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Liu X, Wu W, Huang Y, Fu Y, Huang Y, Li Q. Repeatability of Pentacam-derived intraocular lens decentration measurements and the level of agreement with OPD-Scan III: A prospective observational case series. PLoS One 2024; 19:e0299064. [PMID: 38517869 PMCID: PMC10959365 DOI: 10.1371/journal.pone.0299064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 01/03/2024] [Indexed: 03/24/2024] Open
Abstract
PURPOSE This study aimed to assess the repeatability of intraocular lens (IOL) decentration measurements obtained through Pentacam, based on corneal topographic axis (CTA) and pupillary axis (PA), and to evaluate the level of agreement between Pentacam and OPD-Scan III devices in measuring IOL decentration. METHODS In this prospective observational case series, three measurements were performed with Pentacam to evaluate the repeatability of the measurements. The analysis included the calculation of the mean and standard deviations (SD), conducting a repeated measures analysis of variance (rANOVA), and determining an intraclass correlation coefficient (ICC) to assess the repeatability of the measurements. Moreover, Bland-Altman analysis was employed to assess the agreement between Pentacam and OPD-Scan III devices in measuring IOL decentration. IOL decentration measurements were obtained with respect to both CTA and PA. RESULTS A total of 40 eyes from 40 patients were analyzed. The rANOVA revealed no significant difference among three consecutive measurements of IOL decentration obtained with Pentacam. The mean SD of all parameters ranged from 0.04 mm to 0.07 mm. With CTA as the reference axis, the ICC values for Pentacam measurements of IOL decentration were 0.82 mm for the X-axis, 0.76 mm for the Y-axis, and 0.82 mm for spatial distance. When using PA as the reference axis, the corresponding ICC values were 0.87, 0.89, and 0.77, respectively. The 95% limits of agreement for all IOL decentration measurements were wide when comparing Pentacam and OPD-Scan III. CONCLUSIONS Pentacam demonstrated high repeatability in measuring IOL decentration with respect to both CTA and PA. However, due to poor agreement between Pentacam and OPD-Scan III measurements, caution should be exercised when using data interchangeably between the two devices.
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Affiliation(s)
- Xiaobao Liu
- Shengli Clinical Medical College of Fujian Medical University; Fujian Medical University, Fuzhou, China
| | - Wenjie Wu
- Shengli Clinical Medical College of Fujian Medical University; Fujian Medical University, Fuzhou, China
- Department of Ophthalmology, Fujian Provincial Hospital, Fuzhou, China
| | - Yulong Huang
- Shengli Clinical Medical College of Fujian Medical University; Fujian Medical University, Fuzhou, China
| | - Yabo Fu
- Shengli Clinical Medical College of Fujian Medical University; Fujian Medical University, Fuzhou, China
- Department of Ophthalmology, Longyan People Hospital of Fujian, Longyan, China
| | - Yue Huang
- Shengli Clinical Medical College of Fujian Medical University; Fujian Medical University, Fuzhou, China
| | - Qiong Li
- Shengli Clinical Medical College of Fujian Medical University; Fujian Medical University, Fuzhou, China
- Department of Ophthalmology, Fujian Provincial Hospital, Fuzhou, China
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LoBue SA, Martin CR, Benson KK, Trosclair KB, Shelby CL, Coleman III WT. The Role of Early Nd:YAG Laser Capsulotomy in Improving Visual Performance in Mild to Moderately Symptomatic Trifocal Patients. Clin Ophthalmol 2023; 17:3991-4000. [PMID: 38148832 PMCID: PMC10750775 DOI: 10.2147/opth.s448784] [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: 11/20/2023] [Accepted: 12/12/2023] [Indexed: 12/28/2023] Open
Abstract
Purpose To determine the effect of early Nd:YAG (neodymium:yttrium-aluminum-garnet) laser capsulotomy on objective and subjective visual quality in symptomatic trifocal intraocular lens (IOL) patients. Methods A single-center, prospective study examined symptomatic patients after bilateral cataract extraction with trifocal IOL implantation. A ten-question survey was conducted one month after surgery. Study endpoints included the assessment of monocular and binocular uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), contrast sensitivity (CS), and subjective visual quality before and after Nd:YAG capsulotomy prior to 4 months after cataract surgery. Results A total of 38 eyes from 21 patients were included with a TFAT00 (n = 23) or TFAT30-60 (n = 15). Overall satisfaction with the IOL was 8.55 ± 1.77 (range 5-10). A Nd:YAG capsulotomy was performed at 55 ± 26 days. Monocular UDVA and UNVA > 20/25 before Nd:YAG were 53.0% and 42.0%, which improved post-Nd:YAG to 63.0% and 66.0%, respectively (P = 0.41, P = 0.051). Binocular UDVA and UNVA >20/25 before Nd:YAG were 82.0% and 63.0%, which increased to 97% and 97%, respectively (P < 0.05, P < 0.001). CS increased in all post-Nd:YAG capsulotomies (P < 0.01). The presence of glare was documented at 74% pre-Nd:YAG, which decreased to 41% post-Nd:YAG (P < 0.01). Glare which limited activities was documented at 24%, which decreased to 5% post-Nd:YAG (P = 0.21). Conclusion Early treatment of posterior capsule opacities in mild to moderately dissatisfied trifocal IOL patients may be beneficial in improving CS, visual quality, and reducing the presence and severity of dysphotopsias.
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Affiliation(s)
- Stephen A LoBue
- Department of Ophthalmology, Willis-Knighton Medical Center, Shreveport, LA, USA
| | - Curtis R Martin
- Department of Ophthalmology, Willis-Knighton Medical Center, Shreveport, LA, USA
| | - Krysta K Benson
- Department of Ophthalmology, Willis-Knighton Medical Center, Shreveport, LA, USA
| | - Krystle B Trosclair
- Department of Graduate Medical Education, Statistics, Willis-Knighton Medical Center, Shreveport, LA, USA
| | - Christopher L Shelby
- Department of Ophthalmology, Willis-Knighton Medical Center, Shreveport, LA, USA
| | - Wyche T Coleman III
- Department of Ophthalmology, Willis-Knighton Medical Center, Shreveport, LA, USA
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Meng J, Fang Y, Lian J, Chen X, Zhou J, He W, Zhang K, Yang F, Lu Y, Zhu X. Visual and patient-reported outcomes of a diffractive trifocal intraocular lens in highly myopic eyes: a prospective multicenter study. EYE AND VISION (LONDON, ENGLAND) 2023; 10:19. [PMID: 37020245 PMCID: PMC10077756 DOI: 10.1186/s40662-023-00336-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 03/16/2023] [Indexed: 04/07/2023]
Abstract
BACKGROUND To investigate the visual and patient-reported outcomes of a diffractive trifocal intraocular lens (IOL) in highly myopic eyes. METHODS Patients with planned cataract removal by phacoemulsification and implantation of a trifocal IOL (AT LISA tri 839MP) were enrolled in the prospective, multicenter cohort study. Patients were allocated into three groups according to their axial length (AL): control group, AL < 26 mm; high myopia group, AL 26-28 mm; extreme myopia group, AL ≥ 28 mm. At 3 months post-surgery, data for 456 eyes of 456 patients were collected, including visual acuity, defocus curve, contrast sensitivity (CS), visual quality, spectacle independence, and overall satisfaction. RESULTS After surgery, the uncorrected distance visual acuity improved from 0.59 ± 0.41 to 0.06 ± 0.12 logMAR (P < 0.001). In all three groups, about 60% of eyes achieved uncorrected near and intermediate visual acuity of 0.10 logMAR or better, but significantly fewer eyes in the extreme myopia group achieved uncorrected distance visual acuity of 0.10 logMAR or better (P < 0.05). Defocus curves revealed that the visual acuity was significantly worse in the extreme myopia group than others at 0.00, - 0.50, and - 2.00 diopters (P < 0.05). CS did not differ between the control and high myopia groups but was significantly lower in the extreme myopia group at 3 cycles per degree. The extreme myopia group also had greater higher-order aberrations and coma, lower modulation transfer functions and VF-14 scores, more glare and halos, worse spectacle independence at far distance, and consequently lower patient satisfaction than others (all P < 0.05). CONCLUSIONS In eyes with a high degree of myopia (AL < 28 mm), trifocal IOLs have been shown to provide similar visual outcomes to those in non-myopic eyes. However, in extremely myopic eyes, acceptable results may be obtained with trifocal IOLs, but a reduced level of uncorrected distance vision is expected.
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Affiliation(s)
- Jiaqi Meng
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Xuhui District, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China
| | - Yanwen Fang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Xuhui District, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China
| | - Jingcai Lian
- Shanghai Xinshijie Zhongxing Eye Hospital, Shanghai, China
| | - Xu Chen
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai, China
| | - Jing Zhou
- Shanghai Bright Eye Hospital, Shanghai, China
| | - Wenwen He
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Xuhui District, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China
| | - Keke Zhang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Xuhui District, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China
| | - Fan Yang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Xuhui District, Shanghai, 200031, China
| | - Yi Lu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Xuhui District, Shanghai, 200031, China.
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China.
| | - Xiangjia Zhu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Xuhui District, Shanghai, 200031, China.
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China.
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, 200032, China.
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Zamora-de La Cruz D, Bartlett J, Gutierrez M, Ng SM. Trifocal intraocular lenses versus bifocal intraocular lenses after cataract extraction among participants with presbyopia. Cochrane Database Syst Rev 2023; 1:CD012648. [PMID: 36705482 PMCID: PMC9881452 DOI: 10.1002/14651858.cd012648.pub3] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Presbyopia occurs when the lens of the eyes loses its elasticity leading to loss of accommodation. The lens may also progress to develop cataract, affecting visual acuity and contrast sensitivity. One option of care for individuals with presbyopia and cataract is the use of multifocal or extended depth of focus intraocular lens (IOL) after cataract surgery. Although trifocal and bifocal IOLs are designed to restore three and two focal points respectively, trifocal lens may be preferable because it restores near, intermediate, and far vision, and may also provide a greater range of useful vision and allow for greater spectacle independence in individuals with presbyopia. OBJECTIVES To assess the effectiveness and safety of implantation with trifocal versus bifocal IOLs during cataract surgery among people with presbyopia. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2022, Issue 3); Ovid MEDLINE; Embase.com; PubMed; ClinicalTrials.gov; and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We did not use any date or language restrictions in the electronic search for trials. We last searched the electronic databases on 31 March 2022. SELECTION CRITERIA: We included randomized controlled trials that compared trifocal and bifocal IOLs among participants 30 years of age or older with presbyopia undergoing cataract surgery. DATA COLLECTION AND ANALYSIS We used standard Cochrane methodology and graded the certainty of the body of evidence according to the GRADE classification. MAIN RESULTS We identified seven studies conducted in Europe and Turkey with a total of 331 participants. All included studies assessed visual acuity using a logarithm of the minimum angle of resolution (LogMAR chart). Of them, six (86%) studies assessed uncorrected distance visual acuity (the primary outcome of this review). Some studies also examined our secondary outcomes including uncorrected near, intermediate, and best-corrected distance visual acuity, as well as contrast sensitivity. Study characteristics All participants had bilateral cataracts with no pre-existing ocular pathologies or ocular surgery. Participants' mean age ranged from 55 to 74 years. Three studies reported on gender of participants, and they were mostly women. We assessed all of the included studies as being at unclear risk of bias for most domains. Two studies received financial support from manufacturers of lenses evaluated in this review, and at least one author of another study reported receiving payments for delivering lectures with lens manufacturers. Findings All studies compared trifocal versus bifocal IOL implantation on visual acuity outcomes measured on a LogMAR scale. At one year, trifocal IOL showed no evidence of effect on uncorrected distance visual acuity (mean difference (MD) 0.00, 95% confidence interval (CI) -0.04 to 0.04; I2 = 0%; 2 studies, 107 participants; low-certainty evidence) and uncorrected near visual acuity (MD 0.01, 95% CI -0.04 to 0.06; I2 = 0%; 2 studies, 107 participants; low-certainty evidence). Trifocal IOL implantation may improve uncorrected intermediate visual acuity at one year (MD -0.16, 95% CI -0.22 to -0.10; I2 = 0%; 2 studies, 107 participants; low-certainty evidence), but showed no evidence of effect on best-corrected distance visual acuity at one year (MD 0.00, 95% CI -0.03 to 0.04; I2 = 0%; 2 studies, 107 participants; low-certainty evidence). No study reported on contrast sensitivity or quality of life at one-year follow-up. Data from one study at three months suggest that contrast sensitivity did not differ between groups under photopic conditions, but may be worse in the trifocal group in one of the four frequencies under mesopic conditions (MD -0.19, 95% CI -0.33 to -0.05; 1 study; I2 = 0%, 25 participants; low-certainty evidence). One study examined vision-related quality of life using the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) at six months, and suggested no evidence of a difference between trifocal and bifocal IOLs (MD 1.41, 95% CI -1.78 to 4.60; 1 study, 40 participants; low-certainty evidence). Adverse events Adverse events reporting varied among studies. Of five studies reporting information on adverse events, two studies observed no intraoperative and postoperative complications or no posterior capsular opacification at six months. One study reported that glare and halos were similar to the preoperative measurements. One study reported that 4 (20%) and 10 (50%) participants had glare complaints at 6 months in trifocal and bifocal group, respectively (risk ratio 0.40, 95% CI 0.15 to 1.07; 40 participants). One study reported that four eyes (11.4%) in the bifocal group and three eyes (7.5%) in the trifocal group developed significant posterior capsular opacification requiring YAG capsulotomy at one year. The certainty of the evidence for adverse events was low. AUTHORS' CONCLUSIONS We found low-certainty of evidence that compared with bifocal IOL, implantation of trifocal IOL may improve uncorrected intermediate visual acuity at one year. However, there was no evidence of a difference between trifocal and bifocal IOL for uncorrected distance visual acuity, uncorrected near visual acuity, and best-corrected visual acuity at one year. Future research should include the comparison of both trifocal IOL and specific bifocal IOLs that correct intermediate visual acuity to evaluate important outcomes such as contrast sensitivity, quality of life, and vision-related adverse effects.
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Affiliation(s)
- Diego Zamora-de La Cruz
- Anterior Segment Department, Instituto de Oftalmología Fundación Conde de Valenciana, Mexico City, Mexico
| | - John Bartlett
- Jules Stein Eye Institute, UCLA, Los Angeles, California, USA
| | - Mario Gutierrez
- Retina and Vitreous Department, Instituto de Oftalmología Fundación Conde de Valenciana, Mexico City, Mexico
| | - Sueko M Ng
- Department of Ophthalmology, University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado, USA
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Megiddo-Barnir E, Alió JL. Latest Development in Extended Depth-of-Focus Intraocular Lenses: An Update. Asia Pac J Ophthalmol (Phila) 2023; 12:58-79. [PMID: 36706334 DOI: 10.1097/apo.0000000000000590] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/06/2022] [Indexed: 01/28/2023] Open
Abstract
In recent years, there has been an overwhelming influx of different types of intraocular lenses (IOLs) as treatment for presbyopia. The extended depth-of-focus (EDOF) technology creates a single elongated focal point to enhance depth of focus, in contrast to the multiple foci of multifocal (MF) lenses. In this way, the EDOF lenses aim to reduce photic phenomena, glare, and halos, which have been reported in MF IOLs. A potential disadvantage of this is a blur due to decreased retinal image quality when the amount of the aberrations is increased excessively. Multifocality and EDOF characteristics are not exclusive of each other. Frequently, EDOF IOLs are combined with MF optical designs, a bifocal IOL may exhibit EDOF characteristics, likewise an aspheric monofocal IOL or a diffractive or refractive trifocal IOL. Thus, EDOF lenses are commonly subjected to confusion. A wide range of different types of EDOF lenses are available on the market to surgeons. In this practical update, we aim to clarify what is a true EDOF lens, classify the different types of the EDOF lenses based on their optical principle and review their recently reported outcomes. Comprehensive patient examination and selection, combined with knowledge of the most updated options and adequate patient counseling, can avoid dissatisfaction and yield the desired outcomes.
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Affiliation(s)
| | - Jorge L Alió
- Cornea, Cataract & Refractive Surgery Unit, VISSUM (Miranza Group), Alicante, Spain
- Department of Ophthalmology, Miguel Hernandez University, Alicante, Spain
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Elsner R, Sievers J, Kunert M, Reiss S, Bohn S, Schünemann M, Stolz H, Guthoff R, Stachs O, Sperlich K. The Rostock Method for Qualitative and Quantitative Evaluation of Intraocular Lenses. Klin Monbl Augenheilkd 2022; 239:1440-1446. [PMID: 36493765 DOI: 10.1055/a-1953-7302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND For quantitative and qualitative evaluation of the imaging properties of IOLs, axial cross-sectional images can be obtained from the 3-dimensional light distribution by means of an optical bench, as is known from light sheet recordings in fluorescein baths. This paper presents a new image-processing algorithm to enhance the quality of generated axial cross-sectional images, and the two methods are then compared. MATERIAL AND METHODS The 3-dimensional point spread function of a diffractive trifocal IOL (AT LISA tri 839MP, Carl Zeiss Meditec AG, Jena, Germany) was recorded on an optical bench developed in Rostock for different pupil diameters. A specially adapted image processing algorithm was then applied to the measurements, allowing through-focus curves to be generated. In addition, cross-sectional images of the IOLs studied were acquired using the light sheet method in a fluorescein bath. RESULTS The study clearly shows the superiority of the newly developed method over the light sheet method in terms of image quality. In addition to the individual focal points, fine focal structures as well as halos can be made visible in the cross-sectional images obtained using the new method. In the generated through-focus curves, 3 intensity peaks can be identified, which represent the near, intermediate and far focus of the tested MIOL and cannot be represented by light sheet methods. CONCLUSION The interaction of the optical bench with the developed image processing algorithm allows a more detailed understanding of the image formation and false light phenomena of IOLs, which was restricted by the technical limitations of the existing light sheet method. In addition, other quantities such as the through-focus curve can be derived quantitatively.
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Affiliation(s)
- Ricardo Elsner
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Rostock, Deutschland.,Interdisziplinäre Fakultät Leben, Licht & Materie, Universität Rostock, Deutschland
| | - Jan Sievers
- Institut für Physik, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland
| | - Martin Kunert
- Klinik für Augenheilkunde, Dietrich-Bonhoeffer-Klinikum Neubrandenburg, Deutschland
| | - Stefan Reiss
- Labor für Sehhilfen - Bereich Optik und Technik der Brille, Berliner Hochschule für Technik, Berlin, Deutschland
| | - Sebastian Bohn
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Rostock, Deutschland.,Interdisziplinäre Fakultät Leben, Licht & Materie, Universität Rostock, Deutschland
| | - Melanie Schünemann
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Rostock, Deutschland.,Interdisziplinäre Fakultät Leben, Licht & Materie, Universität Rostock, Deutschland
| | | | - Rudolf Guthoff
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Rostock, Deutschland.,Interdisziplinäre Fakultät Leben, Licht & Materie, Universität Rostock, Deutschland
| | - Oliver Stachs
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Rostock, Deutschland.,Interdisziplinäre Fakultät Leben, Licht & Materie, Universität Rostock, Deutschland
| | - Karsten Sperlich
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Rostock, Deutschland.,Interdisziplinäre Fakultät Leben, Licht & Materie, Universität Rostock, Deutschland
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Jing D, Jiang X, Ren X, Su J, Wei S, Hao R, Chou Y, Li X. Change Patterns in Corneal Intrinsic Aberrations and Nerve Density after Cataract Surgery in Patients with Dry Eye Disease. J Clin Med 2022; 11:jcm11195697. [PMID: 36233565 PMCID: PMC9572385 DOI: 10.3390/jcm11195697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/12/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to evaluate the change patterns in corneal intrinsic aberrations and nerve density after cataract surgery in dry eye disease. The preoperative, 1- and 3-month postoperative dry eye-related parameters were obtained by the Oculus keratograph and the ocular surface disease index questionnaire. The corneal intrinsic aberrations were measured using the Pentacam HR system. In vivo confocal microscopy was performed to observe the vortical and peripheral corneal nerves. An artificial intelligence technique run by the deep learning model generated the corneal nerve parameters. Corneal aberrations on the anterior and total corneal surfaces were significantly increased at 1 month compared with the baseline (p < 0.05) but gradually returned to the baseline by 3 months (p > 0.05). However, the change in posterior corneal aberration lasted up to 3 months (p < 0.05). There was a significant decrease in the corneal vortical nerve maximum length and average density after the operation (p < 0.05), and this damage lasted approximately 3 months. The corneal vortical nerve maximum length and average density were negatively correlated with the anterior corneal surface aberrations before and 1 month after the operation (correlation coefficients, CC = −0.26, −0.25, −0.28; all p < 0.05). Corneal vortex provided a unique site to observe long-term corneal nerve injury related to eye dryness. The continuous damage to the corneal vortical nerve may be due to the continuous dry eye state.
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Affiliation(s)
- Dalan Jing
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing 100191, China
| | - Xiaodan Jiang
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing 100191, China
| | - Xiaotong Ren
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing 100191, China
| | - Jie Su
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing 100191, China
| | - Shanshan Wei
- Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100069, China
| | - Ran Hao
- Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100069, China
| | - Yilin Chou
- Department of Ophthalmology, BenQ Medical Centre, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing 210017, China
- Correspondence: (Y.C.); (X.L.); Tel.: +86-18600862321 (Y.C.); +86-13911254862 (X.L.)
| | - Xuemin Li
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing 100191, China
- Correspondence: (Y.C.); (X.L.); Tel.: +86-18600862321 (Y.C.); +86-13911254862 (X.L.)
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Far and Near Contrast Sensitivity and Quality of Vision with Six Presbyopia Correcting Intraocular Lenses. J Clin Med 2022; 11:jcm11144150. [PMID: 35887913 PMCID: PMC9316344 DOI: 10.3390/jcm11144150] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/12/2022] [Accepted: 07/15/2022] [Indexed: 11/16/2022] Open
Abstract
The objective of this prospective, randomized, double-masked study was to compare the contrast sensitivity and quality of vision of patients bilaterally implanted with the following six different presbyopia correcting intraocular lenses (IOLs): SV25T0 (n = 19), ATLISA 809M (n = 18), ATLISA TRI 839MP (n = 19), ZKB00 (n = 20), ZLB00 (n = 20) and Symfony ZXR00 (n = 20). For comparison purposes, 36 patients were implanted with a monofocal lens (ZA9003). Contrast sensitivity was assessed binocularly at distance under photopic, mesopic and mesopic plus glare conditions, and at near under photopic conditions. Quality of vision was explored in terms of photic phenomena and spectacle independence. Overall, the monofocal lens offered better contrast sensitivity, under all illumination conditions, and less occurrence and intensity of photic phenomena. Amongst the multifocal IOL (MIOL) designs, the extended depth of focus Symfony ZXR00 provided better contrast sensitivity than the other MIOLs, particularly at intermediate and high spatial frequencies. Up to 40% and 50% of patients implanted with MIOLs reported glare and halos, respectively. The SV25T0 resulted in less occurrence and intensity of halos. The evaluation of photic phenomena and contrast sensitivity under different illumination conditions may reflect real-life, visually challenging situations, and thus provide insightful information to assist ophthalmic surgeons when selecting the best intraocular lens for their patients.
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Reinstein DZ, Archer TJ, Vida RS, Carp GI, Reinstein JFR, McAlinden C. Objective and Subjective Quality of Vision After SMILE for High Myopia and Astigmatism. J Refract Surg 2022; 38:404-413. [PMID: 35858192 DOI: 10.3928/1081597x-20220516-03] [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 report subjective and objective quality of vision (QoV) results for high myopic small incision lenticule extraction (SMILE) between -9.00 and -13.00 diopters (D). METHODS This was a prospective study recruiting 114 patients undergoing SMILE with attempted spherical equivalent refraction (SEQ) correction from -9.00 to -13.00 D, and cylinder up to 5.00 D. Patients were informed before surgery of the increased risk of QoV symptoms. Patients completed the Rasch validated QoV questionnaire. Objective QoV was assessed by corneal and whole eye aberrations, HD Analyzer Objective Scatter Index (OSI) (Keeler), and contrast sensitivity. Patient satisfaction was assessed on a scale from 0 (very dissatisfied) to 10 (very satisfied). Individual item and total Rasch-scaled scores for the three subscales (frequency, severity, and bothersomeness) of the QoV questionnaire were calculated before and 12 months after surgery. RESULTS The mean patient satisfaction score was 9.27 ± 1.18 (range: 2 to 10), 8 or higher in 93%, and 7 or higher in 98% of patients. One patient with a satisfaction score of 2 had a simple refractive error re-treatment and then reported a satisfaction score of 10. The total mean ± standard deviation Rasch-scaled QoV score for the frequency, severity, and bothersomeness subscales before surgery was 24 ± 19, 20 ± 16, and 19 ± 18, respectively. Scores increased after surgery to 41 ± 18, 32 ± 16, and 30 ± 21, respectively (P < .001). Corneal aberrations (6 mm, OSI) increased on average by 0.39 µm for spherical aberration, 0.41 µm for coma, and 0.56 µm for higher order aberrations root mean square. OSI increased on average by 0.58. There was a small but statistically significant improvement in contrast sensitivity at 3, 6, 12, and 18 cycles per degree. There were no statistically significant correlations found between subjective scores for starbursts and objective measurements. CONCLUSIONS Satisfaction was high following SMILE for high myopia. As expected, there was an increase in QoV symptoms, mainly glare and starbursts. The acceptance of QoV symptoms for high myopic SMILE was high, indicating that residual refractive error and visual acuity are the major drivers for patient satisfaction with appropriate preoperative informed consent. [J Refract Surg. 2022;38(7):404-413.].
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10
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Zhu Y, Zhong Y, Fu Y. The effects of premium intraocular lenses on presbyopia treatments. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2022; 2:100042. [PMID: 37846220 PMCID: PMC10577869 DOI: 10.1016/j.aopr.2022.100042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/28/2022] [Accepted: 02/20/2022] [Indexed: 10/18/2023]
Abstract
Background Presbyopia has become a global disease affecting the world's aging population. Among various treatments, cataract extraction and intraocular lens (IOL) implantation have become the most popular and common methods of presbyopia correction. During the twentieth century, IOLs have underwent significant innovation and advancements to meet the patients' high demands for functional vision at all distances. Main Text To meet the increasing needs for excellent near and intermediate vision for daily activities, some premium IOLs with more than one focus have been developed, for example, the refractive MfIOLs, diffractive MfIOLs, extended depth of field (EDOF) IOLs, and accommodating IOLs (AIOLs) were introduced to meet this need. In addition, the add-on MfIOLs have been explored as promising supplementary IOLs for pseudophakic presbyopia. When selecting the MfIOLs, the IOLs' features, patients' characteristics, preoperative eye conditions, and treatment expectations should be considered. Conclusions In this review, we focus on the multifocal IOLs (MfIOLs) commonly used for presbyopia correction and systematically summarized their optical designs and clinical outcomes. More evidence-based studies are required to provide guidelines for MfIOL selection, provide maximum visual benefits, and develop personalized visual solutions in the future.
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Affiliation(s)
- Yanan Zhu
- Corresponding author. Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jiefang Road, Hangzhou, 310009, Zhejiang Province, China.
| | | | - Yanyan Fu
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang Province, China
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11
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Sievers J, Elsner R, Bohn S, Schünemann M, Stolz H, Guthoff RF, Stachs O, Sperlich K. Method for the generation and visualization of cross-sectional images of three-dimensional point spread functions for rotationally symmetric intraocular lenses. BIOMEDICAL OPTICS EXPRESS 2022; 13:1087-1101. [PMID: 35284182 PMCID: PMC8884235 DOI: 10.1364/boe.446869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/21/2021] [Accepted: 12/30/2021] [Indexed: 06/14/2023]
Abstract
Cross-sectional images of three-dimensional point spread functions of intraocular lenses are used to study their image formation. To obtain those, light sheet-based methods are established. Due to the non-negligible thicknesses of the light sheets, the image quality of the cross-sectional images is constrained. To overcome this hurdle, we present a dedicated evaluation algorithm to increase image quality in the post-processing step. Additionally, we compare the developed- with the light sheet method based on our own investigations of a multifocal diffractive intraocular lens conducted in an in-house designed optical bench. The comparative study showed the clear superiority of the newly developed method in terms of image quality, fine structure visibility, and signal-to-noise ratio compared to the light sheet based method. However, since the algorithm assumes a rotationally symmetrical point spread function, it is only suitable for all rotationally symmetrical lenses.
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Affiliation(s)
- Jan Sievers
- Department of Ophthalmology, Rostock University Medical Center, 18057 Rostock, Germany
- Department Life, Light & Matter, University of Rostock, 18055 Rostock, Germany
- Institute of Physics, Martin–Luther–University Halle–Wittenberg, 06120 Halle (Saale), Germany
| | - Ricardo Elsner
- Department of Ophthalmology, Rostock University Medical Center, 18057 Rostock, Germany
- Department Life, Light & Matter, University of Rostock, 18055 Rostock, Germany
| | - Sebastian Bohn
- Department of Ophthalmology, Rostock University Medical Center, 18057 Rostock, Germany
- Department Life, Light & Matter, University of Rostock, 18055 Rostock, Germany
| | - Melanie Schünemann
- Department of Ophthalmology, Rostock University Medical Center, 18057 Rostock, Germany
- Department Life, Light & Matter, University of Rostock, 18055 Rostock, Germany
| | - Heinrich Stolz
- Department Life, Light & Matter, University of Rostock, 18055 Rostock, Germany
- Institute of Physics, University of Rostock, 18055 Rostock, Germany
| | - Rudolf F. Guthoff
- Department of Ophthalmology, Rostock University Medical Center, 18057 Rostock, Germany
- Department Life, Light & Matter, University of Rostock, 18055 Rostock, Germany
| | - Oliver Stachs
- Department of Ophthalmology, Rostock University Medical Center, 18057 Rostock, Germany
- Department Life, Light & Matter, University of Rostock, 18055 Rostock, Germany
| | - Karsten Sperlich
- Department of Ophthalmology, Rostock University Medical Center, 18057 Rostock, Germany
- Department Life, Light & Matter, University of Rostock, 18055 Rostock, Germany
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12
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Freissinger S, Vounotrypidis E, Stetzer E, Bayer I, Shajari M, Kreutzer T, Keidel L, Kern C, Priglinger S, Wolf A. Visual outcome after rhegmatogenous retinal detachment repair surgery in patients with multifocal vs monofocal intraocular lenses. J Cataract Refract Surg 2021; 47:1561-1567. [PMID: 33974368 DOI: 10.1097/j.jcrs.0000000000000684] [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: 12/27/2020] [Accepted: 04/22/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate functional outcome after retinal detachment (RD) repair surgery in eyes with a multifocal intraocular lens (mIOL). SETTING Ludwig-Maximilians-University, Munich, Germany. DESIGN Single-center case control study. METHODS 52 pseudophakic eyes with successful anatomical outcome after surgical RD repair were included. Retrospectively, 21 mIOL eyes were compared with a matched group of 21 monofocal eyes over 6 weeks. Prospectively, corrected distance visual acuity (CDVA) was evaluated over 12 months in these eyes. Furthermore, uncorrected distance, intermediate, and near visual acuity (UDVA, UIVA, and UNVA, respectively), defocus curves, and patient-reported outcomes were evaluated at 1 year in 24 mIOL eyes. RESULTS 52 eyes of 48 patients comprised the study. The mean CDVA (logMAR) improved significantly from 1.35 ± 1.38 to 0.29 ± 0.37 at 6 weeks and remained stable at 12 months postoperatively in monofocal eyes (P = .001) and from 1.16 ± 1.2 to 0.37 ± 0.29 (6 weeks) and 0.20 ± 0.36 (12 months) in mIOL eyes (P = .001). Univariate factorial analysis of variance showed no statistically significant differences in CDVA at 6 weeks or 12 months postoperatively for IOL type or for preoperative macular status (P > .05). In the prospective cohort of 24 mIOL eyes, a mean CDVA of 0.13 ± 0.33 logMAR, UDVA of 0.21 ± 0.34 logMAR, UIVA of 0.17 ± 0.28 logMAR, and UNVA of 0.23 ± 0.32 logMAR was achieved. Macular status did not affect final outcome significantly (P > .05). Most patients stated they usually did not need spectacles; no patient wanted mIOL replacement. CONCLUSIONS 1 year after successful anatomical repair after 23-gauge vitrectomy with gas tamponade, functionality of mIOL was restored, and CDVA was comparable with that of patients with monofocal IOL.
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Affiliation(s)
- Sigrid Freissinger
- From the Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany (Freissinger, Vounotrypidis, Bayer, Shajari, Kreutzer, Keidel, Kern, Priglinger, Wolf); University Eye Hospital Ulm, Ulm, Germany (Vounotrypidis, Stetzer, Wolf)
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13
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Coassin M, Mori T, Di Zazzo A, Poddi M, Sgrulletta R, Napolitano P, Bonini S, Orfeo V, Kohnen T. Effect of minimonovision in bilateral implantation of a novel non-diffractive extended depth-of-focus intraocular lens: Defocus curves, visual outcomes, and quality of life. Eur J Ophthalmol 2021; 32:2942-2948. [PMID: 34825597 DOI: 10.1177/11206721211064018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate overall patient satisfaction, spectacle independence, visual acuity, and prevalence of optical phenomena following bilateral implantation of a new non-diffractive extended depth-of-focus intraocular lens targeted for minimonovision. METHODS Multicenter prospective case series. Postoperative far and near visual acuity at 3 months and patient quality of life by NEI-VFQ-25 questionnaire were assessed. Postoperative evaluation included defocus curves analysis, spectacle independence assessment, and recording of photic phenomena. RESULTS The study enrolled 97 eyes of 59 patients that underwent femtosecond-assisted cataract surgery with AcrySof IQ Vivity intraocular lens implantation. Thirty subjects (60 eyes) were eligible for analysis. After 3 months, postoperative achieved binocular uncorrected visual acuity was -0.03 ± 0.06 logarithm of the minimum angle of resolution for distance, 0.06 ± 0.06 logarithm of the minimum angle of resolution for intermediate, and 0.19 ± 0.03 logarithm of the minimum angle of resolution for near. Defocus curve showed a smooth profile with no abrupt decrease of visual acuity. Minimonovision significantly improved visual acuity compared to when minimonovision was neutralized, for values of defocus curves from -1 to -3 D (p < 0.05). Twenty-six (87%) patients reported complete spectacle independence. High levels of satisfaction for distance and near vision resulted at VFQ-25 questionnaire. Only two patients complained of halos (6.7%) and one of them also of glare (3.3%). CONCLUSIONS Implantation of this new non-diffractive extended depth-of-focus intraocular lens with minimonovision resulted in satisfying far, intermediate, and near visual acuity with a consistent reduction of spectacle dependence and improvement in patient's quality of life.
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Affiliation(s)
- Marco Coassin
- Ophthalmology, 9317University Campus Bio-Medico, Roma, Italy
| | - Tommaso Mori
- Ophthalmology, 9317University Campus Bio-Medico, Roma, Italy
| | | | - Maria Poddi
- Ophthalmology, 9317University Campus Bio-Medico, Roma, Italy
| | | | | | - Stefano Bonini
- Ophthalmology, 9317University Campus Bio-Medico, Roma, Italy
| | - Vincenzo Orfeo
- 47235Clinica Mediterranea, Ophthalmology Unit, Napoli, Italy
| | - Thomas Kohnen
- Department of Ophthalmology, 144867Goethe University, Frankfurt, Germany
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Zhang Z, Jiang H, Zhou H, Zhou F. Comparative Efficacy Between Trifocal and Bifocal Intraocular Lens Among Patients Undergoing Cataract Surgery: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2021; 8:647268. [PMID: 34660614 PMCID: PMC8514957 DOI: 10.3389/fmed.2021.647268] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 09/06/2021] [Indexed: 11/24/2022] Open
Abstract
The comparative efficacy of trifocal and bifocal intraocular lenses (IOLs) remained uncertain among patients undergoing cataract surgery. A systematic review and meta-analysis was performed to answer this question. PubMed, Cochrane Library and Embase were searched to capture relevant randomized controlled trials (RCTs). Visual acuity (VA) and patient's satisfaction were regarded as primary outcomes. Secondary outcomes included residual sphere, spherical equivalence, residual cylinder, posterior capsular opacification (PCO), spectacle independence, and other complications. Statistical analysis was done using RevMan 5.2.0. A total of 9 studies (11 RCTs) with 297 participants (558 eyes) were included. Meta-analysis showed significant differences between trifocal and bifocal IOLs in the uncorrected near VA (mean difference [MD], −0.008; 95% confidence interval [Cl], −0.015 to −0.001; P = 0.028) and uncorrected intermediate VA (MD, −0.06; 95% CI, −0.10 to −0.02; P < 0.01). Trifocal IOLs were associated with decreased PCO incidence when compared to bifocal IOLs (relative risk [RR], 0.54; 95% CI, 0.31 to 0.95; P = 0.03). Trifocal IOLs may be superior to bifocal IOLs because of its improved intermediate VA and reduced incidence of PCO.
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Affiliation(s)
- Ziran Zhang
- Department of Clinical Medicine, First Clinical Medical College, Nanjing Medical University, Nanjing, China
| | - Haiyang Jiang
- Department of Geriatrics, Huai'an Medical Area, Affiliated General Hospital of Eastern Theater Command, Huai'an, China
| | - Hongwei Zhou
- Department of Ophthalmology, The Affiliated Lianshui County People's Hospital of Kangda College of Nanjing Medical Universty, Huai'an, China
| | - Fang Zhou
- Beijing Key Laboratory of Megaregions Sustainable Development Modeling, Capital University of Economics and Business, Beijing, China.,Department of Public Affairs, College of Urban Economics and Public Administration, Capital University of Economics and Business, Beijing, China
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15
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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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16
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Spadea L, Giannico MI, Formisano M, Alisi L. Visual Performances of a New Extended Depth-of-Focus Intraocular Lens with a Refractive Design: A Prospective Study After Bilateral Implantation. Ther Clin Risk Manag 2021; 17:727-738. [PMID: 34295162 PMCID: PMC8291859 DOI: 10.2147/tcrm.s320422] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 07/05/2021] [Indexed: 01/19/2023] Open
Abstract
Purpose The aim of the present study was to evaluate the visual outcome of a new extended depth-of-focus (EDOF) intraocular lens (IOL) after bilateral implantation. A qualitative and quantitative analysis was performed and data were compared with those given by other studies regarding multifocal IOLs, which have the same purpose of giving spectacle independence to the patients. Methods The study enrolled 40 eyes of 20 patients who underwent cataract surgery with bilateral implantation of an EDOF IOL (Evolve Soleko, Rome, Italy). The mean age was 74.5±9 years (range 59-83ys). Refractive outcomes and contrast sensitivity were evaluated preoperatively and at 6-month follow-up. We also examined reading speed, glare, halos, difficulties in the night driving, the requirement for spectacles, and overall satisfaction with vision. Two questionnaires were administered for this purpose. Results At 6 months, the percentage of eyes within ±0.50 diopters (D) from emmetropia was 82.5%. Of all patients, 90% were satisfied with their vision. The percentage of spectacle-free for near and distance vision patients was 70% and 95%, respectively. A postoperative binocular uncorrected 60cm intermediate visual acuity (UI60VA) of 0.2 logMAR or better was achieved in 92% of patients. Contrast sensitivity significantly improved postoperatively (p<0.001) and mean reading speed was good. Conclusion This new EDOF IOL seems to provide an effective alternative to patients who desire a spectacle-free lifestyle postoperatively. These lenses can supply a satisfactory distance, intermediate and near vision, and retain good contrast sensitivity, with most patients reporting excellent satisfaction.
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Affiliation(s)
- Leopoldo Spadea
- Eye Clinic, Policlinico Umberto 1, "Sapienza" University of Rome, Rome, Italy
| | | | - Martina Formisano
- Eye Clinic, Policlinico Umberto 1, "Sapienza" University of Rome, Rome, Italy
| | - Ludovico Alisi
- Eye Clinic, Policlinico Umberto 1, "Sapienza" University of Rome, Rome, Italy
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17
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Fernández J, Rodríguez-Vallejo M, Martínez J, Burguera N, Piñero DP. What we have learnt from 30 years living with positive dysphotopsia after intraocular lens implantation?: a review. EXPERT REVIEW OF OPHTHALMOLOGY 2021. [DOI: 10.1080/17469899.2021.1917997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Joaquín Fernández
- Department of Ophthalmology (Qvision, VITHAS Hospital, Almería, Spain
| | | | - Javier Martínez
- Department of Ophthalmology (Qvision, VITHAS Hospital, Almería, Spain
| | - Noemi Burguera
- Department of Ophthalmology (Qvision, VITHAS Hospital, Almería, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- Department of Ophthalmology (Imqo-oftalmar), Vithas Medimar International Hospital, Alicante, Spain
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18
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Gabrić N, Gabrić I, Gabrić K, Biščević A, Piñero DP, Bohač M. Clinical Outcomes With a New Continuous Range of Vision Presbyopia-Correcting Intraocular Lens. J Refract Surg 2021; 37:256-262. [PMID: 34038663 DOI: 10.3928/1081597x-20210209-01] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE To evaluate the clinical outcomes including patient-reported outcome measures in a sample of eyes undergoing bilateral cataract surgery with implantation of a new model of presbyopia-correcting intraocular lens (IOL). METHODS This non-randomized prospective case series enrolled 206 eyes of 103 patients undergoing phacoemulsification cataract surgery with bilateral implantation of the TECNIS Synergy IOL (Johnson & Johnson Vision). High and low contrast visual acuity, refractive, defocus curve, and patient-reported visual performance (Catquest-9SF questionnaire) outcomes were evaluated during a 3-month follow-up. RESULTS A total of 96.1% (99 of 103) and 91.3% (94 of 103) of patients achieved binocular postoperative uncorrected distance (UDVA) and near visual acuity (UNVA) of 0.00 logMAR (20/20), respectively. Mean postoperative mesopic UNVA for both eyes was 0.14 ± 0.03 logMAR. Likewise, mean binocular UDVA and UNVA were 0.00 ± 0.03 and 0.04 ± 0.02 logMAR. An almost flat mean defocus curve was obtained, with visual acuities between 0.00 and 0.10 logMAR for most defocus levels in both eyes. A reduction of contrast led to a limited but statistically significant change in UNVA in both eyes (P < .001). The Rasch calibrated scoring of item 2 and the Rasch calibrated mean score of the Catquest-9SF questionnaire increased significantly with surgery (P < .001). CONCLUSIONS This new presbyopia-correcting IOL provides a continuous range of functional focus, with a limited deterioration under mesopic conditions, which is perceived as a satisfactory outcome by the patient if proper patient selection is performed. [J Refract Surg. 2021;37(4):256-262.].
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Schallhorn JM, Pantanelli SM, Lin CC, Al-Mohtaseb ZN, Steigleman WA, Santhiago MR, Olsen TW, Kim SJ, Waite AM, Rose-Nussbaumer JR. Multifocal and Accommodating Intraocular Lenses for the Treatment of Presbyopia: A Report by the American Academy of Ophthalmology. Ophthalmology 2021; 128:1469-1482. [PMID: 33741376 DOI: 10.1016/j.ophtha.2021.03.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/10/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE To review the published literature assessing the efficacy and safety of presbyopia-correcting intraocular lenses (IOLs) for the treatment of presbyopia after cataract removal. METHODS Literature searches were undertaken in January 2018 and September 2020 in the PubMed, Medline, and Cochrane Library databases. This yielded 761 articles, of which 34 met the criteria for inclusion in this assessment and were assigned a level of evidence rating by the panel methodologist. Thirteen studies were rated level I and 21 studies were rated level II. RESULTS Presbyopia-correcting lenses were effective at improving distance and near visual acuity after cataract surgery. Near acuity at different focal lengths was related directly to the effective add power of multifocal and extended depth-of-focus (EDOF) IOLs. Most multifocal and EDOF lenses that were compared with a control monofocal lens demonstrated that patient-reported spectacle independence was superior to the monofocal lens. All patients who had multifocal and EDOF lenses implanted showed decreased contrast sensitivity and reported more visual phenomena as compared with control participants who received monofocal lenses. CONCLUSIONS Presbyopia-correcting lenses improve uncorrected near and distance visual acuity and decrease spectacle dependence after cataract surgery. Mesopic contrast sensitivity is decreased compared with monofocal lenses, and patient-reported visual phenomena are more likely in patients receiving multifocal or EDOF lenses.
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Affiliation(s)
- Julie M Schallhorn
- Francis I. Proctor Foundation and Department of Ophthalmology, University of California, San Francisco, California
| | - Seth M Pantanelli
- Department of Ophthalmology, Penn State College of Medicine, Hershey, Pennsylvania
| | - Charles C Lin
- Byers Eye Institute, Stanford University, Palo Alto, California
| | | | | | | | - Timothy W Olsen
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota
| | - Stephen J Kim
- Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Jennifer R Rose-Nussbaumer
- Francis I. Proctor Foundation and Department of Ophthalmology, University of California, San Francisco, California; Division of Research, Kaiser Permanente Northern California, Oakland, California
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20
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Hervella L, Villegas EA, Robles C, Artal P. Spherical Aberration Customization to Extend the Depth of Focus With a Clinical Adaptive Optics Visual Simulator. J Refract Surg 2021; 36:223-229. [PMID: 32267952 DOI: 10.3928/1081597x-20200212-02] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 02/10/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE To evaluate the use of the VAO adaptive optics visual simulator (Voptica SL, Murcia, Spain) for customization of spherical aberration to increase depth of focus. METHODS Through-focus visual acuity with both high- and low-contrast letters from +1.00 to -3.00 diopters (D) was measured in 17 dilated eyes with three different induced amounts of spherical aberration for a 4.5-mm pupil diameter: control (0 µm), -0.15 µm, and -0.30 µm. RESULTS The defocus curves followed the same behavior with both values of contrast, but the visual acuity was 0.2 logMAR lower with low contrast. The mean values of high-contrast logMAR visual acuity at far, intermediate (67 cm), and near (40 cm) were -0.10, 0.11, and 0.37 for control, 0.04, 0.00, and 0.15 for -0.15 µm, and 0.23, 0.00, and 0.06 for -0.30 µm conditions. The 95% confidence interval ranged from ±0.14 to ±0.45 logMAR and the middle 50% of the distribution was approximately 0.2 logMAR. CONCLUSIONS Negative values of spherical aberration extend the depth of focus in different ways depending on each patient. The VAO is a new instrument that allows the visual customization of spherical aberration to enhance depth of focus. [J Refract Surg. 2020;36(4):223-229.].
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Auffarth GU, Gerl M, Tsai L, Janakiraman DP, Jackson B, Alarcon A, Dick HB. Clinical evaluation of a new monofocal IOL with enhanced intermediate function in patients with cataract. J Cataract Refract Surg 2021; 47:184-191. [PMID: 32932369 DOI: 10.1097/j.jcrs.0000000000000399] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 08/04/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE To evaluate the effectiveness and safety of 2 enhanced monofocal intraocular lenses (IOLs). The TECNIS Eyhance IOL (Model ICB00) was compared with a standard monofocal IOL (TECNIS Monofocal, Model ZCB00). SETTING European multicenter study. DESIGN Prospective, bilateral, randomized, comparative/evaluator-masked, controlled study. METHODS Adult subjects scheduled to undergo bilateral, primary phacoemulsification cataract extraction and posterior IOL implantation were randomized to receive the enhanced monofocal ICB00 IOL or the monofocal ZCB00 IOL in both eyes. Monocular endpoints at 6 months included distance-corrected intermediate visual acuity (DCIVA), photopic corrected distance visual acuity, and uncorrected intermediate visual acuity (UIVA). Binocular visual acuities, monocular corrected distance contrast sensitivity (first eyes), patient-reported outcomes, and safety were assessed at 6 months. RESULTS Overall, 139 patients were bilaterally implanted with the enhanced monofocal IOL (n = 67) or standard monofocal IOL (n = 72) and available for the 6-month visit. The enhanced monofocal IOL significantly improved mean monocular and binocular DCIVA and UIVA by at least 1-line logarithm of the minimum angle of resolution vs the standard monofocal IOL (all P ≤ .0001). Distance vision for the enhanced monofocal IOL was 20/20 or better and comparable with that of the standard monofocal lens at 6 months. Contrast sensitivity, photic phenomena outcomes, and rates of adverse events were similar between the 2 groups. CONCLUSIONS In patients undergoing cataract surgery, TECNIS Eyhance IOL Model ICB00 provided enhanced intermediate vision and similar distance performance and photic phenomena compared with a standard monofocal IOL, along with improved functional performance in daily life.
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Affiliation(s)
- Gerd U Auffarth
- From the International Vision Correction Research Centre (IVCRC), University-Eye-Clinic (Auffarth), Heidelberg, Augenklinik Ahaus (Gerl), Ahaus, Germany; Johnson & Johnson Vision (Tsai, Janakiraman, Jackson), Santa Ana, California, USA; AMO (Alarcon), Groningen, the Netherlands; University Eye Hospital (Dick), Bochum, Germany
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Siedlecki J, Schmelter V, Schworm B, Mayer WJ, Priglinger SG, Dirisamer M, Luft N. Corneal wavefront aberrations and subjective quality of vision after small incision lenticule extraction. Acta Ophthalmol 2020; 98:e907-e913. [PMID: 32212414 DOI: 10.1111/aos.14420] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 03/04/2020] [Indexed: 02/04/2023]
Abstract
PURPOSE To analyse in depth the associations between objectively measured corneal higher-order aberrations (HOAs) and subjectively perceived visual quality after small incision lenticule extraction (SMILE) as quantified with the standardized and clinically validated quality of vision (QOV) questionnaire. METHODS This cross-sectional study included patients after bilateral simultaneous SMILE for the treatment of myopia and/or myopic astigmatism with plano target refraction. Scheimpflug imaging (Pentacam HR; Oculus Optikgeräte GmbH, Wetzlar, Germany) was used to objectively quantify corneal HOAs. The standardized and validated QOV questionnaire was employed to gauge patients' subjectively perceived visual quality regarding frequency, severity and bothering effect of visual disturbances. RESULTS A total of 394 eyes of 197 patients with a mean age of 32.4 ± 7.7 years and a mean postoperative follow-up of 24.3 ± 14.1 months were included. SMILE induced a statistically significant (p < 0.001) increase in spherical aberration (0.074 ± 0.131 µm), coma (0.142 ± 0.179 µm), trefoil (0.018 ± 0.067 µm) as well as in total HOAs (0.191 ± 0.176 µm). Surgically induced and postoperative levels of HOA showed no correlation with the three QOV scores representative of overall visual symptom frequency, severity and bothering effect (all R2 values ≤ 0.016). In addition, the associations between specific visual symptoms (e.g. starburst) and singular HOA terms (e.g. haloes) were very weak (all Rho values ≤ 0.164). CONCLUSIONS Small incision lenticule extraction induced significant amounts of corneal HOAs that, however, showed no clear relationships to patient-reported QOV or specific long-term visual symptoms.
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Affiliation(s)
- Jakob Siedlecki
- University Eye Hospital Ludwig‐Maximilians‐University Munich Germany
- SMILE Eyes Clinic Linz Austria
| | - Valerie Schmelter
- University Eye Hospital Ludwig‐Maximilians‐University Munich Germany
| | - Benedikt Schworm
- University Eye Hospital Ludwig‐Maximilians‐University Munich Germany
- SMILE Eyes Clinic Linz Austria
| | - Wolfgang J. Mayer
- University Eye Hospital Ludwig‐Maximilians‐University Munich Germany
| | - Siegfried G. Priglinger
- University Eye Hospital Ludwig‐Maximilians‐University Munich Germany
- SMILE Eyes Clinic Linz Austria
| | - Martin Dirisamer
- University Eye Hospital Ludwig‐Maximilians‐University Munich Germany
- SMILE Eyes Clinic Linz Austria
| | - Nikolaus Luft
- University Eye Hospital Ludwig‐Maximilians‐University Munich Germany
- SMILE Eyes Clinic Linz Austria
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Rampat R, Gatinel D. Multifocal and Extended Depth-of-Focus Intraocular Lenses in 2020. Ophthalmology 2020; 128:e164-e185. [PMID: 32980397 DOI: 10.1016/j.ophtha.2020.09.026] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 09/14/2020] [Accepted: 09/21/2020] [Indexed: 10/23/2022] Open
Abstract
Ophthalmic surgeons have been overwhelmed by the influx of multifocal intraocular lens (IOL) options in recent years, with close to 100 IOLs on the market in 2020. This practical and technical update on a representative group of established as well as newly launched multifocal IOLs on the market focuses on multifocal IOLs, including extended depth-of-focus lenses. We also describe the optical basis of lens platforms used and thorough preoperative planning to aid decision making. This allows the surgeon the knowledge base to deliver the required relative customized spectacle independence with the least photic phenomenon and loss of contrast possible while achieving high individual patient satisfaction. Data of reviewed IOLs displayed in tabular format include mean monocular uncorrected distance, intermediate, and near visual acuities (logarithm of the minimum angle of resolution), with standard deviations and ranges where available. The range of vision targeted, pupil dependence, toric availability, as well as type of optical platform, are provided as a practical guide to demystify existing terminology on the market that may create interest around a seemingly new design that is actually not novel at all. Halos and glare experienced, levels of patient satisfaction, and spectacle independence achieved also are summarized. A wide range of multifocal IOLs options are available on the market to surgeons. Comprehensive patient selection and examination, combined with knowledge of the most recent options and adequate patient counseling, including neuroadaptation, can avoid dissatisfaction. Many recently available IOLs are awaiting formal results, but the methods by which we label and compare these types of IOLs must also be standardized.
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Affiliation(s)
- Radhika Rampat
- Anterior Segment and Refractive Surgery Department, Rothschild Foundation Hospital, Paris, France
| | - Damien Gatinel
- Anterior Segment and Refractive Surgery Department, Rothschild Foundation Hospital, Paris, France.
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Zamora-de La Cruz D, Zúñiga-Posselt K, Bartlett J, Gutierrez M, Abariga SA. Trifocal intraocular lenses versus bifocal intraocular lenses after cataract extraction among participants with presbyopia. Cochrane Database Syst Rev 2020; 6:CD012648. [PMID: 32584432 PMCID: PMC7388867 DOI: 10.1002/14651858.cd012648.pub2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Presbyopia occurs when the lens of the eyes loses its elasticity leading to loss of accommodation. The lens may also progress to develop cataract, affecting visual acuity and contrast sensitivity. One option of care for individuals with presbyopia and cataract is the use of multifocal or extended depth of focus intraocular lens (IOL) after cataract surgery. Although trifocal and bifocal IOLs are designed to restore three and two focal points respectively, trifocal lens may be preferable because it restores near, intermediate, and far vision, and may also provide a greater range of useful vision and allow for greater spectacle independence in individuals with presbyopia. OBJECTIVES To assess the effectiveness and safety of implantation with trifocal versus bifocal IOLs during cataract surgery among participants with presbyopia. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2019, Issue 9); Ovid MEDLINE; Embase.com; PubMed; ClinicalTrials.gov; and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We did not use any date or language restrictions in the electronic search for trials. We last searched the electronic databases on 26 September 2019. We searched the reference lists of the retrieved articles and the abstracts from the Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO) for the years 2005 to 2015. SELECTION CRITERIA We included randomized controlled trials that compared trifocal and bifocal IOLs among participants 30 years or older with presbyopia undergoing cataract surgery. DATA COLLECTION AND ANALYSIS We used standard Cochrane methodology. MAIN RESULTS We identified five studies conducted in Europe with a total of 175 participants. All five studies assessed uncorrected distance visual acuity (primary outcome of the review), while some also examined our secondary outcomes including uncorrected near, intermediate, and best-corrected distance visual acuity, as well as contrast sensitivity. Study characteristics All participants had bilateral cataracts with no pre-existing ocular pathologies or ocular surgery. Participants' mean age ranged from 58 to 64 years. Only one study reported on gender of participants, and they were mostly women. We assessed all the included studies as being at unclear risk of bias for most domains. Two studies received financial support from manufacturers of lenses evaluated in this review, and at least one author of another study reported receiving payments for delivering lectures with lens manufacturers. Findings All studies compared trifocal versus bifocal IOL implantation on visual acuity outcomes measured on a LogMAR scale. At one year, trifocal IOL showed no evidence of effect on uncorrected distance visual acuity (mean difference (MD) 0.00, 95% confidence interval (CI) -0.04 to 0.04; I2 = 0%; 2 studies, 107 participants; low-certainty evidence) and uncorrected near visual acuity (MD 0.01, 95% CI -0.04 to 0.06; I2 = 0%; 2 studies, 107 participants; low-certainty evidence). Trifocal IOL implantation may improve uncorrected intermediate visual acuity at one year (MD -0.16, 95% CI -0.22 to -0.10; I2= 0%; 2 studies, 107 participants; low-certainty evidence), but showed no evidence of effect on best-corrected distance visual acuity at one year (MD 0.00, 95% CI -0.03 to 0.04; I2= 0%; 2 studies, 107 participants; low-certainty evidence). No study reported on contrast sensitivity or quality of life at one-year follow-up. Data from one study at three months suggest that contrast sensitivity did not differ between groups under photopic conditions, but may be worse in the trifocal group in one of the four frequencies under mesopic conditions (MD -0.19, 95% CI -0.33 to -0.05; 1 study; I2 = 0%, 25 participants; low-certainty evidence). In two studies, the investigators observed that participants' satisfaction or spectacle independence may be higher in the trifocal group at six months, although another study found no evidence of a difference in participant satisfaction or spectacle independence between groups. Adverse events Adverse events reporting varied among studies. Two studies reported information on adverse events at one year. One study reported that participants showed no intraoperative or postoperative complications, while the other study reported that four eyes (11.4%) in the bifocal and three eyes (7.5%) in the trifocal group developed significant posterior capsular opacification requiring YAG capsulotomy. The certainty of the evidence was low. AUTHORS' CONCLUSIONS There is low-certainty of evidence that compared to bifocal IOL, implantation of trifocal IOL may improve uncorrected intermediate visual acuity at one year. However, there is no evidence of a difference between trifocal and bifocal IOL for uncorrected distance visual acuity, uncorrected near visual acuity, and best-corrected visual acuity at one year. Future research should include the comparison of both trifocal IOL and specific bifocal IOLs that correct intermediate visual acuity to evaluate important outcomes such as contrast sensitivity and quality of life.
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Affiliation(s)
- Diego Zamora-de La Cruz
- Anterior Segment Department, Instituto de Oftalmología Fundación Conde de Valenciana, Mexico City, Mexico
- Anterior Segment Department, Hospital Mexiquense de Salud Visual, ISEM, Naucalpan de Juárez, Mexico
| | | | - John Bartlett
- Jules Stein Eye Institute, UCLA, Los Angeles, California, USA
| | - Mario Gutierrez
- Retina and Vitreous Department, Instituto de Oftalmología Fundación Conde de Valenciana, Mexico City, Mexico
| | - Samuel A Abariga
- Department of Ophthalmology, University of Colorado Anschutz Medical Campus, Denver, Colorado, USA
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Visual outcome and optical quality after implantation of zonal refractive multifocal and extended-range-of-vision IOLs: a prospective comparison. J Cataract Refract Surg 2020; 46:540-548. [DOI: 10.1097/j.jcrs.0000000000000088] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Monaco G, Gari M, Di Censo F, Poscia A, Ruggi G, Scialdone A. Visual performance after bilateral implantation of 2 new presbyopia-correcting intraocular lenses: Trifocal versus extended range of vision. J Cataract Refract Surg 2019; 43:737-747. [PMID: 28732606 DOI: 10.1016/j.jcrs.2017.03.037] [Citation(s) in RCA: 141] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 03/05/2017] [Accepted: 03/11/2017] [Indexed: 11/16/2022]
Abstract
PURPOSE To compare the visual outcomes and quality of vision of 2 new diffractive multifocal intraocular lenses (IOLs) with those of a monofocal IOL. SETTING Fatebenefratelli e Oftalmico Hospital, Milan, Italy. DESIGN Prospective case series. METHODS Patients had bilateral cataract surgery with implantation of a trifocal IOL (Panoptix), an extended-range-of-vision IOL (Symfony), or a monofocal IOL (SN60WF). Postoperative examinations included assessing distance, intermediate, and near visual acuity; binocular defocus; intraocular and total aberrations; point-spread function (PSF); modulation transfer function (MTF); retinal straylight; and quality-of-vision (QoV) and spectacle-dependence questionnaires. RESULTS Seventy-six patients (152 eyes) were assessed for study eligibility. Twenty patients (40 eyes) in each arm of the study (60 patients, 120 eyes) completed the outcome assessment. At the 4-month follow-up, the trifocal group had significantly better near visual acuity than the extended-range-of-vision group (P = .005). The defocus curve showed the trifocal IOL had better intermediate/near performance than the extended-range-of-vision IOL and both multifocal IOLs performed better than the monofocal IOL. Intragroup comparison of the total higher-order aberrations, PSF, MTF, and retinal straylight were not statistically different. The QoV questionnaire results showed no differences in dysphotopsia between the multifocal IOL groups; however, the results were significantly higher than in the monofocal IOL group. CONCLUSIONS Both multifocal IOLs seemed to be good options for patients with intermediate-vision requirements, whereas the trifocal IOL might be better for patients with near-vision requirements. The significant perception of visual side effects indicates that patients still must be counseled about these effects before a multifocal IOL is implanted.
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Affiliation(s)
- Gaspare Monaco
- From the Ophthalmology Unit (Monaco, Di Censo, Ruggi, Scialdone), Fatebenefratelli e Oftalmico Hospital, ASST Fatebenefratelli Sacco, Milan, and the Ophthalmology Unit (Gari) and the Public Health Unit (Poscia), Catholic University of Sacred Heart, Rome, Italy.
| | - Mariangela Gari
- From the Ophthalmology Unit (Monaco, Di Censo, Ruggi, Scialdone), Fatebenefratelli e Oftalmico Hospital, ASST Fatebenefratelli Sacco, Milan, and the Ophthalmology Unit (Gari) and the Public Health Unit (Poscia), Catholic University of Sacred Heart, Rome, Italy
| | - Fabio Di Censo
- From the Ophthalmology Unit (Monaco, Di Censo, Ruggi, Scialdone), Fatebenefratelli e Oftalmico Hospital, ASST Fatebenefratelli Sacco, Milan, and the Ophthalmology Unit (Gari) and the Public Health Unit (Poscia), Catholic University of Sacred Heart, Rome, Italy
| | - Andrea Poscia
- From the Ophthalmology Unit (Monaco, Di Censo, Ruggi, Scialdone), Fatebenefratelli e Oftalmico Hospital, ASST Fatebenefratelli Sacco, Milan, and the Ophthalmology Unit (Gari) and the Public Health Unit (Poscia), Catholic University of Sacred Heart, Rome, Italy
| | - Giada Ruggi
- From the Ophthalmology Unit (Monaco, Di Censo, Ruggi, Scialdone), Fatebenefratelli e Oftalmico Hospital, ASST Fatebenefratelli Sacco, Milan, and the Ophthalmology Unit (Gari) and the Public Health Unit (Poscia), Catholic University of Sacred Heart, Rome, Italy
| | - Antonio Scialdone
- From the Ophthalmology Unit (Monaco, Di Censo, Ruggi, Scialdone), Fatebenefratelli e Oftalmico Hospital, ASST Fatebenefratelli Sacco, Milan, and the Ophthalmology Unit (Gari) and the Public Health Unit (Poscia), Catholic University of Sacred Heart, Rome, Italy
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Hammond MD, Potvin R. Visual Outcomes, Visual Quality and Patient Satisfaction: Comparing a Blended Bifocal Approach to Bilateral Extended Depth of Focus Intraocular Lens Implantation. Clin Ophthalmol 2019; 13:2325-2332. [PMID: 31819357 PMCID: PMC6885543 DOI: 10.2147/opth.s232800] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 11/14/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare visual outcomes, quality of vision and patient satisfaction between a blended apodized diffractive bifocal lens combination and bilateral implantation of an extended depth of focus intraocular lens (IOL). Patients and methods Subjects implanted with either the blended bifocal (Blended) or bilateral extended depth of focus (EDOF) IOL combinations were examined 3 to 24 months after second eye surgery. The primary outcome measure was the patient’s best distance-corrected near visual acuity (VA) at 40cm. The secondary outcome measures were scores on the Quality of Vision Survey, the Catquest-9SF and the Visual Functioning Questionnaires, uncorrected binocular intermediate and near VA at 4–6m, 60cm and 40cm, the manifest refraction and the best-corrected monocular and binocular distance VA. Results Twenty-five EDOF subjects and 23 blended subjects were analyzed. The uncorrected and best-distance corrected intermediate VA was statistically significantly better in the EDOF group (p < 0.05); no other significant differences were noted at distance or near. The EDOF group had significantly higher percentage of patients having no difficulty with hobbies and handicrafts (p < 0.05). Eighty-seven percent of the blended subjects and 79% of the EDOF subjects were “very” or “fairly” satisfied with their vision (p = 0.52). The frequency, severity and degree of bother from visual disturbances were comparable between the two groups; however, more subjects in the EDOF group reported severe disturbances (36% vs 4%). Conclusion Distance and near VA are similar with both IOL designs, but intermediate VA was better with the EDOF IOL resulting in lower difficulty with intermediate tasks such as hobbies and handicrafts. Despite the difference at intermediate VA, satisfaction was similar between the two groups and there were greater reports of severe visual disturbances in the EDOF group.
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Asena BS. Visual and refractive outcomes, spectacle independence, and visual disturbances after cataract or refractive lens exchange surgery: Comparison of 2 trifocal intraocular lenses. J Cataract Refract Surg 2019; 45:1539-1546. [DOI: 10.1016/j.jcrs.2019.06.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 05/31/2019] [Accepted: 06/12/2019] [Indexed: 11/16/2022]
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Selektive wellenfrontgeführte Ablation der Hornhaut zur Korrektur refraktiver Fehler nach Implantation einer trifokalen Intraokularlinse. SPEKTRUM DER AUGENHEILKUNDE 2019. [DOI: 10.1007/s00717-019-00435-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Chiam NP, Mehta JS. Comparing Patient-Reported Outcomes of Laser In Situ Keratomileusis and Small-Incision Lenticule Extraction: A Review. Asia Pac J Ophthalmol (Phila) 2019; 8:377-384. [PMID: 31478935 PMCID: PMC6784778 DOI: 10.1097/apo.0000000000000258] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 07/30/2019] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Laser in situ keratomileusis (LASIK) and small-incision lenticule extraction (SMILE) are popular refractive surgeries. The objective refractive outcomes of LASIK and SMILE have been studied extensively; both procedures have comparable safety, efficacy, and predictability. However, owing to various psychosocial factors, refractive patients may report dissatisfaction despite good postoperative vision. Hence the importance of studies on subjective patient-reported outcomes. This review discusses the role of psychometric-technique-based validated questionnaires when evaluating subjective outcomes. It also summarizes the literature on patient-reported outcomes for LASIK and SMILE. DESIGN A literature search was performed on PubMed database to identify studies that have assessed patient-reported outcomes for LASIK and SMILE. RESULTS Several studies have looked into patient-reported outcome measures for LASIK, but the number of equivalent studies for SMILE is limited. Questionnaires (validated and non-validated) are used to evaluate patient-reported outcomes. Validated questionnaires are designed based on psychometric techniques, such as Classic Test Theory, Item Response Theory, and Rasch analysis. The Quality of Life Impact of Refractive Correction (QIRC) questionnaire, a validated questionnaire administered to both LASIK and SMILE patients, suggests that both groups have comparable vision-related quality of life in the first few months postoperatively; but SMILE might confer a slight advantage in the later postoperative period (postoperative month 6). CONCLUSIONS Future LASIK-SMILE comparative studies utilizing standardized validated questionnaires for patient-reported outcome measures with longer follow-up durations would be a welcome contribution to this important aspect of refractive surgery.
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Affiliation(s)
| | - Jodhbir S. Mehta
- Singapore National Eye Centre, Singapore
- Singapore Eye Research Institute, Singapore
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Multifocal Intraocular Lenses Implantation in Presbyopia Correction. Literature Review. ACTA BIOMEDICA SCIENTIFICA 2019. [DOI: 10.29413/abs.2019-4.4.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Reduced dependence on glasses is an increasingly common expectation among those who want to take advantage of new surgical opportunities, especially for patients who lead an active lifestyle. Currently, due to the increase in the duration of active life in people over 40, there is a need for effective correction of presbyopia. Multifocal intraocular lenses are increasingly used in the treatment of presbyopia. After implantation of multifocal intraocular lenses most patients have no need for spectacle or contact vision. However, complications can affect the patient’s quality of life and level of satisfaction. The most common complications of multifocal correction are blurred vision and the presence of optical phenomena (“halo” and “glare”), associated with residual ametropia, clouding of the posterior capsule, large pupil size, anomalies of the wave front, dry eye and lens decentration. The main reasons for this are the failure to attempt to neuroadapt a patient, the dislocation of the lens, the residual refractive error and the clouding of the lens. The review presents the main features of various models of multifocal intraocular lenses, their implantation techniques, associated complications and methods for their correction. The development of multifocal correction of presbyopia and ametropia seems to be a promising direction in ophthalmic surgery.
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He Q, Huang J, Xu Y, Han W. Changes in total, anterior, and posterior corneal surface higher-order aberrations after 1.8 mm incision and 2.8 mm incision cataract surgery. J Cataract Refract Surg 2019; 45:1135-1147. [DOI: 10.1016/j.jcrs.2019.02.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 12/02/2018] [Accepted: 02/23/2019] [Indexed: 11/29/2022]
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Baartman BJ, Karpuk K, Eichhorn B, Ferguson TJ, Sudhagoni RG, Berdahl JP, Thompson VM. Extended depth of focus lens implantation after radial keratotomy. Clin Ophthalmol 2019; 13:1401-1408. [PMID: 31440028 PMCID: PMC6679694 DOI: 10.2147/opth.s208550] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/14/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose To identify the visual performance of radial keratotomy (RK) patients that have undergone cataract surgery with implantation of an extended depth of focus (EDOF) intraocular lens (IOL). Design Retrospective chart review with questionnaire. Methods Medical charts of patients with a history of RK that had undergone phacoemulsification with implantation of the Tecnis Symfony IOL (J&J Vision) were reviewed. Data collected included preoperative demographics, number of RK incisions, pupil size, and preoperative visual acuity and manifest refraction. Primary outcome measures of the study included postoperative uncorrected distance visual acuity (UCVA) and manifest refraction spherical equivalent (SE) at each follow-up visit. Secondary outcomes included results from a telephone questionnaire assessing visual performance and satisfaction. Results Twenty-four eyes of 12 patients were included. UCVA improved from an average Snellen equivalent 20/73 preoperatively to 20/33 at an average final follow-up of 6 months (P=0.0011), while average manifest SE improved from +1.68 D to −0.18 D (P<0.0001). At final follow-up, 15 of 24 eyes (62.5%) were at or within 0.5 D of target refraction, while 20 of 24 eyes (83.3%) were at or within 1.0 D. In total, 79% of eyes (19 of 24) had UCVA of 20/40 or better at distance. In the survey, 78% of patients reported satisfaction with their vision after surgery and 44% of patients reported being spectacle free for all tasks. Conclusions An EDOF lens implant can produce good visual outcomes and satisfaction in patients with a history of RK.
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Affiliation(s)
| | | | - Bradley Eichhorn
- University of South Dakota School of Medicine, Vermillion, SD, USA
| | | | - Ramu G Sudhagoni
- Public Health Department, School of Health Sciences, University of South Dakota, Vermillion, SD, USA
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Seiler TG, Wegner A, Senfft T, Seiler T. Dissatisfaction After Trifocal IOL Implantation and Its Improvement by Selective Wavefront-Guided LASIK. J Refract Surg 2019; 35:346-352. [DOI: 10.3928/1081597x-20190510-02] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 05/09/2019] [Indexed: 11/20/2022]
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35
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Liao X, Lin J, Tan Q, Wen B, Tian J, Lan C. Evaluation of Visual Quality in Pseudophakic Eyes with Different Ocular Spherical Aberrations. Curr Eye Res 2019; 44:963-967. [PMID: 31119951 DOI: 10.1080/02713683.2019.1622019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To evaluate the effects of different residual total ocular spherical aberration (SA) on objective and subjective visual quality in pseudophakic eyes. Methods: This prospective consecutive study comprised 171 patients with age-related cataract and undergone unilateral uneventful phacoemulsification. All participants were divided into four groups based on residual ocular SA at 6 mm pupil: negative SA (≤-0.10 μm, group A), neutral SA (0.00 ± 0.05 μm, group B), slightly positive SA (0.10 ± 0.05 μm, group C), and more positive SA (0.20 μm, group D), respectively. Subjective visual acuity and contrast sensitivity, and objective optical quality and ocular aberrations were analyzed 3 months postoperatively. Results: There was no significant difference in baseline measurements across all groups. Postoperatively, no statistically significant differences were found in visual acuity between groups (P > .05), while differences reached statistical significance in mesopic contrast sensitivity at 12 and 18 cpd (P < .01). There were significant differences in ocular SA and higher-order aberrations at 6 mm pupil, as well as in optical quality parameters (P < .05). Group C showed a minimum value of objective scatter index (1.17 ± 0.55) but maximum values of modulation transfer function cutoff (31.94 ± 9.18) and optical quality value OV 100% (1.07 ± 0.31), indicating lower intraocular scattering and superior optical quality. Conclusions: This comprehensive evaluation is conducive to deepening the understanding of visual and optical performance of pseudophakic eye. A modest amount of positive ocular SA seemed to be a more preferable option for enhancing visual quality after aspheric ntraocular lense (IOL) implantation.
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Affiliation(s)
- Xuan Liao
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College , Nanchong , Sichuan Province , China.,Department of Ophthalmology and Optometry, North Sichuan Medical College , Nanchong , Sichuan Province , China
| | - Jia Lin
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College , Nanchong , Sichuan Province , China.,Department of Ophthalmology and Optometry, North Sichuan Medical College , Nanchong , Sichuan Province , China
| | - Qingqing Tan
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College , Nanchong , Sichuan Province , China.,Department of Ophthalmology and Optometry, North Sichuan Medical College , Nanchong , Sichuan Province , China
| | - Baiwei Wen
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College , Nanchong , Sichuan Province , China.,Department of Ophthalmology and Optometry, North Sichuan Medical College , Nanchong , Sichuan Province , China
| | - Jing Tian
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College , Nanchong , Sichuan Province , China.,Department of Ophthalmology and Optometry, North Sichuan Medical College , Nanchong , Sichuan Province , China
| | - Changjun Lan
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College , Nanchong , Sichuan Province , China.,Department of Ophthalmology and Optometry, North Sichuan Medical College , Nanchong , Sichuan Province , China
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Jin S, Friedman DS, Cao K, Yusufu M, Zhang J, Wang J, Hou S, Zhu G, Wang B, Xiong Y, Li J, Li X, He H, Wan X. Comparison of postoperative visual performance between bifocal and trifocal intraocular Lens based on randomized controlled trails: a meta-analysis. BMC Ophthalmol 2019; 19:78. [PMID: 30871503 PMCID: PMC6419463 DOI: 10.1186/s12886-019-1078-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 03/01/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To compare the clinical performance of bifocal and trifocal intraocular lenses (IOLs) in cataract surgery, a meta-analysis on randomized controlled trials was conducted. METHODS A comprehensive literature retrieval of PubMed, Science Direct and EMBASE was performed in this systematic review. Clinical outcomes included visual acuity (VA), contrast sensitivity (CS), spectacle independence, postoperative refraction and surgical satisfaction. RESULTS There were 8 RCTs included in this study. The difference of uncorrected near VA (UNVA) between the bifocal IOLs and trifocal IOLs had no significance [MD = 0.02, 95%CI: (- 0.03,0.06)]. There was no significant difference in the distant-corrected near VA (DCNVA) with MD of 0.04 [95%CI (- 0.02, 0.10)]. Compared with trifocal group, the uncorrected intermediate visual acuity (UIVA) [MD = 0.09,95%CI:(0.01,0.17)] was significantly worse in the bifocal group. No difference was found in distance-corrected intermediate VA (DCIVA) [MD = 0.09, 95%CI: (- 0.04, 0.23)] between two groups. Analysis on AT LISA subgroup indicated the bifocal group had worse intermediate VA than trifocal group (AT LISA tri 839 M) [MD = 0.18, 95%CI: (0.12, 0.24) for UIVA and MD = 0.19, 95%CI: (0.13, 0.25) for DCIVA]. However, there was no statistically significant difference between the two groups in the uncorrected distance VA (UDVA) and corrected distance visual acuity (CDVA) [MD = 0.01, 95%CI: (- 0.01,0.04) for UDVA; MD = 0.00, 95%CI: (- 0.01,0.01) for CDVA]. The postoperative refraction of bifocal group was similar to that of trifocal group [MD = -0.08, 95% CI: (- 0.19, 0.03) for spherical equivalent; MD = -0.09, 95%CI: (- 0.21, 0.03) for cylinder; MD = -0.09, 95% CI: (- 0.27, 0.08) for sphere]. No difference was found for spectacle independence, posterior capsular opacification (PCO) incidence and patient satisfaction between bifocal IOLs and trifocal IOLs. [RR = 0.89, 95% CI: (0.71, 1.12) for spectacle independence; RR = 1.81, 95% CI: (0.50, 6.54) for PCO incidence; RR = 0.98, 5% CI: (0.86, 1.12) for patient satisfaction]. CONCLUSION Patients receiving trifocal IOLs, especially AT LISA tri 839 M, have a better intermediate VA than those receiving bifocal IOLs. Near and distance visual performance, spectacle independence, postoperative refraction and surgical satisfaction of bifocal IOLs were similar to those of trifocal IOLs.
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Affiliation(s)
- Shanshan Jin
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - David S Friedman
- Dana Center for Preventive Ophthalmology, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Mayinuer Yusufu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Jingshang Zhang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Jinda Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Simeng Hou
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Guyu Zhu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Bingsong Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Ying Xiong
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Jing Li
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Xiaoxia Li
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Hailong He
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Xiuhua Wan
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China.
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Kaymak H, Breyer D, Alió JL, Cochener B. Visual Performance With Bifocal and Trifocal Diffractive Intraocular Lenses: A Prospective Three-Armed Randomized Multicenter Clinical Trial. J Refract Surg 2018; 33:655-662. [PMID: 28991332 DOI: 10.3928/1081597x-20170504-04] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 04/18/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate and compare quality of vision and reading performance outcomes after implantation of bifocal refractive-diffractive, bifocal apodized diffractive, or trifocal diffractive-refractive intraocular lenses (IOLs). METHODS This randomized, prospective, three-armed multicenter (Spain, Germany, and France) trial included 104 eyes of 52 patients (mean age: 63.2 ± 7.7 years). Patients underwent cataract surgery with bilateral implantation of either AT LISA 809M (Carl Zeiss Meditec, Jena, Germany: AT LISA group, 38 eyes), AT LISA tri 839MP (Carl Zeiss Meditec: AT LISA tri group, 32 eyes), or ReSTOR SN6AD1 (Alcon Laboratories, Inc., Fort Worth, TX: ReSTOR group, 34 eyes) IOLs. Visual and refractive outcomes, depth of focus, and reading performance were evaluated at 1, 6, and 12 months postoperatively. RESULTS The AT LISA tri group showed significantly better 12-month uncorrected (UIVA) and binocular distance-corrected (DCIVA) intermediate visual acuity (P ≤ .016) than the AT LISA group. The AT LISA tri group showed a significantly better 3-month UIVA compared to the ReSTOR group (P = .042). Binocular uncorrected and corrected distance visual acuities were not significantly different among groups (P ≥ .092) at the 12-month follow-up. A total of 85.3%, 90.0%, and 78.1% of eyes had a spherical equivalent within ±0.50 D in the AT LISA, AT LISA tri, and ReSTOR groups, respectively, at 12 months (P = .038). No statistically significant differences between the trifocal and bifocal groups were detected for reading performance (P ≥ .055). CONCLUSIONS The trifocal diffractive-refractive IOL provides enhanced intermediate visual restoration compared to bifocal diffractive-refractive or apodized diffractive IOLs. The addition of an intermediate focal point did not deteriorate far or near vision. A comparable reading performance was maintained with the trifocal lens. [J Refract Surg. 2017;33(10):655-662.].
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Zhu X, He W, Zhang Y, Chen M, Du Y, Lu Y. Inferior Decentration of Multifocal Intraocular Lenses in Myopic Eyes. Am J Ophthalmol 2018; 188:1-8. [PMID: 29355482 DOI: 10.1016/j.ajo.2018.01.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 12/23/2017] [Accepted: 01/08/2018] [Indexed: 10/18/2022]
Abstract
PURPOSE To investigate the tilt and decentration of multifocal intraocular lenses (MfIOLs) implanted in myopic eyes. DESIGN A prospective cohort study. METHODS Twenty-eight myopic eyes and 56 emmetropic eyes were evaluated. Phacoemulsification with Tecnis ZMB00 MfIOL (Abbott Medical Optics, Santa Ana, California, USA) implantation was performed. At 1 year post-surgery, routine postoperative examinations were performed, and tilt and decentration of the MfIOLs, high-order aberrations, and modulation transfer function (MTF) were evaluated using the OPD-Scan III aberrometer (Nidek Co, Ltd, Gamagori, Japan). Subjective symptoms were assessed with a Quality of Vision questionnaire. RESULTS Postoperative uncorrected distance visual acuity (VA), best-corrected distance VA, and uncorrected near VA did not differ between the 2 groups. The mean IOL tilt and horizontal decentration were not different between the control and myopic groups. However, the myopic group presented significantly inferior decentration in the capsular bag compared with the control group (-0.03 ± 0.22 mm vs -0.21 ± 0.29 mm, P = .002). The overall decentration values were 0.32 ± 0.14 mm in the controls and 0.40 ± 0.18 mm in the myopic group (P = .023). Axial length was negatively correlated with vertical decentration (r = -0.268, P = 0.014) and positively correlated with overall decentration (r = 0.334, P = .002). Worse aberration data, poorer MTF, and more subjective symptoms were also found in the myopic group than in the controls. CONCLUSION Greater inferior decentration of MfIOLs and a consequent decrease in visual quality were found in myopic eyes, indicating that the increasing incompatibility between IOL and capsular bag size with axial length elongation should not be underestimated.
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He W, Qiu X, Zhang S, Du Y, Zhang Y, Lu Y, Zhu X. Comparison of long-term decentration and tilt in two types of multifocal intraocular lenses with OPD-Scan III aberrometer. Eye (Lond) 2018. [PMID: 29520045 DOI: 10.1038/s41433-018-0068-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To compare the long-term decentration and tilt in two multifocal intraocular lenses (MfIOLs) with an OPD-Scan III aberrometer. METHODS Eighty cataract patients who underwent uneventful MfIOL implantation (42 with AcrySof® IQ ReSTOR® SN6AD1 and 38 with AMO Tecnis® ZMB00) were enrolled. At 1 year after surgery, a postoperative visual acuity evaluation included the measurement of uncorrected distance visual acuity, corrected distance visual acuity, distance-corrected near visual acuity, and distance-corrected intermediate visual acuity. OPD-Scan III aberrometer was used to collect the decentration, tilt, and high-order aberration (HOA) data. Significance was tested with Student's t test, Mann-Whitney U test, paired t test, and χ2 test RESULTS: The average intraocular tilt was lower in the SN6AD1 group than in the ZMB00 group, whereas the average decentration of the two groups did not differ significantly. The mean total ocular HOAs, ocular trefoil, total internal HOAs, and spherical aberrations were significantly lower in the SN6AD1 group than in the ZMB00 group. In both the SN6AD1 and ZMB00 groups, the intraocular tilt was directly proportional to the total ocular HOAs, coma, and spherical aberration. However, there was no significant correlation between decentration and any type of HOA in SN6AD1 group, whereas decentration correlated positively with total ocular HOAs, coma, and spherical aberration in ZMB00 group. CONCLUSION Both MfIOLs significantly improve the visual acuity of the patients. However, tilt was lower in the SN6AD1 group than in the ZMB00 group 1 year after surgery, which provide fewer HOAs and better visual quality.
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Affiliation(s)
- Wenwen He
- Eye Institute,Eye and Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China.,Key Laboratory of Myopia, Ministry of Health, Shanghai, 200031, People's Republic of China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, People's Republic of China
| | - Xiaodi Qiu
- Eye Institute,Eye and Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China.,Key Laboratory of Myopia, Ministry of Health, Shanghai, 200031, People's Republic of China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, People's Republic of China
| | - Shaohua Zhang
- Eye Institute,Eye and Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China.,Key Laboratory of Myopia, Ministry of Health, Shanghai, 200031, People's Republic of China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, People's Republic of China
| | - Yu Du
- Eye Institute,Eye and Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China.,Key Laboratory of Myopia, Ministry of Health, Shanghai, 200031, People's Republic of China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, People's Republic of China
| | - Yinglei Zhang
- Eye Institute,Eye and Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China.,Key Laboratory of Myopia, Ministry of Health, Shanghai, 200031, People's Republic of China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, People's Republic of China
| | - Yi Lu
- Eye Institute,Eye and Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China. .,Key Laboratory of Myopia, Ministry of Health, Shanghai, 200031, People's Republic of China. .,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, People's Republic of China.
| | - Xiangjia Zhu
- Eye Institute,Eye and Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China. .,Key Laboratory of Myopia, Ministry of Health, Shanghai, 200031, People's Republic of China. .,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, People's Republic of China.
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Patient-reported Outcomes for Assessment of Quality of Life in Refractive Error: A Systematic Review. Optom Vis Sci 2017; 94:1102-1119. [PMID: 29095758 DOI: 10.1097/opx.0000000000001143] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE This review has identified the best existing patient-reported outcome (PRO) instruments in refractive error. The article highlights the limitations of the existing instruments and discusses the way forward. PURPOSE A systematic review was conducted to identify the types of PROs used in refractive error, to determine the quality of the existing PRO instruments in terms of their psychometric properties, and to determine the limitations in the content of the existing PRO instruments. METHODS Articles describing a PRO instrument measuring 1 or more domains of quality of life in people with refractive error were identified by electronic searches on the MEDLINE, PubMed, Scopus, Web of Science, and Cochrane databases. The information on content development, psychometric properties, validity, reliability, and responsiveness of those PRO instruments was extracted from the selected articles. The analysis was done based on a comprehensive set of assessment criteria. RESULTS One hundred forty-eight articles describing 47 PRO instruments in refractive error were included in the review. Most of the articles (99 [66.9%]) used refractive error-specific PRO instruments. The PRO instruments comprised 19 refractive, 12 vision but nonrefractive, and 16 generic PRO instruments. Only 17 PRO instruments were validated in refractive error populations; six of them were developed using Rasch analysis. None of the PRO instruments has items across all domains of quality of life. The Quality of Life Impact of Refractive Correction, the Quality of Vision, and the Contact Lens Impact on Quality of Life have comparatively better quality with some limitations, compared with the other PRO instruments. CONCLUSIONS This review describes the PRO instruments and informs the choice of an appropriate measure in refractive error. We identified need of a comprehensive and scientifically robust refractive error-specific PRO instrument. Item banking and computer-adaptive testing system can be the way to provide such an instrument.
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Alió JL, Kaymak H, Breyer D, Cochener B, Plaza-Puche AB. Quality of life related variables measured for three multifocal diffractive intraocular lenses: a prospective randomised clinical trial. Clin Exp Ophthalmol 2017; 46:380-388. [DOI: 10.1111/ceo.13084] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 09/25/2017] [Accepted: 09/27/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Jorge L Alió
- Research Development; Vissum Instituto Oftalmologico de Alicante; Alicante Spain
| | - Hakan Kaymak
- Breyer; Kaymak und Klabe Augenchirurgie; Düsseldorf Germany
| | - Detlef Breyer
- Breyer; Kaymak und Klabe Augenchirurgie; Düsseldorf Germany
| | | | - Ana B Plaza-Puche
- Research Development; Vissum Instituto Oftalmologico de Alicante; Alicante Spain
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Mencucci R, Favuzza E, Caporossi O, Rizzo S. Visual performance, reading ability and patient satisfaction after implantation of a diffractive trifocal intraocular lens. Clin Ophthalmol 2017; 11:1987-1993. [PMID: 29180843 PMCID: PMC5691902 DOI: 10.2147/opth.s142860] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate visual outcome, reading performance, contrast sensitivity, and patient satisfaction after cataract surgery with implantation of a diffractive trifocal intraocular lens (IOL). Patients and methods A total of 42 eyes (21 patients) underwent cataract surgery with implantation of the trifocal IOL AT LISA tri 839MP. Visual acuity, contrast sensitivity, and patient satisfaction were evaluated 3 months postoperatively. Reading performance was evaluated at 3 months postoperatively with the MNREAD charts. Results All eyes achieved a 3-month postoperative monocular uncorrected distance visual acuity of 0.10 logMAR or better (Snellen 20/25). Likewise, 97.62% and 85.71% of eyes achieved a postoperative monocular uncorrected intermediate, and near visual acuity of 0.20 logMAR (Snellen 20/30) or better. All patients achieved postoperative binocular uncorrected distance visual acuity, uncorrected intermediate, and uncorrected near visual acuity of 0.20 logMAR (Snellen 20/30) or better. Mean photopic reading acuity and speed were 0.24±0.07 logMAR and 177.61±20.67 words per minute, respectively. Postoperative contrast sensitivity values were within the ranges of normality for all spatial frequencies evaluated. Postoperative spectacle independence and patient satisfaction was very high, with most of the patients reporting a good or very good visual quality at far, intermediate, and near distances. All patients would choose the same lens again. Conclusion The evaluated trifocal IOL provides an effective restoration of the visual function after cataract surgery, with high levels of distance, intermediate, and near visual acuity, strong reading performance, and patient satisfaction.
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Affiliation(s)
- Rita Mencucci
- Department of Surgery and Translational Medicine, Eye Clinic, University of Florence, Florence, Italy
| | - Eleonora Favuzza
- Department of Surgery and Translational Medicine, Eye Clinic, University of Florence, Florence, Italy
| | - Orsola Caporossi
- Department of Surgery and Translational Medicine, Eye Clinic, University of Florence, Florence, Italy
| | - Stanislao Rizzo
- Department of Surgery and Translational Medicine, Eye Clinic, University of Florence, Florence, Italy
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Salerno LC, Tiveron MC, Alió JL. Multifocal intraocular lenses: Types, outcomes, complications and how to solve them. Taiwan J Ophthalmol 2017; 7:179-184. [PMID: 29296549 PMCID: PMC5747227 DOI: 10.4103/tjo.tjo_19_17] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 12/05/2016] [Indexed: 11/04/2022] Open
Abstract
The multifocal intraocular lenses (IOLs) available are often able to restore visual function and allow spectacle independence after their implantation with great levels of patient satisfaction. The factors associated with the postoperatory success include the careful selection of the patient, the knowledge about the IOLs' design, and their visual performance added to the proper surgical technique and management of possible complications as demonstrated by the evidence available.
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Affiliation(s)
| | | | - Jorge L. Alió
- Division of Ophthalmology, Miguel Hernández University, Alicante, Spain
- Vissum Instituto Oftalmologico de Alicante, Alicante, Spain
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Multifocal intraocular lenses: An overview. Surv Ophthalmol 2017; 62:611-634. [DOI: 10.1016/j.survophthal.2017.03.005] [Citation(s) in RCA: 168] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 02/28/2017] [Accepted: 03/03/2017] [Indexed: 01/18/2023]
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Clinical study inpatient-reported outcomes after binocular implantation of aspheric intraocular lens of different negative spherical aberrations. ASIAN PAC J TROP MED 2017; 10:710-713. [DOI: 10.1016/j.apjtm.2017.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 06/30/2017] [Accepted: 07/05/2017] [Indexed: 11/19/2022] Open
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Kandel H, Khadka J, Lundström M, Goggin M, Pesudovs K. Questionnaires for Measuring Refractive Surgery Outcomes. J Refract Surg 2017; 33:416-424. [DOI: 10.3928/1081597x-20170310-01] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 01/18/2017] [Indexed: 11/20/2022]
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Comparison of visual function and patient satisfaction with AcrySof ReSTORSN6AD1 multifocal intraocular compared to monofocal intraocular lenses 5. OPHTHALMOLOGY JOURNAL 2016. [DOI: 10.17816/ov945-12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Purpose. To compare the visual function and patient satisfaction in patients after implantation of the AcrySof ReSTOR SN6AD1 multifocal intraocular lens (IOL) and after implantation of the AcrySof SA60AТ spherical monofocal IOL and Akreos АО aspheric monofocal IOL in cataract surgery.Materials. 34 patients had SN6AD1 multifocal (group 1, 48 eyes), 19 patients had Akreos АО monofocal aspheric (group 2, 30 eyes) and 13 patients had AcrySof SA60AТ monofocal spherical (group 3, 18 eyes) IOL implantations. Patients with multifocal IOL were closely paired in age, sex, and ocular findings with patients who had monofocal IOL implantation. Six months postoperatively uncorrected/corrected distance visual acuity (UDVA/CDVA), uncorrected intermediate (60 cm) and near (35 cm) visual acuity (UNVA), the defocus curve, contrast sensitivity and a quality-of-life questionnaire were evaluated. Furthermore, independence from glasses and the presence of optical phenomena were assessed.Results. Patients in group 2 had statistically better UDVA than in group 1 (p = 0,037). There was no significant difference in the mean uncorrected intermediate and best corrected distance visual acuities between the groups. UNVA was better in group 1 than in groups 2, 3 (p < 0,0001). Photopic contrast sensitivity for high spatial frequencies was better for the groups 2 and 3. Glare was reported by 5,9% in the multifocal group. Halos occurred in 32,4% of patients in group 1. No one reported unwanted visual symptoms in monofocal groups.Conclusion. Multifocal IOLs provided higher spectacle independence and satisfactory functional vision over a broad range of distances but were associated with increased subjective visual symptoms, reduced photopic contrast sensitivity for high spatial frequencies and distance visual quality compared with the monofocal IOLs.
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Torun Acar B, Duman E, Simsek S. Clinical outcomes of a new diffractive trifocal intraocular lens with Enhanced Depth of Focus (EDOF). BMC Ophthalmol 2016; 16:208. [PMID: 27899084 PMCID: PMC5129192 DOI: 10.1186/s12886-016-0389-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 11/22/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND To evaluate the clinical outcomes after the implantation of a new trifocal diffractive intraocular lens (IOL) combined with Enhanced depth of focus (EDOF) technology. METHODS The study enrolled 80 eyes of 40 patients who underwent cataract surgery with bilateral implantation of a diffractive trifocal IOL (Reviol Tri-ED) designed with a combination of enhanced depth of focus. Mean age was 52.09 ± 11.32 years (range from 45 to 70 years). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), corrected intermediate visual acuity (CIVA), uncorrected near visual acuity (UNVA), corrected near visual acuity (CNVA), keratometry (K), and manifest refraction spherical equivalent (MRSE) were evaluated pre- and postoperatively. The contrast sensitivity, defocus curves, and a questionnaire evaluating individual satisfaction were also estimated. RESULTS There was a significant improvement in UDVA, CDVA, UNVA, CNVA, CIVA postoperatively. The defocus curve confirmed good visual acuity also in the intermediate distance. The postoperative MRSE was ranged from -0.75 to 0.75 diopters. Contrast sensitivity also significantly improved postoperatively. The patient satisfaction was high. CONCLUSION The new trifocal EDOF IOL provides visual improvement for far, intermediate, and near distances with a high level of visual quality and patient satisfaction.
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Affiliation(s)
- Banu Torun Acar
- Haydarpasa Numune Education and Research Hospital, Ophthalmology Clinic, Kavakli sok. Menekse ap. No.22K.7 D.14 Caddebostan, Istanbul, Turkey.
| | - Erkan Duman
- Tuzla Government Hospital, Ophthalmology Clinic, Istanbul, Turkey
| | - Saban Simsek
- Haydarpasa Numune Education and Research Hospital, Ophthalmology Clinic, Kavakli sok. Menekse ap. No.22K.7 D.14 Caddebostan, Istanbul, Turkey
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Schrecker J, Langenbucher A. Visual Performance in the Long Term With Secondary Add-on Versus Primary Capsular Bag Multifocal Intraocular Lenses. J Refract Surg 2016; 32:742-747. [DOI: 10.3928/1081597x-20160630-02] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 06/23/2016] [Indexed: 11/20/2022]
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