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Artal P, Arvaniti M, Dimou P, Stavrinos C, Ginis H, Hervella L, Güell JL. Peripheral Vision in Patients Following Intraocular Lens Implantation: A Systematic Review and Meta-Analysis. Am J Ophthalmol 2024; 264:120-134. [PMID: 38521156 DOI: 10.1016/j.ajo.2024.03.016] [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: 11/24/2023] [Revised: 03/13/2024] [Accepted: 03/16/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE To update the literature on peripheral optics and vision following intraocular lens (IOLs) implantation. METHODS We investigated how current IOLs influence peripheral visual function, peripheral optical quality, and visual perception and performance, in patients following cataract surgery. Peripheral vision is described as vision outside the central foveal region of the eye (beyond 4-5° of eccentricity). We systematically searched PubMed, Cochrane Central Register of Controlled Trials, Embase, and gray literature for relevant references. Randomized controlled trials and observational studies were eligible for inclusion. Finally, 47 studies with a total of 5963 participants were eligible for this review, of which 15 were included in the meta-analysis. RESULTS Regarding visual fields, the meta-analysis showed that the pooled estimate of mean deviation (MD) measured with perimetry tests (standard automated perimetry [SAP], short-wavelength automated perimetry [SWAP], and frequency doubling technology [FDT]) appears to be lower than the mean of healthy age-matched controls, regardless of IOL design. Results for pooled estimate show that localized defects (pattern standard deviation [PSD]) were higher than those in the healthy age-matched controls for FDT. We also collected evidence demonstrating that pseudophakia increases peripheral astigmatism and a myopic shift from 20° onward, leading to decreased peripheral image quality compared with that in phakic eyes. Patient-reported outcomes on peripheral vision showed a pooled score estimate of 95.19, indicating high satisfaction, and for the Steps & Stairs questions, a pooled score estimate at 0.23, indicating no to little difficulty seeing steps and stairs. CONCLUSIONS Peripheral image quality is degraded in eyes after cataract surgery. Nevertheless, whether this degradation leads to impaired visual function in the periphery requires further investigation.
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Affiliation(s)
- Pablo Artal
- From the Laboratorio de Optica (P.A.), Universidad de Murcia, Murcia, Spain.
| | | | | | | | | | | | - José Luis Güell
- IMO Instituto de Microcirugía Ocular (J.L.G.), Barcelona, Spain
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Brissette A, Cole B, Hall B. Visual Function After Implantation of Trifocal and Trifocal Toric Intraocular Lenses Using Intraoperative Aberrometry. Clin Ophthalmol 2024; 18:1547-1554. [PMID: 38832075 PMCID: PMC11146617 DOI: 10.2147/opth.s450979] [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: 11/21/2023] [Accepted: 04/28/2024] [Indexed: 06/05/2024] Open
Abstract
Purpose To evaluate patient outcomes and visual function following trifocal and trifocal toric intraocular lens (IOL) implantation using intraoperative aberrometry at a single site in the US. Methods This prospective, single arm study included 21 subjects that completed 3 month follow-up. Inclusion criteria were visually significant cataract and potential post-operative visual acuity of 20/25 or better. Endpoints included postoperative prediction error, refractive outcomes, uncorrected visual acuities at distance (UDVA), intermediate (UIVA), and near (UNVA), contrast sensitivity, and subject responses on the modified Visual Function Quality of Life Questionnaire (VF-14 QOL). Results Binocular UDVA, UIVA, and UNVA were 20/25 or better in 100% (21/21), 100% (21/21), 90% (19/21) of subjects. The absolute prediction error was 0.50 D or less in 79% (33/42) of eyes, and 81% (34/42) and 86% (36/42) of eyes achieved ≤0.5 D of residual astigmatism and manifest refraction spherical equivalent, respectively. On the modified VF-14 QOL, driving at night, reading small print, and reading a newspaper or book were the tasks that had the lowest percentages of subjects reporting no difficulty or a little difficulty. Conclusion Implantation with trifocal and trifocal toric IOLs using intraoperative aberrometry can provide high refractive precision, leading to excellent visual performance and low visual task difficulty at all ranges (distance, intermediate, and near).
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Affiliation(s)
- Ashley Brissette
- Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA
| | - Brigette Cole
- Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA
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Kawamura J, Tanabe H, Shojo T, Yamauchi T, Takase K, Tabuchi H. Comparison of visual performance between diffractive bifocal and diffractive trifocal intraocular lenses. Sci Rep 2024; 14:5292. [PMID: 38438495 PMCID: PMC10912743 DOI: 10.1038/s41598-024-55926-5] [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: 04/26/2023] [Accepted: 02/29/2024] [Indexed: 03/06/2024] Open
Abstract
To evaluate the visual performance of a diffractive bifocal intraocular lens (IOL) with + 4.0 D near addition (ZMB00) and a diffractive trifocal IOL with + 2.17 D and + 3.25 D near addition (AcrySof IQ PanOptix TFNT00), we investigated the 10-week postoperative parameters after cataract surgery in which ZMB00 or TFNT00 lenses were implanted bilaterally from 2011 to 2020 (with a 3-month interval between implantation of the right and left lenses). The study included 1448 eyes of 724 patients. The diffractive bifocal group comprised 1326 eyes of 663 patients (aged 67.0 ± 7.8 years; females/males, 518/145), and the diffractive trifocal group comprised 122 eyes of 61 patients (aged 66.6 ± 7.3 years; females/males, 35/26). A linear mixed-effects model using data for both eyes, with strict adjustments for sex, age, subjective refraction spherical equivalent, subjective refraction cylinder, corneal astigmatism, axial length, corneal higher-order aberrations, and pupil diameter, ensured statistical validity. Uncorrected near visual acuity and higher-order aberrations (ocular/internal, scaled to a pupil size of 4 mm) (Wavefront_4mm_postoperative_Ocular/Internal_Spherical) were significantly better in the bifocal group (p < 0.00068, Wald test). Uncorrected intermediate visual acuity, contrast sensitivity (6.3/4.0/2.5/1.6/1.0/0.7 degrees), and contrast sensitivity with glare (4.0/1.6/1.0/0.7 degrees) were significantly better in the trifocal group (p < 0.00068, Wald test).
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Affiliation(s)
- Junya Kawamura
- Department of Ophthalmology, Tsukazaki Hospital, Himeji, Japan
| | - Hirotaka Tanabe
- Department of Ophthalmology, Tsukazaki Hospital, Himeji, Japan.
| | - Tomohiro Shojo
- Department of Ophthalmology, Tsukazaki Hospital, Himeji, Japan
| | | | - Kosuke Takase
- Department of Ophthalmology, Tsukazaki Hospital, Himeji, Japan
| | - Hitoshi Tabuchi
- Department of Ophthalmology, Tsukazaki Hospital, Himeji, Japan
- Department of Technology and Design Thinking for Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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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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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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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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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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Chang JS, Liu SC, Ma NT, Ng JC. Clinical outcome of a quadrifocal (trifocal) intraocular lens in Chinese patients: prospective, observational case series. J Cataract Refract Surg 2023; 49:246-252. [PMID: 36730641 PMCID: PMC9981318 DOI: 10.1097/j.jcrs.0000000000001094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/31/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE To report the visual outcomes and quality of vision and life after bilateral implantation of a single-piece trifocal intraocular lens (IOL) in Chinese patients. SETTING Hong Kong Sanatorium & Hospital, Hong Kong, China. DESIGN Prospective, observational case series. METHODS Patients with bilateral implantation of AcrySof IQ PanOptix multifocal IOL were included. Distance, intermediate (60 cm), and near (40 cm) visual acuities (VAs) and contrast sensitivity (CS), defocus curve, preoperative higher-order aberration (HOA), dysphotopsia (0 to 5), satisfaction (1 to 5), spectacle independence, and quality of life were evaluated. The association between preoperative HOA and postoperative halos was also assessed. RESULTS 54 eyes of 27 patients were included. The mean binocular distance, intermediate, and near uncorrected VA was -0.05 ± 0.06 (20/18), 0.06 ± 0.10 (20/23), and 0.04 ± 0.05 (20/22), respectively. No eyes lost more than 1 line of vision. Binocular CS was comparable with the monocular population norm of older adults. The defocus curve demonstrated that the binocular VA of 20/25 or better was achieved at a power of -3.00 to +0.50 diopters. The mean scores for halos, glare, and starbursts were 2.4 ± 1.4, 0.2 ± 0.8, and 1.4 ± 1.4 (of 5), respectively. The mean satisfaction score was 4.3 ± 0.7 (of 5). All the patients (100%) reported total spectacle independence. The mean vision-targeted composite score of the vision-related quality-of-life questionnaire was 97.2 ± 9.7 (of 100). Preoperative HOA was not associated with postoperative halos. CONCLUSIONS Implantation of the trifocal IOL provided satisfactory visual outcomes and quality of vision and life, which resulted in a high rate of spectacle independence.
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Sheppard WEA, McCarrick D, Wilkie RM, Baraas RC, Coats RO. A Systematic Review of the Effects of Second-Eye Cataract Surgery on Motor Function. FRONTIERS IN AGING 2022; 3:866823. [PMID: 35821847 PMCID: PMC9261376 DOI: 10.3389/fragi.2022.866823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/16/2022] [Indexed: 11/16/2022]
Abstract
Cataract removal surgery is one of the most commonly performed surgical procedure in developed countries. The financial and staff resource cost that first-eye cataract surgery incurs, leads to restricted access to second-eye cataract surgery (SES) in some areas, including the United Kingdom. These restrictions have been imposed despite a lack of knowledge about the impact of not performing SES on visuo-motor function. To this end, a systematic literature review was carried out, with the aim of synthesising our present understanding of the effects of SES on motor function. Key terms were searched across four databases, PsycINFO, Medline, Web of Science, and CINAHL. Of the screened studies (K = 499) 13 met the eligibility criteria. The homogeneity between participants, study-design and outcome measures across these studies was not sufficient for meta-analyses and a narrative synthesis was carried out. The evidence from objective sources indicates a positive effect of SES on both mobility and fall rates, however, when considering self-report measures, the reduction in falls associated with SES becomes negligible. The evidence for any positive effect of SES on driving is also mixed, whereby SES was associated with improvements in simulated driving performance but was not associated with changes in driving behaviours measured through in vehicle monitoring. Self-report measures of driving performance also returned inconsistent results. Whilst SES appears to be associated with a general trend towards improved motor function, more evidence is needed to reach any firm conclusions and to best advise policy regarding access to SES in an ageing population. Systematic Review Registration:https://osf.io/7hne6/, identifier INPLASY2020100042.
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Brenner LF, Nistad K, Schonbeck U. Rethinking presbyopia: results of bilateral refractive lens exchange with trifocal intraocular lenses in 17 603 patients. Br J Ophthalmol 2022:bjophthalmol-2021-319732. [PMID: 35110276 DOI: 10.1136/bjophthalmol-2021-319732] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 01/20/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To evaluate the safety and effectiveness of bilateral refractive lens exchange (RLE) with trifocal intraocular lens (IOL) as the surgical treatment of presbyopia. SETTINGS Memira AS. Norway, Sweden and Denmark. DESIGN Multicentric retrospective interventional case series. METHODS 17 603 consecutive patients submitted to bilateral presbyopic RLE with trifocal IOLs from 2013 to 2019. The main outcomes were manifest refraction spherical equivalent (MRSE), uncorrected distance (UDVA) and near (UNVA) visual acuity, corrected distance visual acuity (CDVA), vision gain/loss, safety and efficacy indices, IOL power calculation accuracy and rate of excimer laser enhancements. RESULTS Three months postoperatively, the mean MRSE was 0.00±0.40 diopters (D), mean binocular UDVA was -0.03±0.09, with 14 470 patients (82.2%) with combined binocular UDVA and UNVA equal or better than 0.00 and Jaeger 3. Approximately 86% (n=30.124) of the eyes were within 0.50D of MRSE. Enhancement surgery was performed in 5810 eyes (16.5%). IOL power calculation refining improved accuracy and reduced enhancements rate from 20% in 2013 to 12% in 2019. Safety and efficacy indices were 0.98±0.11 and 0.85±0.18, respectively. Myopic eyes presented significant higher safety (1.00±0.19) and efficacy indices (0.87±0.19), with p<0.005. Approximately 0.38% (n=130) of the eyes lost two or more lines of CDVA, with cystoid macular oedema (n=53, 40.8%) and posterior capsular opacification (n=35, 26.9%) as the main causes. After proper care, the final incidence of two or more lines of vision loss was 0.08% (28 eyes). CONCLUSIONS Presbyopic RLE with trifocal IOL is a safe and effective modality of treatment for patients with presbyopia.
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Affiliation(s)
- Luis F Brenner
- Medical Director Norway, Memira Eye Center, Oslo, Norway
| | - Kristin Nistad
- Clinical Excellence and Development Manager, Memira Eye Center, Oslo, Norway
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Bamdad S, Ahmad Razavizadegan S, Farvardin M, Mohaghegh S. Vision-related Quality of Life after Bilateral Implantation of Monofocal and Multifocal Intraocular Lenses. J Ophthalmic Vis Res 2022; 17:19-26. [PMID: 35194492 PMCID: PMC8850852 DOI: 10.18502/jovr.v17i1.10166] [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: 01/28/2019] [Accepted: 09/14/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose To evaluate vision-related quality of life in two sets of patients after routine cataract surgery implanting with traditional versus multifocal intraocular lens (IOLs). Methods In a cross-sectional prospective study, 58 and 33 candidates for cataract surgery were divided into traditional (Acrysof SN60WF, Alcon Laboratories, Inc) and multifocal IOL (AcrySof IQ PanOptix IOL TFNT00, Alcon Laboratories, Inc.) groups, respectively. The primary outcome was VFQ-25 scores. The secondary outcomes were making comparisons between the two IOL types in the near vision and the driving items. Results mean patients' age in traditional and multifocal IOL groups was 60.85 ± 7.40 (55% female) and 59.85 ± 8.95 (36% female) years, respectively. The mean VFQ-25 total scores in traditional and multifocal IOL groups before and after surgery were 63.69 ± 4.95 and 72.15 ± 9.66, and 98.08 ± 0.70 and 95.70 ± 1.30, respectively (P = 0.001 & 0.001). The mean scores of night driving in traditional and multifocal IOL groups were 38.79 ± 20.50 and 44.35 ± 21.12 (P = 0.1) before surgery which improved to 97.41 ± 7.68 and 56.45 ± 11.12 after surgery, respectively (P = 0.001). The mean scores of near vision in traditional and multifocal IOL groups were 46.83 ± 10.56 and 50.53 ± 8.58 (P = 0.2) before surgery which improved to 89.94 ± 4.87 and 100.00 ± 0.00 after surgery, respectively (P = 0.001). Conclusion Vision-related quality of life after cataract surgery with either type of traditional or multifocal (PanOptix) IOLs improved to an excellent level. Traditional IOLs provided more satisfaction in nighttime driving while multifocal IOLs provided increased satisfaction in near and intermediate vision.
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Affiliation(s)
- Shahram Bamdad
- Poostchi ophthalmology research center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyyed Ahmad Razavizadegan
- Poostchi ophthalmology research center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Farvardin
- Poostchi ophthalmology research center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sahar Mohaghegh
- Department of Optometry, School of rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ozturkmen C, Kesim C, Gunel Karadeniz P, Sahin A. Comparative Analysis of a New Hybrid EDOF-Multifocal Diffractive Intraocular Lens with a Trifocal Diffractive Intraocular Lens. Eur J Ophthalmol 2021; 32:2961-2966. [PMID: 34905987 DOI: 10.1177/11206721211067643] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To compare visual acuity, defocus curve and visual quality of life performances of a new hybrid refractive-diffractive intraocular lens (IOL) and a trifocal diffractive IOL. METHODS Patients who underwent cataract surgery with bilateral implantation of ZFR00V or TFNT00 IOLs were enrolled in this study. The main outcomes were defined as uncorrected distant, intermediate and near visual acuities (UDVA, UIVA and UNVA, respectively), defocus curve and VF-14 questionnaire aimed for visual performance. RESULTS Fifty patients, of whom 30 had bilateral ZFR00V implantation, were enrolled in the study. Patients with ZFR00V had significantly better UIVA than patients with TFNT00 (0.05 ± 0.03 vs. 0.07 ± 0.04 logMAR, P = 0.02). Defocus curve showed significantly higher visual acuity in intermediate range for ZFR00V IOL between -1.00 and -1.50 dioptres (all P < 0.05). All patients had good visual performance with mean VF-14 scores above 3 points with no significant difference between two IOL models. Spectacle independence was 100% for both distant and near vision in both group of patients. CONCLUSION Bilateral implantation of ZFR00V in cataract patients shows better intermediate visual acuity scores and similar daily visual performance when compared with trifocal TFNT00 IOL.
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Affiliation(s)
| | - Cem Kesim
- Department of Ophthalmology, 52979Koc University School of Medicine, Istanbul, Turkey
| | - Pinar Gunel Karadeniz
- Department of Biostatistics, Gaziantep SANKO University School of Medicine, Gaziantep, Turkey
| | - Afsun Sahin
- Department of Ophthalmology, 52979Koc University School of Medicine, Istanbul, Turkey.,52979Koc University Research Center for Translational Medicine, Istanbul, Turkey
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Arrigo A, Gambaro G, Fasce F, Aragona E, Figini I, Bandello F. Quantitative biometric cutoffs for the choice of the intraocular lens power calculation formula for a recently introduced nondiffractive extended depth-of-focus intraocular lens. Eur J Ophthalmol 2021; 32:2949-2953. [PMID: 34859698 DOI: 10.1177/11206721211065551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This study aimed to analyze biometry values cutoffs for the choice of the best intraocular lens power calculation formula for AcrySof IQ Vivity intraocular lens. METHODS The study was designed as interventional case series with 3 months of follow-up. Intraocular lens power calculation formulas included Barrett Universal II and SRK/T. The first was adopted for the intraocular lens power choice. The quantitative analysis focused on the identification of specific biometric cutoffs considering axial length, anterior chamber depth, and corneal powers. We included only the dominant eye in the statistical analysis. RESULTS One hundred and eight eyes of 54 patients (23 males; mean age 62 ± 5 years) with no ocular diseases were included. Best-corrected visual acuity improved from 0.3 ± 0.2 to 0.0 ± 0.0 logMAR. All the eyes reached spectacles-free far and intermediate visions; a spherical addition of + 1.0D was necessary to adjust near vision. We identified significant quantitative cutoffs based on axial length and anterior chamber depth. Barrett Universal II resulted the best formula for eyes disclosing an axial length >25 mm, whereas SRK/T turned out to be the best choice for the eyes characterized by an anterior chamber depth <2.8 mm. Our analysis disclosed an overall sensitivity of 0.8 and a specificity of 0.7 (p < 0.01). CONCLUSIONS Axial length and anterior chamber depth influence the choice of Barrett Universal II and SRK/T formulas. Quantitative biometric cutoffs may be useful to discriminate the best formula to be adopted.
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Affiliation(s)
- Alessandro Arrigo
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Francesco Fasce
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Emanuela Aragona
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Francesco Bandello
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Ozturkmen C, Kesim C, Karadeniz PG, Sahin A. Visual acuity, defocus curve and patient satisfaction of a new hybrid EDOF-multifocal diffractive intraocular lens. Eur J Ophthalmol 2021; 32:2988-2993. [PMID: 34766507 DOI: 10.1177/11206721211057338] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Purpose: To evaluate the visual acuity, defocus curve and visual quality of life following bilateral implantation of a new hybrid extended depth of focus (EDOF)-multifocal diffractive intraocular lens (IOL). Methods: Patients who underwent cataract surgery with bilateral implantation of Tecnis Synergy IOL were enrolled in this study. The main outcomes were defined as uncorrected distant, intermediate and near visual acuities (UDVA, UIVA and UNVA, respectively), defocus curve and VF-14 questionnaire aimed for visual performance. Results: The mean ± SD values for binocular UDVA, UIVA and UNVA were -0.01 ± 0.04, 0.05 ± 0.03 and 0.03 ± 0.05 logMAR, respectively. Defocus curve showed a continuous vision above 0.16 logMAR between +0.50 D and -2.50 D. Patients had good visual performance with mean VF-14 scores above 3 points. Driving at night (3.47 ± 0.64) was found to be the most difficult task to perform. Spectacle independence was 100% for both distant and near vision. Conclusion: Bilateral implantation of Tecnis Synergy IOL in cataract patients shows good visual acuity and performance, covering a good visual range without any need of spectacles.
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Affiliation(s)
| | - Cem Kesim
- Department of Ophthalmology, 52979Koc University School of Medicine, Istanbul, Turkey
| | | | - Afsun Sahin
- Department of Ophthalmology, 52979Koc University School of Medicine, Istanbul, Turkey.,Koc University Research Center for Translational Medicine, Istanbul, Turkey
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Semiz F, Lokaj AS, Caliskan G, Verlato G, Musa NH, Semiz CE, Demirsoy ZA. Perception of Trifocal IOL Performance in Young Adults with High Astigmatism and Hyperopia and its Improvement Using Small Incision Lenticule Extraction. Acta Inform Med 2021; 29:118-124. [PMID: 34584335 PMCID: PMC8443134 DOI: 10.5455/aim.2021.29.118-124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 06/17/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Hyperopia is a kind of refractive error in which incoming light is focused behind, instead of on, the retina wall due to insufficient accommodation by the lens. It is likely affected by ethnicity, geography, and a family history of hyperopia or accommodative esotropia and is categorized as low (≤ 2.00D), moderate (2.00–4.00 D), and high (> 4.00D). Beyond hyperopia refractive error, patients may have poor accommodative function or visual perceptual skills. Objective: This study aimed to present the latest approaches to planning trifocal intraocular lens (IOL) and toric trifocal IOL implantation for residual refractive errors in young adults with high astigmatism and hyperopia and increase the patients’ best visual outcome and satisfaction using Small Incision Lenticule Extraction (SMILE) after implantation. Methods: Eighty eyes of 40 consecutive patients who underwent refractive lensectomy were included in this retrospective study. It included patients aged 20–45 years seeking spectacle independence with pre-operative high spherical hypermetropia of 4D or higher and astigmatism of 3D or higher. Patients’ treatment status was categorized as trifocal IOL (n=40) and toric trifocal IOL (n=40).The mean patient follow-up time was six months after IOL implantation. First, we assessed visual acuity and satisfaction for both groups and then examined laser vision correction results of patients who were dissatisfied after IOL implantation (trifocal IOL group) and underwent SMILE surgery to increase satisfaction level. Results: There were no statistically significant differences between trifocal IOL and toric trifocal IOL for near (UNVA), intermediate (UIVA), and distance (UDVA) uncorrected visual acuity. Comparisons related to patient satisfaction six months after IOL implantation were statistically significant for using a computer and night driving. In the trifocal IOL group, compared to pre-operative values, sphere and cylinder at six months were significantly improved. Conclusion: In young adults, toric trifocal and trifocal IOL provided sufficient results in visual acuity; however, patients were dissatisfied after implantation. This study reported patient satisfaction levels, including quality of life and life without glasses by using Small Incision Lenticule Extraction (SMILE) surgery.
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Affiliation(s)
- Faruk Semiz
- Department of Ophthalmology, Eye Hospital, Prishtina, Kosova
| | | | - Gulser Caliskan
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, IItaly
| | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, IItaly
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Clinical Outcomes of Combined Implantation of an Extended Depth of Focus IOL and a Trifocal IOL in a Korean Population. J Ophthalmol 2021; 2021:9034258. [PMID: 34540288 PMCID: PMC8443383 DOI: 10.1155/2021/9034258] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/20/2021] [Indexed: 12/03/2022] Open
Abstract
Purpose To evaluate monocular and binocular visual performance and patient-reported outcomes following combined implantation of a diffractive extended depth of focus (EDoF) IOL (Carl Zeiss AT LARA 829MP) and a diffractive trifocal IOL (Carl Zeiss AT LISA tri 839MP). Methods This prospective study enrolled consecutive patients undergoing lens phacoemulsification of cataract and combined implantation of an EDoF IOL in the dominant eye and a trifocal IOL in the nondominant eye. Assessment included uncorrected visual acuity at near distances (UNVA), intermediate distances (UIVA), and far distances (UDVA), uncorrected defocus curve, contrast sensitivity (CS), reading speed, and patient satisfaction, evaluated six months after the surgery with the Visual Function Questionnaire (VFQ-25). Results A total of 25 patients were enrolled. At six months postoperatively, outcomes of binocular UNVA, UIVA, and UDVA were superior to those of monocular outcomes. The binocular defocus curve showed significantly better results in comparison with the AT LISA tri IOL eyes at defocus levels of −1.0 D and −1.5 D (P=0.008 and P=0.002, respectively) and compared to the AT LARA IOL eyes at defocus levels of −3.0, −3.5 D, and −4.0 D (P=0.019, P=0.019, and P=0.035, respectively). All of the patients were spectacle-free at far and intermediate distances, while 4% of patients needed spectacles at the near distance. Reading speed showed a rather high and gentle slope curve between 0.1 logMAR and 0.4 logMAR, and optical phenomena were improved after combined implantation of IOLs except halos. There were no significant differences in CS between the binocular and monocular results of each IOL. Conclusions The combined implantation of an EDoF IOL and a trifocal IOL seems to be a good option for patients with demands for spectacle independence in their daily life, with minimal photic phenomena.
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Brar S, Ganesh S, Rp N, Cr R. Clinical Outcomes and Patient Satisfaction with a New Diffractive-Refractive Trifocal Intraocular Lens - A 12 Month Prospective Study. Clin Ophthalmol 2021; 15:3247-3257. [PMID: 34376969 PMCID: PMC8349194 DOI: 10.2147/opth.s320202] [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: 05/14/2021] [Accepted: 07/05/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the clinical outcomes and patient satisfaction after implantation of Optiflex Trio, a new trifocal intraocular lens (IOL) following cataract surgery. Methods Patients undergoing phacoemulsification for age-related cataracts and who satisfy the eligibility criteria underwent bilateral implantation with Optiflex Trio trifocal IOL. At follow -up visits of 1, 3, 6, and 12 months, binocular uncorrected and corrected distance, intermediate and near visual acuity, reading performance, contrast sensitivity (CS) and patient satisfaction for dysphotopsia and spectacle independence were evaluated using questionnaires. Results A total of 54 eyes from 27 patients with mean age of 66.30±7.48 years were included in the study. At 12 months, 78% (n = 21) patients had binocular cumulative UDVA of 20/20 or better. Post-op SE refraction accuracy was within ±0.50 D for 93% (n = 50) eyes, and refractive cylinder accuracy was within ≤0.50 D in 94% (n = 51) eyes. The mean binocular UNVA was 0.01±0.05 LogMAR, and the mean UIVA at 60 and 80 cm was 0.07±0.06 and 0.03±0.05 LogMAR, respectively, at 12 months. Reading speeds at 40, 60 and 80 cm showed improvement overtime. No patient had complained of severe dysphotopsia, and none of the patients required glasses for any activity. No eye underwent YAG-laser capsulotomy for significant PCO at the end of mean follow-up. Conclusion After 12 months, Optiflex Trio trifocal IOL provided a complete visual restoration with good visual quality outcomes in terms of uncorrected distance, intermediate and near visual acuity. The incidence of dysphotopsia was low, and spectacle independence was high, resulting in good patient satisfaction. Trial Registry CTRI/2019/10/021647 (www.ctri.nic.in).
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Affiliation(s)
- Sheetal Brar
- Department of Phaco-Refractive Surgery, Nethradhama Super Speciality Eye Hospital, Jayanagar, Bengaluru, Karnataka, 560070, India
| | - Sri Ganesh
- Department of Phaco-Refractive Surgery, Nethradhama Super Speciality Eye Hospital, Jayanagar, Bengaluru, Karnataka, 560070, India
| | - Nikhil Rp
- Department of Phaco-Refractive Surgery, Nethradhama Super Speciality Eye Hospital, Jayanagar, Bengaluru, Karnataka, 560070, India
| | - Roopashree Cr
- Department of Phaco-Refractive Surgery, Nethradhama Super Speciality Eye Hospital, Jayanagar, Bengaluru, Karnataka, 560070, India
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Abstract
PURPOSE To compare the clinical outcomes obtained after implantation of 1 of 3 models of diffractive trifocal IOLs. SETTING Hospital da Luz, Lisbon, Portugal. DESIGN Prospective randomized comparative study. METHODS Patients undergoing cataract surgery with bilateral implantation of 1 of 3 models of diffractive trifocal IOLs were enrolled. The IOL models implanted were the FineVision POD F, RayOne Trifocal, or the AcrySof IQ PanOptix IOL (30 eyes of 15 patients in each group). Visual acuity (VA), refraction, defocus curve, and contrast sensitivity outcomes were evaluated during a 3-month follow-up. Furthermore, the Quality of Vision questionnaire (QoV) was used to evaluate the frequency, severity, and discomfort of different visual symptoms. RESULTS A total of 90 eyes of 45 patients were included. No statistically significant differences were found between groups in distance, intermediate, and near VA (P ≥ .112) and postoperative refraction (P ≥ .059). Postoperative binocular uncorrected intermediate VA of 0.10 logarithm of the minimum angle of resolution (logMAR) or better was found in 14 (93.33%) patients in the 3 groups. Postoperative binocular uncorrected near VA of 0.10 logMAR or better was found in 13 (86.67%), 14 (93.33%), and 13 (86.67%) patients in the POD F, RayOne, and PanOptix IOLs groups, respectively. No statistically significant differences were found between groups in scotopic contrast sensitivity with and without glare and in the QoV scores (P ≥ .057), except for the difference between the POD F and RayOne IOLs groups in depth perception severity, which was less in the RayOne IOL group (P = .019). CONCLUSIONS The 3 trifocal IOLs evaluated provided a complete visual restoration with good visual quality outcomes.
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Viljanen A, Koskela K, Koskela H, Tuuminen R, Uusitalo H. One-year Results of Health-related and Vision-related Quality of Life After Clear Lens Extraction and Multifocal Intraocular Lens Implantation. Am J Ophthalmol 2021; 227:240-244. [PMID: 33823159 DOI: 10.1016/j.ajo.2021.03.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 03/25/2021] [Accepted: 03/25/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Multifocal intraocular lenses (MIOLs) are effective in treating presbyopia before cataracts develop. This study measured health-related quality of life (HRQoL) and vision-related quality of life (VRQoL) after clear lens extraction (CLE) and MIOL implantation. DESIGN Before-and-after study METHODS: Patients were treated in Medilaser Coronaria, CorGroup, Oulu, Finland. HRQoL was measured by a generic 15-dimension (15D) instrument. VRQoL was measured with Visual Function Index-14 (VF-14) questionnaire. RESULTS CLE and MIOL implantation was performed in 137 patients. The patient age was 57 ± 6.2 years (mean ± standard deviation), and 58% were women. The near add was 2.1±0.3 diopters (D). The overall HRQoL 15D score increased from 0.938±0.058 to 0.955±0.057 at 6 months (P < .0001 vs baseline) and to 0.948±0.060 at 1 year (P = .02 vs baseline). The VRQoL VF14 score increased from 85.32±15.57 to 96.57±5.07 at 6 months (P < .0001 vs baseline) and to 96.61±6.48 at 1 year (P < .0001 vs baseline). The increase of HRQoL was correlated with the increase of VRQoL (P < .04). CONCLUSIONS CLE and MIOL implantation improved HRQoL and VRQoL compared to spectacles in this 1-year follow-up study. Improvement of HRQoL was correlated with VRQoL.
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Affiliation(s)
- Antti Viljanen
- From the Medilaser Coronaria, Silmaasema Silmasairaala, CorGroup, Oulu.
| | - Kimmo Koskela
- From the Medilaser Coronaria, Silmaasema Silmasairaala, CorGroup, Oulu
| | - Harri Koskela
- From the Medilaser Coronaria, Silmaasema Silmasairaala, CorGroup, Oulu
| | - Raimo Tuuminen
- Helsinki Retina Research Group, University of Helsinki, Helsinki
| | - Hannu Uusitalo
- SILK, Department of Ophthalmology, Tampere University, Tays Eye Center, Tampere, Finland
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Shatz AC, Potvin R. Spectacle Independence and Quality of Vision After Bilateral Implantation of a Trifocal Intraocular Lens. Clin Ophthalmol 2021; 15:2545-2551. [PMID: 34168428 PMCID: PMC8216748 DOI: 10.2147/opth.s318203] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/08/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose To evaluate the patient-reported spectacle independence and quality of vision for patients who were bilaterally implanted with a trifocal intraocular lens (IOL). Design Single site, prospective, single-arm study. Methods Subjects presenting for cataract surgery who had an interest in reducing their dependence on glasses at multiple distances were enrolled. Subjects were bilaterally implanted with a trifocal IOL and followed for 3 months post-surgery. A spectacle independence questionnaire and a quality of vision questionnaire were administered at the 3-month visit. The binocular visual acuity at distance (4 m), intermediate (60 cm) and near (40 cm) was also measured in the uncorrected and distance-corrected state. Results All but one subject reported no need for glasses for distance and intermediate work, and most (25/29) reported no need for glasses for near work. Almost all subjects reported never wearing glasses or wearing them only a little, and being able to function without glasses at any distance all or most of the time. Ninety percent of subjects (26/29) reported being completely or mostly satisfied with their vision overall, without the use of glasses or contact lenses. The mean binocular visual acuity 1 and 3 months after surgery was better than 0.1 logMAR (20/25) at all test distances in both the uncorrected and distance-corrected states. The reported quality of vision appeared similar to previously reported data for the same IOL. Conclusion The trifocal IOL provided nearly all subjects with functional vision and spectacle independence for distance, intermediate and near work. It is a viable alternative for patients looking to reduce their overall dependence on spectacles after cataract surgery.
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Extended depth-of-focus (EDOF) AcrySof® IQ Vivity® intraocular lens implant: a real-life experience. Graefes Arch Clin Exp Ophthalmol 2021; 259:2717-2722. [PMID: 34050809 DOI: 10.1007/s00417-021-05245-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/29/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE Extended depth-of-focus (EDOF) is a promising intraocular lens (IOL) technology for cataract surgery. The aim of the study was to report the real-life experience related to the implant of EDOF AcrySof® IQ Vivity® (Alcon Inc., USA) IOL. METHODS The study was designed as a interventional, prospective, case series with 3 months of follow-up. Patients needing cataract surgery, without any other kind of ocular diseases, were recruited and implanted with AcrySof® IQ Vivity® IOL. We evaluated the refractive success of this IOL through complete ophthalmologic assessments and the administration of the Quality of Vision test. The main outcome measures were the refractive outcome; far, intermediate, and near vision; and Quality of Vision score. RESULTS We included 108 eyes (54 patients; age 62 ± 5 years). Intra-operative and post-operative complications were 0%. Thirty out of 100 eyes (28%) required toric IOL. Best-corrected visual acuity improved from 0.4 ± 0.3 LogMAR to 0.0 ± 0.0 LogMAR (p < 0.01). Refractive outcome was very good for far and intermediate visions, whereas a spherical addition of at least + 1.0D was required for near vision. The mean Quality of Vision score was of 15.5 ± 6.5. The most complained visual disturbances were haloes and glares, although resulting well-tolerated. Dynamic pupillometry findings well-correlated with the amount of complained post-operative visual discomforts. CONCLUSIONS AcrySof® IQ Vivity® IOL is a well-tolerated choice to correct far and intermediate vision. Spectacles are needed to optimize near vision. Our data strongly suggest dynamic pupillometry as a useful investigation to optimize post-operative refractive success.
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Ozulken K, Kiziltoprak H, Yuksel E, Mumcuoğlu T. A Comparative Evaluation of Diffractive Trifocal and New Refractive/Extended Depth of Focus Intraocular Lenses for Refractive Lens Exchange. Curr Eye Res 2020; 46:811-817. [PMID: 33047991 DOI: 10.1080/02713683.2020.1833347] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate and compare the visual performance and quality of life (QOL) associated with refractive/extended depth of focus (EDOF) intraocular lenses (IOLs) and diffractive trifocal IOLs in refractive lens exchange patients. MATERIALS AND METHODS This was a comparative interventional study of patients undergoing implantation of Lucidis (Swiss Advanced Vision, SAV‑IOL SA, Neuchâtel, Switzerland) or AT LISA tri 839MP (Carl Zeiss Meditec AG, Germany) IOLs. Near, intermediate, and distance best corrected and uncorrected visual acuities were collected at 1 and 3 months postoperatively. The vision-related QOL was evaluated 1 and 3 months after surgery, using the National Eye Institute Visual Function Questionnaire-14 (VF-14 QOL questionnaire). RESULTS A total of 74 patients underwent refractive lens exchange and IOL implantation, with 38 patients in the EDOF group and 36 in the trifocal group. Among all visual acuities, uncorrected near visual acuity was statistically significantly better with the Lucidis IOL at the first month (p = .02) and diminished at the third-month visit (p = .16). When we compared the VF-14 QOL questionnaire scores, reading small print, reading a newspaper or book, and driving at night were statistically significantly better in the Lucidis group at the first month (p = .00, for each). That difference persisted only in driving at night at the third-month visit (p = .04). Reading small print, driving at night, and doing fine handwork were the most difficult tasks in the AT LISA group at the first month, and only driving at night remained so at the third-month visit. CONCLUSIONS The refractive results and visual outcomes at all distances of EDOF and trifocal IOLs were highly satisfactory. However, the EDOF design in the Lucidis IOL achieves lower rates of glare in the early period after refractive lens exchange.
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Affiliation(s)
- Kemal Ozulken
- Ophthalmology Department, TOBB ETU Medical School, Ankara, Turkey
| | - Hasan Kiziltoprak
- Ophthalmology Department, Bingol Women's Health and Children's Hospital, Bingol, Turkey
| | - Erdem Yuksel
- Ophthalmology Department, Kastamonu Medical School, Kastamonu, Turkey
| | - Tarkan Mumcuoğlu
- Ophthalmology Department, TOBB ETU Medical School, Ankara, Turkey
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Donmez O, Asena BS, Kaskaloglu M, Akova YA. Patients satisfaction and clinical outcomes of binocular implantation of a new trifocal intraocular lens. Int Ophthalmol 2020; 40:1069-1075. [PMID: 32328922 DOI: 10.1007/s10792-020-01390-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 12/28/2019] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate the clinical outcomes following bilateral implantation of PanOptix intraocular lens (IOL). METHODS This study included consecutive patients scheduled to undergo cataract or refractive lens exchange surgery between October 2017 and June 2018 at two centers. Manifest refraction, uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA, 60 cm) and uncorrected near visual acuity (UNVA, 40 cm), defocus curves, presence of dysphotopsia, need for spectacles, presence of posterior capsule opacification and visual function were evaluated at 6 months after surgery. RESULTS The IOL was implanted in 138 eyes of 69 patients. The mean binocular UDVA was 0.02 ± 0.05 logMAR, UIVA 0.06 ± 0.07 logMAR and UNVA 0.05 ± 0.07 logMAR. Defocus curve showed two peaks at 0.00 D and - 1.50 D. Complete spectacle independence was reported in 94.2% of the patients. The mean VF-14 test result was 97.7 ± 2.2 (93.2-100). Only one patient (1.4%) reported seeing bothersome halos. The presence of posterior capsule opacification was noted in seven eyes (10%), whereas Nd:Yag capsulotomy was required only in one eye. CONCLUSIONS This trifocal IOL provided excellent visual outcomes at all distances with high spectacle independence and patient's satisfaction.
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Affiliation(s)
- Oya Donmez
- Department of Ophthalmology, Bayindir Hospital, Ankara, Turkey
| | | | | | - Yonca A Akova
- Department of Ophthalmology, Bayindir Hospital, Ankara, Turkey.
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Hamdi IM. Subjective Perception Of Trifocal IOL Performance, Including Toric Models. Clin Ophthalmol 2019; 13:1955-1961. [PMID: 31631963 PMCID: PMC6778730 DOI: 10.2147/opth.s223062] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 09/13/2019] [Indexed: 11/25/2022] Open
Abstract
Purpose To study the patients’ perception of trifocal IOL (Panoptix™) performance. Patients and methods 60 eyes of 35 were implanted with trifocal IOL. Refractive (sphere – S, cylinder – Cyl and spherical equivalent – SE, all in D) and visual (distance uncorrected – VAsc, distance corrected – VAcc, intermediate – IntVA, near uncorrected – NVAsc and distance corrected near – NVAcc, all in LogMAR) results were recorded. Patients were asked about satisfaction (per eye), spectacle independence, near and intermediate activities, distance activities in quantity and quality, finally about personal facial care (per patient). Comparison was made between non-toric (48) and toric models, genders (18 males) and between bilateral (25 patients) and unilateral implantations. Results were correlated to age and IOL power. Results With a SE of mean −0.3 ± 0.5 D, cases achieved mean VAsc 0.09 ± 0.1 (~20/25), VAcc 0.05 ± 0.1 (~20/22), IntVA 0.05 ± 0.9 (~20/22), NVAsc 0.05 ± 0.09 (~~20/22) and NVAcc 0.04 ± 0.8 (~~20/22). Mean level of satisfaction was 85.7 ± 16.5, spectacle independence 96.0 ± 10.6, near activities 95.4 ± 9.8, intermediate activities 97.7 ± 6.4, quantity of distance activities 90.2 ± 10.1, quality of distance activities 88.0 ± 12.1 and facial care 92.6 ± 11.9. All comparisons (non-toric and toric, male and female and bilateral and unilateral implantation) were statistically insignificant (P>0.05). Correlation with age and IOL power was also statistically insignificant (P>0.05). Conclusion As perceived by patients, trifocal IOL resulted in very high level of satisfaction. This satisfaction is reflected on diverse visual activities. This level is achieved regardless of gender, IOL model or even unilateral implantation. It is also achieved regardless the age of patients or preoperative eye status.
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Affiliation(s)
- Islam Mahmoud Hamdi
- Ophthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.,Ophthalmology Consultant, The Eye Consultants Center, Jeddah, Saudi Arabia
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Yesilirmak N, Akova YA, Donmez O. Comparison of Mix-and-Match Implanted Bifocal IOLs and Bilateral Implanted Trifocal IOLs After Femtosecond Laser–Assisted Cataract Surgery. J Refract Surg 2019; 35:559-564. [DOI: 10.3928/1081597x-20190806-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 08/06/2019] [Indexed: 11/20/2022]
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de Medeiros AL, Jones Saraiva F, Iguma CI, Kniggendorf DV, Alves G, Chaves MAPD, Vilar C, Motta AFP, Carricondo PC, Takashi Nakano C, Nosé W, Hida WT. Comparison of visual outcomes after bilateral implantation of two intraocular lenses with distinct diffractive optics. Clin Ophthalmol 2019; 13:1657-1663. [PMID: 31695317 PMCID: PMC6718244 DOI: 10.2147/opth.s202895] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 06/13/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose The aim of this study was to compare the visual outcomes and subjective visual quality between bilateral implantation of an extended depth of focus intraocular lens, J&J Vision Tecnis Symfony® ZXR00 (Group A) and bilateral implantation of a diffractive trifocal intraocular lens, Alcon Acrysof IQ PanOptix® TNFT00 (Group B). Methods This prospective, nonrandomized, comparative study of consecutive cases assessed 52 eyes of 26 patients operated on by the same surgeon (WTH) and binocularly implanted with multifocal intraocular lenses between May 2016 and July 2018. Binocular visual acuity for far, intermediate and near was tested in all cases. Ophthalmological evaluation included the measurement of binocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA) at 40 cm, uncorrected intermediate visual acuity (UIVA) at 70 cm, monocular visual defocus curve and the quality of life (QoL) questionnaire, National Eye Institute Visual Functioning Questionnaire - 25 ( NEI-VFQ 25). Results Postoperative UDVA was 0.00 and 0.09 logMAR (P<0.001), UIVA was 0.20 and 0.39 logMAR (P<0.001) and UNVA was 0.16 and -0.01 logMAR (P<0.001) in groups A and B, respectively; postoperative CDVA was -0.05 and 0.06 logMAR (P<0.001) in groups A and B, respectively. Conclusion Both groups reported good subjective quality of vision regarding long, intermediate and short distances. Group A had a better performance for binocular UDVA, UIVA at 70 cm and CDVA, while regarding the monocular defocus curve, Group A outperformed Group B for long distances. Furthermore, Group B surpassed it in the short to very short distances, between the range of ≥2.00 D to 5.00 D of vergence. While Group A had a better performance regarding the vergences between 0.00 and 1.00 D (P<0.05) and at the vergence of +2.50 D (P=0.007). Group B outran Group A for UNVA at 40 cm.
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Affiliation(s)
| | | | - Camila Ishii Iguma
- Cataract Sector, Hospital Oftalmológico De Brasília, Brasília, DF, Brazil
| | | | - Guilherme Alves
- Cataract Sector, Hospital Oftalmológico De Brasília, Brasília, DF, Brazil
| | | | - Cesar Vilar
- Cataract Sector, Renato Ambrosio Eye Research Center, Brasília, DF, Brazil
| | | | | | | | - Walton Nosé
- Cataract Sector, Renato Ambrosio Eye Research Center, Brasília, DF, Brazil
| | - Wilson Takashi Hida
- Cataract Sector, Renato Ambrosio Eye Research Center, Brasília, DF, Brazil.,Cataract Sector, Hospital Oftalmológico De Brasília, Brasília, DF, Brazil
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Simple and precise patient satisfaction questionnaire for laser refractive surgery. J Cataract Refract Surg 2019; 45:1213. [PMID: 31371015 DOI: 10.1016/j.jcrs.2019.05.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 05/15/2019] [Indexed: 11/21/2022]
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