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Mita N, Yamazaki M, Seki Y, Sasaki Y, Shibuya E, Mito T, Hatsusaka N, Kubo E, Sasaki H. Prediction of low-addition segmented refractive intraocular lens position and deviation using anterior-segment optical coherence tomography. PLoS One 2024; 19:e0305076. [PMID: 38857255 PMCID: PMC11164357 DOI: 10.1371/journal.pone.0305076] [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: 12/05/2023] [Accepted: 05/22/2024] [Indexed: 06/12/2024] Open
Abstract
This study aimed to develop and analyze the accuracy of predictive formulae for postoperative anterior chamber depth, tilt, and decentration of low-added-segment refractive intraocular lenses. This single-center, retrospective, observational study included the right eyes of 96 patients (mean age: 72.43 ± 6.58 years), who underwent a cataract surgery with implantation of a low-added segmented refractive intraocular lens at the Medical University Hospital between July 2019 and January 2021, and were followed up for more than 1 month postoperatively. The participants were divided into an estimation group to create a prediction formula and a validation group to verify the accuracy of the formula. Anterior segment optical coherence tomography (CASIA 2, Tomey Corporation, Japan) and swept-source optical coherence tomography biometry (IOL Master 700, Carl Zeiss Meditec AG) were used to measure the anterior ocular components. A predictive formula was devised for postoperative anterior chamber depth, intraocular lens tilt, and intraocular lens decentration (p <0.01) in the estimation group. A significant positive correlation was observed between the estimated values calculated using the prediction formula and the measured values for postoperative anterior chamber depth (r = 0.792), amount of intraocular lens tilt (r = 0.610), direction of intraocular lens tilt (r = 0.668), and amount of intraocular lens decentration (r = 0.431) (p < 0.01) in the validation group. In conclusion, our findings reveal that predicting the position of the low-added segmented refractive intraocular lens enables the prognosis of postoperative refractive values with a greater accuracy in determining the intraocular lens adaptation.
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Affiliation(s)
- Norihiro Mita
- Department of Ophthalmology, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| | - Mai Yamazaki
- Department of Ophthalmology, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| | - Yusuke Seki
- Department of Ophthalmology, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| | - Yu Sasaki
- Department of Ophthalmology, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| | - Eri Shibuya
- Department of Ophthalmology, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| | - Tsuyoshi Mito
- Department of Ophthalmology, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| | - Natsuko Hatsusaka
- Department of Ophthalmology, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| | - Eri Kubo
- Department of Ophthalmology, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| | - Hiroshi Sasaki
- Department of Ophthalmology, Kanazawa Medical University, Kahoku, Ishikawa, Japan
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Lee Y, Choi HI, Bae S, Chung HS, Kim JY, Lee H. Analysis of intraocular lens decentration and tilt after femtosecond laser-assisted cataract surgery using swept-source anterior optical coherence tomography. Heliyon 2024; 10:e29780. [PMID: 38699005 PMCID: PMC11064088 DOI: 10.1016/j.heliyon.2024.e29780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 03/21/2024] [Accepted: 04/15/2024] [Indexed: 05/05/2024] Open
Abstract
Objective To evaluate and compare the magnitude of intraocular lens (IOL) decentration and tilt following conventional and femtosecond laser-assisted cataract surgery (FLACS) using swept-source anterior optical coherence tomography (SS-OCT). Methods In this retrospective observational study, we enrolled patients who underwent conventional cataract surgery or FLACS with the implantation of hydrophobic 1-piece monofocal IOL. The magnitude of IOL decentration and tilt were measured using SS-OCT. Visual acuity, intraocular pressure, spherical equivalent, axial length, contrast sensitivity, and satisfaction questionnaire were evaluated before and one-month post-surgery. Additionally, postoperative internal cylinder measurements were obtained using a wavefront aberrometer. Correlation factors between each parameter and IOL decentration or tilt were analyzed. Results This study included 100 eyes from 100 patients. Mean IOL decentration and tilt were 0.21 ± 0.13 mm and 5.01 ± 1.49°, respectively. Conventional cataract surgery (versus FLACS, P = 0.001) and male sex (versus female, P = 0.047) were significantly correlated with higher postoperative decentration. Preoperative lens diameter (P < 0.001), preoperative lens tilt (P = 0.007), and preoperative intraocular pressure (P = 0.027) were correlated with higher postoperative tilt. Fifty eyes that underwent FLACS demonstrated mean postoperative decentration of 0.21 ± 0.13 mm and tilt of 4.64 ± 1.48°. Compared with the conventional surgery group, the FLACS group significantly differed in postoperative decentration (0.30 ± 0.12 mm, P < 0.001) but not in tilt (5.03 ± 1.35°, P = 0.173). Postoperative visual acuity did not significantly differ between the two groups. Conclusion Patients who underwent FLACS demonstrated better IOL decentration and tilt than those who underwent conventional cataract surgery one-month post-surgery. However, differences in IOL decentration and tilt did not affect postoperative visual acuity.
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Affiliation(s)
- Yunhan Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hoon Il Choi
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Seonha Bae
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Ho Seok Chung
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jae Yong Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hun Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- Department of Ophthalmology, Brain Korea 21 Project, University of Ulsan College of Medicine, Seoul, South Korea
- Center for Cell Therapy, Asan Medical Center, Seoul, South Korea
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Stodulka P, Packard R, Mordaunt D. Intraoperative trypan blue central landmark and its use in capsulotomy and capsulorhexis centration. J Cataract Refract Surg 2024; 50:498-504. [PMID: 38651697 DOI: 10.1097/j.jcrs.0000000000001385] [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: 09/19/2023] [Accepted: 12/08/2023] [Indexed: 04/25/2024]
Abstract
PURPOSE To compare 3 capsulotomy centration methods. SETTING Private clinic, Zlin, Czech Republic. DESIGN Prospective, consecutive case series. METHODS 180 eyes undergoing cataract surgery had anterior capsule staining with microfiltered 0.4% trypan blue solution before selective laser capsulotomy. The first 60 eyes (Group 1) had mydriatic dilated pupil centered capsulotomies. The next 60 eyes (Group 2) were centered on the trypan blue central landmark (TCL). The final 60 capsulotomies (Group 3) were centered on the patient fixated coaxial Purkinje reflex (CPR). Measurements between key anatomical landmarks and the TCL, CPR capsulotomies, and implanted intraocular lens (IOL) center were made. RESULTS The TCL, observed in >94% of eyes in the study, coincided with the CPR with a displacement of <0.1 ± 0.1 mm. Group 1 capsulotomies were noticeably decentered on the IOLs by 0.3 ± 0.2 mm. The Group 2 symmetrical IOL relationship was maintained with a decentration of 0.15 ± 0.1 mm. Group 3 had a similar decentration with the IOLs with 0.15 ± 0.1 mm. Verification with IOLMaster 700 data and CALLISTO Eye System showed that the CPR and the TCL were coincident with the measured visual axis. CONCLUSIONS The clearly visible TCL served as an alternate landmark to the patient fixated CPR, and being on the anterior capsule was not sensitive to tilt. Further patient compliance was not required. Both were superior to dilated pupil centration, to achieve symmetric IOL coverage. This has application for both capsulotomies and capsulorhexes.
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Affiliation(s)
- Pavel Stodulka
- From the Gemini Eye Clinic, Zlin, Czech Republic (Stodulka); Prince Charles Eye Unit, King Edward VII Hospital, Windsor, United Kingdom (Packard); Department of Engineering, Zurich University of Applied Science, Zurich, Switzerland (Mordaunt)
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Thakur A, Adiga S, Malhotra C, Sachdeva K, Singh S, Jain AK. Effect of decentration on the quality of vision in two aspheric posterior chamber intraocular lenses: A contralateral eye study. Indian J Ophthalmol 2024; 72:558-564. [PMID: 38189441 PMCID: PMC11149516 DOI: 10.4103/ijo.ijo_1639_23] [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: 06/22/2023] [Accepted: 09/14/2023] [Indexed: 01/09/2024] Open
Abstract
PURPOSE To perform an intraindividual comparison of the quality of vision and the effect of decentration between two aspheric intraocular lenses: aspheric balanced curve (ABC) design Vivinex iSert XY1 (Hoya Surgical Optics, Singapore) and anterior aspheric design Tecnis ZCB00 (Abbott Medical Optics, CA). SETTING Tertiary Eye Care Centre. DESIGN Prospective, randomized comparative study using a random number table. METHODS Thirty patients were randomized to the implantation of Vivinex iSert XY1 in one eye and Tecnis ZCB00 in the contralateral eye. Then, 12 weeks postoperatively, a laser ray-tracing aberrometer was used to evaluate the visual Strehl ratio, higher-order aberrations (HOA), decentration of IOL from the visual axis and geometric axis, angle alpha, and angle kappa. Contrast sensitivity was measured using the functional visual analyzer. RESULTS The visual internal Strehl ratio was higher ( P < 0.05) at all pupil sizes and the spherical aberrations values were lower ( P < 0.05) at larger pupil sizes (5 mm and 6 mm) in the Vivinex group. The mean decentration from the visual axis in the Vivinex group was significantly more than that in the Tecnis group ( P < 0.01). With an increase in angle alpha, there was a greater decline in the visual Strehl ratio for Tecnis; however, there was a statistically significant decline at 3 mm pupil size for Tecnis ZCB00 ( P = 0.028). The contrast sensitivity was similar for both IOLs. CONCLUSION In comparison to an anterior aspheric design IOL, the ABC design IOL yielded better quality of vision, neutralized spherical aberrations to a larger extent, and provided a relatively superior quality of vision with decentration.
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Yan W, Auffarth GU, Khoramnia R, Łabuz G. Blue-Light Filtering Monofocal Intraocular Lenses: A Study on Optical Function and Tolerance to Misalignment. J Refract Surg 2024; 40:e79-e88. [PMID: 38346120 DOI: 10.3928/1081597x-20240112-02] [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: 02/15/2024]
Abstract
PURPOSE To investigate the optical performance and tolerance to misalignment of blue-light filtering monofocal intraocular lenses (IOLs). METHODS The optical properties of two monofocal IOLs featuring yellow chromophores, CT Lucia 621 PY (Carl Zeiss Meditec AG) and Clareon CNA0T0 (Alcon Laboratories, Inc), were assessed in monochromatic and polychromatic light while introducing spherical aberration (SA). Optical quality metrics derived from the modulation transfer function were assessed after optimal IOL centration at 3- and 4.5-mm pupils. In addition, each IOL's tolerance to misalignment was examined by inducing up to 1 mm of decentration and the effect of tilting it by 5 degrees at 3 mm. RESULTS The IOLs' resolution and contrast, while tested using a 3-mm aperture and an SA-neutral corneal model, indicated the CT Lucia 621 PY had a slightly higher modulation transfer function (MTF) at 50 lp/mm than the CNA0T0 under monochromatic conditions (0.77 vs 0.69). On introducing SA with (0.49 vs 0.40) and without (0.75 vs. 0.70) chromatic aberration, the CT Lucia 621 PY maintained its minimally better performance. When assessed with a 4.5-mm aperture in monochromatic light, the CT Lucia 621 PY displayed improved MTF with aberration-free cornea (0.71 vs 0.40) but performed worse after introducing SA (0.44 vs 0.62). However, both lenses achieved comparable MTF values under spherical and chromatic aberrations (0.28 vs 0.27). The IOL misalignment test revealed a better tolerance to tilt and decentration of the CT Lucia 621 PY across all conditions. CONCLUSIONS The CT Lucia 621 PY and CNA0T0 showed similar optical quality in different situations, with equal simulated distance visual acuity for both models. However, the CT Lucia 621 PY's aspheric design offers an advantage when dealing with often imperfect physiological conditions, displaying a more robust performance under tilt and decentration. [J Refract Surg. 2024;40(2):e79-e88.].
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Park CH, Moon K, Kim JH, Shim KY, Jun JH. CONTRIBUTION FACTORS OF EFFECTIVE LENS POSITION, TILT, AND DECENTRATION DURING FLANGED SCLERAL FIXATION OF INTRAOCULAR LENS: A Model Eye Study. Retina 2024; 44:324-332. [PMID: 37851957 DOI: 10.1097/iae.0000000000003960] [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: 10/20/2023]
Abstract
PURPOSE The authors aimed to elucidate the factors related to effective lens position, tilt, and decentration of scleral fixed intraocular lenses (IOLs) with a flanged haptic technique in an artificial eye model using anterior segment optical coherence tomography. METHODS Two bent 27-gauge needles were passed through a 1.0- or 2.0-mm scleral tunnel, 2.0 mm posterior to the limbus and 180° apart. Both haptics of a three-piece IOL were docked with guide needles and externalized. Factors related to the IOL position were analyzed using anterior segment optical coherence tomography and a stereomicroscope. RESULTS The 1.0-mm scleral tunnel induced a significantly longer effective lens position than the 2.0-mm tunnel and suture fixation ( P < 0.05 and P < 0.01, respectively). Discrepancy in scleral tunnel length induced higher decentration of the optic to the opposite side of the haptic-embedded shorter tunnel and tilt perpendicular to the fixed axis than that in the scleral tunnel of the same length ( P < 0.001 and P < 0.05, respectively). If the scleral fixation points of both haptics are not exactly 180° apart, the IOL may become decentered and tilted ( P < 0.01 and P < 0.05, respectively). CONCLUSION In the flanged haptic technique, the length, balance, and position of both scleral tunnels determine IOL effective lens position, tilt, and decentration.
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Affiliation(s)
| | - Kun Moon
- Seoul Balgeunsesang Eye Clinic, Seoul, South Korea
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, South Korea
| | - Jessica H Kim
- University of California, San Diego, School of Medicine, California; and
| | - Kyu Young Shim
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, South Korea
| | - Jong Hwa Jun
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, South Korea
- Viterbi Family Department of Ophthalmology, Shiley Eye Institute, San Diego, California
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Hong Y, Sun Y, Liu H, Ji Y. Effect of Decentration, Rotation, and Tilt on Objective Optical Quality of Plate Haptic Toric Intraocular Lenses in the Early Postoperative Period. Transl Vis Sci Technol 2024; 13:19. [PMID: 38407885 PMCID: PMC10902868 DOI: 10.1167/tvst.13.2.19] [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: 04/12/2023] [Accepted: 01/19/2024] [Indexed: 02/27/2024] Open
Abstract
Purpose This study aimed to determine the influence of decentration, rotation, and tilt on objective optical quality of plate haptic toric intraocular lenses (tIOLs). Methods The area ratio of modulation transfer function (MTF), strehl ratio of point spread function (PSF), and higher order aberrations (HOAs) for 3 mm and 5 mm pupil diameter (PD) were evaluated at postoperative 1 month. The retroillumination images pictured by OPD-scan III were used to quantify the degree of decentration and rotation, whereas the tIOL tilt was directly obtained by the tilt aberration. Patients were separated into two subgroups based on tIOL misalignment cutoff values. Results There were 29 eyes (24 patients) in the study. The decentration of more than 0.25 mm did not substantially differ from those less than or equal to 0.25 mm. PSF of 3 mm PD and MTF, intraocular HOAs, and trefoil aberration for 3 mm and 5 mm PD significantly deteriorated with a rotation of more than 3 degrees, whereas only intraocular HOAs for 5 mm PD and coma for 3 mm and 5 mm PD were significantly severe with a tilt of more than 0.1 µm and 0.25 µm in corresponding PD. Furthermore, tIOL rotation and tilt were highly correlated with intraocular trefoil aberration and coma, respectively. Conclusions The decentration of the monofocal bitoric IOLs is more tolerant to optical quality degradation after 1 month of surgery but more sensitive to intraocular trefoil aberration caused by rotation and coma aberration induced by tilt. Translational Relevance As far as we know, this is the first study to investigate the relationship between the plate haptic bitoric IOL misalignment and objective optical quality measured by OPD-scan III in the real world, which may provide reference information for IOL selection to improve surgical outcomes.
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Affiliation(s)
- Yingying Hong
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yang Sun
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Houyi Liu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Yinghong Ji
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
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Huang Y, Yu M, Liu X, Li Q, Ke X, Cai Y, Wu W. Postoperative intraocular lens stability following cataract surgery with or without primary posterior continuous curvilinear capsulorrhexis: an intra-individual randomized controlled trial. Int Ophthalmol 2023; 43:4759-4771. [PMID: 37731157 DOI: 10.1007/s10792-023-02876-y] [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: 12/11/2022] [Accepted: 08/26/2023] [Indexed: 09/22/2023]
Abstract
PURPOSE To evaluate the effect of primary posterior continuous curvilinear capsulorrhexis (PPCCC) on the positional stability of IOLs. METHODS This study is a prospective intra-individual comparative randomized controlled trial including 31 patients (62 eyes). Eyes of the same patient were randomly assigned to the PPCCC group (18 right eyes and 13 left eyes) or group without PPCCC (NPCCC group). Eyes in both groups were implanted with a one-piece foldable hydrophobic acrylic IOL via routine cataract surgery. Patients in the PPCCC group underwent additional manual PPCCC before IOL implantation. Examinations were performed 1 day, 1 week, 1 month and 3 months postoperatively. IOL tilt (x, y), decentration (x, y), anterior chamber depth (z) and refractive prediction error data were collected and analyzed with Pentacam. RESULTS Postoperatively, the range of IOL position change over 3 months in PPCCC group was comparable to NPCCC group, which indicated smaller value in every tilt and decentration index. PPCCC eyes showed comparable tilt and decentration with NPCCC eyes in this study endpoint: mean tilt (x, y), decentration (x, y) and anterior chamber depth (ACD) were 1.04 ± 0.56°, 0.90 ± 0.64°, 0.239 ± 0.140 mm, 0.233 ± 0.133 mm and 4.01 ± 0.32 mm, respectively, in the PPCCC group vs. 1.09 ± 0.76°, 1.10 ± 0.82°, 0.252 ± 0.153 mm, 0.244 ± 0.155 mm and 4.01 ± 0.38 mm, respectively, in the NPCCC group. Refractive prediction error in the PPCCC group demonstrated a mild hyperopic shift vs. the NPCCC group (0.13 ± 0.50 vs. 0.05 ± 0.39; p = 0.208), and corrected distance visual acuity (CDVA) did not differ between the two groups (0.027 ± 0.014 vs. 0.059 ± 0.185; p = 0.377). CONCLUSIONS Comparable IOL tilt, decentration, ACD and refractive prediction error were observed in PPCCC eyes with that underwent routine cataract surgery. Little IOL position fluctuation and good visual acuity were shown in PPCCC group over time. TRAIL REGISTRATION The study was registered at the Chinese Clinical Trial Register Center on May 27th, 2020 (protocol code ChiCTR2000033304, 27/05/2020).
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Affiliation(s)
- Yue Huang
- Ophthalmology Department, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, 134.Dongjie Rd, Fuzhou, 350001, Fujian, China
| | - Mengting Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, China
| | - Xiaobao Liu
- Ophthalmology Department, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, 134.Dongjie Rd, Fuzhou, 350001, Fujian, China
| | - Qiong Li
- Ophthalmology Department, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, 134.Dongjie Rd, Fuzhou, 350001, Fujian, China
- Ophthalmology Department, Fujian Provincial Hospital, 134.Dongjie Rd, Fuzhou, 350001, Fujian, China
| | - Xiaozheng Ke
- Ophthalmology Department, Fujian Provincial Hospital, 134.Dongjie Rd, Fuzhou, 350001, Fujian, China
| | - Yajing Cai
- Ophthalmology Department, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, 134.Dongjie Rd, Fuzhou, 350001, Fujian, China
| | - Wenjie Wu
- Ophthalmology Department, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, 134.Dongjie Rd, Fuzhou, 350001, Fujian, China.
- Ophthalmology Department, Fujian Provincial Hospital, 134.Dongjie Rd, Fuzhou, 350001, Fujian, China.
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Li K, Yang G, Chang S, Yao J, He C, Lu F, Wang X, Wang Z. Comprehensive assessment of the anterior segment in refraction corrected OCT based on multitask learning. BIOMEDICAL OPTICS EXPRESS 2023; 14:3968-3987. [PMID: 37799701 PMCID: PMC10549746 DOI: 10.1364/boe.493065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/28/2023] [Accepted: 06/28/2023] [Indexed: 10/07/2023]
Abstract
Anterior segment diseases are among the leading causes of irreversible blindness. However, a method capable of recognizing all important anterior segment structures for clinical diagnosis is lacking. By sharing the knowledge learned from each task, we proposed a fully automated multitask deep learning method that allows for simultaneous segmentation and quantification of all major anterior segment structures, including the iris, lens, cornea, as well as implantable collamer lens (ICL) and intraocular lens (IOL), and meanwhile for landmark detection of scleral spur and iris root in anterior segment OCT (AS-OCT) images. In addition, we proposed a refraction correction method to correct for the true geometry of the anterior segment distorted by light refraction during OCT imaging. 1251 AS-OCT images from 180 patients were collected and were used to train and test the model. Experiments demonstrated that our proposed network was superior to state-of-the-art segmentation and landmark detection methods, and close agreement was achieved between manually and automatically computed clinical parameters associated with anterior chamber, pupil, iris, ICL, and IOL. Finally, as an example, we demonstrated how our proposed method can be applied to facilitate the clinical evaluation of cataract surgery.
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Affiliation(s)
- Kaiwen Li
- School of Electronic Science and Engineering,
University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China
| | - Guangqian Yang
- School of Electronic Science and Engineering,
University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China
| | - Shuimiao Chang
- Department of Cataract, Shanxi Eye Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Jinhan Yao
- Department of Cataract, Shanxi Eye Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Chong He
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China
| | - Fang Lu
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China
| | - Xiaogang Wang
- Department of Cataract, Shanxi Eye Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Zhao Wang
- School of Electronic Science and Engineering,
University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China
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Ren Z, Liu X, Zhang Y, Li W, Huang Y. Laboratory Evaluation of Optical Performance of Aspheric Monofocal Intraocular Lenses With Various Anti-misalignment Designs Under the Influence of Decentration and Tilt. J Refract Surg 2023; 39:446-455. [PMID: 37449503 DOI: 10.3928/1081597x-20230605-02] [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: 07/18/2023]
Abstract
PURPOSE To assess the effectiveness and characteristics of aspheric monofocal intraocular lenses (IOLs) with different anti-misalignment designs. METHODS Three types of anti-misalignment IOLs (with aspheric balance curve design, ZO optic design, and high-order optical aspheric surface design) and no anti-misalignment IOLs were involved. From each type of these IOLs, +8.00, +17.00, and +26.00 diopter (D) lenses were used for detection at the 3- and 4.5-mm apertures. The modulation transfer function (MTF) and 50% of the maximum value of the MTF (MTF50) were measured while IOLs were centered, decentered by 0.3, 0.5, and 0.7 mm, and tilted by 3, 5, and 7 degrees. RESULTS Within the average clinical range of IOL malpositions (0.3-mm decentration or 3.00-D tilt), the anti-misalignment design slightly reduced the negative effect of decentration and tilt (P = .1845 and .6495, t test) on the optical performance of IOLs. Beyond the average range, the anti-misalignment design narrowed the reductions of MTF50 from 23.18% to 8.60% for decentration and from 40.31% to 27.96% for tilt (P = .0010, two-factor analysis of variance). The optical performance varied in anti-misalignment IOLs with different diopters, types, and degrees of malpositions at different aperture sizes. In both photopic and mesopic conditions and all probable misalignments, from the perspective of MTF50, better sharpness generally may be achieved with the 8.00-D ZO optic designed lens and 17.00-D high-order optical aspheric surface designed lens. For 26.00-D IOLs with different misalignments, the ABC design was more resistant to decentrations, whereas the high-order optical aspheric surface design was more resistant to tilts. CONCLUSIONS Aspheric monofocal IOLs with an anti-misalignment design can effectively resist decentration and tilt. Anti-misalignment IOLs for complicated cataract could be selected according to diopter of IOL and types and degrees of probable IOL malpositions. [J Refract Surg. 2023;39(7):446-455.].
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Cui Y, Li Q, Shi X, Zhou D. A comparative study of transscleral sutured intraocular lens fixation and sutureless flanged intraocular lens fixation. BMC Ophthalmol 2023; 23:23. [PMID: 36650453 PMCID: PMC9843930 DOI: 10.1186/s12886-023-02782-y] [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: 10/03/2022] [Accepted: 01/13/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND To compare the intraocular lens (IOL) tilt and decentration and visual outcomes of transscleral sutured IOL fixation and sutureless flanged IOL fixation. To investigate the influence of IOL tilt and decentration on internal higher-order aberrations (HOAs) in these two techniques. METHODS Patients who received transscleral sutured or sutureless flanged IOL fixation procedures were included in this prospective, non-randomized, comparative study. Corrected distance visual acuity (CDVA) was measured at baseline and at every postoperative visit for 12 months. IOL tilt and decentration were measured using a second-generation anterior segment optical coherence tomography (Casia2) and internal HOAs were measured using iTrace Visual Function Analyzer at 3 months postoperatively. RESULTS The study included 27 eyes from the transscleral sutured IOL fixation group and 26 eyes from the sutureless flanged IOL fixation group. There was no significant difference in CDVA between the two groups at all time points. The two groups did not differ in refractive difference from the predicted value, corneal endothelial cell loss, IOL tilt, IOL decentration, internal astigmatism or internal HOAs. Vertical IOL decentration significantly correlated with total internal optical aberration (r = 0.288, P = 0.036), total internal HOA (r = 0.440, P = 0.001), internal coma (r = 0.348, P = 0.001), vertical internal coma (r = 0.388, P = 0.004), average height of modulation transfer function (r = - 0.364, P = 0.007) and Strehl ratio (r = - 0.297, P = 0.031). Horizontal IOL decentration significantly correlated with horizontal internal coma (r = 0.312, P = 0.023). CONCLUSIONS Transscleral sutured IOL fixation and sutureless flanged IOL fixation had similar IOL positions and visual outcomes. IOL decentrations correlated with internal HOAs and thus should be avoided.
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Affiliation(s)
- Ying Cui
- grid.24696.3f0000 0004 0369 153XBeijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 China
| | - Qiyan Li
- grid.24696.3f0000 0004 0369 153XBeijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 China
| | - Xiangyu Shi
- grid.24696.3f0000 0004 0369 153XBeijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 China
| | - Dan Zhou
- grid.24696.3f0000 0004 0369 153XBeijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 China
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Short-term clinic observation of misalignment and rotational stability after implantable collamer lens implantation. Graefes Arch Clin Exp Ophthalmol 2022; 261:1473-1481. [PMID: 36484805 DOI: 10.1007/s00417-022-05929-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 11/04/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022] Open
Abstract
PURPOSE We aimed to investigate misalignment (tilt and decentration) and rotational stability of the implantable collamer lens V4c 6 months after implantation and to explore the potential risk factors associated with postoperative misalignment and rotation. METHODS A total of 36 eyes of 36 patients with high myopia and myopic astigmatism who underwent implantable collamer lens V4c implantation were included in this study. Tilt, decentration, and rotation of the implantable collamer lens were assessed postoperatively at l week, 1 month, 3 months, and 6 months. Correlation analysis was used to identify the potential risk factors for implantable collamer lens tilt, decentration, and rotation at 6 months postoperatively. Higher-order aberration was measured to evaluate the effect of implantable collamer lens misalignment on visual quality at pupil diameters of 4.0 mm and 6.0 mm. RESULTS The tilt and decentration at the last follow-up were 2.43 ± 1.35° and 0.278 ± 0.160 mm, respectively. There was a significant positive correlation between tilt and decentration (r = 0.31, P = 0.046). No significant correlation was detected between implantable collamer lens decentration and internal higher-order aberrations (P > 0.05). The degree of implantable collamer lens rotation (3.11 ± 2.00°) was significantly associated with the vault (r = - 0.422, P = 0.01), while it was positively associated with the preoperative anterior chamber depth (r = 0.36, P = 0.034). No significant correlation was found between postoperative astigmatism and rotation (r = - 0.07, P = 0.351). CONCLUSIONS The implantable collamer lens V4c provides relatively stable misalignment and rotation after implantation. The ICL lens vault is a potential risk factor for postoperative implantable collamer lens rotation. The absolute value of decentration and tilt was relatively small, which showed no correlation with internal higher-order aberration in short-term observation.
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Guo D, Meng J, Zhang K, He W, Ma S, Lu ZL, Lu Y, Zhu X. Tolerance to lens tilt and decentration of two multifocal intraocular lenses: using the quick contrast sensitivity function method. EYE AND VISION (LONDON, ENGLAND) 2022; 9:45. [PMID: 36451233 PMCID: PMC9713962 DOI: 10.1186/s40662-022-00317-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/05/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Quick contrast sensitivity function (qCSF) method is an advanced quick method for contrast sensitivity function (CSF) evaluation. This study evaluated the contrast sensitivity (CS) of eyes undergoing cataract surgery with multifocal intraocular lens (IOL) implantation and its tolerance to IOL tilt and IOL decentration using the qCSF method. METHODS Patients undergoing uneventful phacoemulsification and a trifocal IOL (Zeiss AT LISA tri 839MP, Carl Zeiss, Germany) or an extended depth-of-focus (EDOF) IOL (Tecnis Symfony ZXR00, Johnson & Johnsons, USA) implantation were included. Monocular contrast sensitivity was measured using the qCSF method at one month post-surgery. IOL tilt and decentration were measured using an optical aberrometer (OPD-Scan III, NIDEK, Japan). RESULTS Seventy-two patients/eyes with the 839MP IOL and 64 patients/eyes with the ZXR00 IOL were included. Area under the log CSF (AULCSF) and CS acuity did not differ significantly between the two groups. The ZXR00 IOL group showed better CS at 1 cpd (1.137 ± 0.164 vs. 1.030 ± 0.183 logCS) and 1.5 cpd (1.163 ± 0.163 vs. 1.071 ± 0.161 logCS), while the 839MP IOL group had better CS at 6 cpd (0.855 ± 0.187 vs. 0.735 ± 0.363 logCS). In the 839MP IOL group, all CSF metrics were negatively correlated with IOL tilt (all P < 0.05), while in the ZXR00 IOL group, the CS at 3 cpd had no significant correlation with IOL tilt (P > 0.05). Among myopic eyes, fewer CSF metrics were negatively correlated with IOL tilt in the ZXR00 IOL group than in the 839MP IOL group. No significant correlation was found between CSF metrics and IOL decentration. CONCLUSIONS The ZXR00 and the 839MP IOL groups presented comparable CSF. CS was negatively correlated with IOL tilt, instead of decentration in multifocal IOLs, particularly among myopic eyes. The ZXR00 IOL had better tolerance to IOL tilt in myopic eyes.
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Affiliation(s)
- Dongling Guo
- grid.8547.e0000 0001 0125 2443Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,grid.506261.60000 0001 0706 7839Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China ,grid.8547.e0000 0001 0125 2443State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Jiaqi Meng
- grid.8547.e0000 0001 0125 2443Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,grid.506261.60000 0001 0706 7839Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China ,grid.8547.e0000 0001 0125 2443State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Keke Zhang
- grid.8547.e0000 0001 0125 2443Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,grid.506261.60000 0001 0706 7839Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China ,grid.8547.e0000 0001 0125 2443State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Wenwen He
- grid.8547.e0000 0001 0125 2443Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,grid.506261.60000 0001 0706 7839Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China ,grid.8547.e0000 0001 0125 2443State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Shiyu Ma
- grid.8547.e0000 0001 0125 2443Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,grid.506261.60000 0001 0706 7839Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China ,grid.8547.e0000 0001 0125 2443State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Zhong-lin Lu
- grid.449457.f0000 0004 5376 0118Division of Arts and Sciences, NYU Shanghai, Shanghai, China ,grid.137628.90000 0004 1936 8753Center for Neural Science and Department of Psychology, New York University, New York, USA ,grid.449457.f0000 0004 5376 0118NYU-ECNU Institute of Brain and Cognitive Science at NYU Shanghai, Shanghai, China
| | - Yi Lu
- grid.8547.e0000 0001 0125 2443Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,grid.506261.60000 0001 0706 7839Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China ,grid.8547.e0000 0001 0125 2443State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Xiangjia Zhu
- grid.8547.e0000 0001 0125 2443Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,grid.506261.60000 0001 0706 7839Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China ,grid.8547.e0000 0001 0125 2443State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
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A Comparison of Visual Quality and Contrast Sensitivity between Patients with Scleral-Fixated and In-Bag Intraocular Lenses. J Clin Med 2022; 11:jcm11102917. [PMID: 35629043 PMCID: PMC9147216 DOI: 10.3390/jcm11102917] [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: 03/17/2022] [Revised: 05/17/2022] [Accepted: 05/20/2022] [Indexed: 01/27/2023] Open
Abstract
Purpose: To analyze visual quality and contrast sensitivity in patients after intraocular lens (IOL) implantation with sutured scleral fixation. Setting: Chang Gung Memorial Hospital, Taoyuan, Taiwan. Design: Retrospective observational study. Methods: Data on the refractive outcome, visual acuity, and subjective visual symptoms in patients with scleral-fixated or in-bag IOL implantation were collected from September 2019 to March 2020. We also investigated patients’ postoperative higher-order aberrations (HOAs) and dysphotopsia using a wavefront aberrometer and glaretester, respectively. The following values were compared: corrected distance visual acuity, spherical equivalent, root mean square values for aberrations, and contrast sensitivity. Results: A total of 23 eyes implanted with scleral-fixated IOL and 74 eyes with in-bag IOL were studied. The mean postoperative spherical equivalent and logarithm of the minimum angle of resolution after scleral fixation were −1.09 ± 3.32 D and 0.20 ± 0.17, respectively. The ocular HOAs were higher in the scleral-fixation group than in the in-bag group (p = 0.001). Contrast sensitivity was negatively associated with age, and it was similar between the two groups after controlling for the age effect. Conclusions: Ocular HOAs and refractive errors were higher in the scleral-fixation group than in the in-bag group. However, no significant difference was noted in contrast sensitivity between advanced scleral fixation and in-bag IOL implantation.
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Chen Y, Meng J, Cheng K, Lu Q, Wei L, Lu Y, Zhu X. Influence of IOL Weight on Long-Term IOL Stability in Highly Myopic Eyes. Front Med (Lausanne) 2022; 9:835475. [PMID: 35479960 PMCID: PMC9035698 DOI: 10.3389/fmed.2022.835475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/07/2022] [Indexed: 01/17/2023] Open
Abstract
Purpose This study aimed to investigate the influence of intraocular lens (IOL) weight on long-term IOL stability in highly myopic eyes. Materials and Methods A total of 205 highly myopic cataract eyes of 205 patients implanted with the MC X11 ASP (Group A, 86 eyes) or 920H IOL (Group B, 119 eyes) were included in this retrospective study. Eyes were divided into 3 subgroups according to the IOL power: low (≥-5 to <5 D), medium (≥5 to <14 D), and high (≥14 D) IOL power. At 3 years after surgery, IOL decentration and tilt, high-order aberrations, and anterior capsular opening (ACO) area were measured. The influence of IOL weight on long-term IOL stability was evaluated. Results Group B had a significantly greater IOL weight than Group A (Group B vs. Group A: 28.31 ± 2.01 mg vs. 25.71 ± 4.62 mg, P < 0.001). Correspondingly, Group B presented significantly greater overall and inferior decentration than Group A, especially for low and medium IOL power (all P < 0.05). In both groups, overall and vertical decentration was significantly correlated with IOL weight (all P < 0.05). Group B showed a significantly greater ACO area than Group A (P < 0.05). Multivariate analysis showed that decentration in Group A was affected by IOL weight, while decentration in Group B was affected by IOL weight and AL. Conclusions Higher IOL weight may lead to greater long-term IOL decentration in highly myopic eyes, while the haptic design may play a role in anterior capsular contraction.
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Affiliation(s)
- Yuxi Chen
- Department of Ophthalmology and Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia (Fudan University), National Health Commission, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Jiaqi Meng
- Department of Ophthalmology and Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia (Fudan University), National Health Commission, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Kaiwen Cheng
- Department of Ophthalmology and Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia (Fudan University), National Health Commission, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Qiang Lu
- Department of Ophthalmology and Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia (Fudan University), National Health Commission, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Ling Wei
- Department of Ophthalmology and Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia (Fudan University), National Health Commission, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Yi Lu
- Department of Ophthalmology and Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia (Fudan University), National Health Commission, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
- Yi Lu
| | - Xiangjia Zhu
- Department of Ophthalmology and Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia (Fudan University), National Health Commission, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
- *Correspondence: Xiangjia Zhu
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Liu Z, Lin H, Jin G, Tan X, Qu B, Jin L, Chen X, Wang W, Han X, Xu J, Ying G, Han Y, He M, Congdon N, Chen W, Luo L, Liu Y. In-the-Bag Versus Ciliary Sulcus Secondary Intraocular Lens Implantation for Pediatric Aphakia: A Prospective Comparative Study. Am J Ophthalmol 2022; 236:183-192. [PMID: 34653355 DOI: 10.1016/j.ajo.2021.10.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/03/2021] [Accepted: 10/06/2021] [Indexed: 11/01/2022]
Abstract
PURPOSE To compare outcomes of in-the-bag vs ciliary sulcus secondary intraocular lens (IOL) implantation for pediatric aphakia. DESIGN Prospective interventional case series. METHODS This institutional study was conducted in 202 children (355 aphakic eyes) diagnosed as having congenital cataracts and who underwent cataract extraction before age 24 months. Pediatric aphakic eyes underwent in-the-bag or ciliary sulcus secondary IOL implantation according to the amount of residual lens capsule and were monitored for 3 years postoperatively. The main outcome measures were adverse events (AEs), IOL tilt and decentration, and best corrected visual acuity (BCVA) in the operative eye. RESULTS A total of 144 eyes (40.6%, 89 children) received in-the-bag IOL implantation (capsular group), and 211 eyes (59.4%, 132 children) underwent ciliary sulcus IOL implantation (sulcus group). Kaplan-Meier curves showed that the time-dependent incidence of glaucoma-related AEs (GRAEs) (P = .005) and any AEs (P = .002) were higher in the sulcus group. In-the-bag IOL implantation was a strong protective factor against GRAE (hazard ratio, 0.08; 95% CI, 0.01-0.53; P = .009) and any AEs (hazard ratio, 0.21; 95% CI, 0.08-0.57; P = .002). Clinically significant IOL decentration (>0.4 mm) was more common in the sulcus group compared with the capsular group (vertical decentration: 29.8% vs 15.7%, P = .005; horizontal decentration: 30.3% vs 9.35%, P < .001). BCVA in the capsular group was better than that in the sulcus group (logMAR, 0.56 vs 0.67, P = .014). CONCLUSIONS Compared with ciliary sulcus secondary IOL implantation, in-the-bag IOL implantation reduced AEs and yielded better IOL centration and BCVA for pediatric aphakia.
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Adjusted femtosecond laser capsulotomy distance in white cataracts to decrease incomplete capsulotomy: a randomized comparative cohort study. Graefes Arch Clin Exp Ophthalmol 2022; 260:2591-2595. [PMID: 35344089 DOI: 10.1007/s00417-022-05630-9] [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: 11/12/2021] [Revised: 02/01/2022] [Accepted: 03/10/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND To compare safety and effectiveness between standard position and adjusted distance pre- and post-anterior capsule of femtosecond laser capsulotomy in white cataracts surgery. METHODS Selected white cataracts that underwent LenSx femtosecond laser capsulotomy were randomized into groups A (standard position, with 300 µm symmetrically pre- and post-anterior capsule), B (increased distance with 400 µm symmetrically pre- and post-anterior capsule), and C (unsymmetrical distances of 200 µm pre- and 400 µm post-anterior capsule, respectively). All these surgeries were performed by the same experienced surgeon. Complications, including incomplete capsulotomy and capsule tears, were recorded. In addition, femtosecond capsulotomy and phacoemulsification parameters, IOLs centrality and corrected distance visual acuity were assessed. RESULTS A total of 113 eyes were included in this study. There were 8 (21.6%) incomplete capsulotomy and 1 anterior capsule tear in group A. Meanwhile, only 2 eyes (5.1%) had incomplete capsulotomy with none showing capsule tear in group B. In group C, only 1 eye (2.7%) had incomplete capsulotomy and no capsule tear occurred. Mean femtosecond laser capsulotomy time was longer in group B compared with groups A and C. Average cumulative dispersed energy, IOL centrality and corrected distance visual acuity were similar in all groups. CONCLUSIONS Appropriate adjustment on femtosecond laser capsulotomy distance by reducing pre-anterior capsule and increasing post-anterior distance, may decrease incomplete capsulotomy and be more effective in white cataracts surgery. TRIAL REGISTRATION Clinical trial registration number: ChiCTR2100043863.
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Ahn H, Jun I, Seo KY, Kim EK, Kim TI. Femtosecond laser-assisted cataract surgery after corneal refractive surgery. Sci Rep 2022; 12:4263. [PMID: 35277568 PMCID: PMC8917192 DOI: 10.1038/s41598-022-08297-8] [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: 09/02/2021] [Accepted: 03/04/2022] [Indexed: 11/24/2022] Open
Abstract
Cataract is the leading cause of blindness worldwide, and advanced cataract techniques such as femtosecond laser-assisted cataract surgery (FLACS) have been commercially available. Corneal refractive surgery (CRS) is one of the most popular surgeries for the correction of refractive errors. CRS changes the cornea not only anatomically but also pathophysiologically. However, there has been no clinical research analyzing the refractive and safety outcomes of FLACS after CRS. The aim of this retrospective chart review and comparative study is to evaluate the effect and safety of FLACS after CRS comparing with conventional PCS. Participants with a previous CRS history who underwent FLACS or conventional PCS were included in this study. The visual outcomes and the refractive outcomes including refractive, corneal, and ocular residual astigmatism were compared. The safety outcomes were then studied intraoperatively and postoperatively. A total of 102 patients with age-related cataract were enrolled. At 3 months postoperatively, UCVA, BCVA, and predictive error were not significantly different between the FLACS and conventional PCS groups. Reduction of refractive astigmatism was higher in FLACS. Postoperative ORA was significant lower in FLACS. Reduction of ORA was higher in FLACS. The intraoperative and postoperative complications were also not significantly different between the two groups. FLACS could effectively change refractive astigmatism and ORA; without more complications than conventional PCS. FLACS’ competitive edge in postoperative ORA may provide better visual quality than conventional PCS in patients with a previous history of CRS.
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Affiliation(s)
- Hyunmin Ahn
- Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Ikhyun Jun
- Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.,Department of Ophthalmology, Corneal Dystrophy Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemungu, Seoul, 03722, Korea
| | - Kyoung Yul Seo
- Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Eung Kweon Kim
- Department of Ophthalmology, Corneal Dystrophy Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemungu, Seoul, 03722, Korea.,Saevit Eye Hospital, Goyang, Gyunggi-do, Korea
| | - Tae-Im Kim
- Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. .,Department of Ophthalmology, Corneal Dystrophy Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemungu, Seoul, 03722, Korea.
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Ultrasound Biomicroscopy Observation of Suspicious Primary Angle Closure Combined with the Relaxation of Zonule. J Ophthalmol 2022; 2022:1614678. [PMID: 35309110 PMCID: PMC8924569 DOI: 10.1155/2022/1614678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 01/31/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose To investigate the difference in anterior segment parameters between suspicious primary angle closure (PACS) patients and normal patients as assessed by ultrasound biomicroscopy (UBM). Methods From June 2019 to November 2020, 39 patients (50 eyes) with PACS in the Ophthalmology Department of Qingdao University Affiliated Hospital who underwent phacoemulsification and intraocular lens implantation were selected as the PACS group. 32 patients (50 eyes) who underwent phacoemulsification and intraocular lens implantation were selected as the normal group. In addition to routine preoperative examinations such as visual acuity, noncontact intraocular pressure, axis length (AL), and ocular B-ultrasound examination, UBM examinations were also performed, including measuring the central anterior chamber depth (ACD), the maximum transverse diameter of the ciliary process at both ends (STS), the vertical distance between the anterior apex of the lens and the maximum transverse diameter at both ends of the ciliary processes (h), and angle opening distance (AOD500), iris-zonule distance (IZD), trabecular-ciliary process distance (TCPD), trabecular-iris angle (TIA), iris thickness (IT), trabecular-ciliary process angle (TCPA), and anterior placement of the ciliary body (APCB) at four quadrants (superior, nasal, inferior, and temporal quadrants). Results Compared with the normal group, the PACS group showed statistically differences in AL, ACD, h, ACD/AL, h/STS, IZD, AOD500, TCPD, TIA, TCPA, and APCB (P < 0.05), and there were no significant differences in STS and IT between the two groups (P > 0.05). In the PACS group, there were significant differences in AL, ACD, h, ACD/AL, h/STS, IZD, TCPD, TCPA, and APCB between PACS patients with zonular relaxation and without zonular relaxation (P < 0.05), while there were no significant differences in STS, AOD500, TIA, and IT (P > 0.05). Conclusion UBM quantitatively enables to identify the anterior segment morphology, especially the zonules in patients of suspicious primary angle closure combined with the relaxation of zonule. Accurate measurement of UBM can be used to predict whether patients with PACS are combined with zonular relaxation, so as to provide a clinical imaging evidence for the diagnosis.
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Song SH, Song IS, Oh SJ, Son HS, Kang MH. Optical bench simulation for intraocular lenses using field-tracing technology. PLoS One 2021; 16:e0250543. [PMID: 34910725 PMCID: PMC8673660 DOI: 10.1371/journal.pone.0250543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 11/30/2021] [Indexed: 11/21/2022] Open
Abstract
Purpose To evaluate the image quality of intraocular lenses (IOLs) using field-tracing optical simulation and then compare it with the image quality using conventional ray-tracing simulation. Methods We simulated aspheric IOLs with a decenter, tilt, and no misalignment using an aspheric corneal eye model with a positive spherical aberration. The retinal image, Strehl ratio, and modulation transfer function (MTF) were compared between the ray-tracing and field-tracing optical simulation and confirmed by the results reported in an in vitro experiment using the same eye model. Results The retinal image showed interference fringes from target due to diffraction from the object in a field-tracing simulation. When compared with the experimental results, the field tracing represented the experimental results more precisely than ray tracing after passing over 400 μm of the decentration and 4 degrees of the tilt of the IOLs. The MTF values showed similar results for the case of no IOL misalignment in both the field tracing and ray tracing. In the case of the 200-μm decentration or 8-degree tilt of IOL, the field-traced MTF shows lower values than the ray-traced one. Conclusions The field-tracing optical bench simulation is a reliable method to evaluate IOL performance according to the IOL misalignment. It can provide retinal image quality close to real by taking into account the wave nature of light, interference and diffraction to explain to patients having the IOL misalignment.
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Affiliation(s)
- Seok Ho Song
- Department of Physics, Hanyang University College of Natural Science, Seoul, Republic of Korea
| | | | - Se Jin Oh
- Department of Physics, Hanyang University College of Natural Science, Seoul, Republic of Korea
| | - Hyeck-Soo Son
- University Eye Clinic of Heidelberg, Heidelberg, Germany
| | - Min Ho Kang
- Department of Ophthalmology, Hanyang University Guri Hospital, Guri, Republic of Korea
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Republic of Korea
- * E-mail: ,
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21
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Use of P1-P4 Purkinje reflections as a surrogate sign for intraoperative patient fixation. J Cataract Refract Surg 2021; 47:e60-e65. [PMID: 34486578 DOI: 10.1097/j.jcrs.0000000000000805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 08/20/2021] [Indexed: 11/27/2022]
Abstract
Circumferential, even anterior capsular overlap maximizes intraocular lens stability and posterior capsular opacification mitigation and provides best long-term outcomes for the cataract patient. P1 and P4 Purkinje reflections at patient fixation may provide a reliable marker for capsulotomy centration. However, patient fixation may be hindered during surgery because of anesthesia or light sensitivity. In this study, we demonstrate that the relationship between the P1 and P4 Purkinje reflections previewed prior to surgery when the patient is fixating may be recreated intraoperatively if fixation becomes difficult. The final position of P1 and P4 relative to one another at fixation is invariant in a given patient, but there are variations among patients. Knowledge of the P1 and P4 relationship can be used as a surrogate sign of patient fixation to assist in capsulotomy centration during cataract surgery.
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Kalikivayi V, Kalikivayi L, Ganesan AR. Analyses on the distribution and influence of higher-order aberrations both clinically and experimentally among varied refractive errors. Saudi J Ophthalmol 2021; 35:21-28. [PMID: 34667928 PMCID: PMC8486037 DOI: 10.4103/1319-4534.325777] [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: 08/13/2019] [Revised: 12/10/2020] [Accepted: 12/14/2020] [Indexed: 11/11/2022] Open
Abstract
PURPOSE: The aim of this work is to determine and compare the distribution and influence of higher-order aberrations (HOAs) both clinically and experimentally between different refractive errors. METHODS: Commercially available Shack–Hartmann aberrometer was employed to measure the HOA clinically in human eyes. Experimentally, HOA was measured in a model eye by simulating various refractive errors by constructing an aberrometer based on the same Shack Hartmann principle. One-way analyses of variance and simple regression were employed to analyze the distribution and influence of HOA among various refractive errors. RESULTS: A total of 100 eyes were clinically measured for aberrations, of which 35, 50, and 15 eyes were emmetropes, myopes, and hyperopes, respectively. Out of the total root mean square (RMS) value, the HOAs found in the human eyes were 23%, 7%, and 26% and in the model eye, it was 20%, 8%, and 10% between emmetropes, myopes, and hyperopes, respectively. The mean higher-order RMS was almost similar between the groups and among various refractive errors. There was no statistical significance between the individual Zernikes except for the coma in both human and model eyes. CONCLUSION: The mean HOA is similar amidst the different refractive errors. The presence of 23% HOA in emmetropes signifies that larger part of the human eye is capable of complying with HOA without compromising the image quality. This work signifies that HOA does not play an important role in image clarity for human eyes with regular refractive surface unlike irregular refractive surfaces.
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Affiliation(s)
- Venkataramana Kalikivayi
- Department of Optometry, Ahalia School of Optometry, Palakkad, Kerala, India.,Department of Mathematics, SASTRA University, Thanjavur, Tamil Nadu, India.,Department of Optometry, Elite School of Optometry, Indian Institute of Technology, Madras, Chennai, Tamil Nadu, India, India
| | - Lavanya Kalikivayi
- Department of Optometry, Ahalia School of Optometry, Palakkad, Kerala, India
| | - A R Ganesan
- Department of Physics, Applied Optics Laboratory, Indian Institute of Technology, Madras, Chennai, Tamil Nadu, India
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Zhong Y, Zhu Y, Wang W, Wang K, Liu X, Yao K. Femtosecond laser-assisted cataract surgery versus conventional phacoemulsification: comparison of internal aberrations and visual quality. Graefes Arch Clin Exp Ophthalmol 2021; 260:901-911. [PMID: 34636992 DOI: 10.1007/s00417-021-05441-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 10/01/2021] [Accepted: 10/01/2021] [Indexed: 01/19/2023] Open
Abstract
PURPOSE To compare the internal aberrations and optical quality after femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification cataract surgery (CPCS). METHODS This study included patients who received FLACS or CPCS from January 2016 to July 2019. Postoperative examinations included wavefront measurements under pupil diameters of 3.0 mm and 5.0 mm, intraocular lens (IOL) decentration, visual acuity (VA), and refractive outcomes. Visual quality was measured with Strehl ratio and modulation transfer function (MTF). Subgroup analyses were conducted based on monofocal or multifocal-extended depth of focus (EDOF) IOL. RESULTS The study consisted of 221 eyes (105 eyes in FLACS and 116 eyes in CPCS). With a pupil diameter of 5.0 mm, FLACS demonstrated a significantly lower root mean square of total internal aberration (P = 0.004), higher order aberrations (HOAs) (P = 0.034), tilt (P = 0.049), coma (P = 0.004), and spherical aberration (P = 0.014). IOL tilt was found to be positively correlated with total internal aberration (P < 0.001), HOAs (P < 0.001), and coma (P < 0.001). The FLACS group presented significantly smaller IOL decentration than the CPCS group (P < 0.001), but there were no significant differences in terms of VA and refractive outcomes between groups. In the multifocal-EDOF subgroup, Strehl ratio and MTF values were significantly higher in the femtosecond group with a 3.0-mm pupil. CONCLUSION FLACS induced significantly lower values of IOL tilt, decentration, and internal aberrations compared with the CPCS group with a pupil diameter of 5.0 mm, while no significant differences were found in the VA or optical quality over long-term observation. TRIAL REGISTRATION This trial was registered at www.chictr.org.cn (registration number ChiCTR2000038965).
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Affiliation(s)
- Yueyang Zhong
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jiefang Road, Hangzhou, 310009, Zhejiang Province, China
| | - Yanan Zhu
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jiefang Road, Hangzhou, 310009, Zhejiang Province, China
| | - Wei Wang
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jiefang Road, Hangzhou, 310009, Zhejiang Province, China
| | - Kai Wang
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jiefang Road, Hangzhou, 310009, Zhejiang Province, China
| | - Xin Liu
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jiefang Road, Hangzhou, 310009, Zhejiang Province, China
| | - Ke Yao
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jiefang Road, Hangzhou, 310009, Zhejiang Province, China.
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Chen X, Gu X, Wang W, Jin G, Wang L, Zhang E, Xu J, Liu Z, Luo L, Liu Y. Distributions of crystalline lens tilt and decentration and associated factors in age-related cataract. J Cataract Refract Surg 2021; 47:1296-1301. [PMID: 33769775 PMCID: PMC8500366 DOI: 10.1097/j.jcrs.0000000000000631] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 02/23/2021] [Indexed: 12/02/2022]
Abstract
PURPOSE To investigate the characteristics and factors associated with crystalline lens tilt and decentration measured by CASIA2 anterior segment optical coherence tomography. SETTING Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. DESIGN Cross-sectional study. METHODS 1097 eyes of 1097 patients who planned to undergo cataract surgery were enrolled. All patients underwent a general ophthalmologic examination. Lens thickness (LT), front curvature radius (FCR), back curvature radius, lens equator diameter (LED), tilt, and decentration of preoperative crystalline lenses were measured by CASIA2. Univariate and multivariate regression analyses were performed to evaluate the relationships between the tilt and decentration of crystalline lens with related factors. RESULTS The natural crystalline lenses showed a mean tilt of 5.16 degrees toward the inferotemporal direction and a mean decentration of 0.22 mm toward the temporal direction. Of the total 1097 eyes, 119 eyes (10.85%) had a tilt greater than 7 degrees, and 89 eyes (8.11%) had a decentration more than 0.4 mm. Multivariate regression analysis showed that larger decentration, thicker LT, shorter axial length (AL), and FCR were associated with greater lens tilt (P < .001, P = .007, P = .006, and P = .003, respectively). In addition, greater tilt, older and thinner LT were correlated with larger decentration (all P < .001). CONCLUSIONS Preoperative crystalline lens had a certain degree of tilt and decentration in age-related cataract. The greater tilt of the crystalline lens was, the larger decentration of it was. In addition, AL, FCR, LT, and age also correlated with tilt and decentration.
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Simulations of Decentration and Tilt of a Supplementary Sulcus-Fixated Intraocular Lens in a Polypseudophakic Combination Using Ray-Tracing Software. PHOTONICS 2021. [DOI: 10.3390/photonics8080309] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
This study aimed to assess image quality after the tilt and decentration of supplementary intraocular lenses (IOLs) in a two-lens configuration. One was designed for sulcus fixation with a nominal power range of 1D–10D and was combined with a capsular fixation 20D IOL. The optical performance of a ray-tracing model was tested under IOL misalignment through the area under the modulation transfer function (MTFa) and wave aberrations. Tilting by 10° resulted in a 4% reduction of the MTFa for a 10D IOL as compared to 9% for the 20D lens. The two models demonstrated good tolerance to a 1 mm decentration; as for the 10D sulcus-fixated lens, the MTFa loss was 2%, and 4% for the capsular fixation lens. Coma and astigmatism increased three- and four-fold, respectively, after a 10° tilt compared to the aberration level induced by the 1 mm decentration. Both analyses showed a trend towards a lower MTF impact and fewer optical errors with decreasing nominal power. In conclusion, when misaligned, low-power sulcus-fixated IOLs might retain their good optical quality. An extreme tilt of 10° has a more detrimental effect on the IOL performance than a 1 mm decentration. The proper alignment of a high-power capsular fixation lens is important in achieving a desirable postoperative outcome.
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In vivo evaluation of a 1-piece foldable sutureless intrascleral fixation intraocular lens using ultrasound biomicroscopy and anterior segment OCT. J Cataract Refract Surg 2021; 47:316-322. [PMID: 32991506 DOI: 10.1097/j.jcrs.0000000000000444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 09/03/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE To evaluate the optic plate and haptics of a specially designed sutureless intrascleral-fixated intraocular lens (IOL) using ultrasound biomicroscopy and anterior segment optical coherence tomography (AS-OCT). SETTING Department of Ophthalmology, San Marino Hospital, Republic of San Marino. DESIGN Retrospective observational case series. METHODS Eyes that underwent intrascleral fixation with IOL implantation (Carlevale) were included. Preoperative and postoperative refractive outcomes were reported. Optic plate tilt and haptics position were assessed with ultrasound biomicroscopy, whereas intrascleral plug depth and conformation were evaluated with AS-OCT. RESULTS The study comprised 10 aphakic eyes. Postoperative visual acuity improved in all patients. At postoperative month 3, 3 eyes (30%) had a vertical tilt of more than 100 μm, whereas no horizontal tilt was observed in any patient. The mean vertical intraocular tilt was 0.19 ± 0.22 mm. Of 20 haptics, 13 (65%) passed through the ciliary sulcus, 4 (20%) posterior to the ciliary body, and 3 (15%) through the ciliary body. AS-OCT scans showed a mean intrascleral plug depth of 247.20 ± 62.82 μm in the nasal sector and 265.50 ± 30.11 μm in the temporal sector, with adequate integration of the T-shaped plugs in the scleral tissue. CONCLUSIONS This secondary IOL showed good intraocular stability and safe haptics fixation, making it suitable for the intrascleral fixation technique. The specific foldable design results in a low predisposition to optic plate tilt and haptic torsion. In long eyes, the sulcus-to-sulcus distance should be carefully evaluated preoperatively because the flexible structure of the IOL could be subjected to excessive stretching.
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Chen X, Gu X, Wang W, Xiao W, Jin G, Wang L, Dai Y, Zhang E, Ruan X, Liu Z, Luo L, Liu Y. Characteristics and factors associated with intraocular lens tilt and decentration after cataract surgery. J Cataract Refract Surg 2021; 46:1126-1131. [PMID: 32352251 DOI: 10.1097/j.jcrs.0000000000000219] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE To analyze the characteristics and factors associated with intraocular lens (IOL) tilt and decentration after uneventful phacoemulsification with IOL implantation. SETTING Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. DESIGN Cross-sectional study. METHODS All patients underwent a general ophthalmologic examination and anterior segment photography. IOL tilt and decentration were measured with a second-generation anterior segment optical coherence tomography (Casia2). Univariate and multivariate regression analyses were performed to assess the association between IOL tilt and decentration with ocular biometric and systemic parameters, and the visual acuity. RESULTS A total of 196 eyes of 196 patients were enrolled in this study. IOLs showed a mean tilt of 4.8 degrees toward the inferotemporal direction, and the mean decentration was 0.21 mm. Both eyes presented a mirror symmetry relationship. Twenty-two eyes (11.22%) had a tilt greater than 7 degrees, and 21 eyes (10.72%) had a decentration more than 0.4 mm. Multivariate regression analysis showed previous pars plana vitrectomy (PPV) and short axial length (AL) were associated with greater IOL tilt (P = .014 and P < .001). In addition, long AL, thicker lens, and less capsulorhexis-IOL overlap were positively correlated with decentration (P < .001, P = .029, and P = .026). Corrected distance visual acuity did not directly correlate with IOL tilt and decentration (P = .417 and P = .550). CONCLUSIONS PPV history and short AL were associated with greater IOL tilt, whereas longer AL, thicker lens, and overlarge capsulorhexis contribute to greater decentration. Implantation of toric and multifocal IOLs in these patients should be cautious.
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Affiliation(s)
- Xiaoyun Chen
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
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Ning Y, Shao Y, Zhao J, Zhang J, Wang M, Qin Y. Stability of Various Types of Aspheric Intraocular Lenses After Implantation: A One-Year Retrospective Study. Int J Gen Med 2021; 14:2183-2190. [PMID: 34103973 PMCID: PMC8179812 DOI: 10.2147/ijgm.s301887] [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: 01/13/2021] [Accepted: 04/28/2021] [Indexed: 11/23/2022] Open
Abstract
Objective The aim of the present study was to evaluate the stability of four different types of aspheric intraocular lenses (IOLs) after implantation. Methods This retrospective study included 124 eyes implanted with four different types of aspheric IOLs including a one-piece four-loop fixed hydrophilic acrylic IOL, a one-piece flat fixed acrylic IOL, a one-piece two-loop fixed acrylic IOL, and a three-piece two-loop fixed silicone IOL. IOL decentration, tilt, and ocular coma-like aberration (coma) at one-week, one-month, three-month, and one-year time points were evaluated postoperatively. Results IOL decentration, tilt, and coma in the AO, 36A, IQ, and KS-AiN implantation groups were statistically significantly different one week and one year postoperatively (p < 0.01). There were significant differences between each of the pairs of groups (p < 0.01), except for coma between the AO and 36A implantation groups one week postoperatively (p > 0.05). When comparing the different time points (ie, one week, one month, three months, and one year postoperatively), IOL decentration, tilt, and coma were significantly different in each group (p < 0.05). IOL decentration, tilt, and coma in each group increased over the period from one week to one year postoperatively. A positive linear correlation was observed between IOL decentration or tilt and coma one year postoperatively (p < 0.01). Conclusion One-piece multi-point fixed acrylic IOLs demonstrate better stability when compared with three-piece two-point fixed silicone IOLs. IOL decentration, tilt, and coma increase gradually over time. Ocular coma-like aberrations are influenced by the stability of IOLs.
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Affiliation(s)
- Yuan Ning
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Key Lens Research Laboratory of Liaoning Province, Shenyang, 110005, People's Republic of China
| | - Yushuang Shao
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Key Lens Research Laboratory of Liaoning Province, Shenyang, 110005, People's Republic of China
| | - Jiangyue Zhao
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Key Lens Research Laboratory of Liaoning Province, Shenyang, 110005, People's Republic of China
| | - Jinsong Zhang
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Key Lens Research Laboratory of Liaoning Province, Shenyang, 110005, People's Republic of China
| | - Mingwu Wang
- Department of Ophthalmology and Vision Science, The University of Arizona College of Medicine, Tucson, Arizona, 85711-1824, USA
| | - Yu Qin
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Key Lens Research Laboratory of Liaoning Province, Shenyang, 110005, People's Republic of China
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Chassagne B, Canioni L. Individual design of aberration-free intraocular lenses. JOURNAL OF THE OPTICAL SOCIETY OF AMERICA. A, OPTICS, IMAGE SCIENCE, AND VISION 2021; 38:683-689. [PMID: 33983273 DOI: 10.1364/josaa.420066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 03/29/2021] [Indexed: 06/12/2023]
Abstract
An analytical tool capable of easily calculating a new aspheric intraocular lens (IOL) (shape factor, aspherization) chosen to be designed as "aberration free" in terms of spherical aberration and/or coma is reported. In terms of retinal image quality, the theoretical performances given by the new proposed IOLs compare well with commercial IOLs.
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Auffarth GU, Friedmann E, Breyer D, Kaymak H, Holland D, Dick B, Petzold A, Shah S, Ladaria LS, Garcia SA, Khoramnia R. Stability and Visual Outcomes of the Capsulotomy-Fixated FEMTIS-IOL After Automated Femtosecond Laser-Assisted Anterior Capsulotomy. Am J Ophthalmol 2021; 225:27-37. [PMID: 33412122 DOI: 10.1016/j.ajo.2020.12.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 12/22/2020] [Accepted: 12/22/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE To evaluate stability and performance of a new monofocal anterior capsulotomy-fixated intraocular lens (IOL) (FEMTIS; Teleon Surgical B.V., Spankeren, Netherlands) after femtosecond laser-assisted cataract surgery (FLACS). DESIGN Prospective, multicenter, interventional, noncomparative case series. METHODS FLACS with FEMTIS IOL was performed in 336 eyes of 183 cataract patients with fixation of the IOL to the anterior capsulotomy followed up for 12 months. Examination included uncorrected distance visual acuity (UDVA), best-corrected visual acuity (CDVA), subjective refraction, IOL centration, posterior capsule opacification (PCO), and investigators' satisfaction questionnaire. RESULTS At 12 months, mean IOL rotation was 1.50 ± 1.76 degrees and decentration 0.14 ± 0.14 mm from baseline (day of surgery). Mean horizontal IOL tilt was 0.70 ± 0.60 degrees and vertical 1.15 ± 1.06 degrees relative to the baseline (crystalline lens). Mean distance between IOL and iris was 0.32 mm to 0.36 mm for all measured meridians. Mean UDVA was 0.12 ± 0.14 logMAR (range -0.20 to 0.54 logMAR), mean CDVA -0.01 ± 0.09 logMAR (range -0.30 to 0.20 logMAR). Mean spherical equivalent was 0.35 ± 0.53 diopter (D) and 98% of eyes (n = 235) were within ±1.0 D. Median PCO score was 1 with an Nd:YAG laser rate of 3.1% after 12 months. Most surgeons were very satisfied (median score: 1) with surgery and implanted IOL. CONCLUSIONS Implantation of FEMTIS IOL provided excellent visual and stable refractive outcomes. IOL decentration was very low compared to other published studies and showed an exceptional high in-the-bag stability over a 12-month period. This lens benefits from femtosecond laser capsulotomies. It can be positioned very predictably and offers an optimal platform for toric and multifocal IOL optics.
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Ding X, Wang Q, Xiang L, Chang P, Huang S, Zhao YE. Three-Dimensional Assessments of Intraocular Lens Stability With High-Speed Swept-Source Optical Coherence Tomography. J Refract Surg 2021; 36:388-394. [PMID: 32521026 DOI: 10.3928/1081597x-20200420-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 04/20/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE To evaluate the effect of intraocular lens (IOL) optic overlapping on IOL stability and to determine the relationship between the capsulorhexis and IOL movement with the three-dimensional method of swept-source optical coherence tomography (SS-OCT). METHODS This study identified patients with age-related cataracts and divided them into two groups according to their anterior capsule and IOL optic relationship: total anterior capsule overlap (360°) and partial anterior capsule overlap (< 360°). Standard SS-OCT radial scanning was performed in all eyes at 1 day, 1 week, 1 month, and 3 months after cataract surgery, respectively. The obtained photographs were used for the postoperative position measurements of capsulorhexis and IOL after three-dimensional reconstruction. RESULTS This study included 46 eyes of 34 patients: total overlap group (n = 29) and partial overlap group (n = 17). The postoperative aqueous depth significantly decreased in the first week after surgery (P < .001). The IOL tilt was greater in the partial overlap group than that in the total overlap group (P = .014). The IOL moved significantly in the first week postoperatively (both P < .001). IOL decentration in the x-axis was greater in the partial overlap group than that in the total overlap group (P = .024). The IOL and capsulorhexis both moved sharply in the first week (both P < .05). The IOL moved consistently with the capsulorhexis in the 3 months after surgery (all P > .05). CONCLUSIONS The total overlap group showed better IOL centrality and stability. IOL movement may be driven by capsular bag contraction and fibrosis. Thus, it was demonstrated that postoperative IOL position and IOL performance were closely linked with proper size of central continuous curvilinear capsulorhexis. [J Refract Surg. 2020;36(6):388-394.].
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Toto L, Carpineto P, Falconio G, Agnifili L, Di nicola M, Mastropasqua A, Mastropasqua L. Comparative study of Acrysof ReSTOR multifocal intraocular lenses +4.00 D and +3.00 D: visual performance and wavefront error. Clin Exp Optom 2021. [DOI: 10.1111/j.1444-0938.2012.00815.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Lisa Toto
- Department of Medicine and Science of Ageing, Eye Clinic, University “G. d'Annunzio”, Chieti, Italy,
| | - Paolo Carpineto
- Department of Medicine and Science of Ageing, Eye Clinic, University “G. d'Annunzio”, Chieti, Italy,
| | - Gennaro Falconio
- Department of Medicine and Science of Ageing, Eye Clinic, University “G. d'Annunzio”, Chieti, Italy,
| | - Luca Agnifili
- Department of Medicine and Science of Ageing, Eye Clinic, University “G. d'Annunzio”, Chieti, Italy,
| | - Marta Di nicola
- Fondazione Università “G. d'Annunzio”, Center of Excellence on Aging, Department of Biomedical Science, University “G. d'Annunzio”, Laboratory of Biostatistics, Chieti, Italy,
| | - Alessandra Mastropasqua
- Department of Medicine and Science of Ageing, Eye Clinic, University “G. d'Annunzio”, Chieti, Italy,
| | - Leonardo Mastropasqua
- Department of Medicine and Science of Ageing, Eye Clinic, University “G. d'Annunzio”, Chieti, Italy,
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Lu B, Xu H, Wang C, Yan Q, Wang X. Influence of the "Inverted U Method" Nd: YAG Laser Posterior Capsulotomy on Anterior Segment Parameters, Decentration and Tilt of Intraocular Lens in Patients after Phaco-vitrectomy. Semin Ophthalmol 2021; 36:88-93. [PMID: 33734918 DOI: 10.1080/08820538.2021.1884267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE To investigate the effects of the "inverted U method" Nd:YAG laser posterior capsulotomy on anterior segment parameters, decentration and tilt of intraocular lens (IOLs) and visual acuity in posterior capsular opacification (PCO) patients after combined phaco-vitrectomy. METHODS Seventy-six patients (76 eyes) were enrolled in this study, who were diagnosed as PCO and underwent "inverted U method" Nd:YAG laser posterior capsulotomy. All patients had undergone previous combined phaco-vitrectomy for rhegmatogenous retinal detachment. The parameters including IOL decentration, angle of IOL tilt, anterior chamber angle (ACA), anterior chamber depth (ACD), anterior chamber volume (ACV), central corneal thickness (CCT), keratometry, pupil size, axial length (AL), intraocular pressure (IOP), refractive status, corrected distance visual acuity (CDVA), objective scattering index (OSI) and Chinese version of Visual Function 14 (VF-14) index were obtained before and 3 months after capsulotomy. RESULTS After capsulotomy, the tilt angle and decentration of the IOLs at both vertical (tilt: p = .004, decentration: p = .029) and horizontal meridian (tilt: p = .001, decentration: p = .017) were significantly decreased, ACA increased (p = .015), CDVA (p = .000), VF-14 score (p = .000) and OSI (p = .000) were significantly improved. There were a significant decrease in cylindrical error (p = .001) and a myopic shift in spherical error (p = .001) after the capsulotomy. No significant differences in ACD, ACV, CCT, keratometry, pupil size, AL and IOP were detected (p > .05 for all). CONCLUSION The "inverted U method" Nd: YAG laser posterior capsulotomy decreases tilt and decentration of the IOL, increases ACA and causes no change in ACD, ACV, CCT and IOP in patients after phaco-vitrectomy. These changes make a decrease in cylindrical error and a myopic shift in spherical error. Laser capsulotomy significantly improves visual acuity.
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Affiliation(s)
- Bo Lu
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Shenyang, Liaoning Province China
| | - Haoyan Xu
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Shenyang, Liaoning Province China
| | - Chunxia Wang
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Shenyang, Liaoning Province China
| | - Qichang Yan
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Shenyang, Liaoning Province China
| | - Xinling Wang
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Shenyang, Liaoning Province China
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Age-related Changes in Crystalline Lens Tilt and Decentration: A Swept-source Optical Coherence Tomography Study. J Cataract Refract Surg 2021; 47:1290-1295. [PMID: 33769810 DOI: 10.1097/j.jcrs.0000000000000632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 02/23/2021] [Indexed: 11/25/2022]
Abstract
Purpose To investigate the age-related tilt and decentration of crystalline lenses using a swept-source optical coherence tomography biometer (Casia 2, TOMEY, Japan). Setting Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China. Design Cross-sectional study. Methods The direction and magnitude of the crystalline lens were evaluated in 230 participants with ages ranging from 7 to 90 years using swept-source optical coherence tomography. The participants were divided into four age groups, and the differences among the groups were analyzed. Multiple linear regression was used to investigate the main factors influencing crystalline lens tilt and decentration. Results The natural crystalline lens tilted towards the inferotemporal direction with a mean magnitude of 4.3+/-1.5[degrees] (range 0.7-8.95[degrees]). The average decentration toward the superotemporal direction was 0.17+/-0.12 mm (range 0.03-1.15 mm). There was mirror symmetry between the right and left eyes. There were significant differences in the crystalline lens tilt and decentration among the age groups. Multiple linear regression showed that changes in crystalline lens tilt depended on angle [alpha] (p<.01) and anterior chamber depth (ACD; P=.008), while crystalline lens decentration depended on angle [kappa] (P=.003), age (P<.01), and angle [alpha] (P=.002). Conclusions Although there was a significant difference in crystalline lens tilt and decentration among age groups, the variation in the crystalline lens position was partially affected by age. The crystalline lens tilt was greater in eyes with wider angle [alpha] and shallower ACD, while crystalline lens decentration was greater in younger eyes with wider angles [kappa] and [alpha].
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Jujo T, Kogo J, Sasaki H, Sekine R, Sato K, Ebisutani S, Toyoda Y, Kitaoka Y, Takagi H. 27-gauge trocar-assisted sutureless intraocular lens fixation. BMC Ophthalmol 2021; 21:8. [PMID: 33407262 PMCID: PMC7789339 DOI: 10.1186/s12886-020-01758-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 12/04/2020] [Indexed: 01/19/2023] Open
Abstract
Backgrounds However there have been numerous investigations of intrascleral intraocular lens (IOL) fixation techniques, there is room for improvement in terms of simplifying complicated techniques and reducing the high levels of skill required. This study aimed to report a novel technique for sutureless intrascleral fixation of the IOL using retinal forceps with a 27-gauge trocar. Methods Nineteen eyes of 18 patients underwent intrascleral fixation of the IOL from July 2018 to September 2019 were enrolled in this study. A 27-gauge trocar formed 3-mm scleral tunnels positioned at 4 and 10 o’clock, 2 mm from the corneal limbus. We used a 3-piece IOL haptic grasped by a 27-gauge retinal forceps and pulled from the 27-gauge trocar. The IOL was fixed by making a flange. Main outcome measures were visual acuity, corneal endothelial cell density, IOL tilt, decentration, predicted error of refraction and complications. Results The 19 eyes were followed up for 1 month. The mean pre- and postoperative logMAR uncorrected visual acuity (UCVA) was 1.06 ± 0.63 and 0.40 ± 0.26, respectively (p < 0.01), while the mean pre- and postoperative logMAR best corrected visual acuity (BCVA) was 0.27 ± 0.51 and 0.06 ± 0.15, respectively (p = 0.09). The mean corneal endothelial cell density was 2406 ± 625 to 2004 ± 759 cells/mm2 at 1 month (p = 0.13). The mean IOL tilt was 3.52 ± 3.00°, and the mean IOL decentration was 0.39 ± 0.39 mm. There was no correlation among IOL tilt, decentration and BCVA (p > 0.05). The mean prediction error of the target refraction was − 0.03 ± 0.93 D. The complications were vitreous hemorrhage (3 eyes), hyphema (1 eye), IOP elevation (1 eye), iris capture of the IOL (1 eye) and hypotony (2 eyes). No IOL dislocation occurred. Conclusions IOL intrascleral fixation with a flange achieved good IOL fixation and visual outcome in the scleral tunnels created with the 27-gauge trocar.
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Affiliation(s)
- Tatsuya Jujo
- Department of Ophthalmology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, Japan
| | - Jiro Kogo
- Department of Ophthalmology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, Japan.
| | - Hiroki Sasaki
- Department of Ophthalmology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, Japan
| | - Reio Sekine
- Department of Ophthalmology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, Japan
| | - Keiji Sato
- Department of Ophthalmology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, Japan
| | - Sakura Ebisutani
- Department of Ophthalmology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, Japan
| | - Yasuhiro Toyoda
- Department of Ophthalmology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, Japan
| | - Yasushi Kitaoka
- Department of Ophthalmology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, Japan
| | - Hitoshi Takagi
- Department of Ophthalmology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, Japan
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Pérez-Gracia J, Ávila FJ, Ares J, Vallés JA, Remón L. Misalignment and tilt effect on aspheric intraocular lens designs after a corneal refractive surgery. PLoS One 2020; 15:e0243740. [PMID: 33315894 PMCID: PMC7735572 DOI: 10.1371/journal.pone.0243740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 11/26/2020] [Indexed: 12/19/2022] Open
Abstract
PURPOSE To numerically evaluate and compare the tolerance to misalignment and tilt of aspheric intraocular lenses (IOLs) designed for three eyes: with standard cornea and with simulated corneas after myopic and hyperopic laser ablation surgery. METHODS Three aspheric IOLs of +20.00 diopter (D) with different spherical aberration (SA) ([Formula: see text]) values have been designed using a theoretical model eye. Drastic changes on the theoretical eye anterior corneal asphericity have been performed to simulate myopic and hyperopic refractive surgeries. The effect of IOL misalignment and tilt on the image quality has been evaluated using a commercial optical software design for the three eye models. Image quality was assessed from the modulation transfer function (MTF), root mean square (RMS) values of defocus, astigmatism, coma and spherical aberration ([Formula: see text]), and retinal images obtained from a visual simulator using an aleatory optotype of 0.00 LogMar visual acuity (VA). RESULTS IOL misalignment and tilt reduced MTF values in general, and increased wavefront aberrations errors. Aberration-free IOLs maintained best the MTF values when misalignments were applied, together with good on-axis optical quality. IOLs with negative SA ([Formula: see text]) correction decreased the MTF value under 0.43 for misalignments values higher than 0.50 mm with the three corneas. The effect of misalignment on RMS astigmatism and coma was correlated with the IOL SA ([Formula: see text]) and with the three corneas. CONCLUSIONS This theoretical study shows that the largest degradation in image quality arises for the IOL with the highest amount of spherical aberration ([Formula: see text]). Moreover, it has been found that the aspherical design has a more influential role in misalignment tolerance than in tilt tolerance.
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Affiliation(s)
- Jesús Pérez-Gracia
- Departamento de Física Aplicada, Universidad de Zaragoza, Zaragoza, Spain
| | - Francisco J. Ávila
- Departamento de Física Aplicada, Universidad de Zaragoza, Zaragoza, Spain
| | - Jorge Ares
- Departamento de Física Aplicada, Universidad de Zaragoza, Zaragoza, Spain
| | - Juan A. Vallés
- Departamento de Física Aplicada, Universidad de Zaragoza, Zaragoza, Spain
| | - Laura Remón
- Departamento de Física Aplicada, Universidad de Zaragoza, Zaragoza, Spain
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Corneal Topography for Intraocular Lens Selection in Refractive Cataract Surgery. Ophthalmology 2020; 128:e142-e152. [PMID: 33221325 DOI: 10.1016/j.ophtha.2020.11.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 10/26/2020] [Accepted: 11/13/2020] [Indexed: 11/22/2022] Open
Abstract
The purpose of this review is to evaluate the usefulness of corneal topography to select premium intraocular lenses (IOLs), including aspherical IOLs, toric IOLs, and multifocal IOLs, in refractive cataract surgery. Corneal topography can detect corneal regular astigmatism, corneal irregular astigmatism (higher-order aberrations [HOAs]) including spherical aberration, and corneal shape abnormalities after corneal refractive surgery. Surgeons can explain to the patients with significant corneal HOAs about its effect on postoperative visual function before surgery. Multifocal IOLs should not be selected for such eyes. For eyes with abnormal corneal shape, appropriate IOL power calculation formulae can be applied. In the case of toric IOLs, regular astigmatism and corneal HOAs should be checked. Before implanting an aspheric IOL, it is ideal to confirm spherical aberration of the cornea is not below the normal range. Because corneal HOAs, abnormal corneal shape after corneal refractive surgery, corneal regular astigmatism, and corneal spherical aberration increase postoperative refractive errors and poor vision quality with premium IOLs, corneal topography before cataract surgery is helpful in screening patients who are not appropriate candidates for premium IOLs.
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Matsumura T, Takamura Y, Makita J, Kobori A, Inatani M. Influence of sclerotomy size on intraocular lens tilt after intrascleral intraocular lens fixation. J Cataract Refract Surg 2020; 45:1446-1451. [PMID: 31564318 DOI: 10.1016/j.jcrs.2019.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 06/09/2019] [Accepted: 06/11/2019] [Indexed: 01/19/2023]
Abstract
PURPOSE To determine whether differences in sclerotomy size during intrascleral intraocular lens (IOL) fixation influence IOL tilt and visual acuity after surgery. SETTING University of Fukui Hospital and Japanese Red Cross Fukui Hospital, Japan. DESIGN Retrospective case series. METHODS The study reviewed the records of patients who had intrascleral IOL fixation with transconjunctival 25-gauge pars plana vitrectomy and a follow-up longer than 6 months. The preoperative and postoperative visual outcomes, degree of IOL tilt, and intraoperative and postoperative complications were statistically compared between the sclerotomy groups. RESULTS The study included 65 eyes (60 patients). Postoperatively, the maximum degree of IOL tilt was significantly smaller in the 24-gauge sclerotomy group than in the 30-gauge sclerotomy group (P = .003). The degree of IOL tilt was significantly correlated with the amount of postoperative IOL astigmatism (total astigmatism - corneal astigmatism) (P = .0001, R2 = 0.23). There were no statistically significant differences in the preoperative or postoperative corrected distance visual acuity (CDVA) or the complication rate between the sclerotomy groups. CONCLUSION A smaller sclerotomy for intrascleral IOL fixation was associated with greater IOL tilt and IOL astigmatism after surgery; however, this did not clinically or significantly affect the postoperative CDVA.
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Affiliation(s)
- Takehiro Matsumura
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan; Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | - Yoshihiro Takamura
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
| | - Jun Makita
- Department of Ophthalmology, Saitama Medical University Hospital, Japan
| | - Akira Kobori
- Department of Ophthalmology, Japanese Red Cross Fukui Hospital, Fukui, Japan
| | - Masaru Inatani
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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Liu Y, Zhao J, Hu Y, Li B, Wang J, Zhang J. Comparison of the Visual Performance after Implantation of Three Aberration-correcting Aspherical Intraocular Lens. Curr Eye Res 2020; 46:333-340. [PMID: 32935593 DOI: 10.1080/02713683.2020.1798467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To compare the visual performance after implantation of three aberration-correcting aspherical intraocular lens (IOL). MATERIALS AND METHODS Seventy-seven eyes of 77 cataract patients were divided into three groups: 26 eyes implanted with a non-constant aberration IOL (LUCIA 601P IOL, Zeiss Company, Germany); 26 eyes implanted with a spherical aberration -0.18μm IOL (CT ASPHINA 509M, Zeiss Company, Germany) and 27 eyes implanted with a spherical aberration -0.27μm IOL (AMO Tecnis ZCB00, Johnson & Johnson Surgical Vision, USA). Three months after operation, the distance visual acuity, wavefront aberrometry, contrast sensitivity, intraocular stray light, IOL decentration, and tilt were evaluated. RESULTS Three months postoperatively, no statistically significant differences were found in uncorrected distance visual acuity and corrected distance visual acuity (p≥.83). The RMS for total ocular coma was statistically significantly lower in the Lucia group (p=.03) and spherical aberration was statistically significantly lower in the Tecnis group (p<.01). No statistically significant differences were observed among the three lenses in higher order aberration (p=.85) and in contrast sensitivity under both photopic and mesopic lighting conditions (p≥.05). The intraocular stray light was statistically significantly better in the Lucia group (p=.04). No statistically significant differences were observed with respect to IOL decentration (p=.75) and tilt (p=.89). CONCLUSIONS Cataract surgery with non-constant aberration IOL resulted in lower coma and better intraocular stray light than with the spherical aberration -0.18μm and -0.27μm IOLs despite equivalent postoperative levels of visual acuity and contrast sensitivity.
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Affiliation(s)
- Yuqi Liu
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University and the Key Lenticular Laboratory of Liaoning Province , Shenyang, China
| | - Jiangyue Zhao
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University and the Key Lenticular Laboratory of Liaoning Province , Shenyang, China
| | - Yiping Hu
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University and the Key Lenticular Laboratory of Liaoning Province , Shenyang, China
| | - Bowen Li
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University and the Key Lenticular Laboratory of Liaoning Province , Shenyang, China
| | - Jing Wang
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University and the Key Lenticular Laboratory of Liaoning Province , Shenyang, China.,Department of Ophthalmology, Shenyang Aier Excellence Eye Hospital , Shenyang, China
| | - Jinsong Zhang
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University and the Key Lenticular Laboratory of Liaoning Province , Shenyang, China.,Department of Ophthalmology, Shenyang Aier Excellence Eye Hospital , Shenyang, China
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Ashena Z, Maqsood S, Ahmed SN, Nanavaty MA. Effect of Intraocular Lens Tilt and Decentration on Visual Acuity, Dysphotopsia and Wavefront Aberrations. Vision (Basel) 2020; 4:vision4030041. [PMID: 32937750 PMCID: PMC7559075 DOI: 10.3390/vision4030041] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/17/2020] [Accepted: 09/11/2020] [Indexed: 02/07/2023] Open
Abstract
Tilt and decentration of intraocular lenses (IOL) may occur secondary to a complicated cataract surgery or following an uneventful phacoemulsification. Although up to 2–3° tilt and a 0.2–0.3 mm decentration are common and clinically unnoticed for any design of IOL, larger extent of tilt and decentration has a negative impact on the optical performance and subsequently, the patients’ satisfaction. This negative impact does not affect various types of IOLs equally. In this paper we review the methods of measuring IOL tilt and decentration and focus on the effect of IOL tilt and decentration on visual function, in particular visual acuity, dysphotopsia, and wavefront aberrations. Our review found that the methods to measure the IOL displacement have significantly evolved and the available studies have employed different methods in their measurement, while comparability of these methods is questionable. There has been no universal reference point and axis to measure the IOL displacement between different studies. A remarkably high variety and brands of IOLs are used in various studies and occasionally, opposite results are noticed when two different brands of a same design were compared against another IOL design in two studies. We conclude that <5° of inferotemporal tilt is common in both crystalline lenses and IOLs with a correlation between pre- and postoperative lens tilt. IOL tilt has been noticed more frequently with scleral fixated compared with in-the-bag IOLs. IOL decentration has a greater impact than tilt on reduction of visual acuity. There was no correlation between IOL tilt and decentration and dysphotopsia. The advantages of aspheric IOLs are lost when decentration is >0.5 mm. The effect of IOL displacement on visual function is more pronounced in aberration correcting IOLs compared to spherical and standard non-aberration correcting aspherical IOLs and in multifocal versus monofocal IOLs. Internal coma has been frequently associated with IOL tilt and decentration, and this increases with pupil size. There is no correlation between spherical aberration and IOL tilt or decentration. Although IOL tilt produces significant impact on visual outcome in toric IOLs, these lenses are more sensitive to rotation compared to tilt.
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Affiliation(s)
- Zahra Ashena
- Sussex Eye Hospital, Brighton & Sussex University Hospitals NHS Trust, Eastern Road, Brighton BN2 5BF, UK;
| | - Sundas Maqsood
- Eastbourne District General Hospital, Kings Drive, Eastbourne BN21 2UD, UK;
| | - Syed Naqib Ahmed
- Northampton General Hospital, Cliftonville, Northampton NN1 5BD, UK;
| | - Mayank A. Nanavaty
- Sussex Eye Hospital, Brighton & Sussex University Hospitals NHS Trust, Eastern Road, Brighton BN2 5BF, UK;
- Brighton & Sussex Medical School, University of Sussex, Falmer, Brighton BN1 9PX, UK
- Correspondence: ; Tel.: +44-01273-606126
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Cinar E, Yuce B, Aslan F, Erbakan G, Küçükerdönmez C. Intraocular lens tilt and decentration after Nd:YAG laser posterior capsulotomy: Femtosecond laser capsulorhexis versus manual capsulorhexis. J Cataract Refract Surg 2020; 45:1637-1644. [PMID: 31706518 DOI: 10.1016/j.jcrs.2019.07.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/11/2019] [Accepted: 07/09/2019] [Indexed: 12/16/2022]
Abstract
PURPOSE To compare intraocular lens (IOL) tilt and decentration after Nd:YAG laser posterior capsulotomy in eyes that had femtosecond laser-assisted capsulotomy versus manual capsulorhexis. SETTING Ekol Eye Hospital, Izmir, Turkey. DESIGN Retrospective case series. METHODS Intraocular lens decentration and angle of tilt were measured using a Scheimpflug camera before and 1 month after Nd:YAG capsulotomy. RESULTS Eighteen eyes had a femtosecond laser-assisted capsulotomy and 25 eyes a manual capsulorhexis. The mean age was 58.2 years ± 10.2 (SD) (range 44 to 69 years) and 60.6 ± 8.3 years (range 45 to 70 years), respectively. Before capsulotomy, the angle of tilt and decentration at both meridians did not differ significantly between the 2 groups (P > .05). After capsulotomy, the angle of tilt was significantly decreased in both groups (femtosecond: vertical 1.5 degrees and horizontal 1.2 degrees; manual: vertical 1.1 degrees and horizontal) and decentration was significantly increased (femtosecond: vertical 0.085 mm and horizontal 0.096 mm; manual: vertical 0.2 mm and horizontal 0.2 mm) at both meridians (P < .05). After capsulotomy, all tilt and decentration parameters were significantly different between the 2 groups (P < .05) except decentration on the horizontal meridian (P = .669). CONCLUSIONS Nd:YAG posterior capsulotomy performed after femtosecond laser-assisted capsulotomy resulted in better mechanical stability of the IOL. This suggests that a femtosecond laser-created capsulotomy better maintains a proper IOL position. Although the differences were statistically significant, the tilt and decentration values were small and might not be clinically significant.
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Affiliation(s)
| | - Berna Yuce
- University of Health Sciences, İzmir Tepecik Training and Research Hospital Ophthalmology Clinic, İzmir, Turkey
| | - Fatih Aslan
- Alaattin Keykubat University, Department of Ophthalmology, Alanya, Antalya, Turkey
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Yu Z, Li J, Song H. Short-time evaluation on intraocular scattering after implantable collamer lens implantation for correcting high myopia. BMC Ophthalmol 2020; 20:235. [PMID: 32552888 PMCID: PMC7301533 DOI: 10.1186/s12886-020-01482-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/25/2020] [Indexed: 01/19/2023] Open
Abstract
Background To compare the intraocular scattering before and after implantation of implantable collamer lens (ICL) V4c for correction of high myopia in a short term. Methods In this study, 38 eyes of 19 patients who underwent the implantation of ICL V4c were followed up for 3 months. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), objective scattering index (OSI), modulation transfer function cutoff frequency (MTF cutoff), strehl ratio (S/R), OV100%, OV20% and OV9% were measured pre- and postoperatively. Meantime, the Pseudophakic Dysphotopsia Questionnaire (PDQ) was scored to evaluate the subjective satisfaction of intraocular scattering pre- and postoperatively. Results The UCVA were − 0.02 ± 0.06, − 0.03 ± 0.07 and − 0.04 ± 0.07 logMAR at 1 week, 1 month and 3 months postoperatively which were significantly better than those preoperatively (P < 0.05). The BCVA were − 0.09 ± 0.09, − 0.09 ± 0.1 and − 0.1 ± 0.11 logMAR at 1 week, 1 month and 3 months after surgery, which were better than those before surgery significantly (t = 15.64, P < 0.05). The mean OSI were 2.37 ± 1.6, 1.63 ± 0.94, 1.5 ± 0.86 and 1.43 ± 1.05 preoperatively, 1 week, 1 month and 3 months postoperatively which was found significant difference (F = 12.92 P < 0.05). No significant differences were found in MTF cut off (F = 0.61, P = 0.62), S/R (F = 0.58, P = 0.36), OV100% (F = 0.966, P = 0.65), OV20% (F = 0.121, P = 0.96) and OV9% (F = 1.01, P = 0.30) between pre- and postoperatively. The PDQ results indicated that intraocular scattering reduced at 3 months after surgery significantly (P < 0.05). Conclusions The ICL V4c implantation for correcting high myopia induced less intraocular scattering and visual disorder than spectacle correction.
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Affiliation(s)
- Zhe Yu
- Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Clinical College of Ophthalmology, Tianjin Medical University, Nankai University Eye Hospital, No. 4 Gansu Road, Heping District, Tianjin, People's Republic of China
| | - Jun Li
- Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Clinical College of Ophthalmology, Tianjin Medical University, Nankai University Eye Hospital, No. 4 Gansu Road, Heping District, Tianjin, People's Republic of China.
| | - Hui Song
- Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Clinical College of Ophthalmology, Tianjin Medical University, Nankai University Eye Hospital, No. 4 Gansu Road, Heping District, Tianjin, People's Republic of China.
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Comparison of wavefront aberrations in eyes with multifocal and monofocal iols before and after Nd:YAG laser capsulotomy for posterior capsule opacification. Int Ophthalmol 2020; 40:2169-2178. [DOI: 10.1007/s10792-020-01397-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 04/21/2020] [Indexed: 01/19/2023]
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The Influence of Decentration on Higher-Order Aberrations in Artisan Aphakic Intraocular Lens Implantation Eyes. J Ophthalmol 2020; 2020:7601524. [PMID: 32351725 PMCID: PMC7171672 DOI: 10.1155/2020/7601524] [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: 12/18/2019] [Accepted: 03/18/2020] [Indexed: 11/18/2022] Open
Abstract
Purpose To characterize the influence of decentration on higher-order aberrations of Artisan aphakic intraocular lens implantation eyes. Setting. Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, Shanghai, China. Design Retrospective case series. Methods Twenty-three eyes of 18 patients were retrospectively examined. Location of the IOL was imaged using a slit-lamp, and decentration (the distance from the center of a pupil to the geometric center of the IOL) was measured using the AutoCAD 2007 software. Ocular and internal higher-order aberrations were measured using the wavefront analyzer KR-1W (Topcon) and their correlation with decentration were analyzed. Coma, spherical, 3rd-, 4th-order, trefoil, tetrafoil aberrations, ocular, and internal higher-order aberrations were calculated for a 4.0 mm pupil diameter. Results The mean age of patients was 33.6 ± 21.4 years (ranging from 7 to 72 years). The mean follow-up period was 28.2 ± 10.5 months (ranging from 12 to 52 months). The mean postoperative best-corrected visual acuity (BCVA) was 0.19 ± 0.19 logMAR (range −0.18–0.52). The mean decentration was 0.57 ± 0.28 mm (range 0.15–1.21 mm). There was no correlation between Artisan IOL decentration and ocular higher-order aberrations, internal higher-order aberrations, coma, spherical, 3rd-, 4th-order, trefoil, and tetrafoil aberrations, respectively. There was a positive correlation between Artisan IOL decentration and 2nd-astig aberrations when 2nd-astig aberrations were less than 0.1. Conclusions The position of Artisan IOLs showed slight decentration and the amounts of decentration were not large enough to influence higher-order aberrations.
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Iwama Y, Maeda N, Ikeda T, Nakashima H, Emi K. Impact of vitrectomy and air tamponade on aspheric intraocular lens tilt and decentration and ocular higher-order aberrations: phacovitrectomy versus cataract surgery. Jpn J Ophthalmol 2020; 64:359-366. [PMID: 32200517 DOI: 10.1007/s10384-020-00737-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 02/12/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE To evaluate the impact of vitrectomy and air tamponade on aspheric intraocular lens (IOL) tilt and decentration and postoperative internal higher-order aberrations (HOAs) in combined cataract surgery and vitrectomy (phacovitrectomy). STUDY DESIGN Prospective comparative observational study. METHODS Forty-five eyes that underwent phacovitrectomy using aspheric IOLs and 18 eyes that only underwent cataract surgery also using aspheric IOLs were prospectively evaluated. The subjects were divided into three groups: phacovitrectomy without fluid-air exchange (F/Ax) or with F/Ax and cataract surgery alone (Groups A, B, and C, respectively) Surgery-induced changes in lens tilt and decentration and internal HOAs were compared between each pair of groups. Subgroup analysis was conducted for cases with largely tilted (> 7°) or decentered (> 0.40 mm) IOLs 1 month postoperatively. RESULTS Surgery-induced changes in lens tilt in Group B were significantly more pronounced than those in Group C at 1 week, 1 month, and 3 months postoperatively (P = 0.007, 0.009, and 0.043, respectively), while there was no significant difference in surgery-induced changes in lens decentration among the groups. IOLs in Group B were tilted and decentered toward the inferonasal direction. In contrast, there was no significant difference in internal HOAs among the groups at any postoperative visit. Only Group B included cases with largely decentered IOLs, and the internal total HOAs in these cases were significantly larger than those in the others (P = 0.015). CONCLUSION Although largely decentered IOLs were occasionally found in Group B, aspheric IOLs could be effectively used in phacovitrectomy.
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Affiliation(s)
- Yasuaki Iwama
- Department of Ophthalmology, Osaka Rosai Hospital Clinical Research Center for Optical Sensory Organ Disability, 1179-3, Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan.
| | - Naoyuki Maeda
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Toshihide Ikeda
- Department of Ophthalmology, Osaka Rosai Hospital Clinical Research Center for Optical Sensory Organ Disability, 1179-3, Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Hiroshi Nakashima
- Department of Ophthalmology, Osaka Rosai Hospital Clinical Research Center for Optical Sensory Organ Disability, 1179-3, Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Kazuyuki Emi
- Department of Ophthalmology, Osaka Rosai Hospital Clinical Research Center for Optical Sensory Organ Disability, 1179-3, Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan
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Pupil influence on the quality of vision in rotationally asymmetric multifocal IOLs with surface-embedded near segment. J Cataract Refract Surg 2019; 43:1420-1429. [PMID: 29223231 DOI: 10.1016/j.jcrs.2017.08.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 06/21/2017] [Accepted: 08/18/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate the influences of preoperative pupil parameters on the visual outcomes of the SBL-3, a rotationally asymmetric multifocal intraocular lens (IOL) with a surface-embedded near segment. SETTING Cathedral Eye Clinic, Belfast, Northern Ireland, United Kingdom. DESIGN Retrospective comparative case series. METHODS Postoperatively, patients divided into 4 groups according to their pupil size as follows: Group A: 2.50 to 2.99 mm, Group B: 3.00 to 3.50 mm, Group C: 3.51 to 4.00 mm, and Group D: 4.01 to 4.50 mm. The uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuities, IOL centration and tilt, and quality of vision (QoV) questionnaires were compared between the 4 groups for 18 months postoperatively. RESULTS The study comprised 90 patients (180 eyes). The mean preoperative pupil (photopic and mesopic) diameter was 4.3 mm ± 0.3 (SD) and 5.6 ± 1.4 mm, respectively, which decreased to 3.8 ± 0.7 mm and 4.9 ± 1.2 mm, respectively, at 18 months. Eighteen months postoperatively, both photopic and mesopic pupil groups had a statistically significant reduction in size from preoperative levels. No significant differences in UDVA, UIVA, and UNVA were found between the groups (P > .001). Significant differences in the QoV questionnaire day scores and night scores were found between the 4 groups (P < .001). CONCLUSIONS The rotationally asymmetric multifocal IOL provided excellent optical performance during 18-months follow-up. The preoperative photopic pupil is an important parameter for consideration of this type of IOL because smaller pupils have a significant negative subjective impact on QoV.
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Ferguson TJ, Wiley WF. Anterior Capsulotomy Innovations and Techniques: Review. CURRENT OPHTHALMOLOGY REPORTS 2019. [DOI: 10.1007/s40135-019-00219-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Marianelli BF, Mendes TS, de Almeida Manzano RP, Garcia PN, Teixeira IC. Observational study of intraocular lens tilt in sutureless intrascleral fixation versus standard transscleral suture fixation determined by ultrasound biomicroscopy. Int J Retina Vitreous 2019; 5:33. [PMID: 31384481 PMCID: PMC6664768 DOI: 10.1186/s40942-019-0182-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 07/17/2019] [Indexed: 11/10/2022] Open
Abstract
Background The position of the intraocular lens (IOL) is a major factor that affects the final visual acuity after cataract surgery. However, no prospective study has compared the IOL positions associated with the sutureless intrascleral technique and the standard transscleral suturing technique. The current study compared the IOL positions in the two techniques using ultrasound biomicroscopy (UBM) in vivo. Methods Twenty-one eyes of 21 patients were included in this observational study conducted between February and May 2015. Eleven patients underwent the sutureless intrascleral technique, and 10 patients underwent transscleral fixation with suturing. Ophthalmologic examination and UBM were performed in all patients. Optic tilt was measured in relation to the iris plane. The haptic location was defined. Mann-Whitney test and multiple linear regression were used to analyze the vertical and horizontal gradients. Significant differences were considered when p ≤ 0.05. Results The most common indication for scleral fixation was a complication during phacoemulsification (81.81% in the sutureless group and 60% in the suture group). The mean vertical and horizontal tilts were, respectively, 0.24 ± 0.21 and 0.25 ± 0.19 mm in the sutureless group and 0.14 ± 0.17 and 0.23 ± 0.16 mm in the suture group. No significant differences were seen in the vertical tilt and horizontal tilt (p = 0.888 and p = 0.148, respectively) between the groups. Gender (p = 0.835), age (p = 0.888), follow-up time (p = 0.915), and surgical duration (p = 0.094) were not associated with optic tilt. Of the 22 haptics in the sutureless group, 21 (95.45%) were in the intrascleral tunnel; of the 20 haptics in the suture group, 13 (65%) were posterior to the ciliary body, four (20%) anterior to the ciliary body, and three (15%) in the ciliary sulcus. Conclusion This study showed that there are no significant differences in the IOL positions between the two techniques.
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Affiliation(s)
- Bruna Ferraço Marianelli
- 1Department of Ophthalmology, Santa Casa de São Paulo, São Paulo, Brazil.,2Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
| | - Thaís Sousa Mendes
- 1Department of Ophthalmology, Santa Casa de São Paulo, São Paulo, Brazil
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Hirnschall N, Buehren T, Trost M, Findl O. Pilot evaluation of refractive prediction errors associated with a new method for ray-tracing–based intraocular lens power calculation. J Cataract Refract Surg 2019; 45:738-744. [DOI: 10.1016/j.jcrs.2019.01.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 12/29/2018] [Accepted: 01/16/2019] [Indexed: 10/27/2022]
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Song WK, Lee JA, Kim JY, Kim MJ, Tchah H. Analysis of Positional Relationships of Various Centers in Cataract Surgery. KOREAN JOURNAL OF OPHTHALMOLOGY 2019; 33:70-81. [PMID: 30746914 PMCID: PMC6372378 DOI: 10.3341/kjo.2018.0085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 10/01/2018] [Indexed: 01/19/2023] Open
Abstract
Purpose To analyze the positional relationships of various centers in patients undergoing femtosecond laser-assisted cataract surgery (FLACS). Methods The locations of the pupil center (PC), limbal center (LC) and lens center were analyzed in each patient using optical coherence tomography during FLACS in 35 eyes of 35 patients. Using the preoperative corneal aberrometry device, angle kappa and the location of the visual axis (VA) were calculated. After acquiring the relative horizontal and vertical coordinates of each center, the distance and location among each center were compared. The relative location and distance of each center were statistically evaluated. Results The distance from the PC to the lens center was 0.147 ± 0.103 mm, that from the LC to the lens center was 0.205 ± 0.104 mm, and that from the VA to the lens center was 0.296 ± 0.198 mm. The distance from the PC to the VA was 0.283 ± 0.161 mm, that from the LC to the VA was 0.362 ± 0.153 mm, and that from the lens center to the VA was 0.296 ± 0.198 mm. Among the various centers, the PC was the closest to the lens center, whereas the LC and VA were the farthest. Based on the location of the lens center, the PC, LC, and VA exhibited differences in the X and Y coordinate positions (vertical p = 0.004, horizontal p < 0.001). Among them, the LC was significantly inferior and temporal compared to the PC (vertical p = 0.026, horizontal p = 0.023). Based on the location of the VA, the respective locations of the PC, LC and lens center in two dimensions did not significantly differ (vertical p = 0.310, horizontal p = 0.926). Conclusions This study demonstrated the positional and locational relationships between the centers regarding FLACS. The locations of the PC, LC, and VA were different from the lens center with the PC being the closest. Surgeons should be aware of these positional relationships, especially in FLACS.
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Affiliation(s)
- Woo Keun Song
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin Ah Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Yong Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Myoung Joon Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hungwon Tchah
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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