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Negishi K, Masui S, Ayaki M, Torii H, Yotsukura E, Nishi Y. Clinical Results and Factors Affecting Visual Function in Eyes Implanted with an Enhanced Monofocal Intraocular Lens. Clin Ophthalmol 2023; 17:3965-3973. [PMID: 38146453 PMCID: PMC10749537 DOI: 10.2147/opth.s438599] [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: 09/04/2023] [Accepted: 12/13/2023] [Indexed: 12/27/2023] Open
Abstract
Purpose To compare the clinical results achieved with the enhanced monofocal intraocular lenses (IOLs) with those of the monofocal IOL and investigate factors affecting the distance, intermediate, and near vision. Patients and Methods Patients were included who underwent bilateral consecutive cataract surgeries using the same IOLs with follow-up to 1 month postoperatively. Refractions, monocular UDVA and CDVA, and binocular distance-corrected functional visual acuity at 5 meters (BDCFVA), at 66 centimeters (BDCIFVA) and at 40 centimeters (DCNVA) were assessed. Multiple regression analysis was used to assess the factors affecting binocular BDCFVA, BDCIFVA, and BDCNFVA. Subjective symptoms were assessed using the Near Activity Visual Questionnaire (NAVQ) and visual analogue scale (VAS). Results Sixty patients (120 eyes) implanted with the Tecnis Eyhance IOL (30 patients, 60 eyes) or the Tecnis monofocal IOL (30 patients, 60 eyes) were included. The Tecnis Eyhance IOL provided significantly better binocular BDCIFVA than the Tecnis monofocal IOL in patients under 70 years of age. Multiple regression analysis showed that age was the only factor affecting distance and intermediate visual function in eyes with the Tecnis Eyhance IOL; gender, pupillary diameter, axial length, and average keratometry were not significant. There were no significant differences in subjective symptoms. Conclusion The comprehensive cohort analysis did not confirm the advantage on the intermediate vision of the Tecnis Eyhance IOL. Younger age may be an important factor to benefit from the unique optical characteristics of this IOL.
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Affiliation(s)
- Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku‑Ku, Tokyo, Japan
| | - Sachiko Masui
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku‑Ku, Tokyo, Japan
| | - Masahiko Ayaki
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku‑Ku, Tokyo, Japan
- Otake Clinic Moon View Eye Center, Yamato-City, Kanagawa, Japan
| | - Hidemasa Torii
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku‑Ku, Tokyo, Japan
| | - Erisa Yotsukura
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku‑Ku, Tokyo, Japan
| | - Yasuyo Nishi
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku‑Ku, Tokyo, Japan
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Efron N, Morgan PB, Nichols JJ, Walsh K, Willcox MD, Wolffsohn JS, Jones LW. All soft contact lenses are not created equal. Cont Lens Anterior Eye 2021; 45:101515. [PMID: 34583895 DOI: 10.1016/j.clae.2021.101515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/11/2021] [Accepted: 09/19/2021] [Indexed: 12/13/2022]
Abstract
Soft contact lenses that have been prescribed by eye care practitioners are sometimes substituted for alternative lenses by unqualified, unregulated and sometimes even fully regulated lens suppliers, in the mistaken belief that there is essentially no difference between different soft lens types. This review considers the implications of inappropriately substituting soft contact lens types in terms of (a) lens properties: surface treatment, internal wetting agents, material, total diameter, back optic zone radius, thickness, edge profile, back surface design, optical design, power, colour (tint) and ultraviolet protection; and (b) lens usage: wearing modality (daily versus overnight wear) and replacement frequency. Potential aspects of patient dissatisfaction and adverse events when prescribed soft lenses are substituted for lenses with different properties or intended usage are considered. Substitution of 15 of the 16 lens properties considered (i.e. except for back surface design) was found to be related to at least one - and as many as six - potential sources of patient dissatisfaction and adverse ocular events. Contact lens are medical devices which are prescribed and fitted; they should never be substituted for another lens type in the absence of a new prescription further to a full finalised fitting, for the simple reason that all soft contact lenses are not created equal. A substituted lens may have properties that results in undesirable consequences in respect of vision, ocular health, comfort and cosmetic appearance, and may be incompatible with the lifestyle of the patient.
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Affiliation(s)
- Nathan Efron
- School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
| | - Phillip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, The University of Manchester, Manchester, UK
| | - Jason J Nichols
- School of Optometry, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Karen Walsh
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Mark D Willcox
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | | | - Lyndon W Jones
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada; Centre for Eye and Vision Research (CEVR), Hong Kong
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Shortened Measurement Time of Functional Visual Acuity for Screening Visual Function. J Ophthalmol 2019; 2019:8950418. [PMID: 31583130 PMCID: PMC6754928 DOI: 10.1155/2019/8950418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 06/02/2019] [Accepted: 06/17/2019] [Indexed: 11/25/2022] Open
Abstract
The functional visual acuity test which is the average of the visual acuities measured during a specific time frame (standard, 60 seconds) has been used recently to assess the visual function in various conditions. The availability of a shorter version of the functional visual acuity test promises to be patient friendly in that it is a simple screening test performed in a shorter period of time than the standard test. The results of measurements of the FVA test between the 30-second measurement time (short-version FVA test) and the standard 60-second measurement are compared, and the feasibility of the short-version FVA test instead of the standard FVA test is investigated. Twenty-eight healthy volunteers (25 men and 3 women) were enrolled in this prospective observational study. All subjects underwent measurement of the binocular distance-corrected visual acuity and the binocular distance-corrected FVA with the 60-second and 30-second measurement times. The interchangeability of the corrected-distance FVA, maximal VA, visual maintenance ratio, and average response time in the short-version and the standard FVA tests was evaluated using the Bland–Altman method, and the results showed agreements of the two tests except for the minimal VA. The short-version FVA test is equivalent to the standard method except for evaluating the visual acuity fluctuations and promises to be a simple visual screening test that can be performed in a shorter time.
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Abstract
Dry eye (DE) causes irregularity of the ocular surface and reduces the quality of vision. An intact, regular tear film is essential for high-quality retinal images; however, visual tasks requiring sustained gazing can disrupt the tear film, eventually degrading visual function. A functional visual acuity (FVA) measurement system has been uniquely developed in Japan to evaluate visual function related to tear stability in patients with DE. FVA has been shown to correlate with optical quality. The system measures the change in visual acuity (VA) over time automatically in aqueous-deficient DE and short tear breakup tear film DE characterized by decreased tear stability and minimal epithelial damage. It is also useful to detect minimal visual deterioration correlated with minimal ocular surface abnormality and vision-related quality of life otherwise undetectable by conventional VA testing, to assess and quantify vision-related symptomatology, and to determine the efficacy of treatments for DE disease. Recently, its use has been expanded, such as for the analysis of visual function accompanying refractive surgery, contact lens, cataract and cataract-related disease, retinal disease, glaucoma, amblyopia, presbyopia, and vehicle driving. Its use has revealed that FVA reflects not only visual function related to tear dynamics, but also visual function related to quick recognition of the target. This simple, noninvasive, and sensitive FVA measurement system may be expected to be used worldwide.
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Affiliation(s)
- Minako Kaido
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
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Hiraoka T, Miyata K, Hayashidera T, Iida M, Takada K, Minami K, Oshika T. Influence of intraocular lens subsurface nanoglistenings on functional visual acuity. PLoS One 2017; 12:e0173574. [PMID: 28328997 PMCID: PMC5362055 DOI: 10.1371/journal.pone.0173574] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 02/23/2017] [Indexed: 11/22/2022] Open
Abstract
To investigate the influence of intraocular lens subsurface nanoglistenings (SSNGs) on functional visual acuity (FVA), thirty-nine eyes of 29 patients were examined in this study. The SSNG group comprised 19 eyes of 14 patients (75.7± 5.4 years, mean ± standard deviation), and the control group comprised 20 eyes of 15 patients (73.6 ± 6.5 years). The SSNGs were diagnosed on the basis of the typical whitish IOL appearance upon slit-lamp examination and results of densitometry regarding surface light scattering using Scheimpflug images. The FVA measurement system (AS-28; Kowa, Aichi, Japan) was used to examine changes in continuous visual acuity (VA) over time, and visual function parameters such as FVA, visual maintenance ratio (VMR), maximum VA, minimum VA, standard deviation of VA, and number of blinks were assessed. The results were compared between the SSNG and control groups, and correlations of FVA parameters with the intensity of surface light scattering, time after surgery, and age were also evaluated. There were significant differences in VMR (P = 0.035) and standard deviation of VAs (P = 0.031) between the two groups, although no significant differences were found in baseline VA, FVA, maximum VA, minimum VA, and number of blinks. None of the FVA parameters showed any significant correlations with the intensity of surface light scattering, time after surgery, or age. There is a possibility that VA is unstable during a continuous gazing task in patients with SSNGs.
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Affiliation(s)
- Takahiro Hiraoka
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
- * E-mail:
| | - Kazunori Miyata
- Department of Ophthalmology, Miyata Eye Hospital, Miyazaki, Japan
| | - Takeshi Hayashidera
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Masaharu Iida
- Department of Ophthalmology, Miyata Eye Hospital, Miyazaki, Japan
| | - Keita Takada
- Department of Ophthalmology, Miyata Eye Hospital, Miyazaki, Japan
| | - Keiichiro Minami
- Department of Ophthalmology, Miyata Eye Hospital, Miyazaki, Japan
| | - Tetsuro Oshika
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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Jung JW, Kim SM, Han SH, Kim EK, Seo KY, Kim TI. Effect of the pigment-free optical zone diameter of decorative tinted soft contact lenses on visual function. Br J Ophthalmol 2015; 100:633-7. [PMID: 26377415 DOI: 10.1136/bjophthalmol-2015-306731] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 08/04/2015] [Indexed: 11/04/2022]
Abstract
AIMS We investigated changes in visual function after wearing decorative tinted soft contact lenses with different pigment-free optical zone diameters. METHODS A prospective study was performed in 30 eyes of 30 healthy volunteers. Best-corrected visual acuity (BCVA), ocular higher-order aberrations (HOAs), modulation transfer function (MTF), Strehl ratio and contrast sensitivity were evaluated after wearing clear lens and tinted lenses with different pigment-free optical zone diameters (4, 5 and 6 mm). RESULTS BCVA decreased from 0.00 logMAR after wearing a clear lens to 0.04±0.04 logMAR after wearing 4 mm optical zone lens (p<0.001). As the optical zone diameter decreased, ocular aberrations were induced. Total HOAs, coma aberration and secondary astigmatism showed significant difference between clear lens and 5 or 4 mm optical zone lenses (p<0.050). Spherical aberration and trefoil showed significant difference between clear lens and 4 mm optical zone lens (p<0.050). The results for Strehl ratio revealed poorer optical quality for both 5 and 4 mm optical zone lens (both p=0.002). The entire ocular MTF was significantly different, corresponding to the decreased optical zone diameter. The HOAs showed a correlation with the blocked pupil covered by the tinted part (r=0.435, p<0.001). In photopic and mesopic conditions, the contrast sensitivity decreased significantly with the reduced pigment-free optical zone diameters. CONCLUSION Decorative tinted contact lenses significantly increased ocular aberrations and decreased optical quality and contrast sensitivity, as the pigment-free optical zone diameter decreased. Therefore, consumers of tinted lenses should be informed about the possible disturbance in visual function. TRIAL REGISTRATION NUMBER NCT02537275.
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Affiliation(s)
- Ji Won Jung
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea Department of Ophthalmology and Inha Vision Science Laboratory, Inha University School of Medicine, Incheon, South Korea
| | - Sang Myung Kim
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Sun Hyup Han
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Eung Kweon Kim
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea Corneal Dystrophy Research Institute, Severance Biomedical Science Institute, and Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyoung Yul Seo
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Tae-Im Kim
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
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Abstract
To evaluate mesopic functional visual acuity (FVA) with a newly developed system in normal subjects and to compare the results with photopic FVA, sixty-eight healthy volunteers (24.03 ± 4.42 [mean ± standard deviation] years) were enrolled in this study. A commercially available FVA measurement system (AS-28; Kowa, Aichi, Japan) was modified to measure FVA under mesopic conditions as well as photopic conditions. Measurements were performed monocularly in photopic conditions during 60 seconds. After dark adaptation for 15 minutes, the same measurements were repeated in mesopic conditions. Outcomes included starting visual acuity (VA), FVA (the average of VAs), visual maintenance ratio (VMR), maximum VA, minimum VA, and numbers of blinks during the 60-second measurement session, and were compared between mesopic and photopic conditions. Starting VA was –0.11 ± 0.08 and 0.39 ± 0.12 logarithm of the minimum angle of resolution (logMAR) in photopic and mesopic conditions, respectively. FVA was –0.06 ± 0.09 and 0.52 ± 0.14 logMAR, VMR was 0.98 ± 0.02 and 0.94 ± 0.04, maximum VA was –0.15 ± 0.06 and 0.33 ± 0.12 logMAR, the minimum VA was 0.05 ± 0.12 and 0.78 ± 0.20 logMAR, and the number of blinks was 8.23 ± 7.54 and 7.23 ± 6.20, respectively. All these parameters except the number of blinks were significantly different between the two conditions (P < 0.001). Besides, the difference between maximum and minimum VAs and standard deviation of VA were significantly larger in mesopic than in photopic conditions (P < 0.001). This study revealed that not only overall visual function decline but also instability of vision under mesopic conditions even in healthy subjects.
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Affiliation(s)
- Takahiro Hiraoka
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
- * E-mail:
| | - Sujin Hoshi
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Yoshifumi Okamoto
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Fumiki Okamoto
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Tetsuro Oshika
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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