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Wu X, Liu X, Li D, Wang X, Huang Y. Therapeutic effect of a new implantation method of rotationally asymmetric multifocal intraocular lenses on visual quality. Int Ophthalmol 2023; 43:4621-4629. [PMID: 37715824 DOI: 10.1007/s10792-023-02862-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/20/2023] [Indexed: 09/18/2023]
Abstract
PURPOSE To assess the visual quality after implantation of a rotationally asymmetric multifocal intraocular lens (IOL) using a new method according to the angle kappa. SETTING Qingdao Eye Hospital, Qingdao, China. DESIGN Prospective case series. METHODS Patients with the implantation of SBL-3 IOLs for age-related cataract from September to December 2019 had the distance-horizontal zone of the IOL placed at the center of the optic axis using the Callisto Eye System. Postoperative visual acuities and defocus curves were recorded. Modulation transfer function cutoff frequency, Strehl ratio, and objective scatter index were measured using the Optical Quality Analysis System. The decentration and tilt of IOLs were analyzed by iTrace aberrometry and anterior segment optical coherence tomography. A questionnaire of patient satisfaction was also collected. RESULTS Thirty patients (60 eyes) were involved, with a balanced sex ratio. Their average age was 56.04 ± 10.83 years. The average angle kappa distance was 0.23 ± 0.121 mm. At 3 months after surgery, the mean uncorrected and corrected distance visual acuities were 0.01 ± 0.07 logMAR and 0.01 ± 0.06 logMAR. The uncorrected intermediate and near visual acuities were 0.09 ± 0.11 logMAR and 0.09 ± 0.11 logMAR. The mean horizontal and vertical tilts of IOLs were 0.67 ± 0.52 degrees and 0.47 ± 0.32 degrees. The mean decentration of IOLs was 0.17 ± 0.08 mm. Most patients were satisfied with their distance, intermediate, and near vision. There was mild glare in 58.3% of the eyes. CONCLUSIONS Locating the center of the optic axis in the distance-horizontal zone during the implantation of SBL-3 IOLs could provide satisfactory visual acuity and quality.
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Affiliation(s)
- Xian Wu
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University, Qingdao, China
| | - Xiaomin Liu
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University, Qingdao, China
| | - Dongfang Li
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University, Qingdao, China
| | - Xiaoyun Wang
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University, Qingdao, China
| | - Yusen Huang
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China.
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University, Qingdao, China.
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Bai H, Li H, Zheng S, Sun L, Wu X. Nd:YAG Capsulotomy Rates with Two Multifocal Intraocular Lenses. Int J Gen Med 2021; 14:8975-8980. [PMID: 34876835 PMCID: PMC8643175 DOI: 10.2147/ijgm.s342039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/11/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate the incidence of Nd:YAG capsulotomy after implantation of two types of multifocal intraocular lenses (MIOLs). Methods This retrospective analysis included patients who had undergone cataract extraction and implanted diffractive MIOL (Acri. LISA tri 839M) or asymmetric refractive MIOL (SBL-3) from May 2016 to September 2018. They were followed up for at least 3 years. During the follow-up period, the relevant data of patients were kept by special person in the hospital. The rates of Nd:YAG capsulotomy and the Kaplan-Meier survival curve were used to analyze the two groups. Results The Asymmetric Refractive MIOL group was comprised of 98 patients (121 eyes), while the Diffractive MIOL group was comprised of 99 patients (120 eyes). There were no significant differences in age, sex, or IOL power between the two groups. The Nd:YAG rate of the asymmetric refractive MIOL group and the diffractive MIOL group was 3.3% and 7.5% respectively (P = 0.15) in the first year, 14.88% and 22.5% respectively (P = 0.129) in the second year, and 21.49% and 34.17% respectively (P = 0.028) in the third year. In the first 7 months of follow-up, the two groups showed the same performance in the Nd:YAG rate. After that, there was a difference between the two groups, and the difference gradually increased. Until the 27th month of follow-up, the difference was significant (P < 0.05). What is more, there were significant differences in survival (without Nd:YAG capsulotomy)/failure (with Nd:YAG capsulotomy) functions (P = 0.0035). Conclusion The incidence of Nd:YAG laser capsulotomy in patients with diffractive MIOLs was higher than that in patients with asymmetric refractive MIOLs.
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Affiliation(s)
- Huiran Bai
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, People's Republic of China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, People's Republic of China
| | - Honglei Li
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, People's Republic of China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, People's Republic of China
| | - Simeng Zheng
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, People's Republic of China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, People's Republic of China
| | - Lihong Sun
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, People's Republic of China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, People's Republic of China
| | - Xiaoming Wu
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, People's Republic of China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, People's Republic of China
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Song Y, Overmass M, Fan J, Hodge C, Sutton G, Lovicu FJ, You J. Application of Collagen I and IV in Bioengineering Transparent Ocular Tissues. Front Surg 2021; 8:639500. [PMID: 34513910 PMCID: PMC8427501 DOI: 10.3389/fsurg.2021.639500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 07/26/2021] [Indexed: 12/13/2022] Open
Abstract
Collagens represent a major group of structural proteins expressed in different tissues and display distinct and variable properties. Whilst collagens are non-transparent in the skin, they confer transparency in the cornea and crystalline lens of the eye. There are 28 types of collagen that all share a common triple helix structure yet differ in the composition of their α-chains leading to their different properties. The different organization of collagen fibers also contributes to the variable tissue morphology. The important ability of collagen to form different tissues has led to the exploration and application of collagen as a biomaterial. Collagen type I (Col-I) and collagen type IV (Col-IV) are the two primary collagens found in corneal and lens tissues. Both collagens provide structure and transparency, essential for a clear vision. This review explores the application of these two collagen types as novel biomaterials in bioengineering unique tissue that could be used to treat a variety of ocular diseases leading to blindness.
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Affiliation(s)
- Yihui Song
- Save Sight Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Morgan Overmass
- Save Sight Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Jiawen Fan
- Key Laboratory of Myopia of State Health Ministry, Department of Ophthalmology and Vision Sciences, Eye and Ear, Nose, and Throat (ENT) Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Chris Hodge
- Save Sight Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- New South Wales (NSW) Tissue Bank, Sydney, NSW, Australia
- Vision Eye Institute, Chatswood, NSW, Australia
| | - Gerard Sutton
- Save Sight Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- New South Wales (NSW) Tissue Bank, Sydney, NSW, Australia
- Vision Eye Institute, Chatswood, NSW, Australia
| | - Frank J. Lovicu
- Save Sight Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Discipline of Anatomy and Histology, School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Jingjing You
- Save Sight Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia
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Patnaik JL, Christopher KL, Pedler MG, Shieh B, Petrash CC, Wagner BD, Mandava N, Lynch AM, Palestine AG, Petrash JM. The Protective Effect of Metformin Use on Early Nd:YAG Laser Capsulotomy. Invest Ophthalmol Vis Sci 2021; 62:24. [PMID: 34415985 PMCID: PMC8383914 DOI: 10.1167/iovs.62.10.24] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Purpose To determine the effect of metformin on early Nd:YAG laser treatment for posterior capsule opacification (PCO) and to explore a molecular mechanism to explain a possible protective effect of metformin against PCO. Methods We conducted: 1) a retrospective cohort study of patient eyes undergoing phacoemulsification at our institution; and 2) laboratory investigation of the effect of metformin on the behavior of lens epithelial cells in the context of an animal model for PCO. Population-averaged Cox proportional hazards modeling was used to estimate risk for time to Nd:YAG. For laboratory studies, expression of markers for epithelial-to-mesenchymal transition (EMT) implicated in PCO pathogenesis was measured in tissue culture and following extracapsular lens extraction in a mouse model. Results The rate of Nd:YAG laser capsulotomy was 13.1% among the 9798 eyes. Both metformin use and diabetes were protective factors for Nd:YAG laser capsulotomy in univariate analysis. However, in multivariable analysis with nondiabetics as the reference group, only metformin use among diabetics was significantly protective of Nd:YAG (hazard ratio: 0.68, 95% CI: 0.54–0.85, P = 0.0008), while eyes of patients with diabetes without metformin use did not significantly differ (P = 0.5026). Treatment of lens epithelial cells with metformin reduced the level of the EMT markers ⍺-SMA and pERK induced by TGF-β2. Similarly, metformin treatment reduced ⍺-SMA expression in lens epithelial cells following extracapsular lens extraction in a mouse model. Conclusions The protective effect of metformin against early Nd:YAG may relate to its ability to downregulate EMT in residual lens epithelial cells that otherwise trend toward myofibroblast development and PCO.
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Affiliation(s)
- Jennifer L Patnaik
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, United States
| | - Karen L Christopher
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, United States
| | - Michelle G Pedler
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, United States
| | - Biehuoy Shieh
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, United States
| | - Carson C Petrash
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, United States
| | - Brandie D Wagner
- Department of Biostatistics, Colorado School of Public Health, Aurora, Colorado, United States
| | - Naresh Mandava
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, United States
| | - Anne M Lynch
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, United States
| | - Alan G Palestine
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, United States
| | - J Mark Petrash
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, United States
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5
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Kim JW, Eom Y, Yoon EG, Choi Y, Song JS, Jeong JW, Park SK, Kim HM. Comparison of Nd:YAG Laser Capsulotomy Rates Between Refractive Segmented Multifocal and Multifocal Toric Intraocular Lenses. Am J Ophthalmol 2021; 222:359-367. [PMID: 33039372 DOI: 10.1016/j.ajo.2020.09.046] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE To investigate the early incidence of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy according to intraocular lens (IOL) type (nontoric vs toric) and surgical techniques (femtosecond laser-assisted cataract surgery vs conventional phacoemulsification) in eyes with refractive multifocal IOLs. DESIGN Retrospective case-control study. METHODS Nine hundred thirteen eyes from 483 patients implanted with Lentis Mplus LS-313 MF20 (767 eyes) or Lentis Mplus Toric LU-313 MF20T (146 eyes) IOLs (Oculentis GmbH, Berlin, Germany) were enrolled. We compared the incidence of Nd:YAG laser capsulotomy between the nontoric and toric groups. In addition, the incidence of Nd:YAG laser capsulotomy was also evaluated according to the surgical technique used. RESULTS The overall incidence of Nd:YAG laser capsulotomy was 10.2% (93/913 eyes). The Nd:YAG laser capsulotomy rate was significantly higher in the toric group (24/146; 16.4%) than in the nontoric group (69/767; 9.0%; P = .007). Of the 913 enrolled eyes, 448 eyes (49.1%) underwent femtosecond laser-assisted cataract surgery and 465 eyes (50.9%) underwent conventional phacoemulsification cataract surgery. There was no significant difference in the incidence of Nd:YAG laser capsulotomy between eyes with femtosecond laser-assisted cataract surgery and eyes with conventional phacoemulsification cataract surgery. CONCLUSION Patients with refractive multifocal toric IOLs had higher early incidence rates of Nd:YAG laser capsulotomy when compared to those with refractive multifocal nontoric IOLs. Furthermore, femtosecond laser-assisted cataract surgery could not reduce the early incidence of Nd:YAG laser capsulotomy in this study.
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Fang Y, Xixia D, Jin L, Lei L, Pingjun C, Hongfang Z, Yun-E Z. Relationship of Posterior Capsular Opacification and Capsular Bend Type Investigation Based on Swept-source Optical Coherence Tomography. Curr Eye Res 2019; 45:17-23. [PMID: 31348676 DOI: 10.1080/02713683.2019.1645183] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To investigate the relationship between capsular bend type and posterior capsule opacification (PCO) at a three-dimensional (3D) level using high-speed swept-source optical coherence tomography (SS-OCT).Methods: This was a retrospective study. A total of 99 eyes that underwent standard cataract surgery with phacoemulsification 2 years ago were analyzed. Standard SS-OCT radial scanning was performed in all eyes and the obtained photos were used for morphological observations of the capsular bend-IOL complex, the adhesion of posterior capsule to the IOL optic, and the position of the anterior capsulorhexis. Digital retroillumination photographs were taken of the posterior capsule of each eye to evaluate PCO (scoring and area).Results: In terms of the PCO score and area, there was no statistical difference between eyes with complete and incomplete adhesion of posterior capsule to IOL (both P > .05), whereas the partial overlap group showed a statistical difference greater than the total overlap group (P < .05). There were two types of capsular bends, completed adhesion (CA) and incomplete adhesion (IA). IA was divided into funnel adhesion (IA-F), parallel adhesion (IA-P), and detached adhesion (IA-D). The incomplete adhesion index (IAI) varied between eyes and ranged from 0 to 1. The PCO score and area in the high IAI group (higher than 0.50) were significantly greater than the low IAI group (< 0.50) (P < .05). In addition, the PCO score and area were significantly higher in the cohort with at least one IA-D capsular bend in six districts to the group that did not have IA-D capsular bend (P < .05).Conclusions: Complete or incomplete adhesion of the posterior capsule to the IOL optic may not be necessary for the development of PCO. Our study suggests that capsular bend type may be used as an index to predict PCO.
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Affiliation(s)
- Yu Fang
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ding Xixia
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Li Jin
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lin Lei
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chang Pingjun
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhang Hongfang
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhao Yun-E
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
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Hao J, Tan LZ, Li L, Bu SC, Ren XJ, Tian F, Zhang H. Comparison of visual quality in cataract patients with low astigmatism after ART2 or ReSTOR intraocular lens implantation. Int J Ophthalmol 2019; 12:424-428. [PMID: 30918811 DOI: 10.18240/ijo.2019.03.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 06/28/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To compare visual quality in cataract patients with low corneal astigmatism who underwent intraocular lens (IOL) implantation, and evaluate effects of low levels of astigmatism on visual outcomes in multifocal pseudophakic eyes. METHODS This retrospective review of clinical records comprised patients with preoperative regular corneal astigmatism of 0.75-1.0 diopters (D) with-the-rule or 0.5-0.75 D against-the-rule who had uneventful cataract surgery and AcrySof IQ ReSTOR Toric-2 IOL (ART2) or AcrySof IQ ReSTOR IOL (ReSTOR) implantation. Retrospective data collection included postoperative ART2 axis rotation, uncorrected astigmatism, uncorrected entire visual acuities, distance corrected entire visual acuities, average modulation transfer function (aMTF), Strehl ratio (SR), spectacle independence, and patient satisfaction between groups. RESULTS Mean ART2 axis rotation was 3.12°±0.70°. No secondary surgery was required to realign IOL axis. Residual astigmatism values were -0.18±0.07 D and -0.91±0.25 D in groups ART2 and ReSTOR (P<0.05). Three months postoperatively, the mean uncorrected distant, intermediate, and near visual acuities of group A were 0.01±0.05, 0.05±0.07, 0.02±0.07 logMAR, respectively; these were better than those of group R, which were 0.08±0.06, 0.15±0.12, and 0.09±0.08 logMAR, respectively (P<0.05). aMTF, SR, and spectacle independence rates were not significantly different. All patients were satisfied with postoperative results. CONCLUSION ART2 is more suitable than ReSTOR for cataract patients with regular corneal astigmatism 0.75-1.0 D with-the-rule or 0.5-0.75 D against-the-rule.
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Affiliation(s)
- Jing Hao
- Tianjin Medical University Eye Hospital, Tianjin 300384, China.,North China University of Science and Technology, Tangshan 063000, Hebei Province, China
| | - Liang-Zhang Tan
- Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Lin Li
- Tangshan Gongren Hospital, Tangshan 063000, Hebei Province, China
| | - Shao-Chong Bu
- Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Xin-Jun Ren
- Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Fang Tian
- Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Hong Zhang
- Tianjin Medical University Eye Hospital, Tianjin 300384, China
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Dick HB, Schultz T, Lesieur G, Morselli S, Toso A, Alio JL, Buckhurst PJ, Johansson B. Evaluation of clinical outcomes following implantation of a sub-2-mm hydrophilic acrylic MICS intraocular lens. Int Ophthalmol 2018; 39:1043-1054. [PMID: 29654574 DOI: 10.1007/s10792-018-0905-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 03/22/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate clinical outcomes following sub-2-mm microincision cataract surgery (MICS) and intraocular lens (IOL) implantation. SETTING Five EU clinical sites. DESIGN Prospective, multicenter, open-label, single-arm, non-randomized. METHODS Preoperative assessment involved visual acuity (VA), intraocular pressure and biometry measurements. 1.4-mm wound-assisted or 1.8-mm MICS was performed. Follow-up visits were made 1 day, 1-2 weeks, 1-2 and 4-6 months after surgery. The incision size, corrected distance VA (CDVA), uncorrected distance VA, manifest refraction spherical equivalent (MRSE), refraction predictability/stability and IOL decentration were assessed. At 12-, 18-, and 24-month, long-term centration, posterior capsular opacification (PCO) and Nd:YAG capsulotomy rates were investigated. RESULTS A total of 103 eyes were implanted with the study IOL (INCISE, Bausch & Lomb), 96 of which were included in visual outcome analysis. A mean 6-month CDVA of - 0.02 logMAR (20/20 + 1) was observed and 75 eyes (79.8%) and 93 eyes (98.3%) achieved a visual acuity of at least 20/20 or 20/40. Mean MRSE was - 0.20 ± 0.60 D. Mean absolute predictive error was 0.44 ± 0.36 D, with 90.4% within 1.00 D of target. Mean total decentration was 0.35 ± 0.36 mm at 6 months and 0.32 ± 0.14 mm at 24 months (p > 0.05). 24-month evaluation of posterior capsular opacification score was 0.03 for the central area. A Nd:YAG rate of 3.4% was observed at 24 months. CONCLUSIONS The new MICS IOL provided excellent visual outcomes and was safe and effective for the sub-2-mm procedure. The MICS IOL demonstrated long-term centration, stability and a low rate of PCO development.
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Affiliation(s)
- H Burkhard Dick
- University Eye Hospital Bochum, In der Schornau 23-25, 44892, Bochum, Germany.
| | - Tim Schultz
- University Eye Hospital Bochum, In der Schornau 23-25, 44892, Bochum, Germany
| | | | - Simonetta Morselli
- Ospedale di Bassano del Grappa Bassano del Grappa, Bassano del Grappa, Italy
| | - Antonio Toso
- Ospedale di Bassano del Grappa Bassano del Grappa, Bassano del Grappa, Italy
| | - Jorge L Alio
- Vissum-Instituto Oftalmologico de Alicante, University Miguel Hernandez, Alicante, Spain
| | | | - Björn Johansson
- Department of Ophthalmology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.,St. Erik Eye Hospital, Stockholm, Sweden
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Pérez-Vives C. Biomaterial Influence on Intraocular Lens Performance: An Overview. J Ophthalmol 2018; 2018:2687385. [PMID: 29736282 DOI: 10.1155/2018/2687385] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 12/08/2017] [Accepted: 01/02/2018] [Indexed: 11/18/2022] Open
Abstract
There is strong evidence that the IOL material is the factor having the greatest impact on posterior capsule opacification (PCO), anterior capsule opacification (ACO) development, and glistening formation after cataract surgery, even though there are other IOL features—such as haptic material and design and edge and optic design—that also have some influence. We reviewed the published literature describing the adverse events that are mainly related to the intraocular lens (IOL) material, such as PCO, ACO, and the subsequent capsule contraction, as well as glistening formation. The adverse events presented in this overview are the most common ones in clinical practice, and therefore, they are generally included in the clinical protocols for IOL evaluation.
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Singh Dhaliwal K. Commentary: Presbyopia correction with intraocular lenses. Indian J Ophthalmol 2018; 66:704-705. [PMID: 29676324 PMCID: PMC5939172 DOI: 10.4103/ijo.ijo_125_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
Modern day cataract surgery is evolving from a visual restorative to a refractive procedure. The advent of multifocal intraocular lenses (MFIOLs) allows greater spectacle independence and increased quality of life postoperatively. Since the inception in 1980s, MFIOLs have undergone various technical advancements including trifocal and extended depth of vision implants more recently. A thorough preoperative workup including the patients' visual needs and inherent ocular anatomy allows us to achieve superior outcomes. This review offers a comprehensive overview of the various types of MFIOLs and principles of optimizing outcomes through a comprehensive preoperative screening and management of postoperative complications.
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Affiliation(s)
| | - Mahipal Sachdev
- Chairman and Medical Director, Centre for Sight, B-5/24, Safdarjung Enclave, New Delhi, India
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Alió JL, Kaymak H, Breyer D, Cochener B, Plaza-Puche AB. Quality of life related variables measured for three multifocal diffractive intraocular lenses: a prospective randomised clinical trial. Clin Exp Ophthalmol 2017; 46:380-388. [DOI: 10.1111/ceo.13084] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 09/25/2017] [Accepted: 09/27/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Jorge L Alió
- Research Development; Vissum Instituto Oftalmologico de Alicante; Alicante Spain
| | - Hakan Kaymak
- Breyer; Kaymak und Klabe Augenchirurgie; Düsseldorf Germany
| | - Detlef Breyer
- Breyer; Kaymak und Klabe Augenchirurgie; Düsseldorf Germany
| | | | - Ana B Plaza-Puche
- Research Development; Vissum Instituto Oftalmologico de Alicante; Alicante Spain
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Kossack N, Schindler C, Weinhold I, Hickstein L, Lehne M, Walker J, Neubauer AS, Häckl D. German claims data analysis to assess impact of different intraocular lenses on posterior capsule opacification and related healthcare costs. Z Gesundh Wiss 2017; 26:81-90. [PMID: 29416961 PMCID: PMC5794811 DOI: 10.1007/s10389-017-0851-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 09/26/2017] [Indexed: 12/31/2022]
Abstract
Aim Cataract extraction is one of the most frequent surgeries in Germany. In most cases, the clouded natural lens is replaced by a hydrophobic or hydrophilic acrylic intraocular lens (IOL) implant. The most common long-term complication after cataract surgery is the development of a posterior capsule opacification (PCO). Although no precise real world data are available, published evidence suggests a lower risk for PCO development for hydrophobic acrylic IOLs compared to hydrophilic acrylic IOLs. Therefore, in the present study we assessed real world data on the impact of different IOL material types on the incidence of post-operative PCO treatment. Subject and methods In this retrospective study, we included 3,025 patients who underwent cataract extraction and implantation of either an acrylic hydrophobic or hydrophilic IOL in 2010. We assessed clinical outcomes and direct costs in a 4-year follow-up period after cataract surgery from a statutory health insurance (SHI) perspective in Germany. Results PCO that required capsulotomies occurred significantly (p < 0.0001) less frequent in patients who had received a hydrophobic IOL (31.57% of 2,078 patients) compared to the group with hydrophilic IOL implants (56.6% of 947 patients) and costs per patient for postoperative treatment in a 4-year follow-up were 50.03 € vs. 87.81 € (i.e. 75% higher in the latter group, p < 0.0001). Conclusion Considering the high prevalence of cataract, the economic burden associated with adverse effects of cataract extraction is of great relevance for the German SHI. Hydrophobic lenses seem to be superior regarding both medical and economic results.
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Affiliation(s)
- Nils Kossack
- WIG2 Institute for Health Economics and Health System Research, Leipzig, Germany
| | - Christian Schindler
- WIG2 Institute for Health Economics and Health System Research, Leipzig, Germany
| | - Ines Weinhold
- WIG2 Institute for Health Economics and Health System Research, Leipzig, Germany
| | | | | | - Jochen Walker
- InGef Institut für angewandte Gesundheitsforschung, Berlin, Germany
| | | | - Dennis Häckl
- WIG2 Institute for Health Economics and Health System Research, Leipzig, Germany
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Jorge PA, Koch CR, Jorge D, Kara-Junior N. Long-term efficiency of cataract surgery with hydrophilic acrylic Ioflex intraocular lens. Clinics (Sao Paulo) 2017; 72:543-546. [PMID: 29069257 PMCID: PMC5629703 DOI: 10.6061/clinics/2017(09)04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 05/16/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To evaluate the efficiency of long-term cataract surgery using low-cost intraocular lens implantation in community campaigns. METHODS Fifty-eight randomly selected patients were evaluated four years after phacoemulsification and Ioflex intraocular lens implantation. Causes of low visual acuity related to the intraocular lens were evaluated, and treatment costs were calculated. RESULTS The mean age of patients was 72±10.2 years. Four years after surgery, 25 eyes (43.0%) had decreased visual acuity related to the intraocular lens: posterior capsule opacification was noted in 24 eyes (41.3%), and intraocular lens opacification was noted in one eye (1.7%). The total cost of the post-surgical complication treatments represented 6.3% of the initial budget of the entire surgical patient group. CONCLUSIONS The efficiency of cataract surgery with low-cost Ioflex intraocular lens implantation was significantly reduced in a long-term follow-up study because postoperative complications related to intraocular lenses emerged at higher rates than when the gold-standard treatment was used.
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Affiliation(s)
- Priscilla A. Jorge
- Departamento de Oftalmologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
| | - Camila Ribeiro Koch
- Departamento de Oftalmologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Delano Jorge
- Departamento de Oftalmologia, Universidade Federal de Sao Paulo, Sao Paulo, SP, BR
| | - Newton Kara-Junior
- Departamento de Oftalmologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
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Alio JL, Plaza-puche AB, Férnandez-buenaga R, Pikkel J, Maldonado M. Multifocal intraocular lenses: An overview. Surv Ophthalmol 2017; 62:611-34. [DOI: 10.1016/j.survophthal.2017.03.005] [Citation(s) in RCA: 168] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 02/28/2017] [Accepted: 03/03/2017] [Indexed: 01/18/2023]
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Shodai R, Negishi K, Arai H, Toda I, Torii H, Tsubota K. Comparative analysis of the visual and refractive outcomes of a refractive segmented multifocal intraocular lens with and without toricity: 1-year results. Jpn J Ophthalmol 2017; 61:142-149. [PMID: 28091897 DOI: 10.1007/s10384-016-0497-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 10/27/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE To compare the visual and refractive outcomes up to 1 year postoperatively following implantation of a refractive segmented or a refractive segmented toric multifocal intraocular lens (IOL). METHODS This retrospective study included 108 eyes of 64 patients who underwent cataract surgery with implantation of a refractive segmented multifocal IOL (Lentis Mplus LS-313 MF30 IOL) (LM group) and 81 eyes of 49 patients with implantation of a refractive segmented toric multifocal IOL (Lentis Mplus LU-313 MF30T IOL) (LMT group). The visual and refractive postoperative outcomes and the rate of additional refractive procedures were evaluated up to 1 year postoperatively. RESULTS The uncorrected distance visual acuity (VA) and uncorrected near VA exceeded 1.0 and 0.60 in decimal VA, respectively, and both were stable postoperative groups. The postoperative subjective refractive astigmatism was also stable and the postoperative refraction was near emmetropia in both groups. No significant differences were found in the need for additional surgical refractive procedures. CONCLUSION The outcomes with a refractive segmented toric multifocal IOL were comparable to those with a non-toric model despite higher preoperative corneal astigmatism.
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Affiliation(s)
- Ryo Shodai
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | | | | | - Hidemasa Torii
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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Mojzis P, Majerova K, Hrckova L, Piñero DP. Implantation of a diffractive trifocal intraocular lens: One-year follow-up. J Cataract Refract Surg 2015; 41:1623-30. [DOI: 10.1016/j.jcrs.2014.11.050] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 11/08/2014] [Accepted: 11/11/2014] [Indexed: 10/23/2022]
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Bourdiol Ducasse AM, Guerzider V, Velasque L, Dominguez M, Lafuma A, Robert J. Comparison of clinical efficacy: Nd:YAG laser rates after implantation of AcrySof® SN60WF, Akreos® AO-MI60 and Hoya® YA-60BB. J Fr Ophtalmol 2013; 36:575-82. [PMID: 23618731 DOI: 10.1016/j.jfo.2012.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Revised: 07/04/2012] [Accepted: 07/17/2012] [Indexed: 11/23/2022]
Abstract
PURPOSE To compare Nd:YAG laser rates following implantation of AcrySof(®) SN60WF (Alcon), Akreos(®) AO-MI60 (Baush & Lomb), and Hoya(®) YA-60BB (Hoya) intraocular lenses. METHODS This retrospective study was conducted at three French centers with each implanting at least two of the three implants. Included patients had undergone uncomplicated cataract surgery with at least 3 years of follow-up. Records of patients implanted with one of the three IOL's were drawn randomly from the surgical logs. Postoperative data were obtained from the medical records of either the surgeon or the referring physician. Time elapsing until Nd:YAG laser was analysed using Kaplan-Meier survival curves. RESULTS Three hundred eyes were implanted (AcrySof(®) 126, Akreos(®) 89, and Hoya(®) 85). AcrySof(®) recipients were the youngest (AcrySof(®) 72.1, Akreos(®) 76.4, and Hoya(®) 75.2 years of age: P=0.0007). The sex ratio was 4:6 male:female. Follow-up was longest for Hoya eyes (AcrySof(®) 29.4, Akreos(®) 24.6 and Hoya(®) 34.6 months; P=0.0002). Eyes implanted with AcrySof(®) had 1.74 times less chance of Nd:YAG laser treatment than Hoya eyes (P=0.0327) and 3.50 times less than Akreos(®) eyes (P<0.0001). The results remained unchanged when the analysis was restricted to events in the first 24 months (Risk Ratios: Hoya(®)=2.64: P=0.02; and Akreos(®)=4.22: P=0.0001). Adjustment on unbalanced confounding variables did not alter the results. CONCLUSIONS Eyes with AcrySof(®) implants required significantly fewer Nd:YAG laser capsulotomies than those with Hoya(®) and Akreos(®) implants and were therefore less subject to Nd:YAG laser treatment complications, thus ensuring better vision at the lowest cost.
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Abstract
PURPOSE OF REVIEW To describe the epidemiology, pathogenesis, and recent developments in the diagnosis and management of postcataract surgery inflammation. RECENT FINDINGS In patients with pre-existing uveitis, control of inflammation with topical and/or systemic therapy for 3 months preoperatively continues to be important in lessening the risk of postoperative inflammation and complications. During cataract surgery, intraocular lens selection in these patients is important. Recent literature suggests that modern intraocular lenses (IOLs), particularly hydrophilic or hydrophobic acrylic lenses, generally have good uveal biocompatibility in uveitic patients. The postoperative course can be complicated by inflammation and cystoid macular edema (CME), and in uveitic patients, intensive perioperative steroid treatment can lessen these complications. Recent studies show that in uveitic patients, the improvement in CME and inflammation after intravitreal triamcinolone is better than after orbital floor triamcinolone injection, but that a single intraoperative orbital floor injection of triamcinolone is as effective as a 4-week course of postoperative oral prednisolone. Although postoperative inflammation in uveitic patients may be due to recurrence of uveitis, one must recognize other important potential causes of postoperative inflammation and treat accordingly. SUMMARY Most patients with postcataract inflammation have good visual outcomes provided that the cause is recognized and that there is adequate perioperative planning in patients predisposed to inflammation.
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