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Lee J, Lee H, Kang DSY, Choi JY, Kim EK, Kim TI. Comparison of Toric Foldable Iris-Fixated Phakic Intraocular Lens Implantation and Limbal Relaxing Incisions for Moderate-to-High Myopic Astigmatism. Yonsei Med J 2016; 57:1475-81. [PMID: 27593877 PMCID: PMC5011281 DOI: 10.3349/ymj.2016.57.6.1475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 04/15/2016] [Accepted: 04/26/2016] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To compare the effectiveness of toric foldable iris-fixated phakic intraocular lens (pIOL) implantation and non-toric foldable iris-fixated pIOL implantation with limbal relaxing incisions (LRIs) for correcting moderate-to-high astigmatism in myopic eyes. MATERIALS AND METHODS The medical records of 146 patients (195 eyes) with myopic astigmatism who underwent toric foldable iris-fixated pIOL implantation (toric group; 94 eyes) or non-toric foldable iris-fixated pIOL implantation with concurrent LRIs (LRI group; 101 eyes) were retrospectively reviewed. For subgroup analysis, the two groups were subdivided according to preoperative astigmatic severity [moderate, 2.00 to <3.00 diopters (D); high, 3.00-4.00 D]. Visual and astigmatic outcomes were compared 6 months postoperatively. RESULTS The uncorrected distance visual acuity was at least 20/25 in 100% and 98% of the toric and LRI group eyes, respectively. The toric group had lower mean residual cylindrical error (-0.67±0.39 D vs. -1.14±0.56 D; p<0.001) and greater mean cylindrical error change (2.17±0.56 D vs. 1.63±0.72 D; p<0.001) than the LRI group, regardless of the preoperative astigmatic severity. The mean correction index (1.10±0.16 vs. 0.72±0.24; p<0.001) and success index (0.24±0.14 vs. 0.42±0.21; p<0.001) also differed significantly between the groups. CONCLUSION Both surgical techniques considerably reduced astigmatism and had comparable visual outcomes. However, toric foldable iris-fixated pIOL implantation was more reliable for correcting moderate-to-high astigmatism in myopic eyes.
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Affiliation(s)
- Jeihoon Lee
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Hun Lee
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
- Department of Ophthalmology, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea
| | | | - Jin Young Choi
- The Institute of Vision Research, Eyereum Eye Clinic, Seoul, Korea
| | - Eung Kweon Kim
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
- Corneal Dystrophy Research Institute, Severance Biomedical Science Institute, and Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Tae Im Kim
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
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Torii H, Negishi K, Watanabe K, Saiki M, Kato N, Tsubota K. Changes in higher-order aberrations after iris-fixated phakic intraocular lens implantation. J Refract Surg 2013; 29:693-700. [PMID: 23957754 DOI: 10.3928/1081597x-20130816-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 06/03/2013] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate surgically induced changes in corneal, internal, and ocular higher-order aberrations (HOAs) after phakic intraocular lens (PIOL) implantation and compare them between two PIOLs with different pupillary diameters. METHODS Twenty-three eyes with an Artisan PIOL (Ophtec BV, Groningen, The Netherlands) (Artisan group) and 30 eyes with an Artiflex PIOL (Ophtec BV) (Artiflex group) were retrospectively evaluated. The corneal, internal, and ocular HOAs and refractive data were recorded preoperatively and 6 months postoperatively. The root mean squares (RMSs) of the total HOAs from the third- to sixth-order Zernike coefficients were calculated. The RMSs of the third- and fourth-order coefficients represented coma-like aberrations (S3) and spherical-like aberrations (S4), respectively. The main outcome measures were the differences in the parameters among the groups with different pupillary diameters. RESULTS The mean postoperative spherical equivalents decreased from -11.84 ± 4.90 to -0.16 ± 0.40 diopters and -9.78 ± 3.20 to -0.09 ± 0.26 diopters in the Artisan and Artiflex groups, respectively. With the 4- and 5-mm pupillary diameters, the postoperative internal and ocular spherical aberrations (Z4(0)) were significantly lower in the Artiflex group than in the Artisan group (4 mm, P = .002, .024; 5 mm, P = .004, .022, respectively). With the 6-mm pupillary diameter, there were no significant postoperative differences in any parameter measured between groups; both groups had positive spherical aberration values. CONCLUSIONS The postoperative ocular spherical aberrations were positive after Artisan and Artiflex implantation. The postoperative ocular spherical aberration was greater in the Artisan group, possibly due to differences in the SAs of both PIOLs.
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Qasem Q, Dooley IJ, D'Arcy F, O'Keefe M. Safety, efficacy, and effect of foldable phakic iris-claw intraocular lenses on higher-order aberrations: Two-year follow-up. J Cataract Refract Surg 2012; 38:2053-4. [PMID: 23079321 DOI: 10.1016/j.jcrs.2012.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Indexed: 11/17/2022]
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Kim WK, Kim HS, Cho EY, Kim JK, Yang H. Effects of Prone Positioning on Critical Distance in Iris-Claw Phakic Intraocular Lens-Implanted Eyes. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2012. [DOI: 10.3341/jkos.2012.53.9.1254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Wook Kyum Kim
- B&VIIT Eye Center, Seoul, Korea
- KAIST GSMSE, Daejeon, Korea
| | | | | | - Jin Kook Kim
- B&VIIT Eye Center, Seoul, Korea
- KAIST GSMSE, Daejeon, Korea
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van Philips LA. Higher-order aberrations after iris-fixated foldable phakic intraocular lens implantation and wavefront-guided photorefractive keratectomy for the correction of myopia. J Cataract Refract Surg 2011; 37:284-94. [DOI: 10.1016/j.jcrs.2010.08.054] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Revised: 08/10/2010] [Accepted: 08/27/2010] [Indexed: 11/16/2022]
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Peris-Martínez C, Artigas JM, Sánchez-Cortina I, Felipe A, Díez-Ajenjo A, Menezo JL. Influence of optic quality on contrast sensitivity and visual acuity in eyes with a rigid or flexible phakic intraocular lens. J Cataract Refract Surg 2010; 35:1911-7. [PMID: 19878823 DOI: 10.1016/j.jcrs.2009.05.054] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2009] [Revised: 05/14/2009] [Accepted: 05/14/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE To determine whether the difference in optic quality between 2 types of phakic intraocular lenses (pIOLs) affects visual quality. SETTING Fundación Oftalmológica del Mediterráneo, Valencia, Spain. METHODS Before implantation of a pIOL for myopia, all eyes had an examination including corrected (CDVA) and uncorrected (UDVA) distance visual acuity testing, corneal endothelial cell count (ECC), and intraocular pressure (IOP) measurement. The postoperative outcomes, determined at least 1 year after surgery, were CDVA; UDVA; contrast sensitivity function under photopic, mesopic, and mesopic with glare conditions; ECC; IOP; keratometry (Scheimpflug photography); and total ocular aberration (Hartmann-Shack aberrometry). RESULTS Twelve eyes had implantation of an Artisan pIOL (rigid pIOL group) and 18 eyes, of an Artiflex pIOL (flexible pIOL group). The mean preoperative CDVA was 0.04 logMAR +/- 0.01 (SD) in both groups (P>.5). The mean postoperative CDVA was 0.01 +/- 0.02 logMAR in the rigid IOL group and 0.01 +/- 0.06 logMAR in the flexible IOL group (P>.9). The photopic contrast sensitivity function was better with the rigid pIOL, and the mesopic contrast sensitivity function was slightly better with the flexible pIOL; however, neither difference was statistically significant. CONCLUSIONS Optic quality, measured by modulation transfer function and evaluated by average modulation, was approximately 13% better with the rigid pIOL than with the flexible pIOL. However, the difference was not enough to affect visual quality. At 1 year, the 2 groups had similar CDVA and contrast sensitivity function values, indicating that other optical or neural factors compensate for differences in optic quality.
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Park SH, Yum JH, Choi SK, Lee JH, Kim JH, Lee DH, Kim TJ. Changes in Higher Order Aberration After Implantable Contact Lens Implantation. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2010. [DOI: 10.3341/jkos.2010.51.9.1210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Se Hoon Park
- Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Jung Hoon Yum
- Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Suk Kyue Choi
- Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Jong Hyun Lee
- Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Jin Hyoung Kim
- Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Do Hyung Lee
- Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Tae Jin Kim
- Department of Ophthalmology, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
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Yamaguchi T, Negishi K, Kato N, Arai H, Toda I, Tsubota K. Factors affecting contrast sensitivity with the Artisan phakic intraocular lens for high myopia. J Refract Surg 2009; 25:25-32. [PMID: 19244950 DOI: 10.3928/1081597x-20090101-05] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the factors affecting postoperative visual function in eyes with Artisan phakic intraocular lenses (PIOLs). METHODS This study examined a retrospective noncomparative case series. Phakic IOLs were implanted in 60 eyes of 36 patients with high myopia. Contrast sensitivity for spatial frequencies of 1.1, 1.7, 2.6, 4.2, 6.6, and 10:4 cycles per degree with and without glare and wavefront aberrations were measured before and 3 months after surgery. The area under the log contrast sensitivity function (AULCSF) was calculated from the contrast sensitivity. Stepwise regression analysis was used to assess the factors that affected the postoperative AULCSF. RESULTS No significant difference was noted between the preoperative AULCSF without glare and the postoperative AULCSF without glare (P=.886). The mean AULCSF with glare improved significantly after surgery (P=.018). The variables affecting the postoperative AULCSF without glare were axial length (partial regression coefficient B=-0.101, P=.0002) and age (B=-0.008, P=.0063). The variables affecting the postoperative AULCSF with glare were axial length (B=-0.127, P<.0001) and age (B=-0.012, P=.0294). The preoperative refraction showed multicollinearity with the axial length, and coma-like aberration and spherical aberration showed multicollinearity with age. CONCLUSIONS Contrast sensitivity without glare was the same before and after surgery and contrast sensitivity with glare improved after surgery. Longer axial length and older age predispose patients to degradation of the postoperative visual function in eyes with Artisan PIOLs.
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Affiliation(s)
- Takefumi Yamaguchi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
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Tahzib NG, MacRae SM, Yoon G, Berendschot TTJM, Eggink FAGJ, Hendrikse F, Nuijts RMMA. Higher-order aberrations after implantation of iris-fixated rigid or foldable phakic intraocular lenses. J Cataract Refract Surg 2008; 34:1913-20. [PMID: 19006738 DOI: 10.1016/j.jcrs.2008.07.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2008] [Accepted: 07/25/2008] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate higher-order aberrations (HOAs) after implantation of Artiflex phakic intraocular lenses (pIOLs). SETTING Department of Ophthalmology, Academic Hospital Maastricht, Maastricht, The Netherlands. METHODS This retrospective comparative case series comprised 27 eyes (14 patients) that had Artiflex pIOL implantation and 22 eyes (13 patients) that had Artisan pIOL implantation. Refractive data, pupil size, IOL decentration, and HOA values were recorded and compared. Laboratory analysis was performed. Follow-up was 1 year. RESULTS In the Artiflex group, the mean spherical equivalent (SE) changed from -9.95 diopters (D) +/- 1.43 (SD) (range -6.75 to -12.13 D) to -0.30 +/- 0.53 D (range -1.94 to 0.56 D). Postoperatively, trefoil-y increased (increase factor 1.73) and spherical aberration decreased (increase factor 0.55). The mean pIOL decentration was 0.24 +/- 0.12 mm; 96.3% were decentered 0.5 mm or less. There was a significant correlation between pIOL decentration and postoperative spherical aberration and coma-y. In the Artisan group, the mean SE changed from -9.90 +/- 2.74 D (range -4.00 to -14.50 D) to -0.20 +/- 0.42 D (range -0.75 to 0.50 D). Postoperatively, trefoil-y and spherical aberration increased (increase factors 3.32 and 6.84, respectively). Laboratory analysis confirmed the negative and positive spherical aberration profile of the Artiflex pIOL and Artisan pIOL, respectively. CONCLUSIONS Artiflex pIOL implantation decreased spherical aberration, while Artisan pIOL implantation increased spherical aberration. Trefoil-y increased in both groups. These changes might be explained by incision size differences in relation to trefoil and differences in optic design in relation to spherical aberration.
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Affiliation(s)
- Nayyirih G Tahzib
- Department of Ophthalmology, Academic Hospital Maastricht, Maastricht, The Netherlands.
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Kohnen T, Cichocki M, Koss MJ. Position of rigid and foldable iris-fixated myopic phakic intraocular lenses evaluated by Scheimpflug photography. J Cataract Refract Surg 2008; 34:114-20. [PMID: 18165090 DOI: 10.1016/j.jcrs.2007.08.037] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2007] [Accepted: 08/10/2007] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate the postoperative intraocular positional stability of 1 rigid poly(methyl methacrylate) (PMMA) phakic intraocular lens (pIOL) model and 2 foldable polysilicone-PMMA iris-fixated pIOL models. SETTING Department of Ophthalmology, Johann Wolfgang Goethe-University Frankfurt am Main, Germany. METHODS One of 3 iris-fixated pIOL models (Artisan, Artiflex I, and Artiflex II, Ophtec BV) was implanted in 45 eyes of 26 patients with myopia or myopic astigmatism. The central distance between the pIOL and corneal endothelium and between the pIOL and anterior surface of the crystalline lens was evaluated using Scheimpflug photography 6 and 12 months after surgery. RESULTS The mean preoperative spherical equivalent was -9.32 diopters +/- 1.78 (SD) (range -6.5 to -13.5 D). Each IOL model was implanted in 15 eyes. The median distance from the central corneal endothelium to the anterior surface of the pIOL at 6 months and 12 months was 2.65 mm and 2.64 mm, respectively, in the Artisan group, 2.47 mm and 2.50 mm, respectively, in the Artiflex I group, and 2.48 mm and 2.52 mm, respectively, in the Artiflex II group. The median distance between the posterior surface of the pIOL and the anterior surface of the crystalline lens at 6 months and 12 months was 0.40 mm and 0.48 mm, respectively, in the Artisan group, 0.53 mm and 0.55 mm, respectively, in the Artiflex I group, and 0.68 mm and 0.66 mm, respectively, in the Artiflex II group. At 12 months, the distance between the pIOL and crystalline lens was statistically significantly greater in the Artiflex II group than in the Artisan group (P<.01). CONCLUSION The intraocular position of rigid pIOLs and foldable silicone iris-supported pIOLs showed a difference between the 3 pIOL models in space to the crystalline lens and the corneal endothelium, which may affect long-term results in terms of IOL interaction with surrounding tissue.
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Affiliation(s)
- Thomas Kohnen
- Department of Ophthalmology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany.
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Bühren J, Kohnen T. [Application of wavefront analysis in clinical and scientific settings. From irregular astigmatism to aberrations of a higher order--Part II: examples]. Ophthalmologe 2008; 104:991-1006; quiz 1007-8. [PMID: 18030477 DOI: 10.1007/s00347-007-1648-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In recent years, wavefront analysis has ceased to be purely a laboratory application and emerged as a method used in ophthalmological diagnosis. This development has been promoted mainly by the widespread use of wavefront-guided LASIK (laser in situ keratomileusis). However, aberrometry is still not a common diagnostic technique, and for many ophthalmologists interpretation of the results is difficult. The second part of this serial paper reviews findings that are relevant for the ophthalmological community and highlights current scientific applications in this area.
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Affiliation(s)
- J Bühren
- Advanced Physiological Optics Lab, Department of Ophthalmology, University of Rochester Medical Center, Rochester, NY, USA
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