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Wu X, Liu X, Li D, Wang X, Huang Y. Therapeutic effect of a new implantation method of rotationally asymmetric multifocal intraocular lenses on visual quality. Int Ophthalmol 2023; 43:4621-4629. [PMID: 37715824 DOI: 10.1007/s10792-023-02862-4] [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: 05/03/2023] [Accepted: 08/20/2023] [Indexed: 09/18/2023]
Abstract
PURPOSE To assess the visual quality after implantation of a rotationally asymmetric multifocal intraocular lens (IOL) using a new method according to the angle kappa. SETTING Qingdao Eye Hospital, Qingdao, China. DESIGN Prospective case series. METHODS Patients with the implantation of SBL-3 IOLs for age-related cataract from September to December 2019 had the distance-horizontal zone of the IOL placed at the center of the optic axis using the Callisto Eye System. Postoperative visual acuities and defocus curves were recorded. Modulation transfer function cutoff frequency, Strehl ratio, and objective scatter index were measured using the Optical Quality Analysis System. The decentration and tilt of IOLs were analyzed by iTrace aberrometry and anterior segment optical coherence tomography. A questionnaire of patient satisfaction was also collected. RESULTS Thirty patients (60 eyes) were involved, with a balanced sex ratio. Their average age was 56.04 ± 10.83 years. The average angle kappa distance was 0.23 ± 0.121 mm. At 3 months after surgery, the mean uncorrected and corrected distance visual acuities were 0.01 ± 0.07 logMAR and 0.01 ± 0.06 logMAR. The uncorrected intermediate and near visual acuities were 0.09 ± 0.11 logMAR and 0.09 ± 0.11 logMAR. The mean horizontal and vertical tilts of IOLs were 0.67 ± 0.52 degrees and 0.47 ± 0.32 degrees. The mean decentration of IOLs was 0.17 ± 0.08 mm. Most patients were satisfied with their distance, intermediate, and near vision. There was mild glare in 58.3% of the eyes. CONCLUSIONS Locating the center of the optic axis in the distance-horizontal zone during the implantation of SBL-3 IOLs could provide satisfactory visual acuity and quality.
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Affiliation(s)
- Xian Wu
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University, Qingdao, China
| | - Xiaomin Liu
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University, Qingdao, China
| | - Dongfang Li
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University, Qingdao, China
| | - Xiaoyun Wang
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University, Qingdao, China
| | - Yusen Huang
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China.
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University, Qingdao, China.
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Yang LWY, Ong HS, Chiam N, Mehta JS. Centration and Stability of Small-Aperture Intraocular Lens in Aberrated Eyes. J Refract Surg 2022; 38:98-105. [DOI: 10.3928/1081597x-20211116-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Baur I, Auffarth GU, Łabuz G, Khoramnia R. Unilateral implantation of a new non-diffractive extended range-of-vision IOL in a young patient with Curschmann-Steinert myotonic dystrophy. Am J Ophthalmol Case Rep 2021; 22:101109. [PMID: 33997472 PMCID: PMC8094889 DOI: 10.1016/j.ajoc.2021.101109] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/01/2021] [Accepted: 04/04/2021] [Indexed: 12/14/2022] Open
Abstract
Purpose We present the case of a 36-year old Curschmann-Steinert myotonic dystrophy patient with posterior subcapsular cataract that we treated with unilateral implantation of an extended depth of focus intraocular lens to address his wish for spectacle independence at far and intermediate distance. Observations The patient underwent phacoemulsification with subsequent implantation of the AcrySof IQ Vivity IOL (Alcon, Fort Worth, TX, USA) in his left eye. Uncorrected distance visual acuity (UDVA) on the left eye increased from +0.40 logMAR preoperatively to −0.12 logMAR at 3 months postoperatively. At the three months follow-up distance corrected intermediate visual acuity (DCIVA) at 80 cm distance was −0.08 logMAR and DCIVA at 66 cm distance was 0.14 logMAR for the left eye. The defocus curve showed a functional defocus of 2.0 diopters at 0.2 logMAR or better, corresponding to the extended depth of focus. Dysphotopsia evaluation with a Halo & Glare simulator (Eyeland-Design Network GmbH, Vreden, Germany) revealed a very low level of photic phenomena. Conclusions and Importance Unilateral implantation of a new generation, non-diffractive extended depth of focus IOL was well tolerated and provided good functional results for far and intermediate distances. The patient reported a very low level of photic phenomena.
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Affiliation(s)
- Isabella Baur
- David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Gerd U Auffarth
- David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Grzegorz Łabuz
- David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Ramin Khoramnia
- David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
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Rementería-Capelo LA, García-Pérez JL, Contreras I, Blázquez V, Ruiz-Alcocer J. Automated refraction after trifocal and trifocal toric intraocular lens implantation. Eur J Ophthalmol 2020; 31:1031-1038. [PMID: 32264702 DOI: 10.1177/1120672120914848] [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: 01/19/2023]
Abstract
BACKGROUND To analyze the correlation between automated refraction and manifest refraction after implantation of a trifocal intraocular lens or its toric version. METHODS This cross-sectional study involved 105 eyes of 105 patients. Subjects were divided in two groups: 62 with trifocal (AcrySof PanOptix) and 43 with trifocal toric (AcrySof PanOptix Toric) intraocular lenses. Automated refraction was employed as starting point for obtaining the manifest refraction. Automated refraction and manifest refraction measurements were analyzed and compared using the vector analysis 3 months after the surgery. RESULTS In both groups, the higher differences between automated refraction and manifest refraction measurements were found for the cylinder and the spherical equivalent (M). Cylinder values for PanOptix were: -0.60 ± 0.36 D with automated refraction and -0.17 ± 38 D with manifest refraction (p < 0.001); for PanOptix Toric, the values were: -0.49 ± 0.31 D with automated refraction and -0.05 ± 0.21 D with manifest refraction (p < 0.001). M values for PanOptix were: -0.23 ± 0.31 D with automated refraction and -0.03 ± 0.16 D with manifest refraction (p < 0.001); for PanOptix Toric, the values were: -0.13 ± 0.40 D with automated refraction and 0.01 ± 0.12 D with manifest refraction (p < 0.001). For the PanOptix group, intraclass correlation coefficients were: 0.51 (sphere), 0.64 (cylinder), 0.42 (M), 0.62 (J0), and 0.37 (J45). For the PanOptix Toric group, the intraclass correlation coefficients were: 0.39 (sphere), 0.61 (cylinder), 0.39 (M), 0.53 (J0), and 0.09 (J45). CONCLUSION The results of this study suggest that patients implanted with the trifocal and the trifocal toric intraocular lens under study showed similar automated refraction results between them, with a slight trend to more negative amounts of cylinder and M. Nevertheless, clinicians should carefully confirm all parameters of the refraction with manifest refraction.
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Affiliation(s)
| | | | - Inés Contreras
- Clínica Rementería, Madrid, Spain.,Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigaciones Sanitaria (IRYCIS), Madrid, Spain
| | | | - Javier Ruiz-Alcocer
- Departamento de Optometría y Visión, Facultad de Óptica y Optometría, Universidad Complutense de Madrid, Madrid, Spain
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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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Multifocal Intraocular Lenses Implantation in Presbyopia Correction. Literature Review. ACTA BIOMEDICA SCIENTIFICA 2019. [DOI: 10.29413/abs.2019-4.4.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Reduced dependence on glasses is an increasingly common expectation among those who want to take advantage of new surgical opportunities, especially for patients who lead an active lifestyle. Currently, due to the increase in the duration of active life in people over 40, there is a need for effective correction of presbyopia. Multifocal intraocular lenses are increasingly used in the treatment of presbyopia. After implantation of multifocal intraocular lenses most patients have no need for spectacle or contact vision. However, complications can affect the patient’s quality of life and level of satisfaction. The most common complications of multifocal correction are blurred vision and the presence of optical phenomena (“halo” and “glare”), associated with residual ametropia, clouding of the posterior capsule, large pupil size, anomalies of the wave front, dry eye and lens decentration. The main reasons for this are the failure to attempt to neuroadapt a patient, the dislocation of the lens, the residual refractive error and the clouding of the lens. The review presents the main features of various models of multifocal intraocular lenses, their implantation techniques, associated complications and methods for their correction. The development of multifocal correction of presbyopia and ametropia seems to be a promising direction in ophthalmic surgery.
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Liu X, Xie L, Huang Y. Effects of decentration and tilt at different orientations on the optical performance of a rotationally asymmetric multifocal intraocular lens. J Cataract Refract Surg 2019; 45:507-514. [DOI: 10.1016/j.jcrs.2018.10.045] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 10/05/2018] [Accepted: 10/16/2018] [Indexed: 02/06/2023]
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Multifocal intraocular lenses: An overview. Surv Ophthalmol 2017; 62:611-634. [DOI: 10.1016/j.survophthal.2017.03.005] [Citation(s) in RCA: 168] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 02/28/2017] [Accepted: 03/03/2017] [Indexed: 01/18/2023]
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Schojai M, Schultz T, Burkhard Dick H. Capsule-Fixated Intraocular Lens Implantation in Small Pupil Cases. J Refract Surg 2017; 33:568-570. [DOI: 10.3928/1081597x-20170620-01] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 06/07/2017] [Indexed: 11/20/2022]
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Prager F, Amon M, Wiesinger J, Wetzel B, Kahraman G. Capsular bag–fixated and ciliary sulcus-fixated intraocular lens centration after supplementary intraocular lens implantation in the same eye. J Cataract Refract Surg 2017; 43:643-647. [DOI: 10.1016/j.jcrs.2017.01.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 12/22/2016] [Accepted: 01/23/2017] [Indexed: 10/19/2022]
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Tchah H, Nam K, Yoo A. Predictive factors for photic phenomena after refractive, rotationally asymmetric, multifocal intraocular lens implantation. Int J Ophthalmol 2017; 10:241-245. [PMID: 28251083 DOI: 10.18240/ijo.2017.02.10] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 05/18/2016] [Indexed: 02/05/2023] Open
Abstract
AIM To investigate the independent factors associated with photic phenomena in patients implanted with refractive, rotationally asymmetric, multifocal intraocular lenses (MIOLs). METHODS Thirty-four eyes of 34 patients who underwent unilateral cataract surgery, followed by implantation of rotationally asymmetric MIOLs were included. Distance and near visual acuity outcomes, intraocular aberrations, preferred reading distances, preoperative and postoperative refractive errors, mesopic and photopic pupil diameters, and the mesopic and photopic kappa angles were assessed. Patients were also administered a satisfaction survey. Photic phenomena were graded by questionnaire. Independent-related factors were identified by correlation and bivariate logistic regression analyses. RESULTS The distance from the photopic to the mesopic pupil center (pupil center shift) was significantly associated with glare/halo symptoms [odds ratio (OR)=2.065, 95% confidence interval (CI)=0.916-4.679, P=0.006] and night vision problems (OR=1.832, 95% CI=0.721-2.158, P=0.007). The preoperative photopic angle kappa was significantly associated with glare/halo symptoms (OR=2.155, 95% CI=1.065-4.362, P=0.041). The photopic angle kappa was also significantly associated with glare/halo symptoms (OR=2.155, 95% CI=1.065-4.362, P=0.041) and with night vision problems (OR=1.832, 95% CI=0.721-2.158, P=0.007) in patients implanted with rotationally asymmetric MIOLs. CONCLUSION A large pupil center shift and misalignment between the visual and pupillary axis (angle kappa) may play a role in the occurrence of photic phenomena after implantation of rotationally asymmetric MIOLs.
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Affiliation(s)
- Hungwon Tchah
- Department of Ophthalmology, Ulsan University College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Kiyeun Nam
- Department of Physical Medicine & Rehabilitation, Dongguk University College of Medicine, Goyang 10326, Korea
| | - Aeri Yoo
- Department of Ophthalmology, Saevit Eye Hospital, Goyang 10447, Korea
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Pazo EE, Richoz O, McNeely R, Millar ZA, Moore TC, Moore JE. Optimized Visual Outcome After Asymmetrical Multifocal IOL Rotation. J Refract Surg 2016; 32:494-6. [DOI: 10.3928/1081597x-20160503-01] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 02/22/2016] [Indexed: 01/12/2023]
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Joshi RS. In-the-bag decentration of an intraocular lens in a patient with a tendency to hypertrophic scarring. Digit J Ophthalmol 2016; 22:28-31. [PMID: 27330480 DOI: 10.5693/djo.02.2014.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2014] [Indexed: 11/20/2022]
Abstract
We report a case of rapid anterior lens capsular contraction leading to decentration of a hydrophilic acrylic lens with stiff haptics (Rayner design). To our knowledge, this is the first report to investigate early capsular contraction with folding of the haptic over the optic in a patient with a tendency toward hypertrophic scar formation.
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Affiliation(s)
- Rajesh Subhash Joshi
- Department of Ophthalmology, Shri Vasantrao Naik Government Medical College, Yavatmal, Maharashtra, India
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Zhang B, Ma JX, Liu DY, Du YH, Guo CR, Cui YX. Optical performance of toric intraocular lenses in the presence of decentration. Int J Ophthalmol 2015; 8:730-5. [PMID: 26309871 DOI: 10.3980/j.issn.2222-3959.2015.04.16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 11/03/2014] [Indexed: 12/18/2022] Open
Abstract
AIM To evaluate the optical performance of toric intraocular lenses (IOLs) after decentration and with different pupil diameters, but with the IOL astigmatic axis aligned. METHODS Optical performances of toric T5 and SN60AT spherical IOLs after decentration were tested on a theoretical pseudophakic model eye based on the Hwey-Lan Liou schematic eye using the Zemax ray-tracing program. Changes in optical performance were analyzed in model eyes with 3-mm, 4-mm, and 5-mm pupil diameters and decentered from 0.25 mm to 0.75 mm with an interval of 5° at the meridian direction from 0° to 90°. The ratio of the modulation transfer function (MTF) between a decentered and a centered IOL (MTFDecentration/MTFCentration) was calculated to analyze the decrease in optical performance. RESULTS Optical performance of the toric IOL remained unchanged when IOLs were decentered in any meridian direction. The MTFs of the two IOLs decreased, whereas optical performance remained equivalent after decentration. The MTFDecentration/MTFCentration ratios of the IOLs at a decentration from 0.25 mm to 0.75 mm were comparable in the toric and SN60AT IOLs. After decentration, MTF decreased further, with the MTF of the toric IOL being slightly lower than that of the SN60AT IOL. Imaging qualities of the two IOLs decreased when the pupil diameter and the degree of decentration increased, but the decrease was similar in the toric and spherical IOLs. CONCLUSIONS Toric IOLs were comparable to spherical IOLs in terms of tolerance to decentration at the correct axial position.
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Affiliation(s)
- Bin Zhang
- Department of Ophthalmology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Jin-Xue Ma
- Department of Ophthalmology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Dan-Yan Liu
- Department of Ophthalmology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Ying-Hua Du
- Department of Ophthalmology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Cong-Rong Guo
- Department of Ophthalmology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Yue-Xian Cui
- Department of Ophthalmology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
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Wang M, Corpuz CCC, Fujiwara M, Tomita M. Visual and optical performance of diffractive multifocal intraocular lenses with different haptic designs: 6 month follow-up. Clin Ophthalmol 2014; 8:919-26. [PMID: 24868143 PMCID: PMC4027939 DOI: 10.2147/opth.s60493] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PURPOSE To evaluate and compare the visual acuity outcomes and optical performances of eyes implanted with two diffractive multifocal intraocular lens (IOL) models with either a plate haptic design or a modified-C design. METHODS This retrospective study comprised cataract patients who were implanted with either a plate haptic multifocal IOL model (Acriva(UD) Reviol BB MFM 611 [VSY Biotechnology, Amsterdam, the Netherlands], group 1) or a modified-C haptic multifocal IOL model (Acriva(UD) Reviol BB MF 613 [VSY Biotechnology, Amsterdam, the Netherlands], group 2) between June 2012 and May 2013. The 6 month postoperative visual acuity, refraction, defocus curve, contrast sensitivity, and wave-front aberration were evaluated and compared between these eyes, using different IOL models. RESULTS One hundred fifty-eight eyes of 107 patients were included in this study. Significant improvement in visual acuities and refraction was found in both groups after cataract surgery (P<0.01). The visual acuity and contrast sensitivity were statistically better in group 1 than in group 2 (P<0.01). No statistically significant difference in the corneal higher-order aberrations was found between the two groups (P>0.05). However, the ocular higher-order aberrations in group 2 were significantly greater than in group 1 (P<0.05). CONCLUSION At 6 months postoperatively, both Acriva(UD) Reviol BB MFM 611 IOL and Acriva(UD) Reviol BB MF 613 IOL achieved excellent visual and refractive outcomes. The multifocal IOL model with plate haptic design resulted in better optical performances than that with the modified-C haptic design.
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Affiliation(s)
| | | | | | - Minoru Tomita
- Shinagawa LASIK Center, Tokyo, Japan ; Department of Ophthalmology, Wenzhou Medical College, Wenzhou, People's Republic of China
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Dick HB, Schultz T. Intraocular Lens Fixated in the Anterior Capsulotomy Created in the Line of Sight by a Femtosecond Laser. J Refract Surg 2014; 30:198-201. [DOI: 10.3928/1081597x-20140217-06] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 01/27/2014] [Indexed: 11/20/2022]
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