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Markoulli M, Fricke TR, Arvind A, Frick KD, Hart KM, Joshi MR, Kandel H, Filipe Macedo A, Makrynioti D, Retallic N, Garcia-Porta N, Shrestha G, Wolffsohn JS. BCLA CLEAR Presbyopia: Epidemiology and impact. Cont Lens Anterior Eye 2024; 47:102157. [PMID: 38594155 DOI: 10.1016/j.clae.2024.102157] [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] [Indexed: 04/11/2024]
Abstract
The global all-ages prevalence of epidemiologically-measured 'functional' presbyopia was estimated at 24.9% in 2015, affecting 1.8 billion people. This prevalence was projected to stabilise at 24.1% in 2030 due to increasing myopia, but to affect more people (2.1 billion) due to population dynamics. Factors affecting the prevalence of presbyopia include age, geographic location, urban versus rural location, sex, and, to a lesser extent, socioeconomic status, literacy and education, health literacy and inequality. Risk factors for early onset of presbyopia included environmental factors, nutrition, near demands, refractive error, accommodative dysfunction, medications, certain health conditions and sleep. Presbyopia was found to impact on quality-of-life, in particular quality of vision, labour force participation, work productivity and financial burden, mental health, social wellbeing and physical health. Current understanding makes it clear that presbyopia is a very common age-related condition that has significant impacts on both patient-reported outcome measures and economics. However, there are complexities in defining presbyopia for epidemiological and impact studies. Standardisation of definitions will assist future synthesis, pattern analysis and sense-making between studies.
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Affiliation(s)
- Maria Markoulli
- School of Optometry and Vision Science, UNSW Sydney, Australia.
| | - Timothy R Fricke
- School of Optometry and Vision Science, UNSW Sydney, Australia; Department of Optometry and Vision Science, University of Melbourne, Australia; National Vision Research Institute, Australian College of Optometry, Melbourne, Australia
| | - Anitha Arvind
- Department of Optometry, School of Medical and Allied Sciences, GD Goenka University, India
| | - Kevin D Frick
- Johns Hopkins Carey Business School, USA; Johns Hopkins Bloomberg School of Public Health Departments of International Health and Health Policy and Management, USA; Johns Hopkins School of Medicine, Department of Ophthalmology, USA
| | - Kerryn M Hart
- School of Medicine, Faculty of Health, Deakin University, Australia; Member Support and Optometry Advancement, Optometry Australia, Australia
| | - Mahesh R Joshi
- School of Health Professions, University of Plymouth, United Kingdom
| | - Himal Kandel
- Save Sight Institute, Faculty of Medicine and Health, The University of Sydney, Australia; Sydney Eye Hospital, Australia
| | - Antonio Filipe Macedo
- Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Sweden; Centre of Physics of Minho and Porto Universities, School of Sciences, University of Minho, Braga, Portugal
| | | | - Neil Retallic
- Specsavers Optical Group, La Villiaze, St. Andrew's, Guernsey, United Kingdom; School of Optometry and Vision Science, University of Bradford, Bradford, United Kingdom
| | - Nery Garcia-Porta
- Applied Physics Department, Optics and Optometry Faculty, University of Santiago de Compostela, Spain; Institute of Materials (iMATUS) of the University of Santiago de Compostela, Spain
| | - Gauri Shrestha
- Optometry Department, BPK Centre for Ophthalmic Studies, Institute of Medicine, Nepal
| | - James S Wolffsohn
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom
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Reitblat O, Velleman DA, Levy A, Assia EI, Kleinmann G. Performance of Extended Depth of Focus Intraocular Lens in Eyes with Preexisting Retinal Disease. Ophthalmologica 2024; 247:241-250. [PMID: 39004074 PMCID: PMC11446292 DOI: 10.1159/000540187] [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: 02/27/2024] [Accepted: 06/30/2024] [Indexed: 07/16/2024]
Abstract
INTRODUCTION Extended depth of focus (EDOF) intraocular lens (IOL) offers improved near and intermediate vision, aiming to reduce spectacle dependence in cataract patients. This research aimed to evaluate the performance of EDOF IOL in patients with retinal pathologies following cataract surgery. METHODS The medical charts of thirty-three eyes with retinal pathologies and 100 healthy eyes that underwent cataract extraction with implantation of an EDOF IOL and had at least 3 weeks of postoperative follow-up were retrospectively included. Patients' overall satisfaction, spectacle dependence, visual perception, and side effects were evaluated with a self-reported questionnaire. RESULTS Mean uncorrected visual acuities (LogMAR) were significantly better in the healthy eyes compared with the eyes with retinal pathologies: 0.05 and 0.10, p = 0.011 (distance), 0.06 and 0.16, p = 0.001 (intermediate), and 0.20 and 0.28, p = 0.026 (near), respectively. No or rare use of spectacles for any distance was reported by 71% and 38% of patients, respectively (p = 0.004). Haloes/glare were reported by 17% and 23%, respectively (p = 0.556); only in 7% and 4% it was clinically disturbing (p > 0.999). The same IOL would be chosen again in 77% and 73% of patients, respectively, (p = 0.550). CONCLUSION Patients with retinal pathologies who were implanted with an EDOF IOL demonstrated excellent distant uncorrected visual results with reasonable intermediate and near uncorrected visual results alongside high satisfaction; however, results were inferior to those of the control healthy eyes.
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Affiliation(s)
- Olga Reitblat
- Ein-Tal Eye Center, Tel Aviv, Israel,
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel,
- Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel,
| | | | - Adi Levy
- Ein-Tal Eye Center, Tel Aviv, Israel
| | - Ehud I Assia
- Ein-Tal Eye Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Guy Kleinmann
- Ein-Tal Eye Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Goldschleger Eye Institute, Sheba Medical Center, Ramat Gan, Israel
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Tavassoli S, Ziaei H, Yadegarfar ME, Gokul A, Kernohan A, Evans JR, Ziaei M. Trifocal versus extended depth of focus (EDOF) intraocular lenses after cataract extraction. Cochrane Database Syst Rev 2024; 7:CD014891. [PMID: 38984608 PMCID: PMC11234495 DOI: 10.1002/14651858.cd014891.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
BACKGROUND Cataract, defined as an opacity of the lens in one or both eyes, is the leading cause of blindness worldwide. Cataract may initially be treated with new spectacles, but often surgery is required, which involves removing the cataract and placing a new artificial lens, usually made from hydrophobic acrylic. Recent advancements in intraocular lens (IOL) technology have led to the emergence of a diverse array of implantable lenses that aim to minimise spectacle dependence at all distances (near, intermediate, and distance). To assess the relative merits of these lenses, measurements of visual acuity are needed. Visual acuity is a measurement of the sharpness of vision at a distance of 6 metres (or 20 feet). Normal vision is 6/6 (or 20/20). The Jaegar eye card is used to measure near visual acuity. J1 is the smallest text and J2 is considered equivalent to 6/6 (or 20/20) for near vision. OBJECTIVES To compare visual outcomes after implantation of trifocal intraocular lenses (IOLs) to those of extended depth of focus (EDOF) IOLs. To produce a brief economic commentary summarising recent economic evaluations that compare trifocal IOLs with EDOF IOLs. SEARCH METHODS We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register), MEDLINE, Embase, and three trial registries on 15 June 2022. For our economic evaluation, we also searched MEDLINE and Embase using economic search filters to 15 June 2022, and the NHS Economic Evaluation Database (EED) from 1968 up to and including 31 December 2014. We did not use any date or language restrictions in the electronic searches. SELECTION CRITERIA We included studies comparing trifocal and EDOF IOLs in adults undergoing cataract surgery. We did not include studies involving people receiving IOLs for correction of refractive error alone (or refractive lens exchange in the absence of cataract). DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Two review authors working independently selected studies for inclusion and extracted data from the reports. We assessed the risk of bias in the studies, and we assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS We included five studies that compared trifocal and EDOF lenses in people undergoing cataract surgery. Three trifocal lenses (AcrySof IQ PanOptix, ATLISA Tri 839MP, FineVision Micro F) and one EDOF lens (TECNIS Symfony ZXR00) were evaluated. The studies took place in Europe and North America. Follow-up ranged from three to six months. Of the 239 enroled participants, 233 (466 eyes) completed follow-up and were included in the analyses. The mean age of participants was 68.2 years, and 64% of participants were female. In general, the risk of bias in the studies was unclear as methods for random sequence generation and allocation concealment were poorly reported, and we judged one study to be at high risk of performance and detection bias. We assessed the certainty of the evidence for all outcomes as low, downgrading for the risk of bias and for imprecision. In two studies involving a total of 254 people, there was little or no difference between trifocal and EDOF lenses for uncorrected and corrected distance visual acuity worse than 6/6. Sixty per cent of participants in both groups had uncorrected distance visual acuity worse than 6/6 (risk ratio (RR) 1.06, 95% confidence intervals (CI) 0.88 to 1.27). Thirty-one per cent of the trifocal group and 38% of the EDOF group had corrected distance visual acuity worse than 6/6 (RR 1.04, 95% CI 0.78 to 1.39). In one study of 60 people, there were fewer cases of uncorrected near visual acuity worse than J2 in the trifocal group (3%) compared with the EDOF group (30%) (RR 0.08, 95% CI 0.01 to 0.65). In two studies, participants were asked about spectacle independence using subjective questionnaires. There was no evidence of either lens type being superior. One further study of 60 participants reported, "overall, 90% of patients achieved spectacle independence", but did not categorise this by lens type. All studies included postoperative patient-reported visual function, which was measured using different questionnaires. Irrespective of the questionnaire used, both types of lenses scored well, and there was little evidence of any important differences between them. Two studies included patient-reported ocular aberrations (glare and halos). The outcomes were reported in different ways and could not be pooled; individually, these studies were too small to detect meaningful differences in glare and halos between groups. One study reported no surgical complications. Three studies did not mention surgical complications. One study reported YAG capsulotomy for posterior capsular opacification (PCO) in one participant (one eye) in each group. One study reported no PCO. Two studies did not report PCO. One study reported that three participants (one trifocal and two EDOF) underwent laser-assisted subepithelial keratectomy (LASEK) to correct residual myopic refractive error or astigmatism. One study reported a subset of participants who were considering laser enhancement at the end of the study period (nine trifocal and two EDOF). Two studies did not report laser enhancement rates. No economic evaluation studies were identified for inclusion in this review. AUTHORS' CONCLUSIONS Distance visual acuity after cataract surgery may be similar whether the lenses implanted are trifocal IOLs or EDOF (TECNIS Symfony) IOLs. People receiving trifocal IOLs may achieve better near vision and may be less dependent on spectacles for near vision. Both lenses were reported to have adverse subjective visual phenomena, such as glare and halos, with no meaningful difference detected between lenses.
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Affiliation(s)
| | - Hadi Ziaei
- Manchester Royal Eye Hospital, Manchester, UK
| | | | - Akilesh Gokul
- Department of Ophthalmology, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand
| | - Ashleigh Kernohan
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Jennifer R Evans
- ICEH (International Centre for Eye Health), London School of Hygiene & Tropical Medicine, London, UK
| | - Mohammed Ziaei
- Department of Ophthalmology, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand
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Llovet-Rausell A, Ortega-Usobiaga J, Albarrán-Diego C, Beltrán-Sanz J, Bilbao-Calabuig R, Llovet-Osuna F. Visual Outcomes and Patient Satisfaction After Bilateral Refractive Lens Exchange With a Trifocal Intraocular Lens in 5,226 Patients With Presbyopia. J Refract Surg 2024; 40:e468-e479. [PMID: 39007809 DOI: 10.3928/1081597x-20240517-01] [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: 07/16/2024]
Abstract
PURPOSE To assess visual and refractive outcomes and visual function after bilateral RayOne Trifocal toric and nontoric intraocular lens (IOL) (Rayner) implantation in patients with presbyopia. METHODS Charts of patients with presbyopia who underwent refractive lens exchange with bilateral implantation of the RayOne Trifocal IOL (toric and non-toric) were retrospectively reviewed. Visual and refractive outcomes were evaluated at 3 months. Patient satisfaction, spectacle independence, and visual disturbance profile were assessed by questionnaires. RESULTS A total of 5,226 patients were assigned to one of two groups: 1,010 patients had toric IOL implantation (toric group) and 4,216 patients received the non-toric model (non-toric group). Mean ± standard deviation visual acuity at 3 months for the toric group was binocular uncorrected distance visual acuity (UDVA) of 0.07 ± 0.11 logMAR, monocular corrected distance visual acuity (CDVA) of 0.05 ± 0.07 logMAR, binocular uncorrected near visual acuity (UNVA) at 40 cm of 0.10 ± 0.09 logMAR, binocular uncorrected intermediate visual acuity (UIVA) at 40 cm of 0.13 ± 0.12 logMAR, postoperative spherical equivalent (SE) of -0.21 ± 0.47 diopters (D), and cylinder of -0.34 ± 0.40 D. The non-toric group had binocular UDVA of 0.04 ± 0.08 logMAR, monocular CDVA of 0.05 ± 0.07 logMAR, binocular UNVA of 0.10 ± 0.08 logMAR, binocular UIVA of 0.13 ± 0.11 logMAR, SE of -0.08 ± 0.38 D, and cylinder of -0.28 ± 0.34 D. No statistically significant differences were found in achieving spectacle independence and there were high levels of satisfaction in both groups. CONCLUSIONS In this retrospective analysis with more than 5,000 patients, both the toric and non-toric RayOne Trifocal IOL models provided good visual performance at all distances, resulting in excellent levels of spectacle independence and patient satisfaction. [J Refract Surg. 2024;40(7):e468-e479.].
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García-Bella J, Burgos-Blasco B, Vidal-Villegas B, Garzón N, Villanueva C, García-Feijoo J. Visual and refractive outcomes after bilateral implantation of an enhanced monofocal intraocular lens: prospective study. J Cataract Refract Surg 2024; 50:585-590. [PMID: 38350145 PMCID: PMC11146183 DOI: 10.1097/j.jcrs.0000000000001422] [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: 07/31/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/15/2024]
Abstract
PURPOSE To evaluate visual and refractive outcomes, as well as patient satisfaction after bilateral implantation of an enhanced monofocal intraocular lens (IOL) with emmetropia as a target refraction. SETTING San Carlos Hospital, Madrid, Spain. DESIGN Prospective, monocentric, noncomparative study. METHODS Adults 21 years or older suitable for cataract surgery and with corneal astigmatism <1.50 diopters (D) were bilaterally implanted with the RayOne EMV IOL and followed up for 3 months. Outcomes measures included refraction, monocular and binocular uncorrected distance visual acuity, corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity, distance-corrected intermediate visual acuity (DCIVA), and defocus curve, aberrometry, and satisfaction. Visual symptoms were assessed using the CatQuest-9SF questionnaire. RESULTS 50 eyes of 25 patients were included. At month 3, the mean manifest spherical equivalent was -0.39 ± 0.28 D, with all eyes within 1.00 D. Binocularly, uncorrected, at distance, 68% of patients could read ≤0.0 logMAR and 95% ≤0.2 logMAR; at intermediate 59% of patients could read ≤0.1 and 100% ≤0.2 logMAR. Mean monocular CDVA was -0.03 ± 0.06 logMAR and mean monocular DCIVA was 0.28 ± 0.07 logMAR. Binocular defocus curve demonstrated a visual acuity ≤0.2 logMAR over a 2 D range from +1.00 D to -1.25 D. Satisfaction was good in 96% of patients. CONCLUSIONS Bilateral implantation of an enhanced monofocal IOL with emmetropia as a target provided excellent binocular CDVA and good DCIVA, with a high level of satisfaction.
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Affiliation(s)
- Javier García-Bella
- From the Department of Ophthalmology, Clinico San Carlos Hospital, Madrid, Spain (García-Bella, Burgos-Blasco, Vidal-Villegas, Villanueva, García-Feijoo); Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain (Garzón, Villanueva)
| | - Bárbara Burgos-Blasco
- From the Department of Ophthalmology, Clinico San Carlos Hospital, Madrid, Spain (García-Bella, Burgos-Blasco, Vidal-Villegas, Villanueva, García-Feijoo); Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain (Garzón, Villanueva)
| | - Beatriz Vidal-Villegas
- From the Department of Ophthalmology, Clinico San Carlos Hospital, Madrid, Spain (García-Bella, Burgos-Blasco, Vidal-Villegas, Villanueva, García-Feijoo); Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain (Garzón, Villanueva)
| | - Nuria Garzón
- From the Department of Ophthalmology, Clinico San Carlos Hospital, Madrid, Spain (García-Bella, Burgos-Blasco, Vidal-Villegas, Villanueva, García-Feijoo); Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain (Garzón, Villanueva)
| | - Celia Villanueva
- From the Department of Ophthalmology, Clinico San Carlos Hospital, Madrid, Spain (García-Bella, Burgos-Blasco, Vidal-Villegas, Villanueva, García-Feijoo); Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain (Garzón, Villanueva)
| | - Julián García-Feijoo
- From the Department of Ophthalmology, Clinico San Carlos Hospital, Madrid, Spain (García-Bella, Burgos-Blasco, Vidal-Villegas, Villanueva, García-Feijoo); Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain (Garzón, Villanueva)
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Won YK, Choi SH, Chung TY, Lim DH. Clinical Outcomes after Bilateral Implantation of a Wavefront-Shaping Extended Depth of Focus (EDOF) IOL with Mini-Monovision. J Clin Med 2024; 13:3225. [PMID: 38892936 PMCID: PMC11172505 DOI: 10.3390/jcm13113225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/12/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
Background: To compare the visual outcomes and optical quality of patients who underwent bilateral implantation of EDOF (AcrySof® IQ Vivity IOL, DFT015) for mini-monovision, trifocal (AcrySof® IQ PanOptix, TNFT00), or monofocal (AcrySof® IQ IOL, SN60WF) IOL. Methods: The monocular-corrected and uncorrected distance visual acuities (CDVA and UDVA, respectively) were evaluated postoperatively at 1 and 3 months. The binocular visual acuity by distance, the binocular defocus curve, contrast sensitivity, and patient satisfaction were examined 3 months postoperatively. All patients were asked to complete questionnaires regarding their satisfaction, visual symptoms, and spectacle dependency. Results: This study included 178 eyes from 89 patients. The postoperative binocular UDVA did not differ significantly among the three groups. In the defocus curve, the Vivity group showed better visual acuity over a range of far and intermediate (60 cm) than the other two IOLs groups. In near-vision, the PanOptix group showed the best near-vision, and the Vivity group showed significantly better vision than the IQ group. The Vivity group showed contrast sensitivity and optical quality comparable to the IQ group. Conclusions: The bilateral implantation of AcrySof® IQ Vivity IOL with the mini-monovision approach provided excellent distance and intermediate visual acuity with good near-vision, resulting in high satisfaction.
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Affiliation(s)
- Yeo Kyoung Won
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
| | - Sung Ho Choi
- First Samsung Eye Clinic, Seoul 06621, Republic of Korea
| | - Tae-Young Chung
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
- Renew Seoul Eye Center, Seoul 06181, Republic of Korea
| | - Dong Hui Lim
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
- Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul 06351, Republic of Korea
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Łabuz G, Khoramnia R, Yan W, van den Berg TJTP, Auffarth GU, Naujokaitis T, Tandogan T. Characterizing glare effects associated with diffractive optics in presbyopia-correcting intraocular lenses. J Cataract Refract Surg 2024; 50:413-419. [PMID: 38237073 DOI: 10.1097/j.jcrs.0000000000001398] [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: 10/05/2023] [Accepted: 01/08/2024] [Indexed: 03/26/2024]
Abstract
PURPOSE To objectively quantify glare of intraocular lenses (IOLs) using a diffractive principle to extend the visual range and to identify models with increased susceptibility to inducing glare. SETTING David J Apple Laboratory, Heidelberg, Germany. DESIGN Laboratory investigation. METHODS Glare was assessed by means of a straylight parameter with a standard C-Quant intended for 7 degrees. In addition, 2 C-Quant modifications were used to test lower angles (ie, 2.5 degrees and 3.5 degrees). The following IOL models were assessed: PanOptix, AT Lisa Tri, Synergy, and Triumf, the latter 2 with chromatic aberration correction at distance. Straylight from trifocal IOLs was compared against a monofocal W-60R lens. The C-Quant test was performed through the studied IOLs by using additional optical components attached to their ocular. RESULTS Straylight (deg 2 sr -1 ) of the control was <1 at all tested angles, with the trifocal models showing comparable straylight at 7 degrees. At 3.5 degrees, Triumf's straylight increased to 15.5 ± 0.6, followed by Synergy (6.2 ± 1.1), PanOptix (4.1 ± 0.3), and AT Lisa Tri (2.0 ± 0.8). The chromatic aberration-correcting models demonstrated correspondingly higher straylight (Synergy: 18.8 ± 1.3; Triumf: 17.3 ± 0.5) at 2.5 degrees compared with PanOptix (4.3 ± 0.4), AT Lisa Tri (2.1 ± 0.1), and monofocal IOLs yielding minimal or no increase. CONCLUSIONS Trifocal IOLs induced increased straylight, but it was limited to lower angles, which may cause difficulties detecting these effects using a standard clinical approach. The latest IOL designs featuring chromatic aberration correction at far focus seem more susceptible than the established trifocal IOLs to inducing a glare phenomenon.
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Affiliation(s)
- Grzegorz Łabuz
- From the The David J Apple Center for Vision Research, Department of Ophthalmology, University Hospital Heidelberg, Heidelberg, Germany (Łabuz, Khoramnia, Yan, Auffarth, Naujokaitis, Tandogan); Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands (van den Berg); Augenklinik Pallas, Olten, Switzerland (Tandogan)
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Wendelstein JA, Casazza M, Reifeltshammer S, Riaz K, Pantanelli S, Mariacher S, Seiler TG, Kohnen T, Bolz M. Unilateral intraindividual comparison and bilateral performance of a monofocal spherical and diffractive extended depth of field intraocular lens mix-and-match approach. Clin Exp Ophthalmol 2024; 52:31-41. [PMID: 38050340 DOI: 10.1111/ceo.14315] [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: 06/22/2023] [Revised: 10/04/2023] [Accepted: 10/08/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND To evaluate the intraindividual visual performance of a spherical and extended depth of field (EDOF) IOL used in a mix-and-match approach. METHODS Single centre (tertiary care centre), retrospective consecutive case series. Included patients had uneventful cataract surgery with implantation of a spherical monofocal IOL (CT Spheris 204) in the dominant eye and a diffractive EDOF IOL (AT LARA 829) in the non-dominant eye. Monocular and binocular defocus curves and visual acuity at various distances were assessed. In addition, binocular reading speed, contrast sensitivity, and patient satisfaction using QOV, Catquest 9SF, and glare/halo questionnaires are reported. RESULTS A total of 29 patients (58 eyes) were included. We observed significant intra-individual differences for monocular DCIVA, DCNVA, UIVA, and UNVA. There were no differences in monocular BCDVA or UDVA. The monocular defocus curves for the two IOLs significantly differed at defocus steps between -1.0 and -3.5 D. 93.10% of patients reported they would opt for the same combination of IOLs. CONCLUSION Excellent uncorrected and corrected distance visual acuity was demonstrated in both groups. The mix-and-match approach described in this study yielded good intermediate vision and improved near vision with high-patient satisfaction.
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Affiliation(s)
- Jascha A Wendelstein
- Medical Faculty, Johannes Kepler University Linz, Linz, Austria
- Department of Ophthalmology and Optometry, Kepler University Hospital GmbH, Johannes Kepler University Linz, Linz, Austria
- Institute of Experimental Ophthalmology, Saarland University, Homburg, Germany
- IROC-Institut für Refraktive und Ophthalmo-Chirurgie, Zürich, Switzerland
| | - Marina Casazza
- Medical Faculty, Johannes Kepler University Linz, Linz, Austria
- Department of Ophthalmology and Optometry, Kepler University Hospital GmbH, Johannes Kepler University Linz, Linz, Austria
| | - Sophia Reifeltshammer
- Medical Faculty, Johannes Kepler University Linz, Linz, Austria
- Department of Ophthalmology and Optometry, Kepler University Hospital GmbH, Johannes Kepler University Linz, Linz, Austria
| | - Kamran Riaz
- Dean A. McGee Eye Institute, University of Oklahoma, Oklahoma City, Oklahoma, USA
| | - Seth Pantanelli
- Department of Ophthalmology, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Siegfried Mariacher
- Medical Faculty, Johannes Kepler University Linz, Linz, Austria
- Department of Ophthalmology and Optometry, Kepler University Hospital GmbH, Johannes Kepler University Linz, Linz, Austria
| | - Theo G Seiler
- IROC-Institut für Refraktive und Ophthalmo-Chirurgie, Zürich, Switzerland
- Klinik für Augenheilkunde, Universitätsklinikum Düsseldorf, Duesseldorf, Germany
- Universitätsklinik für Augenheilkunde, Bern, Switzerland
| | - Thomas Kohnen
- Department of Ophthalmology, Goethe University, Frankfurt, Germany
| | - Matthias Bolz
- Medical Faculty, Johannes Kepler University Linz, Linz, Austria
- Department of Ophthalmology and Optometry, Kepler University Hospital GmbH, Johannes Kepler University Linz, Linz, Austria
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Micheletti JM, Duncan NB, Hall B. Head-to-Head Comparison of Intermediate Vision of Two Monofocal Intraocular Lenses. Clin Ophthalmol 2023; 17:3983-3990. [PMID: 38146452 PMCID: PMC10749565 DOI: 10.2147/opth.s444696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/14/2023] [Indexed: 12/27/2023] Open
Abstract
Purpose To compare intermediate visual outcomes in patients previously implanted with bilateral Clareon monofocal IOLs versus bilateral Eyhance IOLs. Methods This was a non-interventional, single-center, examiner-masked, comparative study. Participants were cataract patients presenting at least 3 months after uncomplicated, bilateral implantation of either Clareon or Eyhance non-toric and toric IOLs. Outcomes measures included binocular distance-corrected intermediate visual acuity (DCIVA), binocular corrected distance visual acuity (CDVA), binocular best-corrected defocus curve, postoperative mean residual spherical equivalent (MRSE), and residual astigmatism. Results A total of 620 eyes of 310 subjects (155 subjects per group) were evaluated. The mean difference in DCIVA was 0.05 logMAR between the Eyhance and Clareon IOLs which was significant (p < 0.01), but within the 0.1 logMAR non-inferiority margin. Mean CDVA of the Clareon group was 0.01 ± 0.03 logMAR compared to 0.02 ± 0.03 logMAR of the Eyhance Group (p > 0.05). Defocus curves from +1.0 D to -3.0 D were not clinically nor statistically different between the Clareon and Eyhance groups (p > 0.05). Conclusion The results of this study show that bilateral implantation of Clareon monofocal IOLs and Eyhance monofocal IOLs lead to similar distance and intermediate visual outcomes.
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Affiliation(s)
| | - Nicole B Duncan
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
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Baur ID, Auffarth GU, Köppe MK, Łabuz G, Khoramnia R. Rotational Stability of Toric Capsular Bag-Fixated Intraocular Lenses in Duet Procedure for Reversible Trifocality. Am J Ophthalmol 2023; 256:156-163. [PMID: 37597721 DOI: 10.1016/j.ajo.2023.08.006] [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: 06/13/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/21/2023]
Abstract
PURPOSE To evaluate the long-term rotational stability of capsular bag-fixated toric intraocular lenses (IOLs) in polypseudophakic eyes of patients who underwent duet procedure for reversible trifocality. DESIGN Retrospective interventional case series. METHODS We included 34 eyes of 20 patients who underwent duet procedure with implantation of a monofocal toric IOL (RayOne toric, Hoya XY1AT, or a Tecnis ZCT800) into the capsular bag and a trifocal-diffractive Sulcoflex IOL into the ciliary sulcus. All toric IOLs were implanted with image-guided navigation. The manifest refraction and uncorrected and distance corrected visual acuity at far, intermediate, and near distance were measured. The position of the axis of the toric IOL was determined with the Pentacam device (Oculus GmbH) by evaluating retroillumination images. The results were compared with the preoperatively planned axis position. RESULTS The median follow-up was 27 months. The spherical equivalent of manifest refraction was -0.04 ± 0.34 diopters (D) postoperatively, and the refractive cylinder was -0.14 ± 0.22 D on average. Binocular uncorrected and corrected distance visual acuity were 0.05 ± 0.11 logMAR and 0.02 ± 0.09 logMAR, respectively. The mean deviation from the calculated cylinder axis was 3.8° ± 3.5° with a median of 2.8° and a maximum deviation of 15.0°. Ninety-four percent of all eyes showed a deviation of less than 10°. CONCLUSIONS The long-term axial alignment of capsular bag-fixated toric IOLs in polypseudophakic eyes was comparable to the results reported for single implantation of toric IOLs. The polypseudophakic approach did not affect the rotational stability of capsular bag-fixated IOLs.
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Affiliation(s)
- Isabella D Baur
- From the Department of Ophthalmology, University Clinic Heidelberg, Heidelberg, Germany
| | - Gerd U Auffarth
- From the Department of Ophthalmology, University Clinic Heidelberg, Heidelberg, Germany
| | - Maximilian K Köppe
- From the Department of Ophthalmology, University Clinic Heidelberg, Heidelberg, Germany
| | - Grzegorz Łabuz
- From the Department of Ophthalmology, University Clinic Heidelberg, Heidelberg, Germany
| | - Ramin Khoramnia
- From the Department of Ophthalmology, University Clinic Heidelberg, Heidelberg, Germany..
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11
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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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Shen J, Cai L, Zhuo B, Abulimiti A, Ni S, Zhang L, Guo H, Chen X, Yang J. Binocular Visual Outcomes Comparison of Two Trifocal Intraocular Lenses in High-Myopic Cataract Patients: A 1-Year Multicenter Study. Am J Ophthalmol 2023; 254:1-10. [PMID: 36963601 DOI: 10.1016/j.ajo.2023.03.015] [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: 11/05/2022] [Revised: 03/10/2023] [Accepted: 03/11/2023] [Indexed: 03/26/2023]
Abstract
PURPOSE To compare the postoperative visual outcomes and quality of vision obtained with 2 types of diffractive trifocal intraocular lenses (IOLs) in patients with highly myopic cataracts. DESIGN Prospective, multicenter, randomized controlled trial. METHODS Patients with high-myopic cataracts were randomized to binocular implantation of either the TFNT00 (n = 27) or the 839 MP (n = 28) trifocal IOLs at 3 surgery centers in China and were followed up for 1 year. Postoperative uncorrected distance, uncorrected intermediate, and uncorrected near visual acuity, and best-corrected distance visual acuity were measured. The defocus curve, high-order aberrations, modulation transfer function curve, Strehl ratio, and reading ability were compared between both groups. The functional vision and incidence of photic phenomena were surveyed using questionnaires. RESULTS Visual acuity at all ranges of vision was significantly improved in both groups. The TFNT00 group showed superior uncorrected intermediate visual acuity to that in the 839 MP group (P = .013). Reading ability at 40 and 60 cm was similar in both groups (P ≥ .05), whereas the preferred reading distances for near and intermediate were significantly different. The TFNT00 group had a significantly higher mean Visual Function Index 14 score, lower incidence of photic phenomena, and less posterior capsular opacity than the 839 MP group. CONCLUSION Bilateral implantation of both types of trifocal IOLs in patients with high-myopic cataracts provided good whole-course visual restoration, although recognition of fine Chinese characters remained impeded. As compared with 839 MP IOL, TFNT00 IOL resulted in greater patient satisfaction in intermediate activities, with a lower photic phenomena incidence.
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Affiliation(s)
- Jiying Shen
- From the Department of Ophthalmology, Shanghai Heping Eye Hospital (J.S., S.N., L.Z., H.G.), Shanghai, China
| | - Lei Cai
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital (L.C., B.Z., J.Y.), Shanghai, China; Key National Health Committee Laboratory of Myopia (L.C., B.Z., J.Y.), Shanghai, China; Fudan University, and Laboratory of Myopia, Chinese Academy of Medical Sciences (L.C., B.Z., J.Y.), Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (L.C., B.Z., J.Y.), Shanghai, China
| | - Baoxian Zhuo
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital (L.C., B.Z., J.Y.), Shanghai, China; Key National Health Committee Laboratory of Myopia (L.C., B.Z., J.Y.), Shanghai, China; Fudan University, and Laboratory of Myopia, Chinese Academy of Medical Sciences (L.C., B.Z., J.Y.), Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (L.C., B.Z., J.Y.), Shanghai, China
| | - Adilamu Abulimiti
- Department of Ophthalmology, Shanghai Aier Eye Hospital (A.A., X.C.), Shanghai, China
| | - Shuang Ni
- From the Department of Ophthalmology, Shanghai Heping Eye Hospital (J.S., S.N., L.Z., H.G.), Shanghai, China
| | - Limei Zhang
- From the Department of Ophthalmology, Shanghai Heping Eye Hospital (J.S., S.N., L.Z., H.G.), Shanghai, China
| | - Haike Guo
- From the Department of Ophthalmology, Shanghai Heping Eye Hospital (J.S., S.N., L.Z., H.G.), Shanghai, China
| | - Xu Chen
- Department of Ophthalmology, Shanghai Aier Eye Hospital (A.A., X.C.), Shanghai, China
| | - Jin Yang
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital (L.C., B.Z., J.Y.), Shanghai, China; Key National Health Committee Laboratory of Myopia (L.C., B.Z., J.Y.), Shanghai, China; Fudan University, and Laboratory of Myopia, Chinese Academy of Medical Sciences (L.C., B.Z., J.Y.), Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (L.C., B.Z., J.Y.), Shanghai, China.
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Khoramnia R, Baur ID, Łabuz G, Köppe MK, Hallak MK, Auffarth GU. Functional outcomes after bilateral refractive lens exchange with a continuous-range-of-vision intraocular lens. J Cataract Refract Surg 2023; 49:1011-1017. [PMID: 37464558 DOI: 10.1097/j.jcrs.0000000000001265] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 07/12/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE To clinically evaluate a diffractive continuous-range-of-vision intraocular lens (IOL) that combines bifocal and extended depth-of-focus technologies in refractive lens exchange (RLE) patients. SETTING University eye clinic. DESIGN Prospective interventional clinical study. METHODS Bilateral implantation of the TECNIS Synergy IOL was performed during a RLE procedure in 28 patients. At 3 months postoperatively, uncorrected (UDVA) and corrected (CDVA) distance visual acuities, uncorrected (UIVA) and distance-corrected (DCIVA) intermediate visual acuities at 80 cm, and uncorrected (UNVA) and distance-corrected (DCNVA) near visual acuities at 40 cm were assessed. Defocus curve testing and contrast sensitivity testing were also performed. RESULTS Binocular UDVA and CDVA of 56 eyes (28 patients) were -0.06 ± 0.07 logMAR and -0.13 ± 0.05 logMAR, respectively. UIVA and DCIVA were -0.06 ± 0.05 logMAR and -0.08 ± 0.06 logMAR, and UNVA and DCNVA were -0.01 ± 0.07 logMAR and -0.04 ± 0.07 logMAR. The defocus curve revealed a visual acuity of 0.10 logMAR or better from +0.50 to -3.00 diopters (D). Photopic contrast sensitivity at spatial frequencies 3.0, 6.0, 12.0, and 18.0 was 1.68 ± 0.20, 1.77 ± 0.19, 1.45 ± 0.18, and 1.02 ± 0.19 log units, respectively. Mesopic contrast sensitivity at the same frequencies was 1.56 ± 0.20, 1.44 ± 0.25, 0.92 ± 0.38, and 0.44 ± 0.37, respectively. CONCLUSIONS The Synergy IOL provided very good distance, intermediate, and near visual outcomes. A visual acuity of 0.10 logMAR or better was achieved from +0.50 to -3.0 D. Contrast sensitivity was within the normal range.
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Affiliation(s)
- Ramin Khoramnia
- From the International Vision Correction Research Center, University Eye Clinic of Heidelberg, Heidelberg, Germany
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14
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Scheepers MA, Bunce CB, Michaelides M, Hall B. Clinical outcomes of a trifocal compared with an extended depth of focus IOL following bilateral cataract surgery. CANADIAN JOURNAL OF OPHTHALMOLOGY 2023; 58:393-400. [PMID: 35661646 DOI: 10.1016/j.jcjo.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 04/29/2022] [Accepted: 05/10/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To compare the visual and patient reported outcomes of 2 presbyopia-correcting intraocular lenses (IOLs). METHODS A total of 134 eyes (67 patients) that underwent cataract surgery with either a trifocal IOL or an extended depth of focus (EDOF) IOL bilaterally and were assessed 3 months after surgery. Outcome measures were binocular distance-corrected visual acuity at near (40 cm), intermediate (60 cm), and distance (6 m); Akman modified Quality of Life (QOL) Questionnaire-14; and 10% contrast visual acuity at distance and near, with and without glare. RESULTS Mean binocular logMAR visual acuity (VA) for the PanOptix compared with the Symfony lenses: distance-corrected near VA, 0.054 versus 0.228; distance-corrected intermediate VA, 0.019 versus 0.063; and distance-corrected distance VA, -0.016 versus -0.021. The QOL questionnaire showed that 62% of the PanOptix group and 48% of the Symfony group had little or no difficulty with all QOL-related tasks. In a multivariable model controlling for pupil size and angle kappa (chord mu distance, right eyes), the differences were -0.005 (range, -0.03-0.02) and 0.165 (range, 0.12-0.21), respectively. Also, 10% contrast acuity was comparable in the 2 different lenses and was unaffected by glare. CONCLUSIONS Binocular distance-corrected near VA was significantly better in the PanOptix group (p < 0.0001). This result remained statistically significant after controlling for pupil size and chord mu distance (p < 0.001). Intermediate and distance VAs were similar between the 2 groups. QOL scores were higher in the PanOptix group.
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Affiliation(s)
| | - Catey B Bunce
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Michel Michaelides
- Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
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15
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McNeely RN, Stewart SA, Moore JE. Visual performance and subjective experience 3 months and 12 months after combined implantation of 2 new complementary continuous phase multifocal intraocular lenses. J Cataract Refract Surg 2023; 49:921-928. [PMID: 37291750 DOI: 10.1097/j.jcrs.0000000000001236] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/05/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE To assess the 3-month and 12-month postoperative visual performance and subjective quality of vision (QoV) after combined implantation of complementary continuous phase multifocal intraocular lenses (IOLs). SETTING Private practice, United Kingdom. DESIGN Case series. METHODS The study enrolled 44 patients undergoing phacoemulsification with implantation of an Artis Symbiose Mid in the dominant eye and an Artis Symbiose Plus in the nondominant eye. Refraction, uncorrected distance visual acuity (UDVA), corrected distance visual acuity, uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), electronic reading desk, and a QoV questionnaire were evaluated at 3 months and 12 months postoperatively. RESULTS The mean binocular UDVA was -0.06 ± 0.08 logMAR and -0.07 ± 0.06 logMAR at 3 months and 12 months ( P = .097), respectively. The mean binocular UIVA was 0.03 ± 0.13 logMAR and 0.03 ± 0.10 logMAR ( P = 1.0), respectively. The mean binocular UNVA was 0.07 ± 0.10 logMAR and 0.07 ± 0.08 logMAR ( P = .875), respectively. There was a significant improvement in QoV for both day and night between 3 and 12 months, with a significant reduction in halos at 12 months. Spectacle independence was reported in 93.2% of cases at 12 months. CONCLUSIONS The Artis Symbiose Mid and Plus IOL combined implantation provided an excellent range of uncorrected vision at 3 and 12 months. There was a significant improvement in QoV and less halos at 12 months. This IOL combination provided very high rates of complete spectacle independence.
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Affiliation(s)
- Richard N McNeely
- From the Cathedral Eye Clinic, Belfast, Northern Ireland, United Kingdom (McNeely, Stewart, Moore); School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland, United Kingdom (Stewart); College of Health and Life Sciences, Aston University, Birmingham, United Kingdom (Moore); Tianjin Medical University, Tianjin, China (Moore)
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Fernández J, Burguera N, Rocha-de-Lossada C, Rachwani-Anil R, Rodríguez-Vallejo M. Influence of a multifocal intraocular lens centration and eye angles on light distortion and ocular scatter index. Graefes Arch Clin Exp Ophthalmol 2023; 261:2291-2299. [PMID: 36884063 DOI: 10.1007/s00417-023-06028-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/10/2023] [Accepted: 02/04/2023] [Indexed: 03/09/2023] Open
Abstract
PURPOSE To assess how eye axes and multifocal intraocular lens (MIOL) centration may impact the light distortion index (LDI) and ocular scatter index (OSI). METHODS Fifty-eight subjects implanted with the trifocal MIOL Q-Flex M 640PM or Liberty 677MY (Medicontur) were included in this retrospective analysis. The following variables were collected with the Pentacam Wave (Oculus) considering the vertex normal as the coordinates center: chord-mu to the center of the pupil, chord-alpha to the geometrical center of the cornea, and chord-MIOL to the center of the diffractive ring. These measurements were correlated with OSI (HD Analyzer, Visiometrics) and LDI (light distortion analyzer, CEORLab). RESULTS Chord-MIOL centroid was 0.12 mm at 62°, chord-mu was 0.09 mm at 174°, and chord-alpha was 0.38 mm at 188°. A relationship was found between OSI and LDI, rho = 0.58, p < 0.0005). No relationships were found between chord-mu or chord-alpha and the LDI or OSI, neither for the total magnitude, nor the decomposition in orthogonal components (p > 0.05). The LDI was significantly correlated with the temporal centration of the MIOL versus the vertex normal (rho = 0.32, p = 0.02). CONCLUSIONS As opposed to what has been previously described, the temporal centration of the MIOL was related to a decrease in the LDI. Future studies with extreme values of the included variables are required to establish cut-offs for considering these variables as exclusion criteria in the implantation of a MIOL.
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Affiliation(s)
- Joaquín Fernández
- Qvision, Department of Ophthalmology, VITHAS Almería Hospital, 04120, Almería, Spain
| | - Noemí Burguera
- Qvision, Department of Ophthalmology, VITHAS Almería Hospital, 04120, Almería, Spain
| | - Carlos Rocha-de-Lossada
- Qvision, Department of Ophthalmology, VITHAS Almería Hospital, 04120, Almería, Spain
- Hospital Regional Universitario de Málaga, Plaza del Hospital Civil, S/N, 29009, Málaga, Spain
- Departamento de Cirugía, Área de Oftalmología, Universidad de Sevilla, Doctor Fedriani, S/N, 41009, Sevilla, Spain
| | - Rahul Rachwani-Anil
- Hospital Norte de Málaga, Avenida Poeta Muñoz Rojas, S/N, Antequera, 29200, Málaga, Spain
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Baur ID, Labuz G, Yildirim TM, Auffarth GU, Khoramnia R. Reversible Multifocality Achieved Through Polypseudophakia. Klin Monbl Augenheilkd 2023; 240:981-988. [PMID: 37391182 DOI: 10.1055/a-2079-1692] [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: 07/02/2023]
Abstract
Simultaneous implantation of a monofocal or monofocal toric intraocular lens (IOL) into the capsular bag and a multifocal IOL into the ciliary sulcus, referred to as duet procedure, allows us to create multifocality that is more easily reversible than the implantation of a capsular bag-fixated multifocal IOL. The optical quality and results after the duet procedure are equivalent to those of a capsular bag-fixated multifocal IOL. Patients who cannot tolerate the side effects of multifocal optics or who develop an ocular condition leading to loss of function such as age-related macular degeneration (AMD) or glaucoma in the course of their lives may benefit from the reversibility of the procedure.
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Affiliation(s)
- Isabella Diana Baur
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Univ.-Augenklinik Heidelberg, Deutschland
| | - Grzegorz Labuz
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Univ.-Augenklinik Heidelberg, Deutschland
| | - Timur Mert Yildirim
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Univ.-Augenklinik Heidelberg, Deutschland
| | - Gerd U Auffarth
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Univ.-Augenklinik Heidelberg, Deutschland
| | - Ramin Khoramnia
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Univ.-Augenklinik Heidelberg, Deutschland
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18
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Blehm C, Hall B. Evaluation of Visual Outcomes and 3-Month Refractive Stability of a New Hydrophobic Acrylic Intraocular Lens. Clin Ophthalmol 2023; 17:1859-1864. [PMID: 37425027 PMCID: PMC10328104 DOI: 10.2147/opth.s415400] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 06/22/2023] [Indexed: 07/11/2023] Open
Abstract
Purpose To determine the refractive stability of a new hydrophobic acrylic intraocular lens (IOL) when implanted bilaterally. Methods This was a prospective, evaluator masked, single surgeon study of 58 eyes of 29 patients. Patients were bilaterally implanted with the Clareon monofocal IOL (CNA0T0, Alcon Vision LLC). Refractive stability was evaluated between 1 and 3 months postoperatively. At 3 months postoperatively, data were also collected for binocular uncorrected and distance corrected visual acuities at distance (4 m) and intermediate (80 cm and 66 cm) and binocular defocus curve. Results Postoperative refraction was statistically equivalent between 1 and 3 months postoperatively (p < 0.001). Mean postoperative uncorrected distance visual acuity was -0.01 ± 0.10 logMAR, and mean corrected distance visual acuity was -0.04 ± 0.06 logMAR. Mean postoperative uncorrected intermediate visual acuity was 0.16 ± 0.13 logMAR and 0.24 ± 0.14 logMAR at 80 cm and 66 cm, respectively. With distance correction in place, mean visual acuity at 80cm and 60cm was 0.16 ± 0.13 logMAR and 0.23 ± 0.14 logMAR, respectively. Conclusion The Clareon monofocal IOL can provide stable refraction, excellent distance vision, and functional intermediate vision postoperatively.
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Shemesh R, Reitblat O, Rodov L, Levy A, Assia EI, Kleinmann G. Results of an Extended Depth-of-Focus Intraocular Lens Implantation in the Second Eye of Monofocal Pseudophakic Patients: A Pilot Study. Asia Pac J Ophthalmol (Phila) 2023; 12:349-354. [PMID: 37523425 DOI: 10.1097/apo.0000000000000622] [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: 03/05/2023] [Accepted: 05/14/2023] [Indexed: 08/02/2023] Open
Abstract
PURPOSE The purpose of this study was to investigate the visual results and patient satisfaction after implantation of an extended depth-of-focus (EDOF) intraocular lens (IOL) in the second eye of patients implanted previously with a monofocal IOL in the first eye. METHODS The medical records and self-reported questionnaires from patients who were implanted with monofocal IOLs in the first eye and EDOF IOLs in the second eye (group A) and from patients implanted bilaterally with EDOF IOLs (group B) were compared for visual acuity (VA), spectacle independence, patient satisfaction, and photic phenomena. RESULTS Group A (23 eyes of 23 patients) had similar distance uncorrected VA and intermediate uncorrected VA compared with group B (72 eyes of 36 patients) (0.03±0.05 vs. 0.04±0.16; P =0.136 and 0.660, respectively). There was a tendency toward a better near uncorrected VA in group A compared with group B (0.15±0.14 vs. 0.23±0.17; P =0.074). Patients' perception of their VA was similar between groups. Spectacle independence for distance vision was reported by 16/17 (94.1%) and 35/36 (97.2%) patients ( P =0.543), 13/17 (76.5%) and 32/36 (88.9%) patients ( P =0.252) for intermediate vision, and 4/17 (23.6%) and 22/36 (61.1%) patients for near vision ( P =0.011), in groups A and B, respectively. There was no difference in complaints of photic phenomena between groups. CONCLUSIONS Patients previously implanted with a monofocal IOL in 1 eye who are interested in improving their spectacle independence can be considered for an EDOF IOL implantation in the second eye and may have similar results to those implanted bilaterally with EDOF IOLs.
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Affiliation(s)
- Rachel Shemesh
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Ein-Tal Eye Center, Tel Aviv, Israel
- Sheba Medical center, Tel-Hashomer, Israel
| | - Olga Reitblat
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Ein-Tal Eye Center, Tel Aviv, Israel
- Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
| | | | - Adi Levy
- Ein-Tal Eye Center, Tel Aviv, Israel
| | - Ehud I Assia
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Ein-Tal Eye Center, Tel Aviv, Israel
- Department of Ophthalmology, Meir Medical Center, Kfar Sava, Israel
| | - Guy Kleinmann
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Ein-Tal Eye Center, Tel Aviv, Israel
- Department of Ophthalmology, E. Wolfson Medical Center, Holon, Israel
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20
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Kaya Ünsal S, Sunay E. The Impact of Angle Lambda on Patient Satisfaction after Optiflex Trio Trifocal Intraocular Lens Implantation. J Ophthalmol 2023; 2023:7911449. [PMID: 37362312 PMCID: PMC10290561 DOI: 10.1155/2023/7911449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 06/07/2023] [Accepted: 06/09/2023] [Indexed: 06/28/2023] Open
Abstract
Purpose To evaluate the vision-related quality of life (QOL), visual acuities, and refractive outcomes of patients with different angle lambda (λ) after a trifocal intraocular lens (IOL) implantation at Veni Vidi Eye Hospital, İstanbul, Turkey. Methods This retrospective, nonrandomized, and noncomparative case series included patients who had phacoemulsification bilaterally with the implantation of a trifocal IOL (Optiflex Trio) and responded to a vision-related QOL questionnaire measuring patient satisfaction. The patients were divided into two groups according to the angle λ with a cutoff value of 0.5 mm. Evaluations were conducted to examine the monocular visual acuities, spherical equivalents, corneal astigmatism measured 3 months after surgery, and outcomes of the QOL questionnaire in the two groups. Results The study examined 130 eyes from 65 patients aged from 41 to 78 years old. There were no statistically significant differences between the two groups at 3 months after surgery in terms of uncorrected distance visual acuity (UDVA), monocular uncorrected intermediate visual acuity (UIVA), monocular uncorrected near visual acuity (UNVA), spherical equivalent, and corneal astigmatism (P > 0.05). Patients with a greater angle λ had significantly more difficulty going out to see movies, plays, or sporting events (P=0.02), driving at night (P=0.002), and driving in difficult conditions (P < 0.001) than patients with a lower angle λ. Conclusions The Optiflex Trio showed good results in terms of visual acuity at all distances, positive refractive outcomes, and high patient satisfaction in daily life according to the QOL questionnaire. An angle λ greater than 0.5 mm may potentially cause dysphotopsia symptoms, especially during nighttime activities.
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Affiliation(s)
| | - Ertan Sunay
- Veni Vidi Eye Hospital, Istanbul 34728, Turkey
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21
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Asena L, Kırcı Dogan İ, Oto S, Dursun Altınors D. Comparison of visual performance and quality of life with a new nondiffractive EDOF intraocular lens and a trifocal intraocular lens. J Cataract Refract Surg 2023; 49:504-511. [PMID: 36700928 DOI: 10.1097/j.jcrs.0000000000001142] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 01/04/2023] [Indexed: 01/27/2023]
Abstract
PURPOSE To compare visual performance and quality of life (QoL) following bilateral implantation of a new nondiffractive extended depth-of-focus (EDOF) intraocular lens (IOL) and a trifocal IOL. SETTING Department of Ophthalmology, Baskent University Faculty of Medicine, Ankara, Turkey. DESIGN Prospective comparative interventional case series. METHODS 104 eyes of 52 patients with cataract, bilaterally implanted with a nondiffractive EDOF IOL or a trifocal IOL, were included. Outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), distance corrected intermediate visual acuity and distance corrected near visual acuity, defocus curves, QoL (Visual Function Index 14), quality of vision (Quality of Vision [QoV] index), contrast sensitivity (Pelli-Robson chart), and binocular reading speed. RESULTS Twenty-six patients were included in each group. The UDVA and CDVA were better in the EDOF group (0.05 ± 0.04 and 0.01 ± 0.04) than the trifocal group (0.13 ± 0.06 and 0.11 ± 0.07) ( P = .02 and .01). Defocus curves showed that visual acuity was better with the EDOF IOL for vergences at 0.00, -0.50, and -1.00 and better with the trifocal IOL for vergences at -2.50, -3.00, -3.50, and -4.00. Contrast sensitivity scores were similar with both IOLs ( P = .12). The overall mean QoL scores were lower in the EDOF group, indicating a better QoL ( P = .04). The QoV was better in the EDOF group with significantly less glare, halos, and blurry vision ( P < .01). CONCLUSIONS The EDOF IOL performed better at distance, and the trifocal IOL performed better at near. Overall QoL and quality of vision were better with the EDOF IOL.
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Affiliation(s)
- Leyla Asena
- From the Department of Ophthalmology, Baskent University Faculty of Medicine, Ankara, Turkey
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22
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Scheepers MA, Hall B. Randomized and double-blind comparison of clinical visual outcomes of 2 EDOF intraocular lenses. J Cataract Refract Surg 2023; 49:354-359. [PMID: 36975011 DOI: 10.1097/j.jcrs.0000000000001113] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 11/29/2022] [Indexed: 03/29/2023]
Abstract
PURPOSE To assess and compare the visual disturbance profiles of 2 extended depth-of-focus (EDOF) intraocular lenses (IOLs). SETTING Private practice (West Kootenays, British Columbia, Canada). DESIGN Prospective, randomized, single-surgeon study. METHODS This was a double-blind prospective study of 138 eyes (69 patients) that underwent bilateral implantation of 1 of 2 EDOF IOLs. Participants were randomized to either the Symfony group or the Vivity group. Outcome measures included Questionnaire for Visual Disturbances; binocular corrected distance visual acuities at distance (6 m), intermediate (66 cm), and near (40 cm); and refractive outcomes. RESULTS At 3 months postoperatively, 21 patients (60%) reported not experiencing glare in the Symfony group compared with 30 (88%) in the Vivity group, a difference of 28% (P = .008). Reports of experiencing starbursts were also significantly different between the Symfony and Vivity groups (23 participants [66%] Symfony and 30 participants [88%] Vivity; P = .027). In addition, 12 participants (34%) reported "moderate" or "severe" starbursts in the Symfony group compared with 3 (9%) in the Vivity group, a difference of 25% (P = .019). Visual acuities and refractive outcomes were similar between groups. CONCLUSIONS Both EDOF lenses provide good visual outcomes at distance and intermediate with acceptable near vision. The Symfony group had increased reports of some visual disturbances, notably the frequency, severity, and bothersomeness of starbursts and glare.
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Affiliation(s)
- Marius A Scheepers
- From the University of British Columbia, Kelowna, British Columbia, Canada (Scheepers); Sengi, Penniac, New Brunswick, Canada (Hall)
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23
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Zhu D, Ren S, Mills K, Hull J, Dhariwal M. Rate of Complete Spectacle Independence with a Trifocal Intraocular Lens: A Systematic Literature Review and Meta-Analysis. Ophthalmol Ther 2023; 12:1157-1171. [PMID: 36745314 PMCID: PMC10011212 DOI: 10.1007/s40123-023-00657-5] [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: 12/08/2022] [Accepted: 01/13/2023] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION A systematic literature review and meta-analysis was conducted to identify and obtain a precise single summary estimate on complete spectacle independence after bilateral implantation of a trifocal intraocular lens (IOL) (AcrySof PanOptix, TFNTXX/TFATXX) for patients undergoing cataract surgery. METHODS A search was conducted in PubMed from January 2017 to September 2021. Relevant congress presentations were also searched to include data from completed studies not yet published. Search terms included the intervention (TFNTXX, TFATXX, PanOptix) and outcomes of interest (patient-reported spectacle independence rates). A Bayesian random-effects meta-analysis was conducted, providing a pooled estimate (median and its 95% credible interval) of complete spectacle independence rates among cataract surgery patients. Subgroup analyses evaluated spectacle independence after cataract surgery across different working distances (near, intermediate, far). RESULTS Nineteen unique clinical studies were identified. Based on a meta-analysis of 13 studies (N = 513 patients), the complete spectacle independence rate after cataract surgery with TFNTXX/TFATXX IOL was 91.6% (95% credible interval 86.8-95.9%). Additionally, the spectacle independence rates at each focal point (N = 13 studies, 603 patients) were 89.6% (near), 96.3% (intermediate), and 95.9% (far). CONCLUSIONS This meta-analysis demonstrated that at least nine out of ten patients receiving TFNTXX/TFATXX trifocal IOL during cataract surgery can expect to achieve complete spectacle independence. This study provides informative data for clinicians and patients to feel confident in the use of trifocal intraocular lenses as presbyopia-correcting IOLs that offer high rates of complete spectacle independence.
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Affiliation(s)
- Dagny Zhu
- NVISION Eye Centers, 17980 Castleton Street, Rowland Heights, CA, 91748, USA.
| | - Shijie Ren
- The University of Sheffield, Sheffield, UK.,ConnectHEOR Limited, London, UK
| | | | | | - Mukesh Dhariwal
- Alcon Vision LLC, Forth Worth, TX, USA.,Health Economics and Outcomes Research, Alcon Vision LLC, Fort Worth, Texas, 76134, USA
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Clinical Evaluation of Reading Performance in Refractive Lens Exchange With a Diffractive Continuous-Range-of-Vision Intraocular Lens. Am J Ophthalmol 2023; 250:25-37. [PMID: 36669611 DOI: 10.1016/j.ajo.2023.01.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/19/2023]
Abstract
PURPOSE Evaluation of reading performance with a novel presbyopia correcting intraocular lens (IOL) in refractive lens exchange using an electronic reading desk. DESIGN Prospective interventional before-and-after clinical study. METHODS In total, 56 eyes of 28 patients were included. Bilateral implantation of the TECNIS Synergy IOL (Johnson & Johnson Surgical Vision) during a bilateral delayed sequential refractive lens exchange procedure. Uncorrected and distance corrected reading acuity, reading distance, reading speed, and the smallest print size that could be read effectively at a set (40 cm/80 cm) and subjectively chosen near and intermediate distance were assessed using the Salzburg Reading Desk preoperatively and 6 months after surgery. RESULTS Uncorrected near reading acuity increased from 0.61 ± 0.16 logarithm of the minimum angle of resolution (logMAR) preoperatively to 0.05 ± 0.09 logMAR postoperatively at the set near distance (40 cm) and from 0.60 ± 0.11 logMAR to 0.07 ± 0.08 logMAR at the subjectively preferred distance (39.6 ± 5.3 cm and 37.7 ± 4.3 cm). Uncorrected intermediate reading acuity was 0.39 ± 0.19 logMAR preoperatively and 0.08 ± 0.07 logMAR postoperatively at the set intermediate distance (80 cm) and 0.43 ± 0.21 logMAR preoperatively and 0.07 ± 0.08 logMAR postoperatively at the preferred intermediate distance (73.5 ± 9.5 cm and 73.3 ± 5.9 cm). CONCLUSIONS Uncorrected intermediate and near reading function considerably improved after bilateral implantation of the TECNIS Synergy IOL. Patients preferred a closer near and intermediate distance to the set distances. However, reading function was comparable for the set and subjectively preferred distances.
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25
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Megiddo-Barnir E, Alió JL. Latest Development in Extended Depth-of-Focus Intraocular Lenses: An Update. Asia Pac J Ophthalmol (Phila) 2023; 12:58-79. [PMID: 36706334 DOI: 10.1097/apo.0000000000000590] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/06/2022] [Indexed: 01/28/2023] Open
Abstract
In recent years, there has been an overwhelming influx of different types of intraocular lenses (IOLs) as treatment for presbyopia. The extended depth-of-focus (EDOF) technology creates a single elongated focal point to enhance depth of focus, in contrast to the multiple foci of multifocal (MF) lenses. In this way, the EDOF lenses aim to reduce photic phenomena, glare, and halos, which have been reported in MF IOLs. A potential disadvantage of this is a blur due to decreased retinal image quality when the amount of the aberrations is increased excessively. Multifocality and EDOF characteristics are not exclusive of each other. Frequently, EDOF IOLs are combined with MF optical designs, a bifocal IOL may exhibit EDOF characteristics, likewise an aspheric monofocal IOL or a diffractive or refractive trifocal IOL. Thus, EDOF lenses are commonly subjected to confusion. A wide range of different types of EDOF lenses are available on the market to surgeons. In this practical update, we aim to clarify what is a true EDOF lens, classify the different types of the EDOF lenses based on their optical principle and review their recently reported outcomes. Comprehensive patient examination and selection, combined with knowledge of the most updated options and adequate patient counseling, can avoid dissatisfaction and yield the desired outcomes.
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Affiliation(s)
| | - Jorge L Alió
- Cornea, Cataract & Refractive Surgery Unit, VISSUM (Miranza Group), Alicante, Spain
- Department of Ophthalmology, Miguel Hernandez University, Alicante, Spain
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26
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Shafer BM, Puls-Boever K, Berdahl JP, Thompson V, Ibach MJ, Zimprich LL, Schweitzer JA. Defocus Curve of Emerging Presbyopic Patients. Clin Ophthalmol 2023; 17:843-847. [PMID: 36937167 PMCID: PMC10022518 DOI: 10.2147/opth.s400194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 02/20/2023] [Indexed: 03/14/2023] Open
Abstract
Purpose To create a defocus curve of emerging presbyopic patients of various age groups. Setting Single site private practice in Sioux Falls, South Dakota. Design This was a non-randomized, prospective study. All subjects were enrolled from healthy volunteers. Methods Subjects aged 37-9, 40-42, 43-45 and 46-48 that have 20/20 best-corrected distance visual acuity (BCDVA) were included. Binocular visual acuity at different defocus steps ranging from +0.5 D to -3 D was measured in each age group. Defocus curves were generated from the mean logMAR visual acuities at each defocus step, by age group. Results Of the 60 subjects, 23.3% of subjects were between the ages of 37-39, 26.7% were between the ages of 40-42, 25% of subjects were between ages 43-45, and 25% were between the ages of 46-48. Visual acuity significantly decreased from plano to -3 D defocus steps in all groups (p < 0.0002, p = 0, p = 0 and p = 0). The 46-48-year-old group had worse visual acuity compared to the other three groups from the -1.0 to -2.0 D defocus steps (p = 0.037, p = 0.022 and 0.017, respectively). Starting at a near point of 40cm, the 37-39 group had the best logMAR vision and the 46-48 group had the worst vision (p = 0.001). Conclusion The defocus curves of emerging presbyopic individuals demonstrate a decreasing visual acuity at near defocus steps that decreases with age. Defocus curves at different age ranges can help doctors explain various presbyopia treatment options in terms of near point capabilities at various ages.
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Affiliation(s)
- Brian M Shafer
- Department of Ophthalmology, Chester County Eye Care, Malvern, PA, USA
- Correspondence: Brian M Shafer, Chester County Eye Care, 325 Central Ave, Suite 101, Malvern, PA, 19355, USA, Email
| | - Keeley Puls-Boever
- Department of Ophthalmology, Vance Thompson Vision, Sioux Falls, SD, USA
| | - John P Berdahl
- Department of Ophthalmology, Vance Thompson Vision, Sioux Falls, SD, USA
| | - Vance Thompson
- Department of Ophthalmology, Vance Thompson Vision, Sioux Falls, SD, USA
| | - Mitch J Ibach
- Department of Ophthalmology, Vance Thompson Vision, Sioux Falls, SD, USA
| | - Larae L Zimprich
- Department of Ophthalmology, Vance Thompson Vision, Sioux Falls, SD, USA
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27
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Pusnik A, Petrovski G, Lumi X. Dysphotopsias or Unwanted Visual Phenomena after Cataract Surgery. Life (Basel) 2022; 13:53. [PMID: 36676002 PMCID: PMC9866410 DOI: 10.3390/life13010053] [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: 12/07/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022] Open
Abstract
Dysphotopsias are unwanted visual phenomena that occur after cataract surgery. They represent some of the most common reasons for patient dissatisfaction after uncomplicated surgery for cataract phacoemulsification with in-the-bag intraocular lens (IOL) implantation. Depending on the form of the optical phenomenon and the effect it poses on vision, dysphotopsias are divided into positive and negative type. Positive dysphotopsias are usually described by patients as glare, light streaks, starbursts, light arcs, rings, haloes, or flashes of light. Negative dysphotopsias are manifested as an arc-shaped shadow or line usually located in the temporal part of the visual field, similar to a temporal scotoma. In addition to their different clinical manifestations, positive and negative dysphotopsia also have different risk factors. Even though up to 67% of patients may experience positive dysphotopsia immediately after surgery, only 2.2% of the cases have persistent symptoms up to a year postoperatively. Surgical intervention may be indicated in 0.07% of cases. The incidence of negative dysphotopsias is up to 26% of all patients; however, by one year postoperatively, the symptoms usually persist in 0.13 to 3% of patients. For both types of dysphotopsia, preoperative patients' education, accurate preoperative diagnostics, and use of an appropriate IOL design and material is mandatory. Despite all these measures, dysphotopsias may occur, and when noninvasive measures fail to improve symptoms, a surgical approach may be considered.
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Affiliation(s)
- Ambroz Pusnik
- Eye Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | - Goran Petrovski
- Center for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Oslo University Hospital, 0450 Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
- Department of Ophthalmology, University of Split School of Medicine and University Hospital Centre, 21000 Split, Croatia
| | - Xhevat Lumi
- Eye Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Center for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Oslo University Hospital, 0450 Oslo, Norway
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
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28
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Moshirfar M, Stapley SR, Corbin WM, Bundogji N, Conley M, Darquea IM, Ronquillo YC, Hoopes PC. Comparative Visual Outcome Analysis of a Diffractive Multifocal Intraocular Lens and a New Diffractive Multifocal Lens with Extended Depth of Focus. J Clin Med 2022; 11:jcm11247374. [PMID: 36555990 PMCID: PMC9781237 DOI: 10.3390/jcm11247374] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/02/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
This study compares the visual and refractive performance of the TECNIS Synergy (DFR00V-DFW150-225-300-375) multifocal intraocular lens (IOL) and the AcrySof IQ PanOptix (TFAT00-30-40-50-60) multifocal IOL. Patients who underwent phacoemulsification and cataract extraction and received either a multifocal Synergy or PanOptix IOL were included. Monocular uncorrected distance (UDVA), intermediate (UIVA), near (UNVA), and corrected distance (CDVA) visual acuities were assessed at three and six months postoperatively. Secondary outcome measures of photic phenomena were also assessed. A total of 140 patients (224 eyes) were included in this study, with 69 patients (105 eyes) in the Synergy group and 71 patients (119 eyes) in the PanOptix group. There were no statistically significant differences in UIVA or CDVA measurements across all time points. When assessing UDVA, at three months postoperatively, there were more eyes in the PanOptix group with vision better than 20/40 (p = 0.04). At three and six months postoperatively, the average UNVA was superior in the Synergy group (p = 0.01, 0.002). While the Synergy group reported more night vision disturbances at one and three months (p = 0.01, 0.03), the PanOptix group had more night vision disturbances at six months (p = 0.02). Although not statistically significant, the AcrySof IQ PanOptix multifocal IOL demonstrated better UDVA and UIVA sooner postoperatively than the TECNIS Synergy multifocal IOL. The Synergy IOL provided statistically better UNVA compared to the PanOptix IOL at three and six months postoperatively. Synergy patients reported more early photic phenomena than PanOptix patients, which later diminished.
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Affiliation(s)
- Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA
- John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT 84112, USA
- Utah Lions Eye Bank, Murray, UT 84107, USA
- Correspondence: ; Tel.: +1-(801)-563-0200
| | - Seth R. Stapley
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ 85308, USA
| | - Wyatt M. Corbin
- Stritch School of Medicine, Loyola University Chicago, Chicago, IL 60153, USA
| | - Nour Bundogji
- John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT 84112, USA
| | - Matthew Conley
- School of Medicine, University of Utah, Salt Lake City, UT 84132, USA
| | - Ines M. Darquea
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA
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29
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Łabuz G, van den Berg TJTP, Auffarth GU, Khoramnia R. Light scattering from a diffractive-refractive intraocular lens: a goniometer-based approach for individual zone assessment. BIOMEDICAL OPTICS EXPRESS 2022; 13:6724-6732. [PMID: 36589585 PMCID: PMC9774873 DOI: 10.1364/boe.474778] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 06/17/2023]
Abstract
We proposed and tested a method to measure light scattering from the diffractive lens profile in an echelle element featuring 9 zones. Measurements were performed using a goniometer-based setup up to 7.5°. The proportion of scattered light was calculated to derive the loss of light. Material scattering was minimal (∼1 deg2/sr); however, each echelle zone acted as a scattering source. A nearly gradual straylight increase was found with the zone number showing peak intensity between 3° and 3.75°. An estimated 6.2% ± 0.1% was lost due to scattering, which ought to be considered when reporting an IOL's light loss.
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Affiliation(s)
- Grzegorz Łabuz
- David J. Apple Center for Vision Research, Department of Ophthalmology, University Hospital Heidelberg, Heidelberg, Germany
| | - Thomas J. T. P. van den Berg
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Gerd U. Auffarth
- David J. Apple Center for Vision Research, Department of Ophthalmology, University Hospital Heidelberg, Heidelberg, Germany
| | - Ramin Khoramnia
- David J. Apple Center for Vision Research, Department of Ophthalmology, University Hospital Heidelberg, Heidelberg, Germany
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30
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Bucci Jnr FA. Patient Preference, Visual Quality, and Multivariate Regression Analysis with Contralateral Bifocal and Trifocal Intraocular Lenses. Clin Ophthalmol 2022; 16:4097-4107. [DOI: 10.2147/opth.s388462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/22/2022] [Indexed: 12/14/2022] Open
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Shen J, Lou H, Yu Q, Yao H, Yuan J. The Connection between High Myopia Patients and MiR-708a or MiR-148 Expression Levels in Aqueous Studies of Visual Acuity. BIOMED RESEARCH INTERNATIONAL 2022; 2022:3363830. [PMID: 36277877 PMCID: PMC9584676 DOI: 10.1155/2022/3363830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 08/13/2022] [Accepted: 08/20/2022] [Indexed: 11/17/2022]
Abstract
Myopia goes far beyond the inconvenience it brings. It is a prevailing and vision-threatening eye disease, especially in Asia. Aberrantly expressed miR-708a and miR-148 are critical for accurate diagnosis, good prognosis, and precise response prediction of myopia. In this paper, we aim to examine the potential contributions of miR-708a, miR-148a, and PAX6 to high myopia (HM). First, aqueous samples were taken from 25 exclusively HM eyes and 25 exclusively cataract eyes. For next-generation sequencing and bioinformatics analysis, RNA from sample 30one was used. Twenty more samples were used for RT-qPCR. 341 miRNAs in total were found in HM eyes; 249 mature miRNAs and 17 new miRNAs showed differential expression. The expression of hsa-miR-127-3p, hsa-let-7i-5p, and hsa-miR-98-5p was identified using RT-qPCR. MiR-708a and miR-148, which may be linked to the development of myopia and serve as possible biomarkers, are notably highly expressed in atrial tissues of HM patients. Our findings may help deepen the understanding of the mechanisms behind the high expression of miR-708a and miR-148 in atrial tissues of patients with HM.
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Affiliation(s)
- Jiang Shen
- Department of Ophthalmology, Ningbo Eye Hospital, Ningbo, 315040 Zhejiang, China
| | - Hong Lou
- Department of Ophthalmology, Ningbo Eye Hospital, Ningbo, 315040 Zhejiang, China
| | - Qihua Yu
- Department of Ophthalmology, Ningbo Eye Hospital, Ningbo, 315040 Zhejiang, China
| | - Hongyan Yao
- Department of Ophthalmology, Ningbo Eye Hospital, Ningbo, 315040 Zhejiang, China
| | - Jianshu Yuan
- Department of Ophthalmology, Ningbo Eye Hospital, Ningbo, 315040 Zhejiang, China
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Clinical Outcomes after Bilateral Implantation of Trifocal Diffractive Intraocular Lenses and Extended Depth of Focus Intraocular Lenses. J Clin Med 2022; 11:jcm11195729. [PMID: 36233597 PMCID: PMC9571716 DOI: 10.3390/jcm11195729] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 11/24/2022] Open
Abstract
The purpose of this retrospective study is to investigate clinical outcomes of bilateral implantation of diffractive trifocal intraocular lenses (IOLs) and extended depth of focus IOLs in Koreans. The clinical outcomes of cataract surgery with bilateral implantation of PanOptix, FineVision, Symfony, and MiniWell were evaluated. Uncorrected distant, intermediate (80 cm, 60 cm), near (40 cm) visual acuity, defocus curve, manifest refraction, contrast sensitivity, and higher-order aberrations, quality of vision, spectacle independence, and subjective satisfaction at postoperative 3 months were assessed. A total of 136 eyes in 68 patients were included in the analyses. PanOptix and FineVision performed better visual acuity compared to Symfony and MiniWell at 40 cm distance. Defocus curve showed broad range of vision in PanOptix and FineVision with visual acuity of more than 0.1 logarithm of the minimum angle of resolution at −2.5 diopter (D) of defocus power, while Symfony and MiniWell presented excellent intermediate vision without a dip at defocus power of −0.5 D to −1.0 D. Glare, halo, and starburst were significantly less in MiniWell compared to others. In conclusion, all four IOLs presented satisfactory clinical outcomes. PanOptix and FineVision provided good near and intermediate vision, while Symfony and MiniWell provided good intermediate vision. MiniWell induced little dysphotopsia.
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Hui N, Chu MF, Li Y, Wang CY, Yu L, Ma B. Comparative analysis of visual quality between unilateral implantation of a trifocal intraocular lens and a rotationally asymmetric refractive multifocal intraocular lens. Int J Ophthalmol 2022; 15:1460-1467. [PMID: 36124189 DOI: 10.18240/ijo.2022.09.08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 04/26/2022] [Indexed: 11/23/2022] Open
Abstract
AIM To compare visual quality after unilateral cataract surgery with implantation of trifocal intraocular lens (IOL) and asymmetric refractive multifocal IOL. METHODS The prospective nonrandom, comparative study consisted of 60 eyes of 60 patients suffering unilateral cataract surgery with implantation of two different IOLs: AT LISA tri 839MP (30 eyes; Carl Zeiss Meditec, Germany) and LS-313 MF30 (30 eyes; Oculentis GmbH, Germany). Visual acuity, refractive outcome, contrast sensitivity, defocus curves, quality of vision, and optical phenomena were evaluated at 3mo postoperatively. RESULTS There were no statistical differences between groups in uncorrected distance visual acuity (P=0.13) and uncorrected near visual acuity (P=0.54). In contrast, uncorrected intermediate visual acuity was better in trifocal group compared to the refractive multifocal group (P=0.02). No significant statistical between-group difference was detected in cylinder (P=0.43). Compared to trifocal group, spherical refraction and spherical equivalent in refractive multi focal group were more myopic (P<0.01). Under photopic conditions, no significant statistical differences were found between groups in contrast sensitivity at 3 and 6 cycles per degree (cpd). The refractive multifocal group performed better at 12 and 18 cpd than the trifocal group (P=0.01, P=0.034, respectively). The questionnaires of quality of vision and optical phenomena showed no differences between groups. CONCLUSION Trifocal IOL is superior to refractive multifocal IOL in intermediate visual acuity. Rotationally asymmetric refractive multifocal IOL is more myopic in automated refraction and significantly better for the photopic contrast sensitivity at high frequency.
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Affiliation(s)
- Na Hui
- Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Mei-Fang Chu
- Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Yan Li
- Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Cong-Yi Wang
- Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Lei Yu
- Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Bo Ma
- Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
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Torky MA, Nokrashy AE, Metwally H, Abdelhameed AG. Visual performance following implantation of presbyopia correcting intraocular lenses. Eye (Lond) 2022:10.1038/s41433-022-02188-y. [PMID: 35941184 DOI: 10.1038/s41433-022-02188-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 06/22/2022] [Accepted: 07/14/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To compare the visual outcomes following bilateral implantation of 3 presbyopia correcting IOLs. METHODS Results are reported for patients who underwent phacoemulsification with bilateral implantation of one of the following IOLs: Panoptix IOL, AT LISA tri IOL and Symphony IOL. Six months postoperative examination included monocular UIVA at 80 and 60 cm and monocular UNVA and DCNVA at 40 cm, monocular UDVA and CDVA, Spherical equivalent (SE) refraction, binocular defocus curve, contrast sensitivity, photopic phenomena, and spectacle independence. RESULTS UIVA at 80 cm was significantly better in the AT LISA group and the Symfony groups than the Panoptix group, while UIVA at 60 cm was better in the Symfony group and the Panoptix group than the AT LISA group. A worse DCNVA was recorded in the Symfony group. At a defocus of -2.50 D, the near VA was similar in the PanOptix and AT LISA groups (0.05, 0.07 logMAR respectively), which were significantly better than the Symfony group (0.3 LogMAR). Binocular photopic and scotopic contrast sensitivity outcomes were similar among the three groups at all spatial frequencies. In Symphony group, the frequency and the degree of bother of photic phenomena was relatively higher than the other two groups. Higher percentage of patients in symphony group reported their need for reading glasses. CONCLUSION PanOptix IOL and AT LISA IOL would be a good choice for patients aiming for an optimum near vision, while Symfony IOL seems suitable for patients having the priority for good intermediate vision.
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Affiliation(s)
- Magda A Torky
- Department of Ophthalmology, Mansoura Ophthalmic Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | - Amgad El Nokrashy
- Department of Ophthalmology, Mansoura Ophthalmic Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Heba Metwally
- Memorial Institute of Ophthalmic Research, Mansoura, Egypt
| | - Ameera G Abdelhameed
- Department of Ophthalmology, Mansoura Ophthalmic Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Knecht VA, Colosi HA, Hassenstein A. Partial monovision achieved by unilateral implantation of a multifocal add-on lens with bilateral pseudophakia: evaluation and results. Graefes Arch Clin Exp Ophthalmol 2022; 260:2753-2762. [PMID: 35175409 PMCID: PMC9325843 DOI: 10.1007/s00417-022-05584-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/04/2022] [Accepted: 02/01/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To assess the results of partial monovision (PMV) in comparison to a bilateral monofocal implantation (MMV). METHODS The PMV group was treated bilaterally with a monofocal intraocular lens (IOL) implantation, followed 3 months later by the implantation of a multifocal AddOn® lens (+ 3.00 D) into the non-dominant eye. The MMV group received a bilateral monofocal IOL implantation intending to achieve a slight anisometropia (0.0 D/ - 0.50 D). The near visual acuity (UNVA), intermediate visual acuity (UIVA), distance visual acuity (UDVA), defocus curve, and Lang-Stereotest II were conducted uncorrected, binocular, and minimum 3 months after the last operation. For the contrast sensitivity test, the patients were refractively corrected. The Quality of Vision Questionnaire (QoV), Visual Function Questionnaire (VF-14), spectacle independence, and general satisfaction were also assessed. RESULTS A total of 27 PMV patients and 28 MMV patients without ocular diseases relevant to visual acuity were examined. The PMV group was significantly better at UNVA (0.11 ± 0.08 logMAR vs 0.56 ± 0.16 logMAR) and between - 2.00 and - 4.00 D in the defocus curve (p < 0.001). At the UIVA, the PMV group was slightly better (0.11 ± 0.10 logMAR vs 0.20 ± 0.18 logMAR) but not significant (p = 0.054). The UDVA (- 0.13 ± 0.09 logMAR vs - 0.09 ± 0.14 logMAR) (p = 0.315) and contrast sensitivity (p = 0.667) revealed no differences between the groups. The stereo vision was in favor of PMV (p = 0.008). Spectacle independence was statistically better for PMV at distance, intermediate, and near (distance p = 0.012; intermediate p < 0.001; near p < 0.001). In the VF-14 Questionnaire, the PMV was statistically superior (p < 0.001). The QoV Questionnaire showed no differences regarding frequency and severity of visual disturbances. Both groups were highly satisfied (p = 0.509). CONCLUSION Patients with PMV are more independent of glasses and are able to read without disadvantages in distance vision, due to halos and glare. The concept of PMV is well suited for the desire of eyeglass independence, without optical side effects.
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Affiliation(s)
- Vitus André Knecht
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- Department of Ophthalmology, Charité University Medicine Berlin, Mittelallee 4, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Horaţiu Alexandru Colosi
- Department of Medical Education, Division of Medical Informatics and Biostatistics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andrea Hassenstein
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Semiz F, Lokaj AS, Musa NH, Semiz CE, Demirsoy ZA, Semiz O. SMILE for the Treatment of Residual Refractive Error After Cataract Surgery. Ophthalmol Ther 2022; 11:1539-1550. [PMID: 35643966 PMCID: PMC9253212 DOI: 10.1007/s40123-022-00526-7] [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: 03/28/2022] [Accepted: 05/09/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION In the context of managing patients' expectations and satisfaction regarding visual acuity after cataract surgery, we aimed to investigate the improvement in visual acuity and patient satisfaction after small-incision lenticule extraction (SMILE) in pseudophakic (trifocal intraocular lens, IOL) patients with residual myopic refraction after cataract surgery. METHODS Seventy-six patients (82 eyes) who underwent cataract surgery with ZEISS AT LISA tri 839MP IOL implantation were included in this retrospective study. The included patients were 56-79 years old, wanted spectacle independence, and had preoperative myopic refraction between - 1.0 and - 2.25 diopters (D) and astigmatism between - 0.75 and - 1.75 D. The treatment status of these patients was defined as trifocal IOL (n = 82). SMILE was performed in patients who were dissatisfied after cataract surgery, and these patients were followed up for 1 year on average. We evaluated visual acuity and satisfaction and further examined laser vision correction and satisfaction levels in patients who were dissatisfied after trifocal IOL implantation. RESULTS The possible reasons for patient dissatisfaction were reading books, using a computer, and driving at night. After SMILE, the residual myopic refractive error (spherical) decreased significantly from - 2.08 ± 0.28 [- 2.25 to - 1.0] preoperatively to - 0.25 ± 0.20 - 0.5 to 0] 1 year postoperatively (p < 0.001). Additionally, the uncorrected distance visual acuity increased from 0.65 ± 0.08 [0.52-0.7] logMAR preoperatively to 0.09 ± 0.02 [0.05-0.1] logMAR at 1 month postoperatively (p < 0.001), 0.09 ± 0.02 [0.05-0.1] logMAR at 6 months postoperatively, and 0.06 ± 0.02 [0.05-0.1] logMAR at 12 months postoperatively (p < 0.001). Patient satisfaction measures after SMILE (reading, night driving, and using a computer) were significantly improved. CONCLUSION SMILE is a reliable method for treating residual refraction after cataract surgery, as it provides results in the shortest time without complications and increases patient satisfaction. TRIAL REGISTRATION The protocol was registered on clinicaltrials.gov (NCT04693663).
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Affiliation(s)
- Faruk Semiz
- Department of Ophthalmology, Eye Hospital, Prishtina, Kosova.
| | | | | | | | | | - Olcay Semiz
- Department of Ophthalmology, Eye Hospital, Prishtina, Kosova
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Self-rated quality of vision and optical phenomena intensity of diffractive presbyopia-correcting IOLs: EDoF, trifocal vs panfocal. J Cataract Refract Surg 2022; 48:877-886. [PMID: 34753879 DOI: 10.1097/j.jcrs.0000000000000862] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 11/01/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE To investigate the self-rated quality of vision (SQV) and optical phenomena intensity of 3 diffractive multifocal intraocular lenses (mIOLs). SETTING Department of Ophthalmology, Goethe University Frankfurt, Germany. DESIGN Prospective comparative case series. METHODS Patients who had bilateral implantation of a diffractive extended depth-of-focus (EDoF), trifocal, or panfocal mIOL were assessed. Outcome parameters were SQV, symptom intensity of optical phenomena under 3 lighting conditions, quality of everyday lifestyle activities, spectacle independence (SI), and contrast sensitivity (CS). RESULTS The study comprised 108 eyes. The 3 lenses provided good total SQV under all lighting conditions. EDoF patients reported a slightly better total SQV (EDoF: 9.8 ± 6.67, trifocal: 22.2 ± 7.09, panfocal: 19.6 ± 16.25 visual analog scale, P = .041). A similar percentage of patients reported the presence of optical phenomena with no difference between mIOLs ( P > .05). EDoF, trifocal, and panfocal patients rated symptom intensity of optical phenomena mild to moderate under all lighting conditions; however, EDoF patients reported a lower symptom intensity of halos ( P < .05). Reported quality of everyday lifestyle activities and CS were comparable ( P < .05). All panfocal and trifocal patients (100%) achieved complete SI, whereas almost half (44%) of the EDoF patients used reading spectacles. CONCLUSIONS Diffractive EDoF, trifocal, and panfocal mIOLs provided good total SQV with mild to moderate intensity of optical phenomena under all lighting conditions. EDoF patients experienced the same percentage of optical phenomena but reported a weaker symptom intensity of halos and better night-driving ability. EDoF patients would all choose the same IOL, although a significant number of them needed reading spectacles, indicating that SI is not the main factor that determines patient selection of IOLs.
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Far and Near Contrast Sensitivity and Quality of Vision with Six Presbyopia Correcting Intraocular Lenses. J Clin Med 2022; 11:jcm11144150. [PMID: 35887913 PMCID: PMC9316344 DOI: 10.3390/jcm11144150] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/12/2022] [Accepted: 07/15/2022] [Indexed: 11/16/2022] Open
Abstract
The objective of this prospective, randomized, double-masked study was to compare the contrast sensitivity and quality of vision of patients bilaterally implanted with the following six different presbyopia correcting intraocular lenses (IOLs): SV25T0 (n = 19), ATLISA 809M (n = 18), ATLISA TRI 839MP (n = 19), ZKB00 (n = 20), ZLB00 (n = 20) and Symfony ZXR00 (n = 20). For comparison purposes, 36 patients were implanted with a monofocal lens (ZA9003). Contrast sensitivity was assessed binocularly at distance under photopic, mesopic and mesopic plus glare conditions, and at near under photopic conditions. Quality of vision was explored in terms of photic phenomena and spectacle independence. Overall, the monofocal lens offered better contrast sensitivity, under all illumination conditions, and less occurrence and intensity of photic phenomena. Amongst the multifocal IOL (MIOL) designs, the extended depth of focus Symfony ZXR00 provided better contrast sensitivity than the other MIOLs, particularly at intermediate and high spatial frequencies. Up to 40% and 50% of patients implanted with MIOLs reported glare and halos, respectively. The SV25T0 resulted in less occurrence and intensity of halos. The evaluation of photic phenomena and contrast sensitivity under different illumination conditions may reflect real-life, visually challenging situations, and thus provide insightful information to assist ophthalmic surgeons when selecting the best intraocular lens for their patients.
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Gundersen KG, Potvin R. Refractive and Visual Outcomes After Implantation of a Secondary Sulcus Intraocular Lens with an Extended Depth of Focus. Clin Ophthalmol 2022; 16:1861-1869. [PMID: 35711970 PMCID: PMC9192784 DOI: 10.2147/opth.s366145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 05/31/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose To evaluate the range of vision, visual function, and quality of vision after implantation of a secondary extended depth of focus intraocular lens (EDOF IOL) implanted in the sulcus. Setting One clinical practice in Haugesund, Norway. Design Prospective single arm non-interventional study. Methods Eligible subjects presenting for surgery, or who had previous successful primary cataract or refractive lens exchange surgery in both eyes were subsequently implanted with the AddOn® secondary EDOF IOL in the sulcus. Manifest refraction and visual acuity at distance, intermediate and near were measured 3 months after surgery, along with the monocular defocus curve. Subjects also completed a visual function and a quality of vision questionnaire. Results The study included 32 eyes of 16 subjects. At 3 months postoperative, the mean refraction spherical equivalent (MRSE) was −0.16 ± 0.30 D, with a residual cylinder of 0.29 ± 0.27 D. The mean monocular uncorrected VA was 0.1 logMAR (20/25) or better at all test distances. The monocular defocus curves showed a depth of focus of 2.0 D. For every category except reading fine print, all but one subject (94%) had no difficulty or little difficulty with near tasks. Glare and halos were the most common visual disturbances, with no reports of starbursts. There was no evidence of any intralenticular opacification in any of the eyes, and no evidence of iris chafing/depigmentation. Conclusion This secondary EDOF IOL provided excellent distance and intermediate vision, and very good near vision to subjects. Subject reported near visual function was also very good and visual disturbances were limited. This lens appears to be a good option for patients who would like to improve their range of vision. Results appear as good or better than those reported for primary EDOF lenses.
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Affiliation(s)
- Kjell Gunnar Gundersen
- IFocus Øyeklinikk AS, Haugesund, Norway
- Correspondence: Kjell Gunnar Gundersen, IFocus Øyeklinikk AS, Sørhauggata 111, Haugesund, 5527, Norway, Tel +47 808900, Email
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Kim S, Yi R, Chung SH. Comparative Analysis of the Clinical Outcomes of Mix-and-Match Implantation of an Extended Depth-of-Focus and a Diffractive Bifocal Intraocular Lens. Eye Contact Lens 2022; 48:261-266. [PMID: 35333819 DOI: 10.1097/icl.0000000000000887] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate and compare the clinical outcomes of the extended depth-of-focus intraocular lens (EDOF-IOL) and the diffractive bifocal IOL. METHODS Fifty-six eyes of 28 patients underwent cataract surgery with implantation of an EDOF-IOL (TECNIS Symfony, ZXR00) in their dominant eye and a diffractive bifocal IOL (+3.25 D add TECNIS ZLB00) in their nondominant eye. Monocular and binocular uncorrected distance, intermediate and near visual acuity, defocus curves, contrast sensitivity, patient satisfaction score (0-5), and spectacle dependence at near vision were evaluated at 3 months after the surgery. RESULTS Postoperative binocular uncorrected distant visual acuity was 0.009±0.031 logMAR, uncorrected intermediate visual acuity was 0.090±0.158 logMAR, and uncorrected near visual acuity was 0.099±0.068 logMAR. The monocular defocus curve demonstrated better performance at intermediate distance in eyes with an EDOF-IOL and better performance at near distance in eyes with a diffractive bifocal IOL. An EDOF-IOL exhibited better outcomes in contrast sensitivity compared with a diffractive bifocal IOL. Three patients (10.7%) required glasses for near vision. CONCLUSION Mix-and-match implantation of a diffractive bifocal IOL with an EDOF-IOL provides an excellent range of vision, and high levels of contrast sensitivity and patient satisfaction.
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Affiliation(s)
- Seonjoo Kim
- Department of Ophthalmology (S.K., S.-H.C.), Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; and Department of Ophthalmology, Gimpo Hangil Eye Hospital (R.Y.), Gimpo, Gyeonggi do, Republic of Korea
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Chao CC, Lin HY, Lee CY, Mai ELC, Lian IB, Chang CK. Difference in Quality of Vision Outcome among Extended Depth of Focus, Bifocal, and Monofocal Intraocular Lens Implantation. Healthcare (Basel) 2022; 10:healthcare10061000. [PMID: 35742051 PMCID: PMC9223205 DOI: 10.3390/healthcare10061000] [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: 04/08/2022] [Revised: 05/18/2022] [Accepted: 05/24/2022] [Indexed: 02/04/2023] Open
Abstract
We aimed to compare the postoperative quality of vision among patients who received extended depth of focus (EDOF), bifocal, and monofocal intraocular lens (IOL) implantation. A retrospective study was conducted, and 87 patients who underwent cataract surgery were enrolled. Patients were categorized into different groups according to IOL design, with 24, 29, and 34 individuals constituting bifocal, EDOF, and monofocal groups. Preoperative and postoperative visual acuity (VA), biometry data, refractive status, contrast sensitivity (CS), higher-order aberrations (HOAs), and a quality of vision questionnaire that consisted of 11 questions were obtained 1 month postoperatively. The Kruskal−Wallis test and Pearson’s chi-square test were applied for statistical analyses. The postoperative CDVA was better in the EDOF group than in the bifocal group (p = 0.043), and the residual cylinder was lower in the EDOF groups than in the other two groups (both p < 0.05). The CS was worse in the EDOF group than in the other two groups (all p < 0.05), while the spherical aberration and trefoil were lower in the EDOF group than in the bifocal group (both p < 0.05). In terms of the quality of vision, the scores were better in the monofocal group than in the EDOF group in seven items (all p < 0.05), and the quality of vision in the bifocal group was better than in the EDOF group in small print reading (p = 0.042). In addition, the incidence of glare was lower in the monofocal group than in the other two groups (p < 0.001), while the spectacle dependence ratio was significantly higher in the monofocal group compared to the other two groups (p < 0.001). In conclusion, the general quality of vision was better in the monofocal group compared to the bifocal and EDOF groups, while the spectacle dependence ratio was significantly higher in the monofocal group than in the other two groups.
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Affiliation(s)
- Chen-Cheng Chao
- Nobel Eye Institute, Taipei 100008, Taiwan; (C.-C.C.); (C.-Y.L.)
- Department of Optometry, MacKay Junior College of Medicine, Nursing, and Management, Taipei 11260, Taiwan;
| | | | - Chia-Yi Lee
- Nobel Eye Institute, Taipei 100008, Taiwan; (C.-C.C.); (C.-Y.L.)
| | - Elsa Lin-Chin Mai
- Department of Optometry, MacKay Junior College of Medicine, Nursing, and Management, Taipei 11260, Taiwan;
- Department of Optometry, Yuanpei University of Medical Technology, Hsinchu 30015, Taiwan
- Department of Ophthalmology, Far Eastern Memorial Hospital, Taipei 220216, Taiwan
| | - Ie-Bin Lian
- Institute of Statistical and Information Science, National Changhua University of Education, Changhua 50007, Taiwan;
| | - Chao-Kai Chang
- Nobel Eye Institute, Taipei 100008, Taiwan; (C.-C.C.); (C.-Y.L.)
- Department of Optometry, Yuanpei University of Medical Technology, Hsinchu 30015, Taiwan
- Departament of Optometry, Da-Yeh University, Chunghua 515006, Taiwan
- Correspondence: ; Tel.: +886-2-2370-5666
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Baur ID, Auffarth GU, Łabuz G, Khoramnia R. [Implantation of a Toric IOL with Enhanced Depth of Focus for Unilateral Traumatic Cataract]. Klin Monbl Augenheilkd 2022. [PMID: 35580622 DOI: 10.1055/a-1809-5187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Isabella Diana Baur
- Universitäts-Augenklinik Heidelberg, Universitätsklinikum Heidelberg, Deutschland
| | - Gerd U Auffarth
- Universitäts-Augenklinik Heidelberg, Universitätsklinikum Heidelberg, Deutschland
| | - Grzegorz Łabuz
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg, Deutschland
| | - Ramin Khoramnia
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg, Deutschland
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Baur ID, Auffarth GU, Łabuz G, Khoramnia R. Clinical outcomes in patients after duet procedure for reversible trifocality using a supplementary trifocal IOL. Am J Ophthalmol 2022; 241:217-226. [PMID: 35526588 DOI: 10.1016/j.ajo.2022.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE We report the clinical outcomes of patients who had primary lens implantation in the capsular bag and subsequently a supplementary trifocal lens implanted in the ciliary sulcus (duet procedure) to create reversible trifocality. DESIGN Retrospective interventional case series. METHODS Twenty-five patients were included in this single center clinical study, who had undergone either refractive lens exchange for presbyopia correction or cataract surgery. All had lens removal by phacoemulsification and duet procedure to achieve reversible trifocality. Preoperatively and three months postoperatively, uncorrected (UDVA) and corrected distance visual acuity (CDVA) were assessed, as well as uncorrected (UNVA), distance corrected (DCNVA) and corrected near visual acuity (CNVA). At the postoperative examination, uncorrected (UIVA), distance corrected (DCIVA) and corrected intermediate visual acuity (CIVA), defocus curve testing and dysphotopsia evaluation were also performed. RESULTS Monocular UDVA and CDVA improved from 0.71 ± 0.43 logMAR and 0.12 ± 0.16 logMAR preoperatively to 0.04 ± 0.10 logMAR and -0.01 ± 0.09 logMAR postoperatively. Monocular UNVA and DCNVA were both 0.06 ± 0.08 logMAR and UIVA and DCIVA 0.00 ± 0.10 logMAR and -0.02 ± 0.10 logMAR postoperatively. Monocular defocus curve testing revealed a visual acuity of 0.2 logMAR or better from +0.75 to -3.5 diopters. CONCLUSIONS Duet procedure using a trifocal supplementary IOL provided excellent results for far, near and intermediate distance, comparable to those reported for capsular bag fixated trifocal IOLs. The duet procedure offers the advantage of an exit-strategy in cases with a future loss of function or side effects associated with the optics.
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Twelve-Month Clinical Outcomes After Implantation of a Novel, Modular, Anterior Shape-Changing Fluid Optic Intraocular Lens. J Cataract Refract Surg 2022; 48:1134-1140. [PMID: 35297798 DOI: 10.1097/j.jcrs.0000000000000935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 03/10/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To report the initial safety and effectiveness profile for an anterior shape-changing, modular IOL, Juvene (JIOL), for the treatment of aphakia and presbyopia after removal of the natural crystalline lens due to cataract. SETTING Two private practices in Monterrey and Tijuana, Mexico. DESIGN Exploratory, prospective, multi-center, open-label, non-comparative clinical trial. METHODS A convenience sample of subjects aged 50-80 years with planned cataract surgery were recruited to undergo unilateral or bilateral implantation with the JIOL. Subjects were required to complete an informed consent and be able to dilate to at least 6.0 mm pharmacologically, be in good overall health, and have no significant eye health history to qualify. Visual acuities, defocus curves, and contrast sensitivity were measured for all subjects 12 months postoperatively. RESULTS Fifty-one of 58 eyes completed the 12-month visit. Intraoperative complication rates were extremely low (N=1; missed base lens tab). The most frequent adverse events (AE) were prolonged inflammation (N=6) and cystoid macular edema (N=4); all AEs were resolved without sequelae by the 12-month visit. Mean monocular logMAR corrected distance visual acuity (CDVA), distance-corrected intermediate (DCIVA) and near (DCNVA) were 0.01, 0.08, and 0.24, respectively. Defocus testing showed VA > 20/40 from approximately +1.00 D through -2.00 D. Binocular implantation (n=16) provided superior performance over monocular implantation. CONCLUSIONS The Juvene IOL offers a novel solution to treat presbyopia, providing clear functional vision performance across a range of distances with an acceptable initial safety profile.
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Britton JJL, El-Defrawy S, Wong BM, Chandrakumar M, Omali NB, Pham S, Hatch W. Patient Satisfaction and Visual Function Following Implantation of Trifocal or Extended Range of Vision Intraocular Lenses. Clin Ophthalmol 2022; 16:669-676. [PMID: 35282167 PMCID: PMC8906876 DOI: 10.2147/opth.s339385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/22/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Materials and Methods Results Conclusion
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Affiliation(s)
- Julia J L Britton
- Faculty of Medicine, National University of Ireland-Galway, Galway, Ireland
| | - Sherif El-Defrawy
- Department of Ophthalmology and Vision Science, Kensington Eye Institute, Toronto, Ontario, Canada
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Correspondence: Sherif El-Defrawy, Kensington Eye Institute, 340 College Street #400, Toronto, Ontario, M5T 3A9, Canada, Tel +1 416 978-7931, Email
| | - Bryan M Wong
- Department of Ophthalmology and Vision Science, Kensington Eye Institute, Toronto, Ontario, Canada
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Manokaraananthan Chandrakumar
- Department of Ophthalmology and Vision Science, Kensington Eye Institute, Toronto, Ontario, Canada
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Negar B Omali
- Department of Ophthalmology and Vision Science, Kensington Eye Institute, Toronto, Ontario, Canada
| | - Song Pham
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Wendy Hatch
- Department of Ophthalmology and Vision Science, Kensington Eye Institute, Toronto, Ontario, Canada
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
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Comparison of Visual Outcomes and Quality of Life in Patients with High Myopic Cataract after Implantation of AT LISA Tri 839MP and LS-313 MF30 Intraocular Lenses. J Ophthalmol 2022; 2022:5645752. [PMID: 35265369 PMCID: PMC8901302 DOI: 10.1155/2022/5645752] [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: 11/17/2021] [Accepted: 02/04/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose To investigate the benefits of multifocal lens in patients with high myopic cataract and compare the clinical effects between AT LISA tri 839MP and MPlus LS-313 MF30 intraocular lenses (IOLs) in high myopic eyes. Methods This retrospective cohort study analyzed 60 eyes with axial length >26 mm in 40 patients. Thirty eyes were implanted with MF30, and the remaining 30 eyes were implanted with 839MP. Postoperative uncorrected distance visual acuity (UDVA), best corrected distance visual acuity (BCDVA), uncorrected intermediate visual acuity (UIVA) and uncorrected near visual acuity (UNVA), defocus curve, modulation transfer function (MTF) curve, Strehl ratio (SR), and complications were compared between the two groups. Results All vision outcomes were significantly improved in both groups (p < 0.05). There was no significant between-group difference in UDVA at 1 and 3 months postoperatively (p > 0.05). However, UIVA and UNVA were significantly better in the 839MP group (p < 0.05). The VF-14 score, especially for near vision quality, was significantly higher in the MF30 group (2.2 ± 0.9 vs. 0.8 ± 0.7; p ≤ 0.001). The SR of both groups significantly increased postoperatively (p < 0.05). All the 3-month MTF curve values (MTF 10 total, MTF 10 internal, MTF 30 total, and MTF 30 internal) were significantly better in the 839MP group (p < 0.05). Meanwhile, all the high-order aberration values (coma, spherical aberration, and trefoil) were significantly greater in the MF30 group (p < 0.05). Conclusion Multifocal IOL implantation achieves good quality of distance, intermediate, and near vision in patients with high myopia, improving their quality of life. Both 839MP and MF30 IOLs can provide good distance vision, but 839MP performs better in near and intermediate vision. However, for some patients with an extra-long optic axis, MF30 may be a good choice because of its wider range of degrees.
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Qin M, Ji M, Zhou T, Yuan Y, Luo J, Li P, Wang Y, Chen X, Chen W, Guan H. Influence of angle alpha on visual quality after implantation of extended depth of focus intraocular lenses. BMC Ophthalmol 2022; 22:82. [PMID: 35177032 PMCID: PMC8855559 DOI: 10.1186/s12886-022-02302-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 02/01/2022] [Indexed: 11/18/2022] Open
Abstract
Background To assess postoperative changes in angle alpha, and to evaluate the postoperative visual quality of patients with different angle alpha values after implantation of extended depth of focus (EDOF) intraocular lenses (IOLs). Methods Seventy-nine eyes of 79 patients who had phacoemulsification with EDOF IOLs implantation were enrolled. A cut-off value of 0.3 mm, 0.4 mm, and 0.5 mm in preoperative angle alpha was chosen to divide eyes into groups. Distance, intermediate, and near visual acuities, modulation transfer function (MTF), and aberrations were recorded during a 6-month follow-up. A patient questionnaire was completed. Results There were no significant differences in angle alpha postoperatively compared to preoperatively. No significant differences were found in visual acuity and MTF between all groups. With 5 mm pupil diameter, there were significant differences of higher-order aberrations and spherical aberration in ocular aberration and internal aberration between angle alpha<0.4 mm and angle alpha≥0.4 mm. Additionally, significant differences of coma were also added in cut-off value of 0.5 mm. When the value of angle alpha is 0.4 mm or higher, there were significant differences in the score of halos and glare. Conclusions Angle alpha did not affect visual acuity, but the value of 0.4 mm or higher in angle alpha affected the visual quality under scotopic conditions and occurrence of halos and glare. For patients with 0.4 mm or higher in angle alpha, the choice to implant a EDOF IOL should be carefully considered. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-022-02302-4.
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Affiliation(s)
- Miaomiao Qin
- Eye Institute, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu, China
| | - Min Ji
- Eye Institute, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu, China
| | - Tianqiu Zhou
- Eye Institute, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu, China
| | - Yurong Yuan
- Eye Institute, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu, China
| | - Jiawei Luo
- Eye Institute, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu, China
| | - Pengfei Li
- Eye Institute, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu, China
| | - Ying Wang
- Eye Institute, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu, China
| | - Xiaojuan Chen
- Eye Institute, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu, China
| | - Wei Chen
- Eye Institute, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu, China.
| | - Huaijin Guan
- Eye Institute, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu, China.
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Bala C, Poyales F, Guarro M, Mesa RR, Mearza A, Varma DK, Jasti S, Lemp-Hull J. Multicountry clinical outcomes of a new nondiffractive presbyopia-correcting IOL. J Cataract Refract Surg 2022; 48:136-143. [PMID: 34288635 PMCID: PMC8845530 DOI: 10.1097/j.jcrs.0000000000000712] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 06/07/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the effectiveness and safety of a new presbyopia-correcting intraocular lens (IOL) with a nondiffractive design, DFT015, compared with an aspheric monofocal IOL, SN60WF. SETTING 19 investigational sites in 4 countries: Australia, Canada, Spain, and the United Kingdom. DESIGN Prospective, randomized, parallel-group, controlled, assessor- and patient-masked clinical study. METHODS Participants aged ≥22 years with bilateral cataracts were randomized to DFT015 or SN60WF in a 5:4 ratio and masked until final postoperative follow-up at month 6. The primary effectiveness objective was superiority of DFT015 over SN60WF in mean monocular photopic distance-corrected intermediate visual acuity (DCIVA) at month 3. Secondary effectiveness objectives included noninferiority of DFT015 to SN60WF in mean monocular photopic corrected distance visual acuity (CDVA) and superiority in the mean monocular photopic distance-corrected near visual acuity (DCNVA) at month 3. Visual disturbances were assessed at month 6. RESULTS 282 patients were randomized to DFT015 (n = 159) or SN60WF (n = 123). All effectiveness objectives were achieved at month 3 in first eyes. For monocular photopic results in first eyes, DFT015 demonstrated superior mean DCIVA (least squares means of -0.139 logMAR in favor of DFT015, P < .001), noninferior mean CDVA (97.5% upper confidence limit [UCL] of the difference was <0.1 logMAR) and superior mean DCNVA (95% UCL of the difference was <0.0 logMAR) compared with SN60WF at month 6. DFT015 exhibited a similar visual disturbance profile to that of SN60WF. CONCLUSIONS DFT015 provided superior intermediate and near vision and a similar visual disturbance profile compared with an aspheric monofocal IOL.
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Comparison of Patient Outcomes following Implantation of Trifocal and Extended Depth of Focus Intraocular Lenses: A Systematic Review and Meta-Analysis. J Ophthalmol 2022; 2021:1115076. [PMID: 35003788 PMCID: PMC8731298 DOI: 10.1155/2021/1115076] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/17/2021] [Indexed: 01/19/2023] Open
Abstract
Purpose The purpose is to compare the outcomes of implantation of trifocal intraocular lenses (TIOLs) and extended depth of focus (EDOF) intraocular lenses (IOLs). Methods A comprehensive search of PubMed, Cochrane Library, EMBASE, and ClinicalTrial.gov was conducted in March 2020 to identify relevant studies. A meta-analysis of the results was performed. Patients implanted with EDOF IOLs or TIOLs in previous studies were included. The primary outcomes of the study were uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), and defocus curve. Results TIOLs and EDOF IOLs provided comparable binocular UDVA (MD = -0.01, 95% CI: -0.04, 0.03, logMAR). However, EDOF IOLs provided better UIVA (MD: -0.08, 95% CI: -0.14, -0.01, logMAR) and worse UNVA (MD: 0.10, 95% CI: 0.06, 0.14, logMAR) than TIOLs. Fewer patients achieved spectacle independence after implantation of EDOF IOLs (RR: 0.74, 95% CI: 0.63, 0.87) than after implantation of TIOLs, especially for near vision (RR = 0.82, 95% CI: 0.68, 0.99). There was no statistically significant difference in contrast sensitivity (CS) under photopic or mesopic conditions with both IOLs. Patient satisfaction after implantation of both IOLs was high. Conclusion EDOF IOLs and TIOLs provide comparable distance vision. However, EDOF IOLs provide better intermediate vision and worse near vision than TIOLs. The advantages of EDOF IOLs over TIOLs in terms of CS, aberrations, and visual disturbance are not significant. Patients are satisfied with both types of IOLs.
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Gundersen KG, Potvin R. Clinical Outcomes and Quality of Vision Associated with Bilateral Implantation of a Wavefront Shaping Presbyopia Correcting Intraocular Lens. Clin Ophthalmol 2022; 15:4723-4730. [PMID: 34983995 PMCID: PMC8699763 DOI: 10.2147/opth.s342947] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 12/10/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To provide normative visual acuity and quality of vision data related to bilateral implantation of a wavefront shaping presbyopia correcting intraocular lens (IOL). Patients and Methods This was a non-interventional research study of the refraction, visual acuity (VA) and quality of vision achieved after bilateral implantation of a wavefront shaping presbyopia correcting intraocular lens between 3 months and 12 months post-surgery. The manifest refraction, and uncorrected and distance corrected VA at near, intermediate and distance (40 cm, 50 cm, 66cm, 4 m) were tested. Binocular mesopic VA at 4m and uncorrected photopic low contrast (25%) VA at 4 m were also tested, the latter with and without a glare source. A patient reported outcome questionnaire was administered. Defocus curve testing with and without simulated myopia in the non-dominant eye was also tested (reported elsewhere). Results Forty subjects completed the study. There was no statistically significant difference between the uncorrected and distance corrected VA at any distance. Mean logMAR binocular VAs were (−0.07 ± 0.07) at 4 m, (0.00 ± 0.07) at 66 cm and (0.07 ± 0.11) at 40 cm. Uncorrected photopic low contrast VA was statistically significantly better without glare (0.09 ± 0.10) compared to with glare (0.44 ± 0.21, p < 0.01). Reported glare, halos and starbursts were “not at all” Or “a little” bothersome for more than 95% of subjects. Hazy vision and blurred vision were reported most often. Conclusion The Vivity IOL provided patients with good distance and intermediate vision, and functional near vision with low reported bother from glare, halos, or starbursts. ![]()
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