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Shen J, Ma D, Cai L, Zhang L, Guo H, Yang J. Comparison of visual outcomes in adult patients with different types of developmental cataracts after toric multifocal intraocular lenses implantation. Graefes Arch Clin Exp Ophthalmol 2023; 261:3521-3530. [PMID: 37382611 PMCID: PMC10667390 DOI: 10.1007/s00417-023-06148-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 06/30/2023] Open
Abstract
PURPOSE To analyze and compare the visual performance and patient satisfaction following the implantation of toric multifocal intraocular lenses (TMIOLs) in adult patients with different types of developmental cataracts (DC) accompanied by corneal astigmatism (CA). METHODS This is a prospective observational cohort study. Patients diagnosed with DC aged 18-30 years were divided into three groups according to the anatomic location of the lens opacity: cortical, nuclear, and posterior subcapsular (PSC) groups, and implanted with TMIOLs. Visual acuity (VA), postoperative refractive astigmatism (RA), intraocular lens (IOL) rotation, high-order aberrations (HOAs), modulation transfer function (MTF) curve, and Strehl ratio were compared. The functional vision and incidence of photic phenomena were surveyed using questionnaires. RESULTS Fifty-five eyes of 37 patients were enrolled and completed a 1-year follow-up. The mean CA was 2.06 ± 0.79 D preoperatively, and the mean RA was 0.29 ± 0.30 D 3-month postoperatively. The IOL rotation was 2.48° ± 1.89°, with no deviation > 10°. At 12 months, mean uncorrected distance VA improved from 0.93 ± 0.41 preoperatively to 0.08 ± 0.08 logarithm of the minimum angle of resolution (logMAR), mean uncorrected near VA increased from 0.45 ± 0.30 preoperatively to 0.12 ± 0.11 logMAR, and mean uncorrected intermediate VA was 0.14 ± 0.08 logMAR. The cortical and nuclear groups displayed better improvements in uncorrected near and intermediate VA than that in the PSC group. Similar results were observed in the 3-month defocus curves, HOAs, MTF curve, halo incidence, and near vision satisfaction. CONCLUSION In adult patients with DC accompanied by CA, TMIOLs implantation achieved good postoperative visual outcomes and significantly reduced glasses dependency. Patients with cortical or nuclear lens opacity showed better whole-course VA and quality of vision, while patients with PSC opacity showed unsatisfactory near vision and suffered more photic phenomena.
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Affiliation(s)
- Jiying Shen
- Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China
| | - Dongmei Ma
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
- The Key Laboratory of Myopia, Ministry of Health, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- Key National Health Committee of the Key Laboratory of Myopia, Fudan University, Shanghai, China
- The Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Lei Cai
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
- The Key Laboratory of Myopia, Ministry of Health, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- Key National Health Committee of the Key Laboratory of Myopia, Fudan University, Shanghai, China
- The Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Limei Zhang
- Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China
| | - Haike Guo
- Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China
| | - Jin Yang
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China.
- The Key Laboratory of Myopia, Ministry of Health, Shanghai, China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China.
- Key National Health Committee of the Key Laboratory of Myopia, Fudan University, Shanghai, China.
- The Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.
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Ito M, Saito A, Ikeda T, Shimizu K. Evaluation of Eye Alignment before and after Cataract Surgery. J Binocul Vis Ocul Motil 2021; 71:90-96. [PMID: 34097586 DOI: 10.1080/2576117x.2021.1927289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose: To assess changes in eye alignment before and after cataract surgery.Subjects and methods: The medical records of 786 cataract patients without eye movement limitation who underwent bilateral cataract surgery under topical anesthesia with monofocal IOL placement were retrospectively reviewed at the Eye Center of Sanno Hospital in Japan.Results: Before cataract surgery, 121 of the 786 patients (15.4%) had constant strabismus, 263 (33.5%) had intermittent strabismus, and 402 (51.1%) had phoria. Among the 121 patients with constant strabismus on the preoperative exam, 64 (52.9%) had exotropia without vertical strabismus, 7 (5.8%) had esotropia without vertical strabismus, and 6 (5.0%) had vertical strabismus without a horizontal component. After surgery, 98 of the 786 patients (12.5%) had constant strabismus, 126 (16.0%) had intermittent strabismus, 562 (71.5%) had phoria. The rate of eye alignment agreement before and after surgery was 72.3% overall. We found that 17 patients (2.2%) who did not have constant strabismus preoperatively developed constant strabismus postoperatively, and all of these patients experienced binocular diplopia. Characteristics of patients at risk for constant strabismus and diplopia postoperatively included patients with vertical deviation preoperatively (intermittent or phoria).Conclusions: Uncomplicated cataract surgery under topical anesthesia did not influence eye alignment classification in 72.3% of patients; however, patients with vertical deviation preoperatively were more likely to transition to constant strabismus after surgery.
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Affiliation(s)
- Misae Ito
- Department of Ophthalmology, Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan.,Eye Center, Sanno Hospital, Tokyo, Japan
| | - Anna Saito
- Eye Center, Sanno Hospital, Tokyo, Japan
| | - Tetsuya Ikeda
- Department of Ophthalmology, Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan.,Eye Center, Sanno Hospital, Tokyo, Japan
| | - Kimiya Shimizu
- Department of Ophthalmology, Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan.,Eye Center, Sanno Hospital, Tokyo, Japan
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Chang JS, Liu SC, Ng JC, Ma PL. Monovision with a Bifocal Diffractive Multifocal Intraocular Lens in Presbyopic Patients: A Prospective, Observational Case Series. Am J Ophthalmol 2020; 212:105-115. [PMID: 31765626 DOI: 10.1016/j.ajo.2019.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/28/2019] [Accepted: 11/08/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE We report the visual outcomes and patient satisfaction after bilateral implantation of a bifocal diffractive intraocular lens with monovision. DESIGN Prospective, observational case series. METHODS Twenty-one subjects underwent cataract surgery or refractive lens exchange with bilateral implantation of the ZMB00 intraocular lens, with the dominant eye and nondominant eye targeted for plano and -1.25 to -1.00 diopters, respectively. Postoperative assessments included visual acuity (VA) at various distances under photopic and mesopic conditions; defocus curve, contrast sensitivity, and stereopsis; and Visual Function Questionnaire-25 and supplementary questionnaire. RESULTS Mean binocular uncorrected VA at distance, intermediate (67 cm), and near (30 cm) were -0.03 ± 0.06, 0.12 ± 0.18, and 0.11 ± 0.05, respectively. No eyes lost >1 line of corrected distance VA. Binocular intermediate VA was significantly better in the uncorrected condition (P = .004) whereas binocular distance VA was better in the distance-corrected condition (P = .014). Near VA was similar in both conditions (P > .05). Stereoacuity and contrast sensitivity were within normal limits. All subjects had a composite score of ≥90 for vision-targeted items in the National Eye Institute Visual Function Questionnaire-25. Halos, glare, and starbursts occurred in 52%, 29%, and 24% of subjects, respectively. All subjects reported a satisfaction score of ≥3.5 of 5 and required no spectacles postoperatively. No intraocular lens exchange was required. CONCLUSIONS Monovision with bilateral bifocal multifocal intraocular lens was safe and provided satisfactory vision at various distances, with good stereopsis and contrast sensitivity. Complete spectacle independence and high satisfaction score were achieved. In comparison with bilateral emmetropic bifocal multifocal intraocular lens, it provided better vision at intermediate and at very near distances without inducing more dysphotopsia.
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Abdelrazek Hafez T, Helaly HA. Spectacle Independence And Patient Satisfaction With Pseudophakic Mini-Monovision Using Aberration-Free Intraocular Lens. Clin Ophthalmol 2019; 13:2111-2117. [PMID: 31802840 PMCID: PMC6827509 DOI: 10.2147/opth.s215229] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 09/30/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose To assess spectacle independence and patient satisfaction with pseudophakic mini-monovision in patients undergoing routine bilateral cataract surgery with implantation of an aspherical aberration-free intraocular lens (Akreos AO, Bausch and Lomb, USA). Methods This study was a retrospective analysis that included 60 eyes of 30 consecutive patients between 2016 and 2018. The included patients had undergone sequential bilateral routine phacoemulsification after choosing the mini-monovision option. Test for ocular dominance was done using a sighting test. Emmetropia was aimed at in the dominant eye, while in the non-dominant eye the aim was myopia between -1 D and -1.5 D. The main outcome parameters were uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), and data reported from a questionnaire given to the patients at 3 months postoperative visit. Results The study included 60 eyes of 30 consecutive patients. The mean binocular UDVA was 0.09 ± 0.07 logMAR. Twenty-eight patients (93%) had binocular UDVA of 0.2 logMAR or better. The mean binocular uncorrected intermediate distance visual acuity (at 65 cm) was 0.16 ± 0.12 logMAR. Twenty-six patients (87%) had binocular uncorrected intermediate distance visual acuity of 0.2 logMAR or better. The mean binocular UNVA (at 35 cm) was 0.30 ± 0.21 logMAR. Fourteen patients (47%) had binocular UNVA of 0.2 logMAR or better. The patients score in the questionnaire was significantly higher in far and intermediate vision than near vision (p = 0.022). The patients score was significantly higher in day vision than night vision (p = 0.031). The mean overall patient satisfaction was good (9.1 ± 1.54). Twenty-eight patients (93%) reported high spectacle independence for far vision (score 8, 9, or 10). Conclusion Pseudophakic mini-monovision shows good results for spectacle independence and high patient satisfaction. It is a safe and inexpensive option after bilateral cataract surgery for correcting distance and intermediate vision. However, it might show lower results with near and night vision which is generally acceptable. Using aberration-free monofocal IOL allows for the residual normal positive corneal aberration that may augment the effect of monovision.
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Affiliation(s)
| | - Hany Ahmed Helaly
- Ophthalmology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Labiris G, Toli A, Perente A, Ntonti P, Kozobolis VP. A systematic review of pseudophakic monovision for presbyopia correction. Int J Ophthalmol 2017; 10:992-1000. [PMID: 28730093 DOI: 10.18240/ijo.2017.06.24] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 02/23/2017] [Indexed: 11/23/2022] Open
Abstract
A systematic review of the recent literature regarding pseudophakic monovision as a reliable methods for presbyopia correction was performed based on the PubMed, MEDLINE, Nature and the American Academy of Ophthalmology databases in July 2015 and data from 18 descriptive and 12 comparative studies were included in this narrative review. Pseudophakic monosvision seems to be an effective method for presbyopia with high rates of spectacles independence and minimal dysphotopsia side-effects, that should be considered by the modern cataract surgeons.
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Affiliation(s)
- Georgios Labiris
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, Alexandroupolis 68100, Greece.,Eye Institute of Thrace, Alexandroupolis 68100, Greece
| | - Aspa Toli
- Eye Institute of Thrace, Alexandroupolis 68100, Greece
| | - Aslin Perente
- Eye Institute of Thrace, Alexandroupolis 68100, Greece
| | | | - Vassilios P Kozobolis
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, Alexandroupolis 68100, Greece.,Eye Institute of Thrace, Alexandroupolis 68100, Greece
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Chang TC, Cavuoto KM. Binocular disturbance after glaucoma drainage device implantation. World J Ophthalmol 2014; 4:25-28. [PMID: 34295652 PMCID: PMC8294125 DOI: 10.5318/wjo.v4.i3.25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 05/20/2014] [Accepted: 06/20/2014] [Indexed: 02/06/2023] Open
Abstract
Binocular vision disturbance is a well-described complication of glaucoma drainage device (GDD) implantation. The pathophysiology is not well-understood, but may involve bulk effects from the implant and surrounding bleb, as well as modulation of muscle function due to surgical trauma and post-operative inflammation, resulting in a combined resection/posterior fixation effect. Retrospective studies have found the risks of motility disorder and diplopia vary widely, estimated to be 56%-86% and 57%-75%, respectively. More recently, cross-sectional studies and prospective trials estimate post-GDD incidence to be approximately 1%-44%, with the incidence in newer generation of implants designed to limit bleb size likely lower at 1%-5%. Suggested methods of management strategies include prismatic spectacles, monocular occlusion, extreme monovision, and strabismus surgery.
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Binocular function in patients with pseudophakic monovision. J Cataract Refract Surg 2014; 40:1349-54. [DOI: 10.1016/j.jcrs.2013.11.038] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 11/14/2013] [Accepted: 11/15/2013] [Indexed: 11/19/2022]
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Mackool RJ. Intentional extreme anisometropia. J Cataract Refract Surg 2013; 39:312. [PMID: 23332284 DOI: 10.1016/j.jcrs.2012.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Indexed: 11/20/2022]
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Intentional extreme anisometropic pseudophakic monovision. J Cataract Refract Surg 2013; 39:309-10. [PMID: 23332279 DOI: 10.1016/j.jcrs.2012.12.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Indexed: 12/19/2022]
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Snyder ME, Perez MA. Intentional anisometropia for diplopic suppression. J Cataract Refract Surg 2013; 39:308-9. [PMID: 23332277 DOI: 10.1016/j.jcrs.2012.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Indexed: 11/28/2022]
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Rutar T. Intentional monovision for long-standing diplopia. J Cataract Refract Surg 2013; 39:311. [PMID: 23332283 DOI: 10.1016/j.jcrs.2012.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Indexed: 11/18/2022]
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