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Artal P, Arvaniti M, Dimou P, Stavrinos C, Ginis H, Hervella L, Güell JL. Peripheral Vision in Patients Following Intraocular Lens Implantation: A Systematic Review and Meta-Analysis. Am J Ophthalmol 2024; 264:120-134. [PMID: 38521156 DOI: 10.1016/j.ajo.2024.03.016] [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: 11/24/2023] [Revised: 03/13/2024] [Accepted: 03/16/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE To update the literature on peripheral optics and vision following intraocular lens (IOLs) implantation. METHODS We investigated how current IOLs influence peripheral visual function, peripheral optical quality, and visual perception and performance, in patients following cataract surgery. Peripheral vision is described as vision outside the central foveal region of the eye (beyond 4-5° of eccentricity). We systematically searched PubMed, Cochrane Central Register of Controlled Trials, Embase, and gray literature for relevant references. Randomized controlled trials and observational studies were eligible for inclusion. Finally, 47 studies with a total of 5963 participants were eligible for this review, of which 15 were included in the meta-analysis. RESULTS Regarding visual fields, the meta-analysis showed that the pooled estimate of mean deviation (MD) measured with perimetry tests (standard automated perimetry [SAP], short-wavelength automated perimetry [SWAP], and frequency doubling technology [FDT]) appears to be lower than the mean of healthy age-matched controls, regardless of IOL design. Results for pooled estimate show that localized defects (pattern standard deviation [PSD]) were higher than those in the healthy age-matched controls for FDT. We also collected evidence demonstrating that pseudophakia increases peripheral astigmatism and a myopic shift from 20° onward, leading to decreased peripheral image quality compared with that in phakic eyes. Patient-reported outcomes on peripheral vision showed a pooled score estimate of 95.19, indicating high satisfaction, and for the Steps & Stairs questions, a pooled score estimate at 0.23, indicating no to little difficulty seeing steps and stairs. CONCLUSIONS Peripheral image quality is degraded in eyes after cataract surgery. Nevertheless, whether this degradation leads to impaired visual function in the periphery requires further investigation.
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Affiliation(s)
- Pablo Artal
- From the Laboratorio de Optica (P.A.), Universidad de Murcia, Murcia, Spain.
| | | | | | | | | | | | - José Luis Güell
- IMO Instituto de Microcirugía Ocular (J.L.G.), Barcelona, Spain
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Abe RY, da Silva MGB, Alves TN, Tzelikis PFDM, Hida WT. Longitudinal evaluation of trifocal and extended depth of focus lenses implantation using standard automated perimetry parameters. Int Ophthalmol 2022; 43:1285-1289. [PMID: 36127503 DOI: 10.1007/s10792-022-02526-9] [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: 12/27/2021] [Accepted: 09/11/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE To evaluate reliability and global indices parameters from standard automated perimetry (SAP) in normal eyes undergoing phacoemulsification cataract surgery with implantation of trifocal or extended depth of focus intraocular lens (IOL). METHODS Prospective study to evaluate the effect of trifocal IOL AcrySof IQ PanOptix® and extended depth of focus intraocular lens (EDOF) Tecnis Symfony® IOL implantation on visual field parameters. Patients underwent SAP pre- and postoperatively. Reliability indices (false negative rate-FN, false positive rate-FP), global indices (foveal sensitivity threshold, visual field index-VFI, standard pattern deviation-PSD, mean deviation MD) and test duration were analyzed. RESULTS A total of 23 eyes from 13 patients were in the trifocal IOL group and a total of 22 eyes from 14 patients were in the EDOF group. The following results were obtained by analyzing pre- and postoperative SAP of EDOF IOL: the rate of change of FN was 1.95/1.41% (p = 0.61); FP 1.64/1.27 (p = 0.60); MD - 1.60/- 1.08 dB (p = 0.15); foveal sensitivity was 34.5/33.9 dB (p = 0.41); VFI 98.5/98.4% (p > 0.99); PSD 1.85/1.86 (p = 0.07); and for test duration 305.81/298.36 s (p = 0.35); all respectively. Analysis of pre- and postoperative parameters of trifocal IOL were the rates of change of FN 1.22/1.83% (p = 0.29); FP 1.65/1.48% (p = 0.95); MD - 1.55/- 1.37 dB (p = 0.19); foveal sensitivity 33.9/34.9 dB (p = 0.47); VFI 98.6/98.3% (p = 0.62); PSD 1.58/2.05 (p = 0.02); and test duration 297.17/298.57 s (p = 0.87); all respectively. CONCLUSION We identified a change in the PSD parameters in the trifocal IOL group. No other significant changes were identified in SAP parameters after implantation of trifocal AcrySof IQ PanOptix® and EDOF Tecnis Symfony® IOL. Longitudinal evaluation showed no changes in SAP after Trifocal and EDOF IOL implantation in normal subjects.
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Affiliation(s)
- Ricardo Yuji Abe
- Hospital Oftalmológico de Brasília, Avenida L2 Sul, SGAS 607, Brasília, DF, 70200670, Brazil.
| | | | - Thiago Nogueira Alves
- Hospital Oftalmológico de Brasília, Avenida L2 Sul, SGAS 607, Brasília, DF, 70200670, Brazil
| | | | - Wilson Takashi Hida
- Hospital Oftalmológico de Brasília, Avenida L2 Sul, SGAS 607, Brasília, DF, 70200670, Brazil
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Lee J, Mori Y, Nejima R, Minami K, Miyata K. Influence of implantations of extended depth-of-focus on standard automated perimetry. Sci Rep 2020; 10:20153. [PMID: 33214642 PMCID: PMC7678857 DOI: 10.1038/s41598-020-77214-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 11/06/2020] [Indexed: 01/19/2023] Open
Abstract
This prospective study aimed to investigate the influence of an extended depth-of-focus intraocular lens (EDOF IOL) on standard automated perimetry. Ninety eyes of 90 patients who had undergone cataract surgery from February 2018 to December 2018 were included. No patients had any diseases that might affect the visual field. ZMB00 (+ 4.00 D add), ZXR00V (+ 1.75 D add), and ZCB00V (Johnson & Johnson Surgical Vision, Santa Ana, CA, USA) were used as multifocal, EDOF, and monofocal IOLs, respectively. Humphrey Visual Field 10–2 testing was performed 2–3 months after cataract surgery, acceptable reliability indices were measured, and mean deviation (MD), pattern standard deviation (PSD), foveal sensitivity and mean sensitivity (MS) were compared. Seventy-one eyes (ZXR00V: 24 eyes, ZMB00: 25 eyes, ZCB00V: 22 eyes) were used for the analyses. The MD and MS of the EDOF and monofocal groups were significantly higher than those of the multifocal group (P < 0.0051). However, the MD and MS of the EDOF and monofocal groups were not different (P > 0.23). The PSD and foveal sensitivity were not different among the groups. In non-glaucomatous patients, the MD and MS of the EDOF IOL were comparable to those of the monofocal IOL and better than those of the multifocal IOL.
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Affiliation(s)
- Jinhee Lee
- Miyata Eye Hospital, 6-3, Kurahara-cho, Miyakonojo, Miyazaki, 885-0051, Japan
| | - Yosai Mori
- Miyata Eye Hospital, 6-3, Kurahara-cho, Miyakonojo, Miyazaki, 885-0051, Japan
| | - Ryohei Nejima
- Miyata Eye Hospital, 6-3, Kurahara-cho, Miyakonojo, Miyazaki, 885-0051, Japan
| | - Keiichiro Minami
- Miyata Eye Hospital, 6-3, Kurahara-cho, Miyakonojo, Miyazaki, 885-0051, Japan.
| | - Kazunori Miyata
- Miyata Eye Hospital, 6-3, Kurahara-cho, Miyakonojo, Miyazaki, 885-0051, Japan
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Hirasawa K, Shoji N, Isono K, Tsuchiya M. Effects of different levels of intraocular stray light on kinetic perimetry findings. PLoS One 2015; 10:e0127159. [PMID: 25965816 PMCID: PMC4429102 DOI: 10.1371/journal.pone.0127159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 04/12/2015] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To evaluate the effect of different levels of intraocular stray light on kinetic perimetry findings. METHODS Twenty-five eyes of 25 healthy young participants were examined by automated kinetic perimetry (Octopus 900) using Goldmann stimuli III4e, I4e, I3e, I2e, and I1e. Each stimulus was presented with a velocity of 3°/s at 24 meridians with 15° intervals. Four levels of intraocular stray light were induced using non-white opacity filter (WOF) filters and WOFs applied to the clear plastic eye covers of the participants. The visual acuity, pupil diameter, isopter area, and kinetic sensitivity of each meridian were analyzed for each WOF density. RESULTS Visual acuity deteriorated with increasing WOF densities (p < 0.01). With a visual acuity of 0.1 LogMAR units, the isopter areas for III4e, I4e, I3e, I2e, and I1e decreased by -32.7 degree2 (-0.2%), -255.7 degree2 (-2.6%), -381.2 degree2 (-6.2%), -314.8 degree2 (-12.8%), and -59.2 degree2 (-15.2%), respectively; kinetic sensitivity for those stimuli decreased by -0.1 degree (-0.1%), -0.8 degree (-1.4%), -1.6 degree (-3.7%), -2.7 degree (-9.7%), and -1.7 degree (-16.2%), respectively. The pupil diameter with each WOF density was not significantly different. CONCLUSION Kinetic perimetry measurements with a high-intensity stimulus (i.e., III4e) were unaffected by intraocular stray light. In contrast, measurements with the I4e, I3e, I2e, and I1e stimuli, especially I2e and I1e, were affected. Changes in the shape of the isopter resulting from opacity must be monitored, especially in cases of smaller and lower-intensity stimuli.
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Affiliation(s)
- Kazunori Hirasawa
- Orthoptics and Visual Science, Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Nobuyuki Shoji
- Orthoptics and Visual Science, Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Karen Isono
- Orthoptics and Visual Science, Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Manami Tsuchiya
- Orthoptics and Visual Science, Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
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Ho JCH. Reduction in mean deviation values in automated perimetry in eyes with multifocal compared to monofocal intraocular lens implants. Am J Ophthalmol 2014; 158:1100-1. [PMID: 25437833 DOI: 10.1016/j.ajo.2014.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 08/13/2014] [Accepted: 08/26/2014] [Indexed: 10/24/2022]
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Nilforushan N, Parsamanesh M, Yu F, Nassiri N, Miraftabi A, Coleman AL. Effect of yellow-tinted intraocular lens on standard automated perimetry and short wavelength automated perimetry in patients with glaucoma. Middle East Afr J Ophthalmol 2014; 21:216-9. [PMID: 25100904 PMCID: PMC4123272 DOI: 10.4103/0974-9233.134671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Purpose: To investigate the effect of cataract surgery and yellow-tinted intraocular lens (IOLs) implantation on perimetry indices of short-wavelength automated perimetry (SWAP) and standard automated perimetry (SAP) testing in patients with coexisting cataract and glaucoma. Materials and Methods: In this prospective comparative case series, phacoemulsification with implantation of yellow-tinted Acrysof Natural IOL was performed in 16 eyes of 16 patients with visually significant cataract (best-corrected visual acuity (VA) better than 20/120) and mild to moderate glaucoma. Pre- and postoperative values for VA and for perimetry indices including mean deviation (MD), pattern standard deviation (PSD), and foveal threshold (FT) from both SAP and SWAP testing were compared. Results: Postoperative VA improved significantly after cataract surgery and yellow-tinted IOL implantation (P < 0.001). After cataract extraction and IOL implantation, MD and FT on SWAP testing improved significantly (P = 0.001); however, there was no statistically significant change with SAP testing between the pre- and postoperative perimetry indices. There was no statistically significant change in PSD with either SAP or SWAP testing postoperatively. The differences between pre- and postoperative values for all perimetry indices under study were not significant when comparing SAP with SWAP tests, except for MD which had improved statistically significantly in SWAP testing (P = 0.03). Conclusions: In mild to moderate glaucoma patients with cataracts, the perimetry indices of SWAP testing improved after phacoemulsification and yellow-tinted IOL implantation. This suggests that the yellow-tinted IOLs have less effect on SWAP testing than visually significant cataracts.
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Affiliation(s)
- Naveed Nilforushan
- Department of Ophthalmology, Ophthalmic Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Parsamanesh
- Department of Ophthalmology, Ophthalmic Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Fei Yu
- Glaucoma Division, Jules Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, USA
| | - Nariman Nassiri
- Glaucoma Division, Jules Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, USA
| | - Arezoo Miraftabi
- Department of Ophthalmology, Ophthalmic Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Anne L Coleman
- Glaucoma Division, Jules Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, USA
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Recent studies provide an updated clinical perspective on blue light-filtering IOLs. Graefes Arch Clin Exp Ophthalmol 2011; 249:957-68. [PMID: 21584764 PMCID: PMC3124647 DOI: 10.1007/s00417-011-1697-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 04/07/2011] [Accepted: 04/08/2011] [Indexed: 11/10/2022] Open
Abstract
Background Recent reviews of blue light-filtering intraocular lenses (IOLs) have stated their potential risks for scotopic vision and circadian photoentrainment. Some authors have challenged the rationale for retinal photoprotection that these IOLs might provide. Our objective is to address these issues by providing an updated clinical perspective based on the results of the most recent studies. Methods This article evaluates the currently available published papers assessing the potential risks and benefits of blue light-filtering IOLs. It summarizes the results of seven clinical and two computational studies on photoreception, and several studies related to retinal photoprotection, all of which were not available in the previous reviews. These results provide a clinical risk/benefit analysis for an updated review for these IOLs. Results Most clinical studies comparing IOLs with and without the blue light-filtering feature have found no difference in clinical performance for; visual acuity, contrast sensitivity, color vision, or glare. For blue light-filtering IOLs, three comparative clinical studies have shown improved contrast sensitivity and glare reduction; but one study, while it showed satisfactory overall color perception, demonstrated some compromise in mesopic comparative blue color discrimination. Comparative results of two recent clinical studies have also shown improved performance for simulated driving under glare conditions and reduced glare disability, better heterochromatic contrast threshold, and faster recovery from photostress for blue light-filtering IOLs. Two computational and five clinical studies found no difference in performance between IOLs with or without blue light-filtration for scotopic vision performance and photo entrainment of the circadian rhythm. The rationale for protection of the pseudophakic retina against phototoxicity is discussed with supporting results of the most recent computational, in-vitro, animal, clinical, and epidemiological investigations. Conclusions This analysis provides an updated clinical perspective which suggests the selection of blue light-filtering IOLs for patients of any age, but especially for pediatric and presbyopic lens exchange patients with a longer pseudophakic life. Without clinically substantiated potential risks, these patients should experience the benefit of overall better quality of vision, reduced glare disability at least in some conditions, and better protection against retinal phototoxicity and its associated potential risk for AMD. Electronic supplementary material The online version of this article (doi:10.1007/s00417-011-1697-6) contains supplementary material, which is available to authorized users.
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Ho JCH. Yellow-tinted intraocular lenses on short-wavelength automated perimetry. Am J Ophthalmol 2011; 151:380; author reply 380-1. [PMID: 21251495 DOI: 10.1016/j.ajo.2010.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Accepted: 10/05/2010] [Indexed: 11/29/2022]
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Kim SW, Jang SY. Reply. Am J Ophthalmol 2011. [DOI: 10.1016/j.ajo.2010.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Jang SY, Kim SW. Reply. Am J Ophthalmol 2010. [DOI: 10.1016/j.ajo.2010.06.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Mainster MA, Turner PL. Effect of yellow-tinted intraocular lenses on short-wavelength automated perimetry. Am J Ophthalmol 2010; 150:589-90; author reply 590-1. [PMID: 20863923 DOI: 10.1016/j.ajo.2010.06.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2010] [Accepted: 06/29/2010] [Indexed: 10/19/2022]
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