1
|
Pantanelli SM, Hatch K, Lin CC, Steigleman WA, Al-Mohtaseb Z, Rose-Nussbaumer JR, Santhiago MR, Keenan TDL, Kim SJ, Jacobs DS, Schallhorn JM. Intraoperative Aberrometry versus Preoperative Biometry for Intraocular Lens Power Calculations: A Report by the American Academy of Ophthalmology. Ophthalmology 2024:S0161-6420(24)00466-4. [PMID: 39365199 DOI: 10.1016/j.ophtha.2024.08.007] [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: 07/30/2024] [Accepted: 08/05/2024] [Indexed: 10/05/2024] Open
Abstract
PURPOSE To evaluate the published literature to compare intraoperative aberrometry (IA) with preoperative biometry-based formulas with respect to intraocular lens (IOL) power calculation accuracy for various clinical scenarios. METHODS Literature searches in the PubMed database conducted in August 2022, July 2023, and February 2024 identified 157, 18, and 6 citations, respectively. These were reviewed in abstract form, and 61 articles were selected for full-text review. Of these, 29 met the criteria for inclusion in this assessment. The panel methodologists assigned a level of evidence rating to each of the articles; 4 were rated level I, 19 were rated level II, and 6 were rated level III. RESULTS Intraoperative aberrometry performed better than traditional vergence formulas, including the Haigis, HofferQ, Holladay, and SRK/T, and similarly to the Barrett Universal II and Hill-RBF with respect to minimization of spherical equivalent (SE) refractive error. For toric IOLs, IA outperformed formulas that only considered anterior corneal astigmatism and was similar to formulas like the Barrett Toric Calculator (BTC), which empirically account for the contribution from the posterior cornea. In eyes with a history of corneal refractive surgery, IA performed similarly to the Barrett True-K and slightly better than other tested methods, including the Haigis-L, Shammas, and Wang-Koch-Maloney formulas. CONCLUSIONS Intraoperative aberrometry corresponds well with modern vergence formulas, including the Barrett Universal II, Hill-RBF, BTC, and Barrett True-K. It has greater accuracy than traditional vergence-based IOL power calculation formulas in eyes with and without a history of corneal refractive surgery. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
Collapse
Affiliation(s)
- Seth M Pantanelli
- Department of Ophthalmology, Penn State College of Medicine, Hershey, Pennsylvania
| | - Kathryn Hatch
- Cornea and Refractive Surgery Service, Massachusetts Eye and Ear, Boston, Massachusetts
| | | | | | - Zaina Al-Mohtaseb
- Whitsett Vision Group, Houston, Texas; Baylor College of Medicine, Houston, Texas
| | - Jennifer R Rose-Nussbaumer
- Stanford University, Palo Alto, California; Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California
| | | | - Tiarnán D L Keenan
- Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland
| | - Stephen J Kim
- Department of Ophthalmology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Deborah S Jacobs
- Cornea and Refractive Surgery Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Julie M Schallhorn
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California; Department of Ophthalmology, University of California, San Francisco, California
| |
Collapse
|
2
|
Akahoshi T. Hydrophobic Trifocal Toric Intraocular Lens Outcomes in Japanese Eyes After Cataract Surgery. Clin Ophthalmol 2024; 18:2021-2031. [PMID: 39010936 PMCID: PMC11249101 DOI: 10.2147/opth.s471846] [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: 04/02/2024] [Accepted: 07/02/2024] [Indexed: 07/17/2024] Open
Abstract
Purpose To analyze the refractive and visual outcomes following cataract surgery and implantation of a new hydrophobic trifocal toric intraocular lens (IOL) in Japanese eyes with different degrees of corneal astigmatism. Methods A total of 66 eyes from 39 patients implanted with a FineVision HP Toric IOL (Beaver-Visitec International Inc) were analyzed retrospectively. The main outcome measures considered were refraction, monocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), and distance-corrected intermediate visual acuity (DCIVA) at 80 and 66 cm, uncorrected near visual acuity (UNVA) and distance-corrected near visual acuity (DCNVA) at 40 cm. Eyes were evaluated at three months post-surgery. Results Sixty-five eyes (98.48%) were within ±0.50D of spherical equivalent, and all were within ±1.00D (mean: 0.00±0.21D). Moreover, 63 eyes (95.45%) had ≤0.50D of residual astigmatism, and all had ≤1.00D (mean: -0.08±0.23D). Similarly, 58 (87.88%) and 60 eyes (90.91%) had ≥20/20 UDVA and CDVA, respectively, with 65 (98.48%) and 66 eyes (100%) achieving ≥20/25 UDVA and CDVA, respectively. In addition, 28 (42.42%) and 23 eyes (34.85%) had ≥20/25 DCIVA at 80 and 66 cm, respectively, with 49 (74.24%) and 52 eyes (78.79%) achieving ≥20/32 DCIVA at 80 and 66 cm, respectively. Finally, 39 (59.09%) and 40 eyes (60.61%) had ≥20/20 UNVA and DCNVA, respectively, with 58 (87.88%) and 59 eyes (89.39%) achieving ≥20/25 UNVA and DCNVA, respectively. Conclusion Our study shows that implantation of the new hydrophobic FineVision HP Toric IOL results in accurate refractive outcomes, with good visual acuity at different distances, in Japanese eyes.
Collapse
Affiliation(s)
- Takayuki Akahoshi
- Cataract and Refractive Surgery Department, Nihonbashi Cataract Clinic, Tokyo, Japan
| |
Collapse
|
3
|
Orbegozo J, Pérez A, Basterra I, Noguera H, González L, Lauzirika G, Piñero DP. Clinical outcomes of a toric continuous range of vision presbyopia-correcting intraocular lens. J Cataract Refract Surg 2024; 50:724-732. [PMID: 38530027 DOI: 10.1097/j.jcrs.0000000000001428] [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: 11/03/2023] [Accepted: 02/12/2024] [Indexed: 03/27/2024]
Abstract
PURPOSE To evaluate the clinical outcomes of the toric version of a presbyopia-correcting intraocular lens (IOL) based on the combination of a diffractive-based extended depth-of-focus (EDOF) pattern and a diffractive multifocal platform. SETTING Miranza COI Bilbao, Bilbao, Spain. DESIGN Prospective case series. METHODS 35 patients (51 to 84 years) with corneal astigmatism ranging from 0.75 to 2.19 diopters (D) undergoing bilateral cataract surgery with implantation of the Synergy Toric II IOL were evaluated during a 3-month follow-up. Visual acuity, refraction, defocus curve, and patient-reported outcomes with the Catquest-9SF questionnaire were analyzed. A vectorial analysis was used to analyze the accuracy of astigmatic correction. RESULTS Mean 3-month monocular postoperative uncorrected distance, intermediate (80 cm) and near (40 cm) visual acuities were 0.06 ± 0.11 logMAR, 0.13 ± 0.12 logMAR, and 0.13 ± 0.09 logMAR, respectively. Mean monocular distance-corrected intermediate (80 cm) and near visual acuity (40 cm) were 0.11 ± 0.12 logMAR and 0.10 ± 0.10 logMAR, respectively. Mean binocular defocus curve showed visual acuities of 0.10 logMAR or better for defocus levels from +0.50 to -2.50 D. Residual cylinder was within ±0.50 D in 97.0% of eyes. The surgically induced astigmatism prediction error ranged between -0.49 D and 0.50 D, with a mean value of 0.04 ± 0.16 D. Mean absolute IOL rotation was 3.79 ± 2.94 degrees. Significant improvements were found in all Rasch-calibrated scores obtained with Catquest-9SF ( P < .001). CONCLUSIONS The implantation of the toric presbyopia-correcting IOL evaluated provides an efficacious astigmatic correction while providing a fully restoration of the visual function across different distances.
Collapse
Affiliation(s)
- Javier Orbegozo
- From the Centro Oftalmológico Integral Bilbao Berri SL, Miranza COI Bilbao, Bilbao, Spain (Orbegozo, Pérez, Basterra, Noguera); R&D Department of Miranza Group, Barcelona, Spain (González, Lauzirika); Instituto de Microcirugía Ocular (IMO) Barcelona, Miranza Group, Barcelona, Spain (González); Miranza Begitek, Donostia-San Sebastián, Spain (Lauzirika); Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain (Piñero)
| | | | | | | | | | | | | |
Collapse
|
4
|
Daya S, Espinosa Lagana M. Visual and Refractive Outcomes of a New Hydrophobic Trifocal Toric Intraocular Lens. Clin Ophthalmol 2024; 18:997-1007. [PMID: 38584722 PMCID: PMC10999220 DOI: 10.2147/opth.s453565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/28/2024] [Indexed: 04/09/2024] Open
Abstract
Purpose To evaluate the visual outcomes and efficacy of astigmatism correction using a new hydrophobic trifocal toric intraocular lens (IOL). Methods This study involved 62 eyes implanted with the FineVision HP Toric IOL. The visual and refractive outcomes were assessed preoperatively and 6 weeks after the surgery. Specifically, monocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA) at 80 and 60 cm and uncorrected near visual acuity at (UNVA) at 40 cm were evaluated. The rotational stability of the lens was also assessed. Results Sixty-one eyes (98.39%) were within ±1.00D and 55 eyes (88.71%) were within ±0.50 D of spherical equivalent, with a mean value of 0.09±0.39 D. 51 (82.26%) and 61 (98.39%) eyes had a UDVA of ≥20/20 and ≥20/25, respectively, and for CDVA these values were as follows: 59 (95.16%) and 62 eyes (100%), respectively. The mean UDVA and CDVA were 0.01±0.06 and -0.01±0.04logMAR, respectively. Greater than or equal to unaided 20/20 vision was achieved at 40 cm in 42 (67.74%), UIVA at 60 cm in 42 (67.74%) and 50 eyes (80.65%) at 80 cm. Those achieving ≥20/25 were 56 (90.32%, 40 cm), 59 (95.16%, 60 cm), and 62 eyes (100%, 80 cm). Postoperative mean values were 0.04±0.07, 0.03±0.07, and 0.00±0.07logMAR for UCNVA, UIVA at 60 cm, and UIVA at 80 cm, respectively. The mean rotation of the IOL was 5.8 degrees. Conclusion This hydrophobic trifocal toric IOL provides good refractive outcomes with excellent visual acuity across multiple distances, providing a full range of focus.
Collapse
Affiliation(s)
- Sheraz Daya
- Centre for Sight, East Grinstead, West Sussex, UK
| | | |
Collapse
|
5
|
Gabrić K, Gabrić N, Piñero DP, Gabrić I. Comparative Analysis of the Clinical Outcomes of Two Toric Presbyopia-Correcting Intraocular Lenses. Ophthalmol Ther 2024; 13:775-790. [PMID: 38240999 PMCID: PMC10853117 DOI: 10.1007/s40123-023-00878-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 12/20/2023] [Indexed: 02/10/2024] Open
Abstract
INTRODUCTION To evaluate and compare the clinical outcomes of two toric presbyopia-correcting intraocular lenses (IOLs). METHODS Non-randomized prospective comparative study including 86 eyes of 51 patients (age 43-83 years) that underwent cataract surgery with implantation of one of the following two IOLs: TECNIS Toric Synergy (Johnson & Johnson Vision) (Synergy group) or AT LISA tri toric 939MP (Carl Zeiss Meditec) (ATLISA group). Visual and refractive outcomes were evaluated during a 6-month follow-up. RESULTS At 6 months after surgery, all eyes achieved uncorrected distance visual acuity 20/25 or better in both groups, whereas 96.2% and 100% of eyes achieved uncorrected near visual acuity (UNVA) 20/25 or better in the ATLISA and Synergy groups, respectively. All eyes achieved postoperative mesopic UNVA 20/30 or better in both IOL groups; 96.2% and 100% of eyes had a manifest cylinder ≤ 0.50 D at 6 months in ATLISA and Synergy groups, respectively. Mean magnitude of error was 0.04 ± 0.20 and - 0.04 ± 0.09 D in ATLISA and Synergy groups, respectively (p = 0.05). In the defocus curve, significant differences were found between IOL groups for most of distance-corrected visual acuities, except those corresponding to defocus of 0 D (p = 0.268) and - 1 D (p = 0.361). CONCLUSIONS The two toric presbyopia-correcting IOLs evaluated provide an efficacious astigmatic correction combined with a successful distance, intermediate and near visual rehabilitation. The visual performance seems to be better for most visual demands with the TECNIS Toric Synergy IOL, especially for distances closer than 40 cm.
Collapse
Affiliation(s)
- Krešimir Gabrić
- University Eye Clinic Svjetlost, Heinzelova Ul. 39, 10000, Zagreb, Croatia
| | - Nikica Gabrić
- University Eye Clinic Svjetlost, Heinzelova Ul. 39, 10000, Zagreb, Croatia
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - Ivan Gabrić
- University Eye Clinic Svjetlost, Heinzelova Ul. 39, 10000, Zagreb, Croatia.
| |
Collapse
|
6
|
Ang RET. Long-term trifocal toric intraocular lens outcomes in Asian eyes after cataract surgery. J Cataract Refract Surg 2023; 49:832-839. [PMID: 37482666 DOI: 10.1097/j.jcrs.0000000000001195] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/05/2023] [Indexed: 07/25/2023]
Abstract
PURPOSE To determine the visual and refractive outcomes of trifocal toric intraocular lens (IOL) implantation in Asian eyes with cataract and astigmatism. SETTING Asian Eye Institute, Makati City, Philippines. DESIGN Prospective study. METHODS 187 eyes were implanted with the FineVision POD FT IOL and followed for 2 years. The measurements included subjective refraction, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), distance-corrected intermediate visual acuity (DCIVA), uncorrected near visual acuity (UNVA), distance-corrected near visual acuity (DCNVA), defocus curve, photopic and mesopic contrast sensitivity, and rotational stability. RESULTS The mean spherical equivalent and cylinder values were, respectively, -0.07 ± 0.34 diopters (D) and -0.48 ± 0.31 D at the 2-year follow-up. At this same follow-up, 69.4% of patients had monocular CDVA and 79.3% had binocular UDVA ≤0.0 logMAR. For intermediate vision, monocular DCIVA reached 74.1%, while binocular UIVA was 86.2% ≤ 0.1 logMAR. Near vision showed 63% for monocular DCNVA and 70.7% for binocular UNVA ≤0.1 logMAR. The mean values at this follow-up were 0.02 ± 0.08, 0.08 ± 0.10, and 0.10 ± 0.12 logMAR for CDVA, DCIVA, and DCNVA, respectively. At the visual acuity threshold of ≤0.20 logMAR, the binocular defocus curve extended up to -3.75 D. Stable contrast sensitivity values were obtained at the different follow-ups. The mean IOL rotation was ≤2 degrees. CONCLUSIONS The FineVision POD FT IOL yielded good visual outcomes at far, near, and intermediate distances with accurate refractive outcomes and good rotational stability in Asian eyes.
Collapse
|
7
|
Kaufman AR, Pineda R. Intraoperative aberrometry: an update on applications and outcomes. Curr Opin Ophthalmol 2023; 34:48-57. [PMID: 36484210 DOI: 10.1097/icu.0000000000000915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW There is now a large body of experience with intraoperative aberrometry. This review aims to synthesize available data regarding intraoperative aberrometry applications and outcomes. RECENT FINDINGS The Optiwave Refractive Analysis (ORA) System utilizes Talbot-moiré interferometry and is the only commercially available intraoperative aberrometry device. There are few studies that include all-comers undergoing intraoperative aberrometry-assisted cataract surgery, as most studies examine routine patients only or atypical eyes only. In non-post-refractive cases, studies have consistently shown a small but statistically significant benefit in spherical equivalent refractive outcome for intraoperative aberrometry versus preoperative calculations. In studies examining axial length extremes, most studies have shown intraoperative aberrometry to perform similarly to preoperative calculations. Amongst post-refractive cases, post-myopic ablation cases appear to benefit the most from intraoperative aberrometry. For toric intraocular lenses (IOLs), intraoperative aberrometry may be used for refining IOL power (toricity and spherical equivalent) and alignment, and most studies show intraoperative aberrometry to achieve low postoperative residual astigmatism. SUMMARY Intraoperative aberrometry can be utilized as an adjunct to preoperative planning and surgeon's judgment to optimize cataract surgery refractive outcomes. Non-post-refractive cases, post-myopic ablation eyes, and toric intraocular lenses may have the greatest demonstrated benefit in intraoperative aberrometry studies to date, but other eyes may also benefit from intraoperative aberrometry use.
Collapse
Affiliation(s)
- Aaron R Kaufman
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | | |
Collapse
|
8
|
Goggin M. Toric intraocular lenses: Evidence‐based use. Clin Exp Ophthalmol 2022; 50:481-489. [PMID: 35584257 PMCID: PMC9543206 DOI: 10.1111/ceo.14106] [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: 04/15/2022] [Revised: 05/10/2022] [Accepted: 05/14/2022] [Indexed: 11/30/2022]
Abstract
Uncorrected refractive astigmatism degrades visual acuity. Spherical intraocular lenses (IOLs) leave astigmatic errors resident in the cornea manifest in refractive astigmatism. Toric IOLs, correcting for this corneal astigmatism, contribute to spectacle‐free vision in the pseudophakic eye. This review provides information to assist surgeons in a rational choice of eyes suitable for toric IOL implantation, methods of IOL cylinder power calculation, surgical techniques for toric IOLs and management of complications. With appropriate application of this information, correction of visually detrimental astigmatism can be achieved routinely.
Collapse
Affiliation(s)
- Michael Goggin
- The Queen Elizabeth Hospital University of Adelaide Woodville South South Australia Australia
| |
Collapse
|