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Chen JL, Al-Mohtaseb ZN, Chen AJ. Criteria for premium intraocular lens patient selection. Curr Opin Ophthalmol 2024; 35:353-358. [PMID: 38920096 DOI: 10.1097/icu.0000000000001067] [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: 06/27/2024]
Abstract
PURPOSE OF REVIEW To discuss available premium intraocular lenses (IOLs), patient selection, and important considerations for each premium IOL. RECENT FINDINGS We review important topics and considerations for premium IOL selection: specifically, toric, extended depth of focus (EDOF), multifocal/trifocal, light adjustable lenses (LALs), and small aperture IOLs. Toric lenses are an excellent option for patients with astigmatism. However, to achieve optimal patient satisfaction, it is critical to account for the ATR astigmatism contribution from the posterior cornea and high angle alphas. Additionally, examining the ocular surface prior to placement of EDOF/multifocal IOLs is important, yet the significance of HOAs on outcomes after implantation still must be elucidated more. Finally, recent studies reveal that the small aperture lens is a good alternative for those with corneal irregularities, and second generation LALs are a great option to achieve target refractions in those with less predictable refractive outcomes, such as in Fuchs' dystrophy or in eyes with previous refractive surgery.
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Affiliation(s)
- Jacqueline L Chen
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | | | - Allison J Chen
- Baylor College of Medicine, Cullen Eye Institute, Department of Ophthalmology, Houston, Texas, USA
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Mito T, Ishida H, Seki Y, Shirayama T, Ukai Y, Sasaki H. Comparison of Postoperative Axial Rotation of the Toric Intraocular Lens in Cataract Surgery Combined with Vitrectomy versus Cataract Surgery Alone. Ophthalmologica 2024:1-7. [PMID: 39004075 DOI: 10.1159/000539986] [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: 03/08/2024] [Accepted: 06/19/2024] [Indexed: 07/16/2024]
Abstract
INTRODUCTION This study compared the postoperative axial rotation of the toric intraocular lens (T-IOL) after cataract surgery combined with vitrectomy versus cataract surgery alone. METHODS This retrospective, non-randomized, observational study enrolled patients who underwent cataract surgery combined with vitrectomy in one eye and cataract surgery alone in the contralateral eye. AcrySof Toric IOLs (Alcon Laboratories) were implanted in both eyes of the same patient. The axial rotation of the T-IOL was analyzed 3 months postoperatively using photographs obtained during and after surgery. In the combined group, T-IOL axial alignment was performed before vitrectomy. Preoperative corneal astigmatism and postoperative residual astigmatism were also compared in both groups. RESULTS This study examined 36 eyes of 18 patients (74.7 ± 6.8 years). The axial rotation was 2.94 ± 1.70° in the cataract group versus 3.06 ± 2.34° in the combined group 3 months postoperatively, and the difference lacked significance (p = 0.98). In the combined group, the mean axial rotation during surgery was 2.17 ± 1.80°. Axial rotation within 5° was observed in 17 of 18 eyes (94.4%) in the cataract group and 16 of 18 eyes (88.9%) in the combined group, with no significant difference (p = 0.54). The comparison of postoperative residual astigmatism with preoperative corneal astigmatism revealed a significant improvement from 1.49 ± 0.40 D to 0.39 ± 0.47 D in the cataract group (p < 0.0001) and from 1.61 ± 0.40 D to 0.42 ± 0.43 D in the combined group (p < 0.0001). CONCLUSIONS The postoperative axial rotation of the T-IOL in eyes that underwent cataract surgery combined with vitrectomy was stable and comparable to that of eyes that underwent cataract surgery alone.
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Affiliation(s)
- Tsuyoshi Mito
- Department of Ophthalmology, Kanazawa Medical University, Uchinada, Japan
| | - Hidetoshi Ishida
- Department of Ophthalmology, Kanazawa Medical University, Uchinada, Japan
| | - Yusuke Seki
- Department of Ophthalmology, Kanazawa Medical University, Uchinada, Japan
| | - Takuro Shirayama
- Department of Ophthalmology, Kanazawa Medical University, Uchinada, Japan
| | - Yuki Ukai
- Department of Ophthalmology, Kanazawa Medical University, Uchinada, Japan
| | - Hiroshi Sasaki
- Department of Ophthalmology, Kanazawa Medical University, Uchinada, Japan
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Camellin U, Franchina F, Latino G, Ninotta I, Palino P, Meduri A, Aragona P. Comparison between IOL MASTER 500 and MYAH with vector analysis in low and mild anterior corneal astigmatism. Eur J Ophthalmol 2024; 34:1046-1052. [PMID: 37919941 DOI: 10.1177/11206721231210895] [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: 11/04/2023]
Abstract
PURPOSE Evaluate the agreement between IOL Master 500 (Carl Zeiss Meditec AG, Germany) and MYAH (Topcon EU, Visia Imaging, Japan) in measuring axial length, keratometry, and anterior corneal astigmatism. SETTING Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, University of Messina, Messina, Italy. METHODS In this prospective study, 40 eyes (right eye 25, left eye 15) of 40 patients were included. Axial length (AL), keratometry (K1, K2), and anterior corneal astigmatism (ACA) were measured. AL, mean K (Kavg) and magnitude of ACA were compared using Bland - Altman plot analysis, parametric and nonparametric statistical analysis. The difference vector and angle of error of the ACA measured by the two devices were evaluated by vector analysis using polar diagrams. RESULTS Mean and standard deviation with IOL Master and with MYAH device was for AL 24.25 ± 1.22 mm and 24.25 ± 1.22 mm (p = .99), for Kavg 42.75 ± 1.53 D and 42.85 ± 1.52 D (p = .78), for Magnitude of ACA 1.00 ± 0.58 D and 0.89 ± 0.56 D (p = .38) respectively. High correlations were found for AL (R² = 0.999), Kavg (R² = 0.996), and ACA Magnitude (R² = 0.889). Bland-Altman analysis of the two devices found high agreement and absence of proportional bias (MYAH-IOL MASTER) were found between the two assessments for AL (bias = -0.0005 mm, p = .93), Kavg (bias = 0.0955 D, p = .76) and ACA (bias = 0.11 D, p = .41). Limit of agreement (upper/lower LoA, 95%CI) were respectively +0.057/-0.058 mm for AL, + 0.29/-0.09 D for Kavg and +0.49/-0.27 D for ACA. No statistical difference was found between the x-component and y-component of the ACA vector (p > .01), the difference vector (IOL MASTER-MYAH) was +0.14 D axis 159 with an absolute mean angle of error of 7.2 ± 7.5 degree. CONCLUSIONS The instruments appear to be interchangeable for measurements of AL, keratometry, and magnitude of ACA with high agreement between the two devices. Also, in the presence of low astigmatism, the two instruments give the same results in terms of ACA.
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Affiliation(s)
- Umberto Camellin
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, University of Messina, Messina, Italy
| | - Francesco Franchina
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, University of Messina, Messina, Italy
| | - Gianluigi Latino
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, University of Messina, Messina, Italy
| | - Ivan Ninotta
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, University of Messina, Messina, Italy
| | - Paola Palino
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, University of Messina, Messina, Italy
| | - Alessandro Meduri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, University of Messina, Messina, Italy
| | - Pasquale Aragona
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, University of Messina, Messina, Italy
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Dan TT, Liu TX, Li ZZ, Liang CP, Li FY. The comparison of white-to-white via triple person-times caliper measuring and machine-measuring in V4c implantable collamer lens implantation. Sci Rep 2024; 14:13878. [PMID: 38880805 PMCID: PMC11180651 DOI: 10.1038/s41598-024-64647-8] [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: 04/03/2024] [Accepted: 06/11/2024] [Indexed: 06/18/2024] Open
Abstract
This study aimed to compare the differences and characteristics of white-to-white (WTW) values obtained before V4c implantation using triple person-times caliper, IOL-Master 700, Pentacam HR, and UBM, and to assess their correlation with vaulting. A total of 930 myopia patients (1842 eyes) who were interested in undergoing ICL surgery were assessed before the procedure using various instruments. The WTW measurements were obtained using a triple person-times caliper, Pentacam HR, and IOL-Master 700, whereas the angle-to-angle (ATA) measurements were obtained using UBM. The size of the ICL was subsequently calculated using triple person-times caliper measurements. The vault of the ICL was assessed using Pentacam HR three months after the surgery. The WTW was determined to be 11.30 ± 0.29 mm, 11.43 ± 0.29 mm, and11.86 ± 0.38 mm, respectively, using the triple person-times caliper, Pentacam HR, and IOL-Master 700. The measurement of ATA was 11.57 ± 0.51 mm, as done by UBM. The ICL vault was measured to be 400.97 ± 198.46 µm when examined with Pentacam HR three monthsafter the procedure. The linear regression analyses of ICL size and WTW of triple person-times caliper, ICL vault and WTW were (R = 0.703, p < 0.001; R = 0.0969, p < 0.001) respectively. The highest correlation was found between IOL-Master and Pentacam HR (r = 0.766, p = 0.000). The lowest correlation was found between UBM and Pentacam HR (r = 0.358, p = 0.002). Bland-Altman analysis showed that the 95% limits of agreement (LoA) were the triple person-times caliper and Pentacam HR (- 0.573, 0.298) and the triple person-times caliper and UBM (- 1.15, - 0.605). This indicated a strong agreement between the triple person-times caliper and Pentacam HR and a lack of agreement between the triple person-times caliper and UBM. Triple person-times caliper measurements offer excellent maneuverability, practicality, and reliable outcomes for determining ICL vaults. Measurements obtained using the triple-person caliper were less differece than those obtained using the Pentacam HR.
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Affiliation(s)
- Ting-Ting Dan
- Department of Ophthalmology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou Province, China
- Guizhou Eye Hospital, Zunyi, 563000, Guizhou Province, China
- Guizhou Provincial Branch of National Eye Disease Clinical Research Center, Zunyi, 563000, Guizhou Province, China
- Special Key Laboratory of Ocular Diseases of Guizhou Province, Zunyi Medical University, Zunyi, 563000, Guizhou Province, China
| | - Tai-Xiang Liu
- Department of Ophthalmology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou Province, China.
- Guizhou Eye Hospital, Zunyi, 563000, Guizhou Province, China.
- Guizhou Provincial Branch of National Eye Disease Clinical Research Center, Zunyi, 563000, Guizhou Province, China.
- Special Key Laboratory of Ocular Diseases of Guizhou Province, Zunyi Medical University, Zunyi, 563000, Guizhou Province, China.
- Department of Ophthalmology, The Affiliated Hospital of Zunyi Medical University, No. 149 Dalian Road, Huichuan District, Zunyi, 563003, Guizhou Province, China.
| | - Zong-Ze Li
- Department of Ophthalmology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou Province, China
| | - Ceng-Peng Liang
- Special Key Laboratory of Ocular Diseases of Guizhou Province, Zunyi Medical University, Zunyi, 563000, Guizhou Province, China
| | - Fa-Yuan Li
- Special Key Laboratory of Ocular Diseases of Guizhou Province, Zunyi Medical University, Zunyi, 563000, Guizhou Province, China
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Russell MK, Hsing YI. Evaluation of the Efficiency of a Digital Workflow for Cataract Planning in Patients with Astigmatism. Clin Ophthalmol 2024; 18:1441-1446. [PMID: 38813538 PMCID: PMC11135556 DOI: 10.2147/opth.s454549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 05/01/2024] [Indexed: 05/31/2024] Open
Abstract
Purpose To evaluate the efficiency and associated costs of a digital cataract workflow system and manual cataract workflow system for patients, with astigmatism presenting for cataract surgery in Brisbane, Australia. Patients and Methods Sixty patients with bilateral cataract requiring toric intraocular lenses (IOL) were sequentially assigned to a manual cataract workflow (n = 30) or digital workflow (n = 30) using EQ Workplace (SW v1.7.0) running on FORUM (SW v.4.2.1.66) (Carl Zeiss Meditec, Jena, Germany). Each step of preoperative data acquisition and analysis was timed. Steps in each workflow were divided into presurgical planning time and total workflow time, the latter including the time required to input toric data into CALLISTO eye (Carl Zeiss Meditec). Secondary outcomes included staff costs within each workflow. Results Median presurgical planning time using a digital workflow process was 6.51 ± 0.65 minutes, and using a manual workflow process, 12.32 ± 0.56 minutes (p < 0.001). Similarly, median total workflow time using a digital workflow process was 6.93 ± 0.57 minutes and using a manual workflow process, 13.49 ± 0.47 minutes (p < 0.001). Evaluating the staff remuneration during presurgical planning and the operating costs associated with running EQ Workplace, there was a cost-reduction of 35% per patient when using the digital cataract workflow process. Conclusion Using a digital cataract workflow process is more efficient and provides staff cost-savings compared to a manual workflow process when planning for toric IOL implantation.
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Chudzinski R, Levron A, Agard E, Douma I, Billant J, Dot C. Comparison of corneal topography maps obtained using the IOLMaster 700 ® and the Anterion ® in candidates for toric IOL implantation. Eye (Lond) 2024:10.1038/s41433-024-03094-1. [PMID: 38653750 DOI: 10.1038/s41433-024-03094-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 03/06/2024] [Accepted: 04/12/2024] [Indexed: 04/25/2024] Open
Abstract
OBJECTIVES To compare central corneal topography (CT) obtained using the IOLMaster 700® biometer to corneal topography obtained using a Swept-Source OCT-based predicated topographer (PT), in candidates for toric intraocular lens (IOL) implantation. METHODS A retrospective comparative study was conducted in consecutive patients undergoing a routine cataract surgery assessment with significant astigmatism on keratometry. Each patient was examined using both the IOLMaster 700® (Carl Zeiss Meditec, Jena, Germany) and the Anterion® (Heidelberg Engineering, Heidelberg, Germany) for routine preoperative measurements. The corneal axial anterior power map obtained with each device was then anonymized and analysed independently by two ophthalmologists using a reading grid. The reading grid assessed the usual parameters describing astigmatism and evaluated if a toric IOL was indicated or a second topography examination was needed to confirm the indication. RESULTS In total, 169 eyes of 120 patients were included. The inter-examination agreement for the astigmatism description ranged from 56 to 85% depending on the reader and parameter. The decision to implant a toric IOL based on the axial map was the same in 59-60% of cases depending on the examiner. A second examination was needed in 18-25% and 8-14% of cases after CT and PT, respectively. The IOLMaster 700® central anterior axial map allowed toric IOL implantation in 58-70% of cases with no need for second corneal examination. CONCLUSION The agreement between the anterior axial maps obtained using both devices was good. However, in about a quarter of the cases, dedicated topography had to be performed to confirm the surgical indication.
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Affiliation(s)
- Roman Chudzinski
- Department of Ophthalmology, Edouard Herriot University Hospital, Hospices Civils de Lyon, France
| | | | | | | | - Jérémy Billant
- Department of Ophthalmology, Edouard Herriot University Hospital, Hospices Civils de Lyon, France
- Desgenettes Military Hospital, Lyon, France
| | - Corinne Dot
- Department of Ophthalmology, Edouard Herriot University Hospital, Hospices Civils de Lyon, France.
- Desgenettes Military Hospital, Lyon, France.
- French Military Health Service Academy of Val de Grâce, Paris, France.
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Ramsauer M, Luft N, Vounotrypidis E, Priglinger SG, Mayer WJ. Accuracy of toric intraocular lens power calculation depending on different keratometry values using a novel network based software platform. Front Med (Lausanne) 2024; 11:1363286. [PMID: 38665295 PMCID: PMC11043607 DOI: 10.3389/fmed.2024.1363286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 04/02/2024] [Indexed: 04/28/2024] Open
Abstract
Purpose To compare different corneal keratometry readings (swept-source-OCT-assisted biometry and Scheimpflug imaging) with a novel software platform for calculation of toric intraocular lenses. Setting Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany. Design Retrospective, non-randomized, clinical trial. Methods Twenty-three eyes undergoing toric intraocular lens implantation were included. Inclusion criteria were preoperative regular corneal astigmatism of at least 1.00 D, no previous refractive surgery, no ocular surface diseases and no maculopathies. Lens exchange was performed with CALLISTO eye (Zeiss). For each patient, the expected postoperative residual refraction was calculated depending on three different corneal parameters of two different devices: standard K-front (K) and total keratometry (TK) obtained by a swept-source-OCT-assisted biometry system (IOL Master 700, Zeiss) as well as total corneal refractive power (TCRP) obtained by a Scheimpflug device (Pentacam AXL, Oculus). Barrett's formula for toric intraocular lenses was used for all calculations within a novel software platform (EQ workplace, Zeiss FORUM®). Results were statistically compared with postoperative refraction calculated according to the Harris dioptric power matrix. Results The standard K values (mean PE 0.02 D ± 0.45 D) and TK values (mean PE 0.09 D ± 0.43 D) of the IOL Master 700 reached similar results (p = 0.96). 78% of eyes in both K and TK groups achieved SE within ±0.5 D of attempted correction and all eyes (100%) were within ±1.0 D of attempted correction in both groups. By contrast, the prediction error in the IOL calculation using the TCRP of the Scheimpflug device was significantly greater (mean PE -0.56 D ± 0.49 D; p = 0.00 vs. standard K and p = 0.00 vs. TK) with adjusted refractive indices. Thirty-nine and Ninety-one percentage of eyes in the TCRP group achieved SE within ±0.5 D (p = 0.008 K vs. TCRP and p = 0.005 TK vs. TCRP) and ± 1.0 D (p = 0.14 vs. TCRP) of attempted correction, respectively. Conclusion All three corneal parameters (standard K, TK, TCRP) performed well in calculating toric IOLs. The most accurate refractive outcomes in toric IOL implantation were achieved by IOL calculations based on swept-source-OCT-assisted biometry. The SS-OCT-based K-front and TK values achieve comparable results in the calculation of toric IOLs.
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Affiliation(s)
- Michaela Ramsauer
- Eye Clinic and Polyclinic, LMU Munich University Hospital, Munich, Germany
| | - Nikolaus Luft
- Eye Clinic and Polyclinic, LMU Munich University Hospital, Munich, Germany
| | | | | | - Wolfgang J. Mayer
- Eye Clinic and Polyclinic, LMU Munich University Hospital, Munich, Germany
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Thulasidas M, Kadam A. Toric intraocular lens: A literature review. Taiwan J Ophthalmol 2024; 14:197-208. [PMID: 39027059 PMCID: PMC11254006 DOI: 10.4103/tjo.tjo_43_21] [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: 05/08/2021] [Accepted: 10/07/2021] [Indexed: 11/04/2022] Open
Abstract
Toric intraocular lenses (IOLs) are universally recommended in cataract cases with preoperative corneal astigmatism ≥1.5 D. An optimal surgical outcome depends on careful patient selection, complete preoperative evaluation, accurate IOL power calculation, precise marking of the axis, meticulous intraoperative approach, and methodical postoperative care. Understanding the importance of posterior corneal astigmatism, surgically induced astigmatism, and effective lens position in IOL power calculation and newer techniques to measure them directly have resulted in better postoperative refractive outcomes. We present a brief overview of toric IOLs along with the preoperative evaluation, IOL power calculation, different marking methods, intraoperative approach, and postoperative outcomes. Functional and anatomical outcomes, including uncorrected visual acuity, residual refractive astigmatism, and postoperative IOL misalignment, which have been reported for both toric IOLs and multifocal toric IOLs, are reviewed.
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Affiliation(s)
- Mithun Thulasidas
- Cataract and Glaucoma Services, Sankara Eye Hospital, Coimbatore, Tamil Nadu, India
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Wolpert LE, LaHood BR, Ullrich K, Goggin M. Toric intraocular lens alignment without prior marking in the anaesthetised eye. Int Ophthalmol 2024; 44:159. [PMID: 38530513 DOI: 10.1007/s10792-024-02951-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 12/04/2023] [Indexed: 03/28/2024]
Affiliation(s)
| | - Benjamin R LaHood
- The Queen Elizabeth Hospital, Adelaide, SA, Australia
- South Australian Institute of Ophthalmology, Adelaide, SA, Australia
- University of Adelaide, Adelaide, SA, Australia
- Ashford Advanced Eye Care, Adelaide, SA, Australia
| | - Katja Ullrich
- The Queen Elizabeth Hospital, Adelaide, SA, Australia
- South Australian Institute of Ophthalmology, Adelaide, SA, Australia
- University of Adelaide, Adelaide, SA, Australia
| | - Michael Goggin
- The Queen Elizabeth Hospital, Adelaide, SA, Australia
- South Australian Institute of Ophthalmology, Adelaide, SA, Australia
- University of Adelaide, Adelaide, SA, Australia
- Ashford Advanced Eye Care, Adelaide, SA, Australia
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Wang Y, Lou X, Qian S, Li Y, Wu X, Li S, Wang Y, Zhao Y, Chang P. Comparison of the effect of capsular bend on the rotational stability between 2 toric intraocular lenses. J Cataract Refract Surg 2024; 50:283-288. [PMID: 38085243 PMCID: PMC10878446 DOI: 10.1097/j.jcrs.0000000000001373] [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: 08/01/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 02/22/2024]
Abstract
PURPOSE To compare the effect of capsular bend on the rotational stability between 2 toric intraocular lenses (IOLs). SETTING Eye Hospital of Wenzhou Medical University, Hangzhou, Zhejiang Province, China. DESIGN Prospective study. METHODS Patients with preexisting astigmatism received AcrySof IQ (SN6AT) or TECNIS (ZCT/ZMT) toric IOL during cataract surgery. CASIA2 was used to record the toric IOL axial orientation and capsular bend index (CBI) at the 1-day, 1-week, 1-month, and 3-month interval postoperatively. The postoperative rotational stability and CBI of both models were compared. RESULTS A total of 58 eyes from 58 patients were enrolled in this study. The total misalignment of the TECNIS (ZCT/ZMT) group (6.96 ± 5.10 degrees, 7.41 ± 5.19 degrees, 6.93 ± 5.29 degrees, and 6.86 ± 5. 27 degrees) was significantly higher than that of the AcrySof IQ (SN6AT) group (3.55 ± 2.21 degrees, 4.00 ± 2.74 degrees, 3.72 ± 2.72 degrees, and 3.52 ± 2.50 degrees) at all follow-up intervals ( P < .05). The mean rotation of the TECNIS (ZCT/ZMT) group (2.66 ± 2.18 degrees) was significantly greater than that of the AcrySof IQ (SN6AT) group (1.65 ± 1.47 degrees) from 1 day to 1 week postoperatively ( P < .05). The capsular bend formation in the TECNIS (ZCT/ZMT) group was delayed compared with the AcrySof IQ (SN6AT) group ( P < .05, at the 1-week, 1-month, and 3-month interval). The TECNIS (ZCT/ZMT) group showed fibrosis in the peripheral anterior capsule, leading to its stretching away from the IOL surface, while the AcrySof IQ (SN6AT) group exhibited gentle adherence of the anterior capsule to the IOL surface. CONCLUSIONS The AcrySof IQ toric IOL (SN6AT) exhibited greater rotational stability than the TECNIS toric IOL (ZCT/ZMT), which may partially result from the delay in capsular bend formation of TECNIS at the 1-day to 1-week follow-up postoperatively.
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Affiliation(s)
- Yiyi Wang
- From the Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); The First Affiliated Hospital of Ningbo University, Ningbo, China (Qian)
| | - Xicong Lou
- From the Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); The First Affiliated Hospital of Ningbo University, Ningbo, China (Qian)
| | - Shuyi Qian
- From the Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); The First Affiliated Hospital of Ningbo University, Ningbo, China (Qian)
| | - Yuanyuan Li
- From the Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); The First Affiliated Hospital of Ningbo University, Ningbo, China (Qian)
| | - Xueer Wu
- From the Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); The First Affiliated Hospital of Ningbo University, Ningbo, China (Qian)
| | - Siyan Li
- From the Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); The First Affiliated Hospital of Ningbo University, Ningbo, China (Qian)
| | - Yalan Wang
- From the Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); The First Affiliated Hospital of Ningbo University, Ningbo, China (Qian)
| | - Yune Zhao
- From the Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); The First Affiliated Hospital of Ningbo University, Ningbo, China (Qian)
| | - Pingjun Chang
- From the Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); The First Affiliated Hospital of Ningbo University, Ningbo, China (Qian)
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11
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Werner L, Hawn VS, Bundogji N, Eid K, Kelkar N, Renschler A, Mamalis N. Rotational stability of a new hydrophobic acrylic intraocular lens platform. J Cataract Refract Surg 2024; 50:289-294. [PMID: 37991418 PMCID: PMC10878450 DOI: 10.1097/j.jcrs.0000000000001361] [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: 07/10/2023] [Revised: 10/03/2023] [Accepted: 11/02/2023] [Indexed: 11/23/2023]
Abstract
PURPOSE To evaluate rotational stability for ease of rotation of a new intraocular lens (IOL) platform with 4 haptics in an ex vivo model and compare it with a control single-piece lens with 2 open loops. SETTING Intermountain Ocular Research Center, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah. DESIGN Experimental study. METHODS 10 human cadaver eyes were prepared as per the Miyake-Apple technique. After injection of the test or control lens, clockwise and counterclockwise rotations were attempted with a hook, with and without an ophthalmic viscosurgical device in place. Ease of rotation was scored as (1) very easy, (2) easy, (3) difficult, and (4) very difficult. Rotation of the entire eye containing test or control IOL was also performed with a multipurpose rotator (2 minutes; 220 revolutions per minute) to evaluate its effect on IOL alignment. RESULTS There were statistically significant differences regarding ease of rotation between test and control lenses in all 4 scenarios, with rotation being more difficult with the test lens ( P < .05, Wilcoxon signed-rank test). No change in the alignment of test or control lenses was observed after eye rotation with the multipurpose rotator. CONCLUSIONS The new IOL platform showed greater rotational stability than the control lens in this model, owing to design features such as 4 small arcs of contact between the haptics and the bag equator, a bulge at the distal end of each haptic, and arcuate haptics with curvatures oriented toward each other.
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Affiliation(s)
- Liliana Werner
- From the Intermountain Ocular Research Center, Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
| | - Vivian S. Hawn
- From the Intermountain Ocular Research Center, Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
| | - Nour Bundogji
- From the Intermountain Ocular Research Center, Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
| | - Kevin Eid
- From the Intermountain Ocular Research Center, Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
| | - Neil Kelkar
- From the Intermountain Ocular Research Center, Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
| | - Andy Renschler
- From the Intermountain Ocular Research Center, Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
| | - Nick Mamalis
- From the Intermountain Ocular Research Center, Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
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12
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Schultz T, Hoffmann S, Dick HB. Comparison of toric intraocular lens alignment between femtosecond laser-assisted capsular marking and digital marking. J Cataract Refract Surg 2024; 50:230-235. [PMID: 37847149 PMCID: PMC10878466 DOI: 10.1097/j.jcrs.0000000000001344] [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: 04/28/2023] [Revised: 10/09/2023] [Accepted: 10/10/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE To compare the accuracy of toric intraocular lens (IOL) alignment between femtosecond laser-assisted capsular marking and digital marking. SETTING Ruhr University Eye Clinic, Bochum, Germany. DESIGN Prospective clinical trial. METHODS In this study, 28 eyes of 23 patients, who underwent femtosecond laser-assisted cataract surgery with implantation of a toric IOL, were included. Intraoperatively, both femtosecond laser-assisted capsular marking and digital marking were applied simultaneously and compared in every case. The toric IOL was aligned to the capsular markings. Postoperatively, the axis of the capsular markings and toric IOL alignment was examined. Visual acuity and refractive outcomes were evaluated. RESULTS Both alignment methods were performed without intraoperative complications in all cases. 25 eyes were included in the final analysis. Misalignment was significantly lower with femtosecond laser-assisted capsular marking than with digital marking (1.71 ± 1.25 degrees vs 2.64 ± 1.70 degrees, P = .016). Deviation from the target axis of the toric IOL was 1.62 ± 1.24 degrees 4 to 6 weeks postoperatively. Postoperative uncorrected distance visual acuity was 0.14 ± 0.13 logMAR, and residual astigmatism was 0.3 ± 0.23 diopter (D) with an astigmatism ≤0.5 D in 93% of eyes. CONCLUSIONS Both methods showed excellent results for the alignment of toric IOLs. However, femtosecond laser-assisted capsular marking was significantly more precise than digital marking and showed good refractive results. In addition, capsular marking offers the possibility to avoid parallax error and evaluating postoperative IOL rotation.
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Affiliation(s)
- Tim Schultz
- From the Ruhr University Eye Hospital, Bochum, Germany
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13
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Ullrich M, Fisus AD, Palkovits S, Hienert J, Hirnschall N, Findl O. Rotational stability and capsular bag performance of a hydrophobic acrylic open-loop single-piece intraocular lens. Eur J Ophthalmol 2024:11206721241234393. [PMID: 38389411 DOI: 10.1177/11206721241234393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
PURPOSE To evaluate the rotational stability and capsular bag performance of a blue light-absorbing hydrophobic acrylic open-loop single-piece intraocular lens (IOL) with a blast-finished anchor wing haptic design during the first 6 postoperative months. METHODS In this prospective clinical study, patients with age-related cataract and potential postoperative corrected distance visual acuity (CDVA) of 0.2 logMAR or better were included. The patients received a non-toric hydrophobic acrylic single-piece IOL with an axis mark (YST0.00; Nidek Co. Ltd, Japan). Surgeries were video-taped. Retroillumination images were acquired 1 h, 1 week and 6 months postoperatively. Rotational stability was assessed by precise image overlay. At 6 months, Purkinje meter measurements were performed to evaluate tilt and decentration. RESULTS In total, 100 eyes of 77 patients were included in the analysis. Mean absolute rotation was 2.1 ± 1.7° (median 1.7, range: 0-7.9) at 6 months (1 h - 6 months postoperatively). IOL rotation was ≤3° and ≤6° in 74 (74%) and 98 (98%) eyes, respectively. Mean absolute IOL rotation from the end of surgery to 6 months was 2.5 ± 2.2° (median 2.3, range: 0-15.6; n = 78). Mean tilt (pupillary axis) and decentration were 4.1 ± 1.9° (median 4.0, range: 0.5-8.2) and 0.35 ± 0.17 mm (median 0.32, range: 0.06-0.91) respectively (n = 84). Postoperatively, 98 (98%) eyes achieved a CDVA of 0.2 logMAR or better, 95 (95%) of ≤0.1 and 81 (81%) of ≤0.0. CONCLUSIONS This hydrophobic acrylic single-piece IOL showed an excellent rotational stability and capsular bag position with low tilt and decentration values.
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Affiliation(s)
- Marlies Ullrich
- VIROS - Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
| | - Andreea D Fisus
- VIROS - Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
| | - Stefan Palkovits
- VIROS - Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
| | - Julius Hienert
- VIROS - Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
| | - Nino Hirnschall
- VIROS - Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
- Department of Ophthalmology and Optometry, Kepler University Hospital GmbH, Johannes Kepler University Linz, Linz, Austria
| | - Oliver Findl
- VIROS - Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
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14
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Shi R, Ma D, Zeng Q, Hua Z, Shen W, Cai L, Yang J. Rotational stability of monofocal and diffractive multifocal toric intraocular lens with identical design and material: a propensity score based prospective comparative study. BMC Ophthalmol 2024; 24:72. [PMID: 38365667 PMCID: PMC10870427 DOI: 10.1186/s12886-024-03281-4] [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: 09/09/2023] [Accepted: 01/03/2024] [Indexed: 02/18/2024] Open
Abstract
PURPOSE To compare the rotational stability of a monofocal and a diffractive multifocal toric intraocular lens(IOLs) with identical design and material. METHODS This prospective study enrolled patients who underwent plate-haptic toric IOL (AT TORBI 709 M and AT LISA 909 M) implantation. Propensity score matching (PSM) was performed to balance baseline factors. Follow-up examinations were conducted at 1 h, 1 day, 3 days, 1 week, 2 weeks, 1 month, and 3 months postoperatively. A linear mixed model of repeated measures was used to investigate the changes in IOL rotation over time. A 2-week timeframe was utilized to assess differences in IOL rotation between the two groups. RESULT After PSM, a total of 126 eyes were selected from each group for further analysis. Postoperatively, the time course of IOL rotation change in the two groups remained consistent, with the greatest rotation occurring between 1 h and 1 day postoperatively. At the 2-week postoperative mark, the monofocal toric IOL exhibited a higher degree of rotation compared to the multifocal toric IOL (5.40 ± 7.77° vs. 3.53 ± 3.54°, P = 0.015). In lens thickness(LT) ≥ 4.5 mm and white-to-white distance(WTW) ≥ 11.6 mm subgroups, the monofocal toric IOL rotated greater than the multifocal toric IOL (P = 0.026 and P = 0.011, respectively). CONCLUSION The diffractive multifocal toric IOL exhibits superior rotational stability compared to the monofocal toric IOL, especially in subgroups LT ≥ 4.5 mm and WTW ≥ 11.6 mm. Moreover, the time course of IOL rotation change is consistent for both, with the maximum rotation occurring between 1 h and 1 day postoperatively.
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Affiliation(s)
- Runhan Shi
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Rd, Shanghai, 200031, China
- Key NHC Laboratory of Myopia, Laboratory of Myopia, Fudan University, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Dongmei Ma
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Rd, Shanghai, 200031, China
- Key NHC Laboratory of Myopia, Laboratory of Myopia, Fudan University, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Qiulin Zeng
- Department of Ophthalmology, Shanghai Xinshijie Dongqu Eye Hospital, Shanghai, China
| | - Zhixiang Hua
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Rd, Shanghai, 200031, China
- Key NHC Laboratory of Myopia, Laboratory of Myopia, Fudan University, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Wenqian Shen
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Rd, Shanghai, 200031, China
- Key NHC Laboratory of Myopia, Laboratory of Myopia, Fudan University, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Lei Cai
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Rd, Shanghai, 200031, China
- Key NHC Laboratory of Myopia, Laboratory of Myopia, Fudan University, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Jin Yang
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Rd, Shanghai, 200031, China.
- Key NHC Laboratory of Myopia, Laboratory of Myopia, Fudan University, Chinese Academy of Medical Sciences, Shanghai, China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China.
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15
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Gurdal F, Ozge G, Ayyildiz O. Determination of the toric axis by using internal astigmatism axis in non-dilated eyes. Int Ophthalmol 2024; 44:46. [PMID: 38336905 DOI: 10.1007/s10792-024-03003-1] [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: 06/17/2023] [Accepted: 10/19/2023] [Indexed: 02/12/2024]
Abstract
PURPOSE To determine the toric intraocular lens (IOL) axis by using internal astigmatism axis obtained from Optical Path Difference (OPD) Scan III (Nidek Co.) in non-dilate eyes. METHODS The eyes of patients who underwent toric IOL implantation for astigmatic correction were investigated. Patients who have ocular surface disorder, keratoconus, posterior capsule opacification were excluded. The IOL axis measured in non-dilated eyes in mesopic conditions by OPD scan III device and the IOL axis measured by using classical slit lamp biomicroscopy method in dilated eyes were detected at postoperative 1st and 6th months. Results were compared with correlation and linear regression analysis. RESULTS Totally, 26 eyes of 18 patients were included. The difference between biomicroscopic IOL axis and OPD internal astigmatism axis was 4.96 ± 4.41 degrees at the 1st month and 3.62 ± 3.5 degrees at the 6th month. There was a significant and high correlation between biomicroscopic IOL axis and OPD internal astigmatism axis at both 1st month (r = 0.992 p < 0.001) and 6th month (r = 0.995 p < 0.001). According to regression analysis, the results of two measurement methods were significantly compatible with each other at 1st month (R Sq = 0.984 p < 0.001) and 6th month (R Sq = 0.990 p < 0.001) and there was a close to ideal linear (R Sq = 1) relationship between two methods. CONCLUSIONS In eyes with toric IOL implantation, the IOL axis and IOL rotation according to target IOL axis can be detected easily and effectively in a short time by OPD scan internal astigmatism axis without the need to dilate the pupil.
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Affiliation(s)
- Fatih Gurdal
- Department of Ophthalmology, Gulhane Training and Research Hospital, University of Health Sciences, Tevfik Saglam Street, Kecioren, Ankara, 06010, Turkey.
| | - Gokhan Ozge
- Department of Ophthalmology, Gulhane Faculty of Medicine, University of Health Sciences, Tevfik Saglam Street, Kecioren, Ankara, 06010, Turkey
| | - Onder Ayyildiz
- Department of Ophthalmology, Gulhane Faculty of Medicine, University of Health Sciences, Tevfik Saglam Street, Kecioren, Ankara, 06010, Turkey
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16
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Yang X, Jiang Y, Lin S, Bai X, Yin Y, Zhao F, Yang J, Tian F, Chen X, Liang J, Bu S. The predictive accuracy of Barrett toric calculator using measured posterior corneal astigmatism derived from swept source-OCT and Scheimpflug camera. Eye (Lond) 2024; 38:132-137. [PMID: 37380787 PMCID: PMC10764741 DOI: 10.1038/s41433-023-02646-1] [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: 02/15/2023] [Revised: 06/01/2023] [Accepted: 06/16/2023] [Indexed: 06/30/2023] Open
Abstract
PURPOSE To compare the performance of Barrett toric calculator incorporated with measured posterior corneal astigmatism (PCA) derived from IOL Master 700 and Pentacam HR versus predicted PCA. METHODS The predicted residual astigmatism using Barrett toric IOL calculator with predicted PCA, measured PCA from IOL Master 700 and measured PCA from Pentacam were calculated with the preoperative keratometry and intended IOL axis with modification. The vector analysis was performed to calculate the mean absolute prediction error (MAE), the centroid of the prediction error and the percentage of eyes with a prediction error within ±0.50 D, ±0.75 D, and ±1.00 D. RESULTS In 57 eyes of 57 patients with mean age of 70.42 ± 10.75 years, the MAE among the three calculation methods were 0.59 ± 0.38 D (Predicted PCA), 0.60 ± 0.38 D (Measured PCA from IOL Master 700) and 0.60 ± 0.36 D (Measured PCA from Pentacam) with no significant difference, either in the whole sample, the WTR eyes and the ATR eyes (F = 0.078, 0.306 and 0.083, p = 0.925, 0.739 and 0.920, respectively). Measured PCA obtained from IOL Master 700 resulted in one level reduction (from Tn to Tn-1) in 49.12% eyes in cylindrical model selection, while measured PCA obtained from Pentacam resulted in one level reduction of toric model selection in 18.18% eyes. CONCLUSION The present study suggested that the incorporation of measured PCA values derived from IOL Master 700 and Pentacam produce comparable clinical outcome with the predicted PCA mode in Barrett toric calculator.
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Affiliation(s)
- Xiaotong Yang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yuanfeng Jiang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Song Lin
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xiaomei Bai
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yufan Yin
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - FangYu Zhao
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Jun Yang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Fang Tian
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xiteng Chen
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Jingli Liang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Shaochong Bu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
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17
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Mukhija R, Fonseca A, Borkum S, Frattaroli P, Barbon E, Nanavaty MA. Toric Intraocular Lens versus Peripheral Corneal Relaxing Incisions for Astigmatism between 0.75 and 2.5 Diopters: 5-Years Outcomes. Curr Eye Res 2024; 49:46-52. [PMID: 37789513 DOI: 10.1080/02713683.2023.2260961] [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: 06/20/2023] [Accepted: 09/14/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE To compare 5-year outcomes of toric intraocular lens (tIOL) or peripheral corneal relaxing incision (PCRI) for correction of keratometric astigmatism (KA) between 0.75 and 2.5 diopters (D). METHODS Setting: University Hospital. Design: Randomized clinical trial. Eighty eyes (80 participants) received either tIOL or PCRI. Patients were assessed preoperatively, 1-month, 1, and 5 years. Primary outcomes were uncorrected (UDVA) and best-corrected distance logMAR visual acuity (CDVA). Secondary outcomes were a manifest refractive sphere, refractive astigmatism (Ra), spherical equivalent (SEQ), KA & mean keratometry (KM), and Quality-of-Life Impact of Refractive Correction (QIRC) scores. RESULTS There was no difference between the two groups in UDVA, CDVA, refractive sphere, KM, RA, and SEQ. KA reduced after 1 month in the PCRI group and remained stable until 5 years. From 1 to 5 years, the number of eyes with distance emmetropia (within ±0.13D) changed from 59% (20/34 eyes) to 32% (6/19 eyes) for tIOLs and from 43% (15/36 eyes) to 20% (4/21 eyes) for PCRIs with 32% (6/19 eyes) and 20% (4/21 eyes) showing >0.5D change in SEQ at 5-years respectively. Compared to 1-year, Ra significantly increased at 5 years in both groups with no difference between the groups. Mean overall QIRC scores were not different between the groups (tIOL: 49.88 ± 7.47; PCRI: 52.09 ± 7.02; p = .18). CONCLUSIONS Although there was no difference between the overall visual and vision-related quality of life outcomes between tIOLs and PCRIs, an increase in refractive astigmatism and reduction in distance emmetropia with time was noted in both groups.
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Affiliation(s)
- Ritika Mukhija
- Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Aneesha Fonseca
- Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Steven Borkum
- Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Paul Frattaroli
- Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Emma Barbon
- Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Mayank A Nanavaty
- Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
- Brighton & Sussex Medical School, University of Sussex, Falmer, Brighton, UK
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18
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Steinmüller LN, Greve D, Rua Amaro D, Bertelmann E, von Sonnleithner C. Analysis of higher-order aberrations in relation to the clinical outcome of an enhanced monofocal IOL. Eur J Ophthalmol 2023; 33:2096-2105. [PMID: 36274639 PMCID: PMC10590024 DOI: 10.1177/11206721221134171] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 09/25/2022] [Indexed: 10/22/2023]
Abstract
PURPOSE To analyse higher-order aberrations of an enhanced monofocal aspheric intraocular lens (IOL) in relation to the clinical outcome compared to a monofocal aspheric IOL. SETTING Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Germany. DESIGN Prospective, monocentric, controlled, non-randomized, two-armed study. METHODS After phacoemulsification, a total of 30 patients (60 eyes) were bilaterally implanted with either TECNIS Eyhance IOL model ICB00 (Johnson & Johnson Surgical Vision, Inc.) or TECNIS Monofocal 1-Piece IOL model ZCB00 (Johnson & Johnson Surgical Vision, Inc.) in 30 eyes each. Assessments were performed 1 and 3 months after surgery including refraction, uncorrected and best-corrected distance, intermediate and near visual acuity, defocus curves, contrast sensitivities under photopic, mesopic and mesopic conditions with glare, higher-order aberrations (HOAs) at pupil sizes of 5, 4, 3 and 2 mm and patient satisfaction. RESULTS At 3-month follow-up, measurements of HOAs revealed significant higher negative internal and ocular primary spherical aberrations in the ICB00 group at pupil sizes of 5, 4, 3 and 2 mm. The ICB00 showed significant better results in intermediate and near visual acuity, but no difference in distance visual acuity. No significant difference was found in contrast sensitivities at any condition or spatial frequency. Spectacle independence was significant better without significant higher rates of dysphotopsia in the ICB00 group. CONCLUSIONS Higher negative spherical aberrations in the ICB00 group at all measured pupil sizes appear to lead to a superior clinical outcome in intermediate and near vision compared to the ZCB00 group without compromising contrast sensitivity or distance visual acuity.
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Affiliation(s)
| | - Daria Greve
- Department of Ophthalmology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - David Rua Amaro
- Department of Ophthalmology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Eckart Bertelmann
- Department of Ophthalmology, Charité – Universitätsmedizin Berlin, Berlin, Germany
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Hong ASY, Ang BCH, Dorairaj E, Dorairaj S. Premium Intraocular Lenses in Glaucoma-A Systematic Review. Bioengineering (Basel) 2023; 10:993. [PMID: 37760095 PMCID: PMC10525961 DOI: 10.3390/bioengineering10090993] [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: 07/06/2023] [Revised: 08/12/2023] [Accepted: 08/16/2023] [Indexed: 09/29/2023] Open
Abstract
The incidence of both cataract and glaucoma is increasing globally. With increasing patient expectation and improved technology, premium intraocular lenses (IOLs), including presbyopia-correcting and toric IOLs, are being increasingly implanted today. However, concerns remain regarding the use of premium IOLs, particularly presbyopia-correcting IOLs, in eyes with glaucoma. This systematic review evaluates the use of premium IOLs in glaucoma. A comprehensive search of the MEDLINE database was performed from inception until 1 June 2023. Initial search yielded 1404 records, of which 12 were included in the final review of post-operative outcomes. Studies demonstrated high spectacle independence for distance and good patient satisfaction in glaucomatous eyes, with positive outcomes also in post-operative visual acuity, residual astigmatism, and contrast sensitivity. Considerations in patient selection include anatomical and functional factors, such as the type and severity of glaucomatous visual field defects, glaucoma subtype, presence of ocular surface disease, ocular changes after glaucoma surgery, and the reliability of disease monitoring, all of which may be affected by, or influence, the outcomes of premium IOL implantation in glaucoma patients. Regular reviews on this topic are needed in order to keep up with the rapid advancements in IOL technology and glaucoma surgical treatments.
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Affiliation(s)
- Ashley Shuen Ying Hong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore;
| | - Bryan Chin Hou Ang
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore 308433, Singapore
- Department of Ophthalmology, National Healthcare Group Eye Institute, Woodlands Health Campus, Singapore 768024, Singapore
| | - Emily Dorairaj
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA;
| | - Syril Dorairaj
- Department of Ophthalmology, Mayo Clinic, Jacksonville, FL 32224, USA;
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Georgiev S, Ruiss M, Dana-Fisus A, Leitgeb RA, Findl O. Comparison of corneal aberrations from anterior segment swept source OCT versus Placido-topography combined spectral domain OCT in cataract patients. EYE AND VISION (LONDON, ENGLAND) 2023; 10:30. [PMID: 37525287 PMCID: PMC10392018 DOI: 10.1186/s40662-023-00348-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 06/01/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND To comprehensively evaluate the agreement of component corneal aberrations from the newly updated wavefront analysis software of a swept-source optical coherence tomographer (SS-OCT) and a referential Placido-topography combined OCT device in elderly cataract patients. METHODS Retrospective study including 103 eyes from 103 elderly patients scheduled for cataract surgery that were measured on the same day with a SS-OCT (Heidelberg Engineering, Germany) device and a Placido-topography combined OCT device (CSO, Italy). Anterior, total, and posterior corneal wavefront aberrations were evaluated for their mean differences and limits of agreement (LoA) via Bland-Altman plots. Vector analysis was additionally employed to compare corneal astigmatism measurements in dioptric vector space. RESULTS Mean differences of all corneal aberrometric parameters did not exceed 0.05 μm. Total corneal aberrations were not significantly different from 0 except for vertical coma (- 0.04 μm; P = 0.003), spherical aberration (- 0.01 μm, P < 0.001), and root mean square (RMS) higher-order aberration (HOA) (0.03 μm, P = 0.04). The 95% LoA for total corneal aberration parameters between both devices were - 0.46 to 0.42 μm for horizontal astigmatism, - 0.37 to 0.41 μm for oblique astigmatism, - 0.19 to 0.17 μm for oblique trefoil, - 0.33 to 0.25 μm for vertical coma, - 0.20 to 0.22 μm for horizontal coma, - 0.22 to 0.20 μm for horizontal trefoil, - 0.11 to 0.08 μm for spherical aberration, and - 0.22 to 0.28 μm for RMS HOA. Vector analysis revealed no statistically significant mean differences for anterior, total, and posterior corneal astigmatism in dioptric vector space. CONCLUSION In eyes undergoing cataract surgery with a regular elderly cornea, corneal wavefront analysis from the SS-OCT device showed functional equivalency to the reference device. Nevertheless, clinically relevant higher order aberration parameters should be interpreted with caution for surgical decision-making.
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Affiliation(s)
- Stefan Georgiev
- VIROS-Vienna Institute for Research in Ocular Surgery, A Karl Landsteiner Institute, Hanusch Hospital, Heinrich-Collin-Strasse 30, 1140, Vienna, Austria
- Center for Medical Physics and Biomedical Engineering, Vienna, Austria
| | - Manuel Ruiss
- VIROS-Vienna Institute for Research in Ocular Surgery, A Karl Landsteiner Institute, Hanusch Hospital, Heinrich-Collin-Strasse 30, 1140, Vienna, Austria
| | - Andreea Dana-Fisus
- VIROS-Vienna Institute for Research in Ocular Surgery, A Karl Landsteiner Institute, Hanusch Hospital, Heinrich-Collin-Strasse 30, 1140, Vienna, Austria
| | - Rainer A Leitgeb
- Center for Medical Physics and Biomedical Engineering, Vienna, Austria
| | - Oliver Findl
- VIROS-Vienna Institute for Research in Ocular Surgery, A Karl Landsteiner Institute, Hanusch Hospital, Heinrich-Collin-Strasse 30, 1140, Vienna, Austria.
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Zeilinger J, Hienert J, Ruiss M, Pilwachs C, Findl O. Rotational stability of a new toric intraocular lens with an advanced optical profile. J Cataract Refract Surg 2023; 49:584-588. [PMID: 36745852 DOI: 10.1097/j.jcrs.0000000000001158] [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] [Received: 10/10/2022] [Accepted: 01/30/2023] [Indexed: 02/08/2023]
Abstract
PURPOSE To examine the rotational stability of a new toric intraocular lens (IOL), the TECNIS Eyhance Toric II, over a course of 3 months. SETTING Vienna Institute for Research in Ocular Surgery, Hanusch Hospital, Vienna, Austria. DESIGN Prospective unmasked single-center study. METHODS 50 eyes of 50 patients with cataract and regular corneal astigmatism ≥0.75 diopters (D) were included. The TECNIS Eyhance Toric II IOL was implanted in 1 eye of each study patient. Images of the alignment axis of the IOL were taken intraoperatively, as well as at 1 hour, 1 week, and 3 months postoperatively. For the measurement of toric IOL rotation, images were superimposed on the basis of ocular landmarks. Uncorrected and corrected distance (4 m) and intermediate (66 cm) visual acuities were assessed at the 3-month visit. RESULTS There was no significant difference in the rotational position between the intraoperative and 3 month timepoints, with a mean rotation of 1.34 ± 1.46 degrees, in 27 examined eyes. ( P = 0.313). No patients had to undergo repositioning of the toric IOL. A significant reduction of refractive cylinder occurred from preoperatively 1.8 ± 1.1 to 0.40 ± 0.42 D at the 3-month visit ( P = .001; n = 43). The corrected distance visual acuity improved significantly from 0.28 ± 0.16 logMAR preoperatively to -0.01 ± 0.13 logMAR at 3 months postoperatively ( P = .001; n = 43). CONCLUSIONS The TECNIS Eyhance Toric II showed a good visual performance with no significant rotation over a course of 3 months and, therefore, an excellent rotational stability. The intraocular lens showed a good safety profile with no adverse events.
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Affiliation(s)
- Johannes Zeilinger
- From the Vienna Institute for Research in Ocular Surgery (VIROS), A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria
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22
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Yang K, Li J, Zhang W, Liu Z, Song C, Zhao Y. Implanting toric implantable collamer lens displays better astigmatism correction than implantable collamer lens combined with manually limbal relaxing incision. BMC Ophthalmol 2023; 23:198. [PMID: 37147624 PMCID: PMC10161410 DOI: 10.1186/s12886-023-02941-1] [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: 04/14/2022] [Accepted: 04/24/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND This retrospective study aimed to compare the outcomes of toric implantable collamer lens (TICL) surgery with those of implantable collamer lens (ICL) implantation combined with limbal relaxing incision (LRI) in patients with low myopia and astigmatism. METHODS A total of 40 eyes of 28 patients who underwent TICL implantation and 40 eyes of 27 patients who underwent ICL implantation combined with manually LRI between 2021 and 2022 were included. Primary outcomes were manifest sphere and cylinder, intraocular pressure, visual acuity, and astigmatism parameters at 1 day, 1 week, and 1, 3, and 6 months postoperatively. RESULTS The two surgeries showed comparable effects on manifest sphere and cylinder, intraocular pressure, and visual acuity (all p > 0.1). Surgery-induced astigmatism (SIA) was maintained as stable in the TICL group (1.73 to 1.68, p = 0.420), but was significantly reduced in the ICL/LRI group (1.74 to 1.17, p = 0.001) from preoperative to postoperative 6 months. The TICL group displayed significantly higher SIA and correction index at postoperative 1, 3, and 6 months than the ICL/LRI group (at 6 months: SIA, 1.68 (1.26, 1.96) vs., 1.17 (1.00, 1.64), p = 0.010; CI: 0.98 (0.78, 1.25) vs. 0.80 (0.61, 1.04), p = 0.018). No complications occurred during follow-up. CONCLUSIONS The effects of ICL/LRI are comparable to those of TICL in correcting myopia. TICL implantation displays better astigmatism correction than ICL/LRI.
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Affiliation(s)
- Ke Yang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Jiaxin Li
- Medical School, Pingdingshan University, Pingdingshan, 467000, China
| | - Weihua Zhang
- Liaocheng People's Hospital, Liaocheng, 252000, China
| | - Zhanjiang Liu
- Chaoyang Central Hospital, Liaoning Province, 122000, China
| | - Chenjie Song
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Yang Zhao
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.
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Pérez-Merino P, Aramberri J, Quintero AV, Rozema JJ. Ray tracing optimization: a new method for intraocular lens power calculation in regular and irregular corneas. Sci Rep 2023; 13:4555. [PMID: 36941337 PMCID: PMC10027892 DOI: 10.1038/s41598-023-31525-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/14/2023] [Indexed: 03/23/2023] Open
Abstract
To develop a novel algorithm based on ray tracing, simulated visual performance and through-focus optimization for an accurate intraocular lens (IOL) power calculation. Custom-developed algorithms for ray tracing optimization (RTO) were used to combine the natural corneal higher-order aberrations (HOAs) with multiple sphero-cylindrical corrections in 210 higher order statistical eye models for developing keratoconus. The magnitude of defocus and astigmatism producing the maximum Visual Strehl was considered as the optimal sphero-cylindrical target for IOL power calculation. Corneal astigmatism and the RMS HOAs ranged from - 0.64 ± 0.35D and 0.10 ± 0.04 μm (0-months) to - 3.15 ± 1.38D and 0.82 ± 0.47 μm (120-months). Defocus and astigmatism target was close to neutral for eyes with low amount of HOAs (0 and 12-months), where 91.66% of eyes agreed within ± 0.50D in IOL power calculation (RTO vs. SRK/T). However, corneas with higher amounts of HOAs presented greater visual improvement with an optimized target. In these eyes (24- to 120-months), only 18.05% of eyes agreed within ± 0.50D (RTO vs. SRK/T). The power difference exceeded 3D in 42.2% while the cylinder required adjustments larger than 3D in 18.4% of the cases. Certain amounts of lower and HOAs may interact favourably to improve visual performance, shifting therefore the refractive target for IOL power calculation.
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Affiliation(s)
- Pablo Pérez-Merino
- Centre for Microsystems Technology, Ghent University and Imec, Technologiepark 126, 9052, Ghent, Belgium.
| | - Jaime Aramberri
- Miranza Begitek, San Sebastian, Spain
- Miranza Okular, Vitoria, Spain
| | - Andrés Vásquez Quintero
- Centre for Microsystems Technology, Ghent University and Imec, Technologiepark 126, 9052, Ghent, Belgium
| | - Jos J Rozema
- Visual Optics Lab Antwerp (VOLANTIS), Faculty of Medicine and Health Sciences, University of Antwerp, Building T4, Universiteitsplein 1, 2610, Wilrijk, Belgium
- Department of Ophthalmology, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
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Li H, He W, Guo D, Fang Y, Meng J, Zhang K, Zhu X, Lu Y. Correction of Asymmetric Bowtie Corneal Astigmatism with a Toric Intraocular Lens: Outcomes and Accuracy of Measurement Modes. J Pers Med 2023; 13:jpm13030401. [PMID: 36983583 PMCID: PMC10057716 DOI: 10.3390/jpm13030401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/15/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023] Open
Abstract
The outcomes of toric intraocular lens (IOL) implantation in correcting asymmetric bowtie corneal astigmatism remain uncertain. The accurate measurement of corneal astigmatism is essential for surgical planning. In this prospective cohort study, patients with asymmetric or symmetric bowtie corneal astigmatism who underwent toric IOL implantation were recruited. Preoperative corneal astigmatism was measured with an IOLMaster and Pentacam (including the simulated keratometry (SimK), total corneal refractive power (TCRP), and wavefront aberration (WFA) modes). At 3 months after surgery, the refractive outcomes and residual astigmatic refractive errors were compared with patients with symmetric bowtie astigmatism. The prediction errors (the differences between the calculated actual corneal astigmatism and the measured corneal astigmatism) were compared among the different measurement modes in the asymmetric group. There were no differences in residual astigmatism between the asymmetric and symmetric groups. However, the mean absolute residual astigmatic refractive error was greater in the asymmetric group than in the symmetric group (0.72 ± 0.42 D vs. 0.53 ± 0.24 D, p = 0.043). In the asymmetric group, the mean absolute prediction errors for the IOLMaster, SimK, TCRP and WFA modes were 0.53 ± 0.40, 0.56 ± 0.47, 0.68 ± 0.52, and 0.43 ± 0.40 D, respectively. The Pentacam WFA mode was the most accurate mode (p < 0.05). The absolute prediction error of the WFA mode was positively correlated with the total corneal irregular astigmatism higher-order aberrations and coma (r = 0.416 and r = 0.473, respectively; both p < 0.05). Our study suggests toric IOL implantation effectively corrected asymmetric bowtie corneal astigmatism. The Pentacam WFA mode may be the most accurate measurement mode, although its accuracy decreased as asymmetry increased.
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Affiliation(s)
- Hao Li
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Wenwen He
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Donglin Guo
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Yanwen Fang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Jiaqi Meng
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Keke Zhang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Xiangjia Zhu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
- Correspondence: (X.Z.); (Y.L.)
| | - Yi Lu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
- Correspondence: (X.Z.); (Y.L.)
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Kim H, Jeong H, Shin K. Development Pattern of Medical Device Technology and Regulatory Evolution of Cataract Treatment. Healthcare (Basel) 2023; 11:healthcare11040453. [PMID: 36832988 PMCID: PMC9957356 DOI: 10.3390/healthcare11040453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/30/2023] [Accepted: 02/02/2023] [Indexed: 02/08/2023] Open
Abstract
To prevent regulation from becoming an obstacle to healthcare technological innovation, regulation should evolve as new healthcare technologies are developed. Although regulation is closely related to healthcare technology development, there are few studies that view healthcare technological advances from the multi-layered perspective of papers, patents, and clinical research and link this with regulatory evolution. Therefore, this study tried to develop a new method from a multi-layer perspective and draw regulatory implications based on it. This study applied this method to intraocular lens (IOLs) for cataract treatment and detected four major healthcare technologies and two recent healthcare technologies. Moreover, it discussed how current regulations evaluate these technologies. The findings provide implications for healthcare technological advances and the evolutionary direction of regulation through the example of IOLs for cataract treatment. This study contributes to the development of theoretical methods for co-evolution with regulations based on healthcare technology innovation.
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Affiliation(s)
- Heejung Kim
- Department of Biomedical Convergence, College of Medicine, Chungbuk National University, Chungdae-ro 1, Seowon-gu, Cheongju 28644, Chungbuk, Republic of Korea
| | - Harry Jeong
- Central Research Institute, Dr. Chung’s Food Co., Ltd., Cheongju 28446, Republic of Korea
| | - Kwangsoo Shin
- Graduate School of Public Health and Healthcare Management, The Catholic University of Korea, Banpo-daero 222, Secho-gu, Seoul 06591, Republic of Korea
- Catholic Institute for Public Health and Healthcare Management, The Catholic University of Korea, Banpo-daero 222, Secho-gu, Seoul 06591, Republic of Korea
- Correspondence:
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Ma D, Yu W, Cai L, Shen J, Guo T, Chen X, Dong J, Zeng Q, Wang A, Hua Z, Zhu X, Zheng T, Lu Y, Yang J. Optimal Timing of Repositioning Surgery for a Plate-Haptic Toric Intraocular Lens: A Multicenter Retrospective Study. J Refract Surg 2023; 39:120-126. [PMID: 36779462 DOI: 10.3928/1081597x-20221221-02] [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: 02/14/2023]
Abstract
PURPOSE To evaluate risk factors for significant rotation and determine optimal timing for repositioning surgery following a plate-haptic toric intraocular lens (IOL) implantation. METHODS This retrospective study enrolled patients who underwent the plate-haptic toric IOL implantation at seven hospitals in Shanghai. IOL rotation and residual astigmatism were compared before and after repositioning surgery. Risk factors for significant IOL rotation after cataract surgery were identified by stepwise multiple linear regression analysis. Spearman's and linear regression analyses were performed to identify factors associated with IOL rotation after repositioning. The receiver operator characteristic (ROC) curve was used to analyze the optimal timing for repositioning surgery. RESULTS Among 2,745 eyes implanted with the toric IOL, 46 eyes (1.68%) of 45 patients underwent repositioning surgery. Axial length and lens thickness were significantly associated with IOL rotation before repositioning. After repositioning surgery, IOL rotation and residual astigmatism were significantly reduced (all P < .001). IOL rotation after repositioning was negatively associated with the timing of repositioning surgery (all P < .001). The ROC curve showed that the optimal cut-off for the timing of repositioning surgery was 15 days or greater. CONCLUSIONS The prevalence of repositioning surgery after the plate-haptic toric IOL implantation was 1.68%, and the optimal timing for repositioning surgery was recommended to be 2 to 3 weeks after cataract surgery. [J Refract Surg. 2023;39(2):120-126.].
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Bu S, Jiang Y, Gao Y, Bai X, Chen X, Zhang H, Tian F. The impact of posterior corneal astigmatism on the surgical planning of toric multifocal intraocular lens implantation. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2023; 3:39-46. [PMID: 37846431 PMCID: PMC10577858 DOI: 10.1016/j.aopr.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/12/2022] [Accepted: 08/21/2022] [Indexed: 10/18/2023]
Abstract
Purpose To investigate the influence of posterior corneal astigmatism on the prediction accuracy of toric multifocal intraocular lens (IOL) calculation. Methods The keratometric astigmatism measured by Lenstar LS 900 (KCAL), keratometric astigmatism (KCAP) and total corneal astigmatism (TCA) measured by Scheimpflug camera (Pentacam HR) were documented and analyzed accordingly. Three deduction models using different parameters were compared. Model 1: KCAL + keratometric corneal surgically induced astigmatism (KCSIA, 0.30 D @ 50°); Model 2: KCAP + KCSIA); Model 3: TCA + total CSIA (TCSIA, 0.23 D @ 50°). The prediction errors of each model as the difference vector between the actual and the intended residual astigmatism were compared. Results Seventy-six eyes implanted with toric multifocal IOLs were included in this study. The vector differences of the actual KCSIA and TCSIA were statistically significant in the total sample and against-the-rule (ATR) subgroup (both P < 0.05). Model 1 deduced the smallest mean values of prediction error, while that of Model 3 were smaller than that of Model 2, both in the total sample and the ATR subgroups (all P < 0.05). Meanwhile, in the total sample and ATR subgroups, the centroid vector magnitudes of Model 3 were smaller than that of Model 1 (0.31 ± 0.76 D and 0.39 ± 0.76 D). Conclusions The calculation of toric multifocal IOL should be individualized especially in the ATR eyes for the impact of PCA on the estimation of the preoperative corneal astigmatism and the CSIA.
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Affiliation(s)
| | | | - Yichen Gao
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 300384, Tianjin, China
| | - Xiaomei Bai
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 300384, Tianjin, China
| | - Xiteng Chen
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 300384, Tianjin, China
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Chang P, Chen D, Hu B, Wang Y, Qian S, Ding X, Zhao Y. Effect of capsular bend on the rotational stability of toric intraocular lens. Eye (Lond) 2023; 37:480-485. [PMID: 35165380 PMCID: PMC9905548 DOI: 10.1038/s41433-022-01964-0] [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: 07/10/2021] [Revised: 01/12/2022] [Accepted: 02/02/2022] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To assess the effect of capsular bend and axial length on the rotational stability of toric IOL. METHODS The prospective study included patients with preexisting astigmatism that were implanted with Acrysof IQ Toric IOL. According to the pre‑operative axial length, all patients were divided into 2 groups: high myopia (AL ≥ 26 mm) group, and emmetropia or low to moderate myopia group (AL <26 mm). High-speed Swept-source Optical Coherence Tomography (SS-OCT) radial scanning was performed after pupil dilation to obtain the toric IOL axial orientation and capsular bending index (CBI) at 1-day, 1-week, 1-month and 3-month intervals postoperatively. The correlation between the rotation of toric intraocular lens and the axial length or CBI was subsequently analyzed. RESULTS 68 eyes of 57 patients were included in the research. The rotation of toric IOL within the high myopia group was greater than the control group (P = 0.001, 1month postoperative). Capsular contact with the IOL was delayed in highly myopic eyes, although the results were not statistically significant (P = 0.094, 1-month postoperatively). There was a positive correlation between the degree of rotation and axial length at the interval found between 1-week and 1-month after the operation (r = 0.333, P = 0.005). There was a significant negative correlation between the IOL rotational speed and CBI (P < 0.001). The regression equation was Y = -0.441*X + 1.712 (R2 = 0.323, P < 0.001). CONCLUSION There was a significant negative correlation between the IOL rotation speed and the CBI, while the influence of the axial length and capsular bending mainly occurred between one week and one month after the operation.
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Affiliation(s)
- Pingjun Chang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Dongjie Chen
- Hwa Mei Hospital, University of Chinese Academy of Science (Ningbo No.2 Hospital), Ningbo, Zhejiang, China
| | - Bin Hu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Yalan Wang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Shuyi Qian
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Xixia Ding
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Yune Zhao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China.
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Liu W, Yang L, Liu J. The Impact of Posterior Corneal Astigmatism on Surgically Induced Astigmatism in Cataract Surgery. Int J Gen Med 2022; 15:8417-8425. [PMID: 36465271 PMCID: PMC9718375 DOI: 10.2147/ijgm.s382774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 11/14/2022] [Indexed: 11/05/2023] Open
Abstract
PURPOSE This study aimed to evaluate the changes in posterior corneal astigmatism after cataract surgery and provide a theoretical basis to accurately evaluate the total corneal astigmatism (TA) to be corrected before toric intraocular lens (IOL) implantation. PATIENTS AND METHODS Sixty-two patients (89 eyes) who underwent phacoemulsification combined with toric IOL implantation (AcrySof IQ Toric SN6AT2-T9) at Shanxi Eye Hospital between January 2017 and September 2018 were enrolled. Surgically induced astigmatism of the posterior cornea (SIAPA) was analysed using vector analysis during pentacam examination. RESULTS The vector variances of keratometric astigmatism (KA), TA, and posterior corneal astigmatism (PA) preoperatively and postoperatively in the "with-the-rule (WTR) astigmatism" group and "overall patient" group were statistically significant (P < 0.05). A statistically significant difference was observed between surgically induced KA (SIAKA) and surgically induced astigmatism of the total cornea (SIATA) for all patients, including those with WTR astigmatism. For all patients, SIAKA was less than SIATA by 0.05 ± 0.21 D, and for patients with WTR astigmatism, SIAKA was less than SIATA by 0.09 ± 0.22 D. For patients in the "against-the-rule (ATR) astigmatism" group, there were no statistically significant differences between SIAKA and SIATA, although SIAKA was greater than SIATA by 0.03 ± 0.18 D. When PA ≤0.4 D or KA ≤2.0 D, SIAPA can be ignored. However, when PA >0.4 D or KA >2.0 D, ignoring SIAPA caused by cataract surgery incision will cause SIAKA in patients with WTR astigmatism to underestimate SIATA, while SIAKA in patients with ATR astigmatism will cause an overestimation of SIATA. CONCLUSION SIA on the posterior corneal astigmatism may have a significant role on more precise planning of toric IOL implantation, especially in cases with higher preoperative anterior or posterior corneal astigmatism.
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Affiliation(s)
- Wenjie Liu
- Cataract Department, Shanxi Eye Hospital, Taiyuan, Shanxi Province, People’s Republic of China
| | - Lichun Yang
- Cataract Department, Shanxi Eye Hospital, Taiyuan, Shanxi Province, People’s Republic of China
| | - Jiewei Liu
- Cataract Department, Shanxi Eye Hospital, Taiyuan, Shanxi Province, People’s Republic of China
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Bellucci C, Panico A, Tedesco SA, Carta A, Gandolfi S, Bellucci R, Mora P. One-dioptre toric IOL versus spherical IOL in eyes with low preoperative corneal astigmatism. Int Ophthalmol 2022; 43:1711-1719. [PMID: 36418805 PMCID: PMC10149477 DOI: 10.1007/s10792-022-02571-4] [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: 05/30/2022] [Accepted: 11/12/2022] [Indexed: 11/25/2022]
Abstract
Abstract
Purpose
To investigate the advantages/disadvantages of a 1.0 D toric IOL vs spherical IOL after regular phacoemulsification in eyes with preoperative astigmatism ≤ 1 D.
Methods
Retrospective comparative series involving pseudophakic eyes with preoperative topographic astigmatism ≤ 1.0 D implanted either with monofocal 1.0 D Toric IOL (T-group), or with spherical IOL (S-group). The postoperative refractive astigmatism (PRA, i.e. surgically induced + corneal) was the main outcome; also considered in the analyses were the uncorrected and best-corrected distance visual acuity (VA). The data were referred to the last postoperative follow-up visit, 2 to 4 months after surgery.
Results
A total of 60 eyes were included: 30 in the T-group and 30 in the S-group, matched for patient’s age, laterality, and axial length. Before surgery, the mean corneal astigmatism was 0.62 ± 0.39 D in the T-group and 0.54 ± 0.33 D in the S-group (p = 0.4). In the S-group, PRA was 0.73 ± 0.37 D, higher than the corresponding preoperative corneal astigmatism (p = 0.040). In the T-group, PRA was 0.58 ± 0.31 D; the variation was not statistically significant. Uncorrected VA was significantly better in the T-group vs the S-group (p = 0.007), and the best-corrected VA was comparable in the two groups.
Conclusion
The present study indicated that in eyes with very low preoperative astigmatism, 1.0 D toric IOLs were able to limit the increase of the PRA instead of those observed with the spherical IOLs. This could support the better uncorrected VA recorded in the T-group.
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Affiliation(s)
- Carlo Bellucci
- Ophthalmology Unit, Department of Medicine and Surgery, University of Parma - Via Gramsci 14, 43126, Parma, Italy.
| | - Angela Panico
- San Giuseppe E Melorio Hospital, Santa Maria Capua Vetere, Italy
| | - Salvatore A Tedesco
- Ophthalmology Unit, Department of Medicine and Surgery, University of Parma - Via Gramsci 14, 43126, Parma, Italy
| | - Arturo Carta
- Ophthalmology Unit, Department of Medicine and Surgery, University of Parma - Via Gramsci 14, 43126, Parma, Italy
| | - Stefano Gandolfi
- Ophthalmology Unit, Department of Medicine and Surgery, University of Parma - Via Gramsci 14, 43126, Parma, Italy
| | | | - Paolo Mora
- Ophthalmology Unit, Department of Medicine and Surgery, University of Parma - Via Gramsci 14, 43126, Parma, Italy
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Li H, Sun J, Bai H, Leng L, Dai Y, Wu X. Incidence and Risk Factors of Repositioning Surgery to Correct Misalignment of Toric Intraocular Lenses after Cataract Surgery: A Single-Center Retrospective Observational Study. Ophthalmic Res 2022; 66:259-264. [PMID: 36223730 DOI: 10.1159/000527408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 09/26/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE The aim of this study was to analyze the incidence and outcomes of repositioning surgery to correct misalignment of several toric intraocular lenses (IOLs) after cataract surgery. METHODS In this retrospective study, patients who underwent repositioning surgery to correct misalignment of toric IOLs following cataract surgery between January 2019 and December 2021 were enrolled. The medical data on patients' age, gender, preoperative axial length, corneal astigmatism, the axis of astigmatism, IOL models, IOL axis, uncorrected distance visual acuity, residual refraction, and postoperative outcomes were analyzed. RESULTS Among the 1,135 eyes implanted with toric IOLs at Qingdao Eye Hospital, 23 (2.026%, 23/1,135) underwent repositioning surgery. Univariate analysis revealed that the incidence of repositioning surgery was significantly lower with AcrySof (0.636%, 5/786) than with ZEISS (2.959%, 5/169) and TECNIS (7.222%, 13/180) IOL platforms; the incidence of repositioning surgery with monofocal toric IOLs (1.169%, 11/941) was significantly lower than multifocal toric IOLs (6.186%, 12/194) (p < 0.001); additionally, a significant difference in age was also observed (p = 0.002). Multivariate logistic regression analysis showed that the IOL platform (p = 0.004) and younger age (p = 0.006) were independent risk factors for repositioning surgery. CONCLUSION The incidence of repositioning surgery of toric IOLs after cataract surgery was 2.026%. It was linked to the IOL platform, multifocal toric IOLs, and younger age.
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Affiliation(s)
- Honglei 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 & Shandong Academy of Medical Sciences, Qingdao, China,
| | - Jiajun Sun
- 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 & Shandong Academy of Medical Sciences, Qingdao, China
| | - Huiran Bai
- 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 & Shandong Academy of Medical Sciences, Qingdao, China
| | - Lin Leng
- 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 & Shandong Academy of Medical Sciences, Qingdao, China
| | - Yunhai Dai
- 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 & Shandong Academy of Medical Sciences, Qingdao, China
| | - Xiaoming 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 & Shandong Academy of Medical Sciences, Qingdao, China
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Résultat réfractif d’un implant torique monofocal retourné. J Fr Ophtalmol 2022; 45:e339-e341. [DOI: 10.1016/j.jfo.2022.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/20/2022] [Indexed: 11/21/2022]
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Quesada GA, Quesada RA, Jones JJ, Straker BJK, Zhao W, Tsai L, Vilupuru S. Reproducibility of the Magnitude of Lens Rotation Following Implantation of a Toric Intraocular Lens with Modified Haptics. Clin Ophthalmol 2022; 16:3213-3224. [PMID: 36199805 PMCID: PMC9529011 DOI: 10.2147/opth.s373976] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 09/05/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the reproducibility of magnitude of postoperative IOL rotation following implantation of a toric intraocular lens (IOL) with modified haptics, in comparison with a Proof-of-Concept (POC) study of prototype IOLs featuring the same haptic design. Patients and Methods A post-market, prospective, multicenter, single-arm, open-label clinical study was conducted. TECNIS Toric II IOL (Johnson & Johnson Vision, Irvine, CA, USA, Models ZCU150 to 600) were implanted in 125 subjects and evaluated at 1-day and 1-week postoperatively. An objective photographic method was used to determine postoperative IOL rotation. Uncorrected distance visual acuity (UCDVA), postoperative astigmatism, and surgeon satisfaction were also assessed. Rotation data were compared to the POC study in which two prototype non-toric monofocal IOLs, one with the same haptic design as Model ZCU, were studied. Results Mean absolute rotation was 0.82° ± 1.0° and 0.84° ± 0.92°at 1-day and 1-week visits, respectively. The percentage of eyes with ≤5° of absolute rotation was 98.9% and 99.5% at the 1-day and 1-week visits, respectively. The magnitude of rotation was similar to the POC study prototype IOLs. At 1-week, mean monocular UCDVA was 0.026 ± 0.135 (~20/21) logMAR and mean residual manifest refractive cylinder was 0.30 D ± 0.35 D. The mean signed axis difference (postoperative minus operative) of the TECNIS Toric II IOL was 0.23° ± 1.27° at 1-day and −0.07° ± 1.25° at 1-week, indicating a clockwise drift. At 1-week, surgeons were very satisfied or satisfied with overall clinical outcomes and rotational stability in 98% of implanted eyes. Conclusion The TECNIS Toric II IOL, with frosted, squared haptics, demonstrated low magnitude of postoperative IOL rotation, excellent uncorrected distance vision, and minimal residual astigmatism. The POC study design was supported, demonstrating that prototype non-toric monofocal IOLs can predict clinical performance of toric IOLs with the same haptic design.
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Affiliation(s)
- Gabriel A Quesada
- Centro de Oftalmología y Cirugía Plástica, San Salvador, El Salvador
| | - Rodrigo A Quesada
- Centro de Oftalmología y Cirugía Plástica, San Salvador, El Salvador
| | | | | | - Wuchen Zhao
- Johnson & Johnson Surgical Vision, Inc, Irvine, CA, USA
| | - Linda Tsai
- Johnson & Johnson Surgical Vision, Inc, Irvine, CA, USA
| | - Srividhya Vilupuru
- Johnson & Johnson Surgical Vision, Inc, Irvine, CA, USA
- Correspondence: Srividhya Vilupuru, Johnson & Johnson Surgical Vision, 31 Technology Dr Suite 200, Irvine, CA, 92618, USA, Tel +1-949-581-5799, Email
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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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Efficacy of the Image-Guided Alignment System for a Four-Haptic Hydrophobic Monofocal Toric Intraocular Lens. Eye Contact Lens 2022; 48:396-402. [PMID: 35580544 DOI: 10.1097/icl.0000000000000901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the difference in performance between the image-guided alignment system and the manual-marking method in the four-haptic hydrophobic monofocal toric intraocular lens (IOL). METHODS Medical records of patients who underwent cataract surgery with a four-haptic hydrophobic monofocal toric IOL implantation between May 2020 and April 2021 and with 3-month visit data available were investigated. Toric IOL misalignment, residual astigmatism, and mean prediction errors between the two groups were compared. RESULTS This study included 49 eyes of 44 patients (women: 68%; mean age: 67.2±7.0 [range: 47-82] years). Twenty-nine eyes of 26 patients were treated with toric IOL implantation using the image-guided system and 20 eyes of 18 patients were treated using the manual-marking method. No statistical differences were observed regarding the baseline characteristics of the two groups. Three months after the surgery, the misalignment of the toric IOL was significantly lower in the image-guided group (2.18°±0.65°, range: 1.26°-3.95°) than in the manual; marking group (4.72°±0.74°, range: 3.44°-6.21°; P<0.001). CONCLUSION In comparison to the manual-marking method, the image-guided system reduced the misalignment of a four-haptic hydrophobic monofocal toric IOL.
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Rementería-Capelo LA, Fernández-Cuenca S, Gros-Otero J, García-Pérez JL, Morán A, Contreras I. Visual and refractive outcomes of monofocal toric intraocular lens implantation in amblyopic eyes. Eur J Ophthalmol 2022; 32:3425-3432. [PMID: 35254149 DOI: 10.1177/11206721221086245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate the visual and refractive outcomes of monofocal toric intraocular lens (IOL) implantation after cataract surgery in amblyopic eyes. METHODS Our center's database was used to identify patients who had undergone bilateral cataract surgery between 2016 and 2020 with the implantation of a toric IOL in their amblyopic eye. Exclusion criteria were the presence of strabismus, ocular pathologies other than cataract or intra-surgical complications. The outcomes analysed were uncorrected distance visual acuity (UDVA), subjective refraction and corrected distance visual acuity (CDVA) one month after surgery. RESULTS Ninety patients were included, with a mean age of 68.96 ± 7.81years. CDVA was lower for the amblyopic eye, both before and after surgery. There was a mean improvement in CDVA of 0.23 ± 0.21 LogMAR for the dominant eye and of 0.39 ± 0.33 for the amblyopic eye, p < 0.001 in both cases. Postoperative subjective refractive cylinder was higher in the amblyopic eye (-0.24 ± 0.39 D versus -0.10 ± 0.25 D, p < 0.01), as well as mean cylinder prediction error (-0.30 ± 0.47 D versus 0.02 ± 0.42 D, p < 0.01), compared to the dominant eye. There was a statistically significant correlation between preoperative and postoperative CDVA in amblyopic eyes (Spearmańs Rho = 260, p = 0.013). Mean postoperative UCVA was 0.15 ± 0.25 for amblyopic and 0.03 ± 0.12 for dominant eyes. Only one patient required distance spectacle correction due to residual astigmatism. CONCLUSIONS Cataract surgery with toric IOL implantation in amblyopic eyes leads to an improvement in visual acuity and to spectacle independence in almost all cases, even in the presence of a higher cylinder prediction error.
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Affiliation(s)
| | | | | | | | | | - Inés Contreras
- Clínica Rementería, Madrid, Spain.,16507Hospital Universitario Ramón y Cajal, Madrid, Spain. Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, Spain
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Llorens-Quintana C, Pavlatos E, Thaware O, Gupta S, Gradin D, Romfh D, Li Y, Huang D. Accuracy of OCT-derived net corneal astigmatism measurement. J Cataract Refract Surg 2022; 48:267-274. [PMID: 34326282 PMCID: PMC8792105 DOI: 10.1097/j.jcrs.0000000000000766] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 07/21/2021] [Indexed: 01/29/2023]
Abstract
PURPOSE To assess the repeatability and accuracy of corneal astigmatism measurement with a spectral-domain optical coherence tomography (OCT) system (Avanti, Optovue) and compare them with Scheimpflug imaging (Pentacam HR, Oculus) and swept-source optical biometry (IOLMaster 700, Carl Zeiss Meditec AG). SETTING Casey Eye Institute, Oregon Health & Science University, Portland, Oregon. DESIGN Prospective cross-sectional observational study. METHODS 60 pseudophakic eyes with monofocal nontoric intraocular lens that previously had refractive surgery were analyzed. To assess accuracy, simulated keratometry (SimK) and net corneal astigmatism, obtained from each device, were compared with subjective manifest refraction astigmatism. Repeatability for corneal astigmatism was assessed for OCT and Pentacam HR by the coefficient of repeatability from 3 repeated measures. RESULTS Compared with manifest refraction, SimK readings produced with-the-rule astigmatic bias that was reduced for net astigmatism for the 3 devices. Except for OCT net astigmatism, all instruments significantly overestimated the magnitude of the astigmatism (linear mixed-effects model [LMM], P < .05). OCT net astigmatism showed the highest accuracy for manifest astigmatism prediction with the smaller 95% confidence ellipse for the mean difference vector. OCT net mean absolute difference was 0.57 diopters (D), significantly smaller than that of the other modalities (LMM, P < .05). Net corneal astigmatism measured with OCT showed the best repeatability (coefficient of repeatability = 0.29 D). CONCLUSIONS OCT has the capability to measure net corneal astigmatism with higher precision and accuracy than Pentacam HR Scheimpflug imaging and IOLMaster 700 swept-source optical biometry in postrefractive subjects.
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Affiliation(s)
- Clara Llorens-Quintana
- From the Casey Eye Institute and Department of Ophthalmology, Oregon Health and Science University, Portland, Oregon
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Kramer BA, Berdahl J, Gu X, Merchea M. Real-world incidence of monofocal toric intraocular lens repositioning: analysis of the American Academy of Ophthalmology IRIS Registry. J Cataract Refract Surg 2022; 48:298-303. [PMID: 34415862 PMCID: PMC8865207 DOI: 10.1097/j.jcrs.0000000000000748] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 07/12/2021] [Indexed: 12/03/2022]
Abstract
PURPOSE To determine the 12-month incidence of reoperation to realign 2 commercially available types of implanted monofocal toric acrylic intraocular lenses (IOLs). SETTING American Academy of Ophthalmology IRIS (Intelligent Research in Sight) Registry. DESIGN Registry retrospective study. METHODS Eyes that underwent cataract extraction and were implanted with a TECNIS or AcrySof monofocal toric IOL in 2016 and 2017 were identified. The rate of reoperation for IOL realignment (Current Procedural Terminology code 66825) within 365 days of implantation was determined for each IOL group. Risk factors for repositioning were evaluated using logistic regression modeling. RESULTS A total of 6482 eyes were implanted with a monofocal toric IOL, including 2013 (31.06%) with a TECNIS and 4469 (68.94%) with an AcrySof IOL. During the first postoperative year, 87 (1.3%) eyes underwent surgical IOL repositioning. The incidence of repositioning was significantly higher (P < .0001) for TECNIS-implanted (3.1%, 62/2013) than for AcrySof-implanted (0.6%, 25/4469) eyes (odds ratio [OR] 5.6; 95% CI, 3.5-8.9). Younger age (OR 0.76; 95% CI, 0.67-0.86 per 5-year increase) was associated with a higher risk for IOL repositioning. CONCLUSIONS Real-world analysis of U.S. patients in the IRIS Registry revealed that the rate of surgical IOL repositioning was 5 times higher in eyes implanted with TECNIS than with AcrySof monofocal toric IOLs for astigmatic correction at the time of cataract surgery. These findings should be considered when selecting a toric IOL for correction of astigmatism in cataract patients, particularly in younger patients with a higher risk for misalignment requiring repositioning.
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Shin YI, Jung JH. Modified Harada-Ito Procedure with Intraoperative Adjustable Sutures Using a Mendez Ring for Excyclotorsion. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2022. [DOI: 10.3341/jkos.2022.63.2.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: We report a case of using a modified Harada-Ito procedure with intraoperative adjustment via a Mendez ring in a patient with bilateral superior oblique palsy, resulting in satisfactory postoperative outcomes.Case summary: A 47-year-old male patient presented with bilateral diplopia after cerebral hemorrhage. Bilateral superior oblique palsy was diagnosed, and double Maddox rod tests confirmed 20° of excyclotorsion in both eyes. After 6 months of observation, surgical correction was attempted. To check the amount of cyclodeviation, a modified Harada–Ito procedure was performed on the superior oblique muscle after marking at the 6 and 12 o'clock positions of the corneal limbus. Following the procedure, a Mendez ring was placed on the limbus to check for the amount of incyclotorsion. Thirty degrees of incyclotorsion was aimed at both eyes, and a 5-mm resection of the right superior oblique tendon was performed for additional correction. There was no complaint of diplopia at 6 months postoperatively, and no deviation was observed.Conclusions: A modified Harada-Ito procedure with intraoperative adjustment using a Mendez ring effectively corrected excyclotorsion with torsional diplopia.
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Impact of Material and Lens Design on Repositioning Surgery of Toric Intraocular Lenses: A Single-Arm Meta-Analysis. J Ophthalmol 2022; 2022:6699596. [PMID: 35223091 PMCID: PMC8881179 DOI: 10.1155/2022/6699596] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/22/2021] [Indexed: 11/29/2022] Open
Abstract
Aim To analyze the pooled incidence rate in repositioning surgery by considering different materials and designs. Methods All published studies investigating the repositioning surgery of toric intraocular lenses (IOLs) before September 1, 2020, were searched and evaluated. The R3.5.2 software was used to extract the data, and a single arm meta-analysis was performed. Results 19 cases from 18 published studies articles were included in the meta-analysis. The pooled incidence rate in repositioning surgery was 2% (I2 = 53%, Pheterogeneity<0.01). Plate and silicone IOLs had significantly higher incidence rates (6% for each) than loop (2%) and hydrophobic acrylate (2%). Incidence rates of Acrysof, Staar, TECNIS, PhysIOL SA, T-flex 623T, and Microsil 6116TU groups were 1% (95% CI [1%–2%]), 6% (95% CI [4%–9%]), 3% (95% CI [2%–4%]), 1.40% (1/71), 3.03% (1/33), and 4.76% (1/21), respectively. Conclusions The pooled incidence rate of repositioning surgery in IOLs was 2%. Materials and designs would be risk factors for the rotational stability of the toric IOLs. Pooled incidence rates of the hydrophobic acrylate and loop group were lower than those of the silicone and plate group. Product identity is the main driver of heterogeneity.
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Hasegawa Y, Honbo M, Miyata K, Oshika T. Type of residual astigmatism and uncorrected visual acuity in pseudophakic eyes. Sci Rep 2022; 12:1225. [PMID: 35075241 PMCID: PMC8786906 DOI: 10.1038/s41598-022-05311-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
It is difficult to assess the pure impact of the type of residual astigmatism (with-the-rule; WTR, against-the-rule; ATR, and oblique astigmatism) on uncorrected distance visual acuity (UDVA) in pseudophakic eyes due to different age distribution of patients between those subgroups. We conducted the current study to investigate the association between astigmatism type and UDVA in eyes after cataract surgery with consideration for various confounding factors such as age. Data were retrospectively collected from 1535 pseudophakic eyes with corrected distance visual acuity (CDVA) of 20/20 or better, and spherical equivalent between − 0.125 D and 0.0 D. They were classified based on the pattern of residual refractive astigmatism into four groups; minimum astigmatism (< 0.5 D), WTR, ATR, and oblique astigmatism groups. The stepwise multivariate regression analysis showed that the magnitude of residual refractive astigmatism (standardized partial regression coefficient β = 0.559, p < 0.001), CDVA (β = 0.381, p < 0.001), minimum astigmatism group (β = − 0.188, p < 0.001), and WTR astigmatism group (β = − 0.058, p < 0.001) were significantly associated with UDVA (r2 = 0.795). Variables excluded from the multivariate regression model include age, preoperative corneal astigmatism, axial length, anterior chamber depth, intraocular lens power, and postoperative spherical equivalent. These results indicate that UDVA is significantly better in eyes with minimum and WTR astigmatism than in those with ATR and oblique astigmatism, after adjustment for confounding parameters. In pseudophakic eyes, oblique and ATR astigmatism exerts a greater impact on UDVA than WTR astigmatism does, even after controlling for age.
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Affiliation(s)
- Yumi Hasegawa
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | | | | | - Tetsuro Oshika
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.
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Avetisov SE, Voronin GV, Yevdokimova AN, Avetisov KS, Shkolyarenko NY, Yusef SN. [The impact of the position of toric intraocular lenses on the functional outcomes of phaco surgery]. Vestn Oftalmol 2022; 138:273-278. [PMID: 36287167 DOI: 10.17116/oftalma2022138052273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The article reviews data on the impact of the position (orientation) of toric intraocular lenses on the functional outcomes of cataract phacoemulsification surgery, discusses the algorithm of astigmatism correction with intraocular lenses including preoperative determination of the size and position of main meridians, calculation of lens parameters, marking of corneal meridians, intraoperative positioning, as well as rotation and/or repositioning of the lens when necessary.
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Affiliation(s)
- S E Avetisov
- Research Institute of Eye Diseases, Moscow, Russia.,I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - G V Voronin
- Research Institute of Eye Diseases, Moscow, Russia.,I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - A N Yevdokimova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - K S Avetisov
- Research Institute of Eye Diseases, Moscow, Russia
| | | | - S N Yusef
- Research Institute of Eye Diseases, Moscow, Russia
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Toric Intraocular Lenses for the Management of Corneal Astigmatism at the Time of Cataract Surgery. J Ophthalmol 2021; 2021:3286043. [PMID: 34961830 PMCID: PMC8710165 DOI: 10.1155/2021/3286043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 12/04/2021] [Indexed: 12/26/2022] Open
Abstract
Methods This audit was conducted in a UK ophthalmology department and included 48 eyes of 42 patients. Surgery was performed during 2019 in patients with 2.50 diopters (D) or more corneal astigmatism. Anterior keratometry readings were used to determine the toric IOL power. Vector analysis using the Alpins method was used to assess changes in astigmatism pre to postoperatively. Results There were 18 right and 26 left eyes included. In terms of gender, 61% of patients were female and 39% were male. The mean (±standard deviation (SD)) age was 70 (±11) years. The mean (±SD) axial length, K1, K2, and delta K was 23.55 (±1.4) mm, 42.71 (±1.39) D, 45.78 (±1.60) D, and 3.01 (±0.89) D, respectively. Postoperatively, the median spherical, cylinder, and spherical equivalent refraction was 0.00 D, −1.00 D, and 0.00 D, respectively. Postoperatively, 41% of the eyes had ≤0.50 D of spectacle astigmatism and 80% had ≤1.00 D. No patient required a secondary procedure to reposition the IOL from rotation. In vector analysis with the use of polar diagrams, there was a tendency for overcorrection of with-the-rule astigmatism and undercorrection of against-the-rule astigmatism. Conclusions Significant reductions in astigmatism can be achieved with the use of toric IOLs in patients undergoing cataract surgery. Further improvements may be possible with surgeon-specific determination of their surgically induced astigmatism and flattening effect from the main corneal incision. Furthermore, the use of an optical biometer that directly measures the posterior corneal curvature and permits automatic toric IOL power determination with modern formulas avoiding the need for manual data entry may reduce the risk of human error and improve visual and refractive outcomes.
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The Effect of Toric Intraocular Lens Implantation in Irregular Corneal Steep and Flat Meridian. J Ophthalmol 2021; 2021:3630668. [PMID: 34777858 PMCID: PMC8589528 DOI: 10.1155/2021/3630668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 10/26/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose To evaluate the effect of toric intraocular lens implantation in cataract patients with irregular corneal steep and flat meridian. Methods Data of 112 eyes of 78 patients who underwent toric intraocular lens implantation were analyzed retrospectively. Steep meridian deviations (not 180°) and steep and flat meridian deviations (not 90°) were classified as 0, 1–9, 10–19, 20–29, 30–39, and over 30°. Meridian deviation was measured with a sagittal map of a rotating Scheimpflug camera (Pentacam®: Oculus, Wetzlar, Germany) using PicPickTools (NGWIN, Seoul, Korea). Results Residual astigmatism (D) of 0 (0.51 ± 0.13, 0.55 ± 0.15) and 1–9 (0.61 ± 0.16, 0.66 ± 0.19) groups were significantly lower than that of 10–19 (0.92 ± 0.24, 0.90 ± 0.28), 20–29 (0.10 ± 0.32, 1.01 ± 0.35), and over 30° groups (1.12 ± 0.37, 1.14 ± 0.40) both in steep meridian deviations and horizontal and vertical meridian deviations at 6 months (P < 0.05). Postoperative mean UCVA (logMAR) of 0 (0.09 ± 0.04, 0.09 ± 0.05) (logMAR) and 1–9 (0.10 ± 0.04, 0.11 ± 0.08) groups was significantly improved compared to that of 10–19 (0.14 ± 0.05, 0.17 ± 0.10), 20–29 (0.18 ± 0.08, 0.21 ± 0.10), and over 30° groups (0.20 ± 0.09, 0.22 ± 0.11) both in steep meridian deviations and horizontal and vertical meridian deviations at 6 months (P < 0.05). Conclusions Correction of astigmatism with toric intraocular lens implantation is not accurate in corneas with steep meridian deviations and steep and flat meridian deviations of more than 10°. Therefore, care should be taken when we perform toric intraocular lens implantation in patients with irregular corneal meridian.
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Meng J, Yu J, He W, Wei L, Lu Y, Zhu X. The Influence of Analysis Mode Selection on Prediction Accuracy of Corneal Astigmatism Using Pentacam. Front Med (Lausanne) 2021; 8:713502. [PMID: 34722562 PMCID: PMC8554023 DOI: 10.3389/fmed.2021.713502] [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: 05/23/2021] [Accepted: 09/13/2021] [Indexed: 11/15/2022] Open
Abstract
Purpose: To evaluate the influence of analysis mode selection on prediction accuracy of corneal astigmatism using Pentacam. Methods: Fifty-nine eyes of 59 patients implanted with toric intraocular lenses (IOLs) were included in the retrospective study. Preoperative corneal astigmatism (total refractive power) measured with Pentacam was analyzed based on 2-, 3-, 4-, or 5-mm ring or zone mode either centered on corneal apex or pupil center. Actual corneal astigmatism was calculated based on residual astigmatism on the corneal plane, surgical-induced astigmatism, and effective toric power on the corneal plane. Prediction error, the difference between actual corneal astigmatism and measured astigmatism, was compared among different analysis modes. Influences of local topography on prediction error were also evaluated. Results: Based on the zone mode, prediction error was lower when centered on corneal apex than on pupil center at different diameters, whereas based on the ring mode, this difference was only seen at 2-mm cornea (all P < 0.05). When centered on the corneal apex, the zone mode showed lower prediction error than the ring mode at 4- and 5-mm corneas (both P < 0.001), regardless of asymmetric or symmetric astigmatism. In symmetric bowtie, the zone mode showed lower prediction error than the ring mode at 2-mm cornea of the small bowtie, and 4- and 5-mm corneas of the large bowtie (all P < 0.05). Conclusions: For toric IOL planning, the corneal apex may be a better reference center. At a cornea diameter ≥4 mm, the zone mode is more accurate than the ring mode. Local topography affects prediction accuracy in the symmetric bowtie.
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Affiliation(s)
- Jiaqi Meng
- Eye Institute, Eye & Ear, Nose and Throat (ENT) Hospital of Fudan University, Shanghai, China
| | - Jifeng Yu
- Department of Ophthalmology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Wenwen He
- Eye Institute, Eye & Ear, Nose and Throat (ENT) Hospital of Fudan University, Shanghai, China.,Key Laboratory of Myopia, Ministry of Health, Shanghai, China.,Key Laboratory of Visual Impairment and Restoration, Shanghai, China.,National Health Commission (NHC) Key Laboratory of Myopia (Fudan University), Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Ling Wei
- Eye Institute, Eye & Ear, Nose and Throat (ENT) Hospital of Fudan University, Shanghai, China
| | - Yi Lu
- Eye Institute, Eye & Ear, Nose and Throat (ENT) Hospital of Fudan University, Shanghai, China.,Key Laboratory of Myopia, Ministry of Health, Shanghai, China.,Key Laboratory of Visual Impairment and Restoration, Shanghai, China.,National Health Commission (NHC) Key Laboratory of Myopia (Fudan University), Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xiangjia Zhu
- Eye Institute, Eye & Ear, Nose and Throat (ENT) Hospital of Fudan University, Shanghai, China.,Key Laboratory of Myopia, Ministry of Health, Shanghai, China.,Key Laboratory of Visual Impairment and Restoration, Shanghai, China.,National Health Commission (NHC) Key Laboratory of Myopia (Fudan University), Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
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Chen X, Xu J, Chen X, Yao K. Cataract: Advances in surgery and whether surgery remains the only treatment in future. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2021; 1:100008. [PMID: 37846393 PMCID: PMC10577864 DOI: 10.1016/j.aopr.2021.100008] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/27/2021] [Accepted: 10/12/2021] [Indexed: 10/18/2023]
Abstract
Background Cataract is the world's leading eye disease that causes blindness. The prevalence of cataract aged 40 years and older is approximately 11.8%-18.8%. Currently, surgery is the only way to treat cataracts. Main Text From early intracapsular cataract extraction to extracapsular cataract extraction, to current phacoemulsification cataract surgery, the incision ranges from 12 to 3 mm, and sometimes to even 1.8 mm or less, and the revolution in cataract surgery is ongoing. Cataract surgery has transformed from vision recovery to refractive surgery, leading to the era of refractive cataract surgery, and premium intraocular lenses (IOLs) such as toric IOLs, multifocal IOLs, and extended depth-of-focus IOLs are being increasingly used to meet the individual needs of patients. With its advantages of providing better visual acuity and causing fewer complications, phacoemulsification is currently the mainstream cataract surgery technique worldwide. However, patient expectations for the safety and accuracy of the operation are continually increasing. Femtosecond laser-assisted cataract surgery (FLACS) has entered the public's field of vision. FLACS is a combination of new laser technology and artificial intelligence to replace fine manual clear corneal incision, capsulorhexis, and nuclear pre-fragmentation, providing new alternative technologies for patients and ophthalmologists. As FLACS matures, it is being increasingly applied in complex cases; however, some think it is not cost-effective. Although more than 26 million cataract surgeries are performed each year, there is still a gap in the prevalence of cataracts, especially in developing countries. Although cataract surgery is a nearly ideal procedure and complications are manageable, both patients and doctors dream of using drugs to cure cataracts. Is surgery really the only way to treat cataracts in the future? It has been verified by animal experiments that lanosterol therapy in rabbits and dogs could make cataract severity alleviated and lens transparency partially recovered. Although there is still much to learn about cataract reversal, this groundbreaking work provided a new strategy for the prevention and treatment of cataracts. Conclusions Although cataract surgery is nearly ideal, it is still insufficient, we expect the prospects for cataract drugs to be bright.
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Affiliation(s)
- Xinyi Chen
- Eye Center, Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310009, China
| | - Jingjie Xu
- Eye Center, Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310009, China
| | - Xiangjun Chen
- Eye Center, Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310009, China
| | - Ke Yao
- Eye Center, Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310009, China
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Pastor-Pascual F, Pastor-Pascual R, Montés-Micó R, Ruiz-Mesa R, Tañá-Rivero P. Transitional conic toric intraocular lens evaluation after femtosecond laser-assisted cataract surgery using intraoperative aberrometry. Int Ophthalmol 2021; 42:177-189. [PMID: 34424437 DOI: 10.1007/s10792-021-02012-8] [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: 01/21/2021] [Accepted: 08/13/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess refractive and visual outcomes following phacoemulsification with femtosecond laser-assisted cataract surgery (FLACS) using intraoperative aberrometry and implantation of a toric intraocular lens (IOL) in eyes with different degrees of astigmatism. METHODS One hundred two eyes of 70 patients who underwent implantation of the transitional toric 565 Precizon IOL (Ophtec BV) were enrolled. FLACS, capsular tension ring insertion, and intraoperative aberrometry were performed. Main outcome measures were refractive error, uncorrected- and corrected distance snellen decimal visual acuity values (UDVA and CDVA, respectively), and IOL rotation. Specifically, a vector analysis was carried out with J0 and J45 evaluation. Eyes were evaluated 1-year after surgery. RESULTS Overall, 94.12% (96 eyes) and 100% (102 eyes) of the eyes showed a spherical equivalent (SE) within ± 0.50D and ± 1.00D, respectively. The mean SE and refractive cylinder were - 0.06 ± 0.29D and - 0.23 ± 0.37D, respectively. Vector analysis revealed that 100% of the eyes were within ± 0.50D for the J0 and J45 cylindrical components. The mean toric axis rotation was 1.10 ± 1.71° (from 0° to 5°), 77% (79 eyes), and 100% (102 eyes) of the eyes showed UDVA and CDVA of 20/25, respectively. The postoperative mean values of monocular UDVA and CDVA were 0.88 ± 0.17 and 0.96 ± 0.07 (about 20/20), respectively. No patient required IOL realignment during the postoperative follow-up. CONCLUSIONS The present study suggests that the use of the Precizon IOL after FLACS, using intraoperative aberrometry in patients with different amounts of astigmatism, provides good visual acuity, accurate refractive outcomes, and excellent rotational stability.
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Affiliation(s)
| | | | - Robert Montés-Micó
- Oftalvist, C/Ruzafa 19, 46004, Valencia, Spain
- University of Valencia, Valencia, Spain
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Hirnschall N, Findl O, Bayer N, Leisser C, Norrby S, Zimper E, Hoffmann P. Sources of Error in Toric Intraocular Lens Power Calculation. J Refract Surg 2021; 36:646-652. [PMID: 33034356 DOI: 10.3928/1081597x-20200729-03] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 07/21/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE To evaluate the influencing factors on remaining astigmatism after implanting a toric intraocular lens (IOL) during cataract surgery. METHODS This retrospective study included parameters that were considered to have an influence on toric IOL power calculation. Therefore, data from the literature and the authors' own data were used. This included axial eye length, anterior chamber depth, central corneal thickness, corneal radii (anterior and posterior), diurnal changes of the cornea, inter-device differences, rotational misalignment of the IOL, tilt and decentration of the IOL, pupil size, angle kappa, and surgically induced astigmatism. Ray-tracing and Gaussian error propagation analysis was performed to quantify the sources of error. RESULTS In total, 4,949 eyes (4,365 eyes of 42 studies and 584 eyes of retrospectively analyzed study data) were included in the study and the difference vector between aimed and calculated remaining astigmatism was 0.81 diopters (D). The main source of error was the preoperative measurement of the cornea (27%), followed by IOL misalignment (14.4%) and IOL tilt (11.3%). Other factors, such as angle kappa (10.9%), pupil size (8.1%), surgically induced astigmatism (7.8%), anterior chamber depth (7.5%), axial eye length (7.5%), and decentration (5.6%), also contributed to the refractive astigmatic error. CONCLUSIONS The main source of error in toric IOL power calculation is the preoperative corneal measurement followed by IOL misalignment and tilt. [J Refract Surg. 2020;36(10):646-652.].
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Nenning M, Hirnschall N, Döller B, Varsits R, Findl O. Evaluation of an intraoperative marking technique using the body axis as a reference. SPEKTRUM DER AUGENHEILKUNDE 2021. [DOI: 10.1007/s00717-021-00498-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Huang YT, Lin CJ, Lai CT, Hsia NY, Tien PT, Bair H, Chen HS, Chiang CC, Lin JM, Chen WL, Wu WC, Tsai YY. Astigmatism Management with Astigmatism-Correcting Intraocular Lens Using Two Toric Calculators - A Comparative Case Series. Clin Ophthalmol 2021; 15:3259-3266. [PMID: 34385813 PMCID: PMC8352642 DOI: 10.2147/opth.s325234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/26/2021] [Indexed: 11/23/2022] Open
Abstract
Background To compare refractive outcomes after phacoemulsification and toric IOL implantation using two different toric calculators for initial astigmatism assessment in a real-world setting. Methods This was a retrospective, comparative, interventional case series. Patients over 30-year-old who underwent phacoemulsification and toric IOL implantation (AcrySof® Toric IOL) by the same surgeon between 2017 and 2018 were included. Eyes with irregular astigmatism, previous corneal refractive surgery, intraocular surgery, corneal pathology, macular pathology and pupil abnormalities were excluded. IOL toricity was determined by using a calculator provided by the AcrySof Toric calculator before 2018 and Barrett Toric Calculator after 2018. Patient demographics, corneal topography, vector and preoperative and postoperative refraction were collected and analyzed at three months postoperative. Results Thirty-two eyes of 32 patients were included in the final analysis. 0.1D for surgically induced astigmatism was used. Group 1 included 14 eyes assessed with the original (AcrySof) toric IOL calculator, and group 2 included 18 eyes assessed with the Barrett toric IOL calculator. In group 1, postoperative astigmatism less than −1.00D, −0.75 D, and −0.5D was achieved in 88.2%, 76.1% and 53.7% of eyes, respectively, while, in group 2, 89% eyes achieved postoperative residual astigmatism less than 0.5D and all eyes achieved postoperative residual astigmatism less than 0.75D. The proportion of patients with lower postoperative astigmatism was significantly higher in Group 2 (p< 0.05 by chi-square test), a pattern that still held when we divided patients into multiple groups. Vector analysis with the Alpins methods also supported better outcomes in the Barrett group (0.71 D vs 0.35 D). Conclusion The Barrett Toric calculator resulted in better results in the prediction of residual astigmatism than original (AcrySof) toric calculators.
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Affiliation(s)
- Yu-Te Huang
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Chun-Ju Lin
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Optometry, Asia University, Taichung, Taiwan
| | - Chun-Ting Lai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Ning-Yi Hsia
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Peng-Tai Tien
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan.,Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan
| | - Henry Bair
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan.,Stanford University School of Medicine, Stanford, CA, USA
| | - Huan-Sheng Chen
- An-Shin Dialysis Center, NephroCare Ltd., Fresenius Medical Care, Taichung, Taiwan
| | - Chun-Chi Chiang
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Jane-Ming Lin
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan.,Department of Optometry, Asia University, Taichung, Taiwan
| | - Wen-Lu Chen
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan.,Department of Optometry, Asia University, Taichung, Taiwan
| | - Wen-Chuan Wu
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Yi-Yu Tsai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Optometry, Asia University, Taichung, Taiwan
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