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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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Skrzypecki J, Izdebska J, Ordon AJ, Przybek-Skrzypecka J, Szaflik JP. Spherical aberrations and their role in modern ophthalmology. Clin Exp Optom 2023; 106:703-710. [PMID: 36822601 DOI: 10.1080/08164622.2022.2160235] [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: 07/20/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 02/25/2023] Open
Abstract
Spherical aberration is an imperfection of the optical system of the human eye. The role of spherical aberration of the human eye in the quality of vision and pseudoaccommodation is reviewed. Spherical aberration is an imperfection of the optical system of the human eye. In most cases, due to well-developed neuroadaptation, it is insignificant for the perception of the image. Nevertheless, its role in modern ophthalmology is far from straightforward. On the one hand, there are clinical scenarios in which an excess of spherical aberration degrades the retinal image and leads to a high dissatisfaction rate among patients.©Recently, there is a growing interest in the modulation of spherical aberration in the clinical setting. Modern intraocular lenses as well as laser refractive procedures are aimed at interfering with spherical aberrations of the optical system in order to increase range of pseudoaccommodation. Here, we review the role of spherical aberration of the human eye in the quality of vision and pseudoaccommodation.
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Affiliation(s)
- Janusz Skrzypecki
- Departament of Ophthalmology, Independent Public University Eye Hospital, Warsaw, Poland
- Department of Experimental Physiology and Pathophysiology, Medical University of Warsaw, Warsaw, Poland
| | - Justyna Izdebska
- Departament of Ophthalmology, Independent Public University Eye Hospital, Warsaw, Poland
- Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland
| | - Agata Joanna Ordon
- Departament of Ophthalmology, Independent Public University Eye Hospital, Warsaw, Poland
- Department of Binocular Vision Pathophysiology and Strabismus, Medical University of Lodz, Lodz, Poland
| | - Joana Przybek-Skrzypecka
- Departament of Ophthalmology, Independent Public University Eye Hospital, Warsaw, Poland
- Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland
| | - Jacek Pawel Szaflik
- Departament of Ophthalmology, Independent Public University Eye Hospital, Warsaw, Poland
- Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland
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3
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Wang D, Liu C, Guan W, Lu Z, Zhao Y, Zhao Y. Effect of larger corneal spherical aberration in improving the near visual acuity of eyes implanted with the TECNIS Symfony. Front Med (Lausanne) 2023; 10:1094966. [PMID: 36910491 PMCID: PMC9995440 DOI: 10.3389/fmed.2023.1094966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023] Open
Abstract
Purpose To explore the effect of corneal spherical aberration on the visual acuity and visual quality of eyes implanted with the TECNIS Symfony intraocular lens (IOL). Methods A total of 43 patients with age-related cataract (60 eyes) undergoing phacoemulsification and TECNIS Symfony IOL implantation were enrolled in this study. The uncorrected distance (UDVA), intermediate (UIVA), near visual acuity (UNVA), corrected distance visual acuity (CDVA), contrast sensitivity, and ocular spherical aberration were recorded 3 months after surgery. Preoperative and postoperative corneal spherical aberration were also measured using the iTrace device. Objective scattering index (OSI), modulation transfer function cut-off frequency (MTF cut-off), and Strehl ratio (SR) were measured by the Optical Quality Analyzing System. Catquest-9SF questionnaire were applied too. Spearman's correlation analysis was used to evaluate the relationship between spherical aberration and visual quality parameters. Results Patients were satisfied with their postoperatively visual quality. And the postoperative logMAR UDVA, UIVA, UNVA, and CDVA was 0.05 ± 0.07, 0.04 ± 0.06, 0.15 ± 0.07, and 0.03 ± 0.05, respectively. The mean preoperative corneal spherical aberration was 0.24 ± 0.10 μm, which is the only factor influencing postoperatively UNVA, and it was negatively correlated with UNVA and glare contrast sensitivity under 18 cpd (cycle/degree, cpd) spatial frequency (r = -0.403, -0.300, -0.360; all P < 0.05). Additionally, the greater the residual spherical aberration of the cornea, the better the near vision after operation. The mean postoperative ocular spherical aberration was -0.03 ± 0.07 μm, it was not correlated with visual acuity, contrast sensitivity, and visual quality (all P > 0.05). Conclusion Preoperative positive spherical aberration can benefit near vision while decrease contrast sensitivities at high spatial frequencies when implanted with the TECNIS Symfony IOL.
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Affiliation(s)
- Dandan Wang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Disease, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chunlu Liu
- Zhejiang University School of Medicine Children's Hospital, Hangzhou, Zhejiang, China
| | - Weichen Guan
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ziyi Lu
- Joint Shantou International Eye Center (JSIEC), The Shantou University, The Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Yinying Zhao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Disease, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yune Zhao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Disease, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
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Fernández-Vega-Cueto L, Vega F, Guerra-Velasco R, Millán MS, Madrid-Costa D, Alfonso JF. Optical and Clinical Outcomes of an Enhanced Monofocal Intraocular Lens for High Hyperopia. J Refract Surg 2022; 38:572-579. [PMID: 36098391 DOI: 10.3928/1081597x-20220802-01] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the optical and clinical performance of an enhanced monofocal intraocular lens (IOL) (TECNIS Eyhance ICB00; Johnson & Johnson Vision) in patients with high hyperopia and a short axial length. METHODS Power mapping, wavefront analysis, and the through-focus modulation transfer function area (TF-MTFa) were measured in vitro for three IOL powers (10.00, 20.00, and 30.00 diopters [D]). The clinical study included 22 patients with an axial length of less than 22.5 mm. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity and binocular defocus curve were evaluated 6 months postoperatively. RESULTS For the three IOL powers, the power mapping revealed an increase in positive power from the periphery to the center of the lens, providing an extra positive correction of 1.00 D for a 2-mm pupil size. The TF-MTFa curves showed only a peak of maximum MTFa at the distance focus. As the pupil size became smaller, there was a focus extension effect, providing an extended depth of focus of up to -1.50 D for a 2-mm pupil size. No significant dependency of the IOL base power on the power profile, wavefront, or optical quality was found. The clinical outcomes showed that all patients achieved a binocular CDVA of 0.1 logMAR or better. The mean visual acuity was better than 0.1 logMAR between +0.50 and -1.50 D of defocus. At a vergence of -2.00 D, the visual acuity was 0.11 ± 0.13 logMAR. CONCLUSIONS The monofocal enhanced IOL provided good distance optical and visual quality and optimal visual acuity up to an intermediate-near vision distance of 50 to 40 cm in patients with high hyperopia and a short axial length. [J Refract Surg. 2022;38(9):572-579.].
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Pieh S, Artmayr C, Pai V, Schartmüller D, Kriechbaum K. Through-Focus Response of Extended Depth of Focus Intraocular Lenses. J Refract Surg 2022; 38:497-501. [PMID: 35947002 DOI: 10.3928/1081597x-20220701-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate extended depth of focus intraocular lenses (EDOF IOLs), intended to extend the depth of field after cataract surgery in a comparative study at the optical bench. METHODS An optical bench with either green or white light was used for this study. The artificial cornea used exhibited a spherical aberration of 0.2 µm. Examinations of the following lenses with a pupil opening of 3 and 4.5 mm were carried out: AcrySof IQ Vivity (Alcon Laboratories, Inc), Isopure (PhysIOL), Tecnis Eyhance (Johnson & Johnson), Vivinex Impress (Hoya Surgical Optics), and xact (Santen). RESULTS Using green light and a pupil aperture of 3 mm, the AcrySof IQ Vivity showed the highest light energy for the intermediate area, whereas the Isopure and Vivinex Impress provided the highest energy for distance vision. Under the same examination conditions with a pupil opening of 4.5 mm, all lenses showed a low light distribution for the intermediate range. Regarding light distribution for distance, the Tecnis Eyhance had the highest light intensity. Using white light, the curves became much wider and more similar to each other. CONCLUSIONS The five EDOF lenses investigated differ mainly by their different weighting of energy between the far and intermediate ranges. [J Refract Surg. 2022;38(8):497-501.].
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Naujokaitis T, Zhao L, Scharf D, Khoramnia R, Auffarth GU. Monofocal intraocular lens with enhanced intermediate function as substitute for multifocal intraocular lens in positive dysphotopsia. Am J Ophthalmol Case Rep 2022; 26:101511. [PMID: 35464676 PMCID: PMC9026612 DOI: 10.1016/j.ajoc.2022.101511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/23/2022] [Accepted: 04/02/2022] [Indexed: 01/19/2023] Open
Abstract
Purpose To present a case of a 62-year-old patient implanted with multifocal intraocular lenses (IOLs) who underwent a bilateral IOL exchange due to positive dysphotopsia. In an attempt to reduce the symptoms and compensate for the loss of multifocality, we implanted an aspheric monofocal IOL with enhanced intermediate function in one eye and a spherical monofocal IOL in the other eye. Observations The patient presented with complaints of halo and glare, measured with a simulator, following the implantation of segmented multifocal IOLs two years earlier. The uncorrected distance visual acuity (UDVA) was 20/20 in both eyes. Before presentation at our clinic, a laser capsulotomy had been performed on the right eye. We proceeded with a bilateral IOL exchange. Because of capsular insufficiency in the right eye, we implanted a spherical monofocal three-piece IOL in the ciliary sulcus with optic capture. In the left eye, we used a monofocal IOL with an enhanced intermediate function. Two weeks postoperatively, UDVA (monocularly) was 20/20 in OD and OS, the uncorrected intermediate visual acuity (UIVA) was 20/32, and the uncorrected near visual acuity (UNVA) was 20/50. Binocularly, UDVA was 20/20, UIVA was 20/25 and UNVA was 20/25. The patient reported a marked decrease in halos and glare. Conclusions and importance When planning IOL exchange surgery, in cases of intolerance to multifocal IOLs, the clinician should consider the dilemma of loss of multifocality. Recent developments in monofocal IOL technology present new options to improve visual function in cases of multifocal IOL explantation.
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Affiliation(s)
| | | | | | | | - Gerd U. Auffarth
- Corresponding author. International Vision Correction Research Centre (IVCRC), Dept. of Ophthalmology, Univ. of Heidelberg, INF 400, 69120, Heidelberg, Germany.
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7
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Alarcon A, Cánovas C, Koopman B, Weeber H, Auffarth GU, Piers PA. Enhancing the Intermediate Vision of Monofocal Intraocular Lenses Using a Higher Order Aspheric Optic. J Refract Surg 2021; 36:520-527. [PMID: 32785725 DOI: 10.3928/1081597x-20200612-01] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 06/12/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To describe and evaluate a new monofocal intraocular lens (IOL) designed to improve intermediate vision using a unique refractive technology. METHODS The new monofocal lens is based on a higher order aspheric optic and is designed to improve intermediate vision. Simulated visual acuity from far to -2.00 diopters (D) was calculated using optical bench data. The effect of corneal higher order aberrations (HOAs) on simulated visual acuity, pupil size, and decentration was assessed using realistic computer eye models. The susceptibility to photic phenomena was evaluated by measuring preclinically the intensity of the light distribution in the retinal plane. The new lens design was compared to a standard aspheric monofocal IOL that shares the same platform, material, and primary spherical aberration as the new design. RESULTS Simulated defocus curves showed increased simulated visual acuity in the intermediate range compared to a standard aspheric monofocal IOL with comparable distance vision, independently of the pupil size and corneal HOAs. At -1.50 D, the new IOL design provided a gain of approximately 0.1 logMAR, whereas at distance, the difference was less than 0.05 logMAR. The tolerance to decentration was also similar in both designs. Finally, experimental results indicate that the susceptibility to photic phenomena with the new lens design was similar to that of a standard aspheric monofocal IOL. CONCLUSIONS Preclinical data showed that the new lens design improves intermediate vision while maintaining comparable distance image quality and keeping the same photic phenomena profile as a standard aspheric monofocal IOL. [J Refract Surg. 2020;36(8):520-527.].
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Rocha-de-Lossada C, Sánchez-González JM, Peraza-Nieves J. Defocus Curves Standardized Criteria on Visual Performance of a Small-Aperture IOL: First Comparison of Results After Contralateral and Bilateral Implantation. J Refract Surg 2020; 36:420. [DOI: 10.3928/1081597x-20200518-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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9
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Du W, Lou W, Wu Q. Personalized aspheric intraocular lens implantation based on corneal spherical aberration: a review. Int J Ophthalmol 2019; 12:1788-1792. [PMID: 31741870 DOI: 10.18240/ijo.2019.11.19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 08/28/2019] [Indexed: 01/19/2023] Open
Abstract
With the evolution of cataract surgery from visual rehabilitation to refractive surgery, aspheric intraocular lenses (IOLs) are being increasingly used in the field of ophthalmology. This increased use can be attributed to negative or zero spherical aberrations with unique optical designs, which counteract some of the positive spherical aberrations of the cornea. These alterations reduce the total spherical aberration of human eyes and improve the visual acuity in patients with cataract postoperatively. At present, various types of aspheric IOLs are used worldwide. Although the implantation of aspheric IOL is beneficial to the patients who need correction of spherical aberrations, much controversy is still associated with ocular residual spherical aberrations that facilitate the best visual quality for patients postoperatively. In order to provide reference for future clinical work and scientific research, this report reviews the relationship between the ocular residual spherical aberration of human eyes and visual quality.
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Affiliation(s)
- Wei Du
- Department of Ophthalmology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Wei Lou
- Department of Ophthalmology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Qiang Wu
- Department of Ophthalmology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
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Savini G, Calossi A, Schiano-Lomoriello D, Barboni P. Precision and Normative Values of a New Computerized Chart for Contrast Sensitivity Testing. Sci Rep 2019; 9:16537. [PMID: 31719575 PMCID: PMC6851081 DOI: 10.1038/s41598-019-52987-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 10/23/2019] [Indexed: 11/09/2022] Open
Abstract
The purpose was to define a normative database for a grating test for contrast sensitivity, based on a chart monitor with high-definition liquid crystal display, and validate its measurements by assessing their repeatability and determining responsiveness to cataract surgery. Three samples were analyzed: (1) healthy volunteers to assess the repeatability of measurements, (2) healthy subjects to develop the normative database, (3) patients undergoing cataract surgery. All subjects were tested with the grating contrast sensitivity test (Vision Chart, CSO) at 1.5, 3, 6, 12 and 18 cycles per degree. The instrument software progressively reduces the contrast of the gratings according to the Quick Estimate by Sequential Testing (QUEST) procedure. In the subjects of the first sample, three consecutive measurements were taken and repeatability was assessed on the basis of the intra-session test-retest variability and the coefficient of variation. The test offered high repeatability, with test-retest variability ranging between 0.05 and 0.23 Log CS and the coefficient of variation between 0.61 and 4.21%. Normative data did not show a normal distribution. The highest median values were observed at 1.5, 3 and 6 cycles per degree frequencies. At these frequencies a ceiling effect was evident. In cataract patients, postoperative values showed an improvement at all spatial frequencies. In conclusion, the new contrast sensitivity test provides repeatable measurements that can be used for clinical purposes. In patients with healthy eyes and good vision, attention has to be paid to the ceiling effect.
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Affiliation(s)
| | - Antonio Calossi
- Department of Physics (Optics and Optometry), University of Florence, Florence, Italy
| | | | - Piero Barboni
- Studio Oculistico d'Azeglio, Bologna, Italy.,Scientific Institute San Raffaele, Milan, Italy
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11
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Wolffsohn JS, Davies LN. Presbyopia: Effectiveness of correction strategies. Prog Retin Eye Res 2018; 68:124-143. [PMID: 30244049 DOI: 10.1016/j.preteyeres.2018.09.004] [Citation(s) in RCA: 148] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 09/14/2018] [Accepted: 09/18/2018] [Indexed: 01/04/2023]
Abstract
Presbyopia is a global problem affecting over a billion people worldwide. The prevalence of unmanaged presbyopia is as high as 50% of those over 50 years of age in developing world populations, due to a lack of awareness and accessibility to affordable treatment, and is even as high as 34% in developed countries. Definitions of presbyopia are inconsistent and varied, so we propose a redefinition that states "presbyopia occurs when the physiologically normal age-related reduction in the eye's focusing range reaches a point, when optimally corrected for distance vision, that the clarity of vision at near is insufficient to satisfy an individual's requirements". Strategies for correcting presbyopia include separate optical devices located in front of the visual system (reading glasses) or a change in the direction of gaze to view through optical zones of different optical powers (bifocal, trifocal or progressive addition spectacle lenses), monovision (with contact lenses, intraocular lenses, laser refractive surgery and corneal collagen shrinkage), simultaneous images (with contact lenses, intraocular lenses and corneal inlays), pinhole depth of focus expansion (with intraocular lenses, corneal inlays and pharmaceuticals), crystalline lens softening (with lasers or pharmaceuticals) or restored dynamics (with 'accommodating' intraocular lenses, scleral expansion techniques and ciliary muscle electrostimulation); these strategies may be applied differently to the two eyes to optimise the range of clear focus for an individual's task requirements and minimise adverse visual effects. However, none fully overcome presbyopia in all patients. While the restoration of natural accommodation or an equivalent remains elusive, guidance is given on presbyopic correction evaluation techniques.
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Affiliation(s)
- James S Wolffsohn
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, B4 7ET, UK.
| | - Leon N Davies
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, B4 7ET, UK
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12
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Schrecker J, Langenbucher A, Seitz B, Eppig T. First results with a new intraocular lens design for the individual correction of spherical aberration. J Cataract Refract Surg 2018; 44:1211-1219. [PMID: 30120004 DOI: 10.1016/j.jcrs.2018.06.055] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 06/26/2018] [Accepted: 06/28/2018] [Indexed: 11/19/2022]
Abstract
PURPOSE To assess the feasibility of individual compensation of corneal spherical aberration with a custom intraocular lens (IOL). SETTING Department of Ophthalmology, Rudolf Virchow Klinikum Glauchau, Glauchau, Germany. DESIGN Prospective case series. METHODS Cataract patients were randomized to receive an individual aberration-correcting IOL (Invidua-aA; Group A) or a standard aspheric aberration-free IOL of otherwise identical design (Aspira-aA; Group B). In Group A, the IOL was designed according to preoperative calculation of the corneal spherical aberration Z(4,0). The aim was to achieve an overall postoperative ocular spherical aberration close to zero. Four weeks and 3 months postoperatively, the refraction, visual acuity (far, intermediate, and near distance), photopic and mesopic contrast sensitivities (with and without glare), defocus curve, corneal and ocular spherical aberration, and pupil size were measured. RESULTS Group A, 57 eyes of 42 patients and Group B, 29 eyes of 27 patients. Preoperatively, there was no difference in corneal spherical aberration between groups (P > .05). Three months postoperatively, residual ocular spherical aberration Z(4,0) was significantly lower in Group A (P < .001). Photopic and mesopic contrast sensitivities (with and without glare) were significantly higher in Group A at most spatial frequencies. Monocular defocus curve and distance, intermediate, and near visual acuity outcomes did not differ significantly between groups. CONCLUSIONS Implantation of a custom monofocal aspheric IOL effectively reduced overall ocular spherical aberration. Clinical outcomes indicate that IOLs with an individual spherical aberration correction improve functional vision, especially contrast sensitivity, compared with standard aberration-free IOLs.
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Affiliation(s)
- Jens Schrecker
- Department of Ophthalmology (Schrecker), Rudolf Virchow Klinikum Glauchau, Glauchau, the Institute of Experimental Ophthalmology (Langenbucher, Eppig) and the Department of Ophthalmology (Seitz), Saarland University, Homburg/Saar, Germany.
| | - Achim Langenbucher
- Department of Ophthalmology (Schrecker), Rudolf Virchow Klinikum Glauchau, Glauchau, the Institute of Experimental Ophthalmology (Langenbucher, Eppig) and the Department of Ophthalmology (Seitz), Saarland University, Homburg/Saar, Germany
| | - Berthold Seitz
- Department of Ophthalmology (Schrecker), Rudolf Virchow Klinikum Glauchau, Glauchau, the Institute of Experimental Ophthalmology (Langenbucher, Eppig) and the Department of Ophthalmology (Seitz), Saarland University, Homburg/Saar, Germany
| | - Timo Eppig
- Department of Ophthalmology (Schrecker), Rudolf Virchow Klinikum Glauchau, Glauchau, the Institute of Experimental Ophthalmology (Langenbucher, Eppig) and the Department of Ophthalmology (Seitz), Saarland University, Homburg/Saar, Germany
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