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Fernández J, Srinivasan S, Burguera N, Martínez J, Rodríguez-Vallejo M. One-year follow-up of a multifocal intraocular lens with optimized elevated phase shift. J Cataract Refract Surg 2023; 49:1018-1024. [PMID: 37464551 DOI: 10.1097/j.jcrs.0000000000001266] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/13/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE To evaluate the standard outcomes of a multifocal intraocular lens (mIOL) with optimized elevated phase shift (EPS). SETTING Qvision, Ophthalmology Department, VITHAS Almería, Spain. DESIGN Retrospective observational. METHODS 41 patients, consecutively operated on cataracts or refractive lens exchange with the implantation of the Liberty 640PM (EPS 2.0) and followed during 12 months, were included in the analysis. Retrieved variables were visual acuities at far, intermediate, and near distances; defocus curves (VADC); and prediction error of 4 formulas optimized for IOLMaster 500 and Pentacam AXL Wave. Patient-reported outcomes were also obtained for assessing spectacle independence, satisfaction, bothersome to dysphotopsia, difficulties in daily life tasks, and decision to be operated with the same mIOL. RESULTS The median monocular efficacy with best distance correction was 0, 0.1, and 0.1 logMAR at far, intermediate, and near distances, respectively, with patients achieving binocularly a median of 0 logMAR at the 3 distances. VADC showed a depth of field of 3 diopters (D) above 0.2 logMAR with a median increase of 0.07 logMAR from -1.5 to -2.5 D. Complete spectacle independence was achieved at far distance, whereas 97.6% and 85.4% was achieved at intermediate and near distances, respectively. 7.3% of patients were bothered by dysphotopsia, and 92.6% of patients were likely to be operated again. CONCLUSIONS EPS 2.0 restored patients' vision in the full range of the depth of field with a nearly monotone decrease of visual performance from far to near, achieving high rates of spectacle independence at all distances and with low positive dysphotopsia rates ( ClinicalTrials.gov Identifier: NCT05735990).
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Affiliation(s)
- Joaquín Fernández
- From the Qvision, Department of Ophthalmology, VITHAS Almería Hospital, Almería, Spain (Fernández, Burguera, Martínez, Rodríguez-Vallejo); Department of Ophthalmology, University Hospital Ayr, Ayr, Scotland (Srinivasan)
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Tañá-Rivero P, Orts-Vila P, Aguilar-Córcoles S, Tañá-Sanz P, Tañá-Sanz S. Contrast Sensitivity and Patient Reported Outcomes After Bilateral Implantation of a Bi-Aspheric Hydrophobic Trifocal Diffractive Intraocular Lens. Clin Ophthalmol 2023; 17:247-258. [PMID: 36698852 PMCID: PMC9869798 DOI: 10.2147/opth.s400136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 12/30/2022] [Indexed: 01/19/2023] Open
Abstract
Purpose To assess contrast sensitivity and patient reported outcomes after uncomplicated cataract surgery with a new bi-aspheric diffractive trifocal intraocular lens (IOL) implantation. Methods Twenty-five patients who underwent bilateral implantation with the Asqelio Trifocal TFLIO130C IOL (AST Products Inc., Billerica, MA, USA) were analyzed at 6 months post-surgery. Binocular contrast sensitivity with and without glare was measured under photopic conditions (85 cd/m2) and mesopic conditions (3 cd/m2). Patients were asked to complete the Catquest-9SF patient outcomes questionnaire and a visual symptoms questionnaire. Results Photopic contrast sensitivity values were either within or above normal levels without glare; when glare was induced, the mean sensitivity values dropped just below normal range. Mesopic contrast sensitivity values were above or within normal range both with and without glare, except for 12 cpd with glare, where the mean fell just below the normal range. Differences in binocular contrast sensitivity threshold values with and without glare were significant for all spatial frequencies tested under both photopic and mesopic conditions (p<0.05). The Catquest-9SF questionnaire outcomes showed that 88% of patients were either satisfied or very satisfied with their sight after the surgery, and in all cases, the results indicated no difficulty in performing different daily activities. The visual symptoms questionnaire indicated no relevant visual symptoms regarding frequency, intensity, or bothersomeness after implantation of the trifocal IOL. Conclusion This novel bi-aspheric diffractive trifocal IOL provides good contrast sensitivity outcomes under bright and dim lighting conditions. Patients were satisfied with the surgery, with no relevant visual symptoms.
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Affiliation(s)
- Pedro Tañá-Rivero
- Cataract Surgery Department, Oftalvist Alicante, Alicante, Spain,Correspondence: Pedro Tañá-Rivero, Cataract Surgery Department, Oftalvist Alicante, C/ Angel Lozano 11, Alicante, 03001, Spain, Tel +34 965 141 500, Email
| | - Paz Orts-Vila
- Cataract Surgery Department, Oftalvist Alicante, Alicante, Spain
| | | | - Pedro Tañá-Sanz
- Cataract Surgery Department, Oftalvist Alicante, Alicante, Spain
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Győry JF, Srinivasan S, Madár E, Balla L. Long-term performance of a diffractive-refractive trifocal IOL with centralized diffractive rings: 5-year prospective clinical trial. J Cataract Refract Surg 2021; 47:1258-1264. [PMID: 33974369 DOI: 10.1097/j.jcrs.0000000000000670] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 03/31/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To report the 5-year visual, refractive, and patient-reported outcomes following implantation of a trifocal intraocular lens (IOL) during cataract surgery. SETTING Csolnoky Ferenc University Hospital, Veszprém, Hungary. DESIGN Prospective, longitudinal, single-center, interventional study. METHODS 100 eyes of 50 patients underwent bilateral implantation of a trifocal IOL during cataract surgery. Preoperative corrected distance (CDVA) and postoperative uncorrected distance visual acuity (UDVA), CDVA, uncorrected (UIVA) and corrected (CIVA) intermediate and uncorrected (UNVA) and corrected (CNVA) near visual acuity were collected. All subjects were seen at day 1, 1 month, 3 months, 6 months, 12 months, and 24 months, and at year 5. Contrast sensitivity, slitlamp photography, and quality of vision questionnaire were performed at months 3, 6, 12, and 24 and at year 5. Of these 50 patients, 41 completed their 5-year follow-up. RESULTS At year 5, 74 eyes of 37 patients were analyzed. The mean postoperative UDVA was 0.02 ± 0.10 (logMAR). The mean CDVA was -0.04 ± 0.07. The mean UIVA was 0.04 ± 0.09. The mean CIVA was 0.00 ± 0.08. The mean UNVA was 0.09 ± 0.09. The mean CNVA was 0.05 ± 0.07. Mesopic and photopic contrast sensitivity values were in the upper third range of the age-matched normal values. CONCLUSIONS 5-year prospective study data showed that bilateral implantation of a diffractive-refractive trifocal IOL with centralized diffractive rings provided good functional vision at all distances. There was high level of spectacle independence and patient satisfaction with minimal levels of dysphotopsia.
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Affiliation(s)
- József F Győry
- From the Department of Ophthalmology, Csolnoky Ferenc Hospital, Veszprém, Hungary (Győry, Madár, Balla); Department of Ophthalmology, University Hospital Ayr, Ayr, Scotland (Srinivasan); University of West of Scotland, Ayr, Scotland, United Kingdom (Srinivasan)
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Nováček LV, Němcová M, Tyx K, Lahodová K, Rejmont L, Rozsíval P, Studený P. Comparison of Clinical Outcomes, Visual Quality and Visual Function of Two Presbyopia-Correcting Intraocular Lenses Made from the Same Material, but with Different Design and Optics. J Clin Med 2021; 10:3268. [PMID: 34362052 PMCID: PMC8347739 DOI: 10.3390/jcm10153268] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/16/2021] [Accepted: 07/22/2021] [Indexed: 02/06/2023] Open
Abstract
This semi-prospective, parallel, comparative investigation evaluated the clinical outcomes and quality of vision (contrast sensitivity, visual function, dysphotopsia, spectacle use, overall satisfaction) after mono- or bilateral implantation of two presbyopia-correcting intraocular lenses (IOL)-the Liberty® 677MY or the AT LISA® tri 839M-in 50 eyes of 25 cataract patients. Clinical outcomes were assessed 3 and 12 months postoperatively. Eighty-nine percent of eyes implanted with the Liberty IOL and 59% of eyes implanted with the AT LISA IOL achieved a refractive outcome ±0.5 diopters of the target (emmetropia). Refractive outcomes were stable with both lenses. The proportions of eyes with 20/20 uncorrected distance visual acuity (UDVA) and 20/20 uncorrected near visual acuity (UNVA) were higher in the Liberty group than in the AT LISA group (UDVA: 56% vs. 41%; UNVA: 83% vs. 66%). Optical quality assessment results were comparable for the two IOLs. Superior photopic contrast sensitivity was found with the Liberty lens. The rate of Nd:YAG capsulotomy at the 12-month follow-up was 16.7% in the Liberty group and 40.6% for the AT LISA IOL. Considering that both lenses are made from the same material, we propose that the noted differences in clinical outcomes may derive from differences in design and optical surface between the two IOLs.
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Affiliation(s)
- Ladislav Viktor Nováček
- Department of Ophthalmology, Institute of Aviation Medicine Prague, 160 00 Prague, Czech Republic; (M.N.); (K.T.); (K.L.); (P.R.)
- Department of Ophthalmology, 1st Faculty of Medicine, Charles University and the Military University Hospital Prague, 121 08 Prague, Czech Republic; (L.R.); (P.S.)
| | - Marie Němcová
- Department of Ophthalmology, Institute of Aviation Medicine Prague, 160 00 Prague, Czech Republic; (M.N.); (K.T.); (K.L.); (P.R.)
| | - Kateřina Tyx
- Department of Ophthalmology, Institute of Aviation Medicine Prague, 160 00 Prague, Czech Republic; (M.N.); (K.T.); (K.L.); (P.R.)
| | - Kristýna Lahodová
- Department of Ophthalmology, Institute of Aviation Medicine Prague, 160 00 Prague, Czech Republic; (M.N.); (K.T.); (K.L.); (P.R.)
| | - Leoš Rejmont
- Department of Ophthalmology, 1st Faculty of Medicine, Charles University and the Military University Hospital Prague, 121 08 Prague, Czech Republic; (L.R.); (P.S.)
| | - Pavel Rozsíval
- Department of Ophthalmology, Institute of Aviation Medicine Prague, 160 00 Prague, Czech Republic; (M.N.); (K.T.); (K.L.); (P.R.)
- Department of Ophthalmology Charles University Prague, School of Medicine Hradec Králové, 500 03 Hradec Králové, Czech Republic
| | - Pavel Studený
- Department of Ophthalmology, 1st Faculty of Medicine, Charles University and the Military University Hospital Prague, 121 08 Prague, Czech Republic; (L.R.); (P.S.)
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Kohnen T, Suryakumar R. Measures of visual disturbance in patients receiving extended depth-of-focus or trifocal intraocular lenses. J Cataract Refract Surg 2021; 47:245-255. [PMID: 32818348 DOI: 10.1097/j.jcrs.0000000000000364] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 07/14/2020] [Indexed: 02/07/2023]
Abstract
The degree of visual disturbance associated with a particular model of intraocular lens (IOL) depends on several factors, including IOL optic, material, and mechanics. Characterization of visual disturbance profiles is paramount for informing clinical IOL selection. Although many studies evaluating presbyopia-correcting IOLs include subjective assessment of visual symptoms, the types of patient-reported outcome measures (PROMs) used to capture these outcomes are inconsistent across studies, complicating data contextualization. Furthermore, some tools produce more meaningful results than others. This review presents a discussion on the scientific literature published on the subjective and semiobjective (halo and glare simulator, light-distortion analyzer, vision monitor, and halometers) methods used to assess visual disturbances in patients implanted with trifocal or extended depth-of-focus IOLs, highlighting their advantages and limitations. It underscores the importance of between-study comparisons and the need for standardized PROMs in clinical IOL research to provide more accurate information for IOL selection.
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Affiliation(s)
- Thomas Kohnen
- From the Department of Ophthalmology (Kohnen), Goethe University Frankfurt, Frankfurt, Germany; and Alcon Vision LLC (Suryakumar), Fort Worth, Texas, USA
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Albayrak S, Comba ÖB, Karakaya M. Visual performance and patient satisfaction following the implantation of a novel trifocal supplementary intraocular lens. Eur J Ophthalmol 2020; 31:2346-2352. [PMID: 33158370 DOI: 10.1177/1120672120969042] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the visual quality, visual performance, and patient satisfaction after the implantation of the last generation supplementary intraocular lens (1stQ AddOn Trifocal) for achieving near vision spectacle-independence in pseudophakic patients who had primary monofocal capsular bag implantation. METHODS Patients who underwent monofocal lens surgery in the past year, and who expressed their explicit desire to become spectacle-independent were included in this prospective observational study. Uncorrected and corrected distance, intermediate and near visual acuities (CDVA, UDVA, DCIVA, UIVA, CNVA, and UNVA), refractive outcomes, lens positioning, contrast sensitivity and patient satisfaction were assessed 6 months postoperatively. RESULTS About 28 eyes of 18 patients were evaluated. No intra- or postoperative complications (iris chafing, iris capture, interlenticular opacification, IOL-dislocation, etc.) could be observed. The postoperative mean UDVA and CDVA were 0.05 ± 0.08 and 0.01 ± 0.03 (logMAR), respectively. The mean UNVA improved from the preoperative 0.50 ± 0.23 to 0.02 ± 0.05 (logMAR), postoperatively (p = 0.0104). The postoperative mean UIVA and DCIVA were 0.06 ± 0.020 and 0.01 ± 0.00 (logMAR), respectively. Twenty-five eyes (89%) had a residual spherical equivalent within 1.0 D from the target refraction, emmetropia. Contrast sensitivity measured in photopic and mesopic conditions were statistically indifferent from the preoperative curves. All patients had better visual function and quality scores compared to the preoperative responses. The highest improvement could be achieved in near vision activities, dependency, and limitation of social functioning. CONCLUSION The 1stQ AddOn Trifocal lens represents a safe and effective option for pseudophakic patients aiming for high quality, spectacle-free vision.
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Affiliation(s)
- Sinan Albayrak
- Yeniyüzyıl University Gaziosmanpaşa Hospital, Istanbul, Turkey
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Serdiuk V, Ustymenko S, Fokina S, Ivantsov I. Comparison of three different presbyopia-correcting intraocular lenses. Rom J Ophthalmol 2020; 64:364-379. [PMID: 33367174 PMCID: PMC7739015 DOI: 10.22336/rjo.2020.58] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Objective (aim): to test the refractive and visual outcomes and the quality of vision after the bilateral implantation of three different multifocal intraocular lenses (MIOLs) in patients with age-related cataract. Methods: In this retrospective, comparative study including 90 eyes of 45 cataract patients, bilateral implantation of either the hydrophilic trifocal Liberty® 677MY capsular bag IOL, the hydrophilic AT LISA® tri 839M lens, or the hydrophobic AcrySof® IQ PanOptix® IOL was performed during routine cataract surgery. Refractive outcomes, visual acuities (VA) for far, intermediate and near distances, as well as visual quality, dysphotopic events and spectacle use were evaluated six months postoperatively. Results: VA curves were similar for the three MIOLs, however the Liberty lens seemed to be superior for far and near, while AT LISA tri provided somewhat better VA in the intermediate range. Refractive correction was the most effective with the Liberty IOL (p=0.0131). Dysphotopic phenomena were usually perceived in low light conditions. Their frequency was lower with the AT LISA tri and Liberty lenses. Symptoms were significantly less disturbing for patients implanted with the Liberty lens, two-thirds of AT LISA tri and Liberty patients, while only 57% of PanOptix patients achieved spectacle independence. Conclusions: All examined MIOLs were found to be safe and efficient in presbyopia-correction of cataract patients, however different models had different advantages. The vision preferences of each patient should always be taken into consideration when choosing a MIOL, and the possible occurrence of dysphotopic events should be also clearly communicated in each case. Abbreviations: ACD = Anterior chamber depth, ANOVA = Analysis of variance, AXL = Axial length, CDVA = Corrected distance visual acuity, CYL = Cylinder; Cylindric refraction, D = Diopter, IOL = Intraocular lens, K1; K2 = Keratometry values, MIOL = Multifocal intraocular lens, n = Number of cases, n.a. = Not applicable, Postop = Postoperative, QoV = Quality of Vision, SD = Standard deviation, SEQ = Spherical equivalent, SPH = Sphere; Spherical refraction, UDVA = Uncorrected distance visual acuity, UIVA = Uncorrected intermediate visual acuity, UNVA = Uncorrected near visual acuity, VA = Visual acuity.
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Affiliation(s)
- Valerii Serdiuk
- Dnipropetrovsk Regional Clinical Ophthalmological Hospital, Ukraine
| | | | - Svetlana Fokina
- Dnipropetrovsk Regional Clinical Ophthalmological Hospital, Ukraine
| | - Ivan Ivantsov
- Dnipropetrovsk Regional Clinical Ophthalmological Hospital, Ukraine
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Palomino-Bautista C, Sánchez-Jean R, Carmona Gonzalez D, Romero Domínguez M, Castillo Gómez A. Spectacle Independence for Pseudophakic Patients - Experience with a Trifocal Supplementary Add-on Intraocular Lens. Clin Ophthalmol 2020; 14:1043-1054. [PMID: 32308364 PMCID: PMC7156274 DOI: 10.2147/opth.s238553] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 01/08/2020] [Indexed: 01/10/2023] Open
Abstract
Purpose To evaluate the refractive and functional outcomes of the trifocal 1stQ AddOn® (Medicontur) supplementary intraocular lenses (IOLs) designed for implantation into the ciliary sulcus. Patients and Methods The study included 18 eyes of 11 pseudophakic patients with uncomplicated previous implantation of monofocal capsular bag IOLs. These patients had a desire for spectacle independence. Distance, intermediate and near visual acuities were measured, and defocus curves were plotted over a period of 6 months following implantation of the add-on IOLs. Intraocular pressure (IOP), endothelial cell density measurements and biomicroscopic evaluation were also performed. Results In this study, 83.3% of eyes had spherical refractions within ±0.5 D from emetropia and 100% of eyes had spherical equivalent refractions that were within ±1.0 D of the target refraction. Visual acuities and defocus curves clearly confirmed trifocal optical performance (UDVA=0.03 ±0.05; UIVA=0.21 ±0.04; UNVA=0.12 ±0.04 logMAR; expressed as mean ±SD). Depth of focus showed identical results (DOF=0.486 D) compared to a trifocal capsular bag IOL, while the defocus curve was found to be superior in the intermediate and near ranges when compared to a trifocal capsular bag IOL. All patients achieved spectacle independence at all distances. All add-on IOLs were well positioned in the ciliary sulcus. No negative changes were noted in connection with endothelial cell counts, IOPs, the angle structure during surgery and during the follow-up period. Conclusion The supplementary trifocal add-on IOL seems to be a safe, efficient and stable solution for achieving spectacle independence in pseudophakic patients with monofocal primary IOLs.
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Affiliation(s)
- Carlos Palomino-Bautista
- Department of Ophthalmology, University Hospital Quirónsalud Madrid, Madrid, Spain.,European University of Madrid, Madrid, Spain
| | - Rubén Sánchez-Jean
- Department of Ophthalmology, University Hospital Quirónsalud Madrid, Madrid, Spain
| | | | - Marta Romero Domínguez
- Department of Ophthalmology, University Hospital Quirónsalud Madrid, Madrid, Spain.,European University of Madrid, Madrid, Spain
| | - Alfredo Castillo Gómez
- Department of Ophthalmology, University Hospital Quirónsalud Madrid, Madrid, Spain.,European University of Madrid, Madrid, Spain
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