLs. Patient satisfaction after implantation of both IOLs was high. Conclusion EDOF IOLs and TIOLs provide comparable distance vision. However, EDOF IOLs provide better intermediate vision and worse near vision than TIOLs. The advantages of EDOF IOLs over TIOLs in terms of CS, aberrations, and visual disturbance are not significant. Patients are satisfied with both types of IOLs.
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