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Łabuz G, Khoramnia R, Naujokaitis T, Auffarth GU. [Optical benchtop evaluation of special intraocular lens optics]. DIE OPHTHALMOLOGIE 2024:10.1007/s00347-024-02064-y. [PMID: 38977490 DOI: 10.1007/s00347-024-02064-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 05/06/2024] [Accepted: 06/03/2024] [Indexed: 07/10/2024]
Abstract
Intraocular lenses (IOL) featuring complex optical designs can pose a challenge in understanding their performance, which may hinder making an informed decision when selecting suitable lenses for patients. This underlines the importance of collecting optical quality data of IOLs and making them available. The deployment of benchtop systems for IOL testing offers not only insights into the design features of various IOL solutions but also provides a platform for objective comparisons of special optics designs, including information about their susceptibility to photic phenomena. Recent advances in IOL testing have improved the ability to predict functional effects on visual acuity and contrast sensitivity from objective optical quality metrics. This, for instance, can be used to study monofocal lenses and the impact of asphericity on vision and IOLs tolerance to misalignment. Monofocal-plus IOLs consistently show only a slight improvement in the depth of focus when tested on the optical bench and in clinical settings. Although the pupil dependence found in this technology may limit the advantages of monofocal-plus over standard monofocal technology to extend the range of vision, it is the key to reduce photic phenomena. Refractive and diffractive extended depth of focus (EDOF) IOLs can effectively enhance intermediate vision, with the latter offering a slightly broader depth of focus but potentially increasing the risk of dysphotopsia. However, the limitation of EDOF IOLs is that they often fail to deliver spectacle independence for reading, which can be overcome by trifocal technology. Still, the available trifocal IOLs differ in their location of intermediate and near foci and the susceptibility to produce glare effects. Therefore, the knowledge from optical benchtop testing of IOLs can support optimizing the IOL selection by aligning the patient's visual needs with the IOL's properties, setting the right expectations, and assessing the risk profile for the occurrence of photic phenomena, potentially leading to improved decision-making.
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Affiliation(s)
- Grzegorz Łabuz
- The David J. Apple Center for Vision Research, Augenklinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.
| | - Ramin Khoramnia
- The David J. Apple Center for Vision Research, Augenklinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - Tadas Naujokaitis
- The David J. Apple Center for Vision Research, Augenklinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - Gerd U Auffarth
- The David J. Apple Center for Vision Research, Augenklinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
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Jo E, Kim B, Kim TI, Kim MK, Choi CY. Clinical Outcomes of a New Hydrophobic Trifocal Intraocular Lens with Hydroxyethyl Methacrylate in Cataract Surgery: A Prospective Multicenter Study. KOREAN JOURNAL OF OPHTHALMOLOGY 2024; 38:212-220. [PMID: 38644651 PMCID: PMC11175982 DOI: 10.3341/kjo.2023.0140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/16/2024] [Accepted: 04/17/2024] [Indexed: 04/23/2024] Open
Abstract
PURPOSE To investigate the clinical outcomes of new hydrophobic trifocal intraocular lens with hydroxyethyl methacrylate in the Korean population. METHODS This prospective, multicenter, and observational study evaluated the clinical outcomes of 80 eyes of 40 patients with age-related cataract underwent cataract surgery using CNWT (Clareon PanOptix). Assessment included monocular and binocular uncorrected distance visual acuity, corrected distance visual acuity, uncorrected intermediate visual acuity (at 60cm), near visual acuity (at 40 and 33 cm), uncorrected defocus curves, questionnaires evaluating photic phenomena, spectacle independence, and spectacle free satisfaction. RESULTS At postoperative 3 months, mean uncorrected binocular visual acuities were 0.04, 0.04, 0.03 logarithm of the minimum angle of resolution (logMAR) at far, intermediate, and near distances, respectively. All patients achieved uncorrected binocular visual acuity of 0.2 logMAR or better. Monocular and binocular defocus curve indicated a mean visual acuity of 0.2 logMAR or better at the defocus range of +1.0 to - 3.0 diopters (100 to 33 cm) and +1.0 to - 3.5 diopters (100 to 28 cm). High spectacle independence was observed at all distances, with 37.5% patients reporting photic phenomena. CONCLUSIONS The Clareon PanOptix intraocular lens has shown positive clinical outcomes, providing a viable option for cataract surgery. These lenses effectively address patients' visual needs, especially in intermediate and near distance tasks, reducing dependence on glasses.
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Affiliation(s)
- Eunhui Jo
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Bokyung Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Tae-im Kim
- Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul,
Korea
- Corneal Dystrophy Research Institute, Department of Ophthalmology, Yonsei University College of Medicine, Seoul,
Korea
| | - Mee Kum Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine,
Korea
- Laboratory of Ocular Regenerative Medicine and Immunology (LORMI), Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul,
Korea
| | - Chul Young Choi
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul,
Korea
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Brissette A, Cole B, Hall B. Visual Function After Implantation of Trifocal and Trifocal Toric Intraocular Lenses Using Intraoperative Aberrometry. Clin Ophthalmol 2024; 18:1547-1554. [PMID: 38832075 PMCID: PMC11146617 DOI: 10.2147/opth.s450979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 04/28/2024] [Indexed: 06/05/2024] Open
Abstract
Purpose To evaluate patient outcomes and visual function following trifocal and trifocal toric intraocular lens (IOL) implantation using intraoperative aberrometry at a single site in the US. Methods This prospective, single arm study included 21 subjects that completed 3 month follow-up. Inclusion criteria were visually significant cataract and potential post-operative visual acuity of 20/25 or better. Endpoints included postoperative prediction error, refractive outcomes, uncorrected visual acuities at distance (UDVA), intermediate (UIVA), and near (UNVA), contrast sensitivity, and subject responses on the modified Visual Function Quality of Life Questionnaire (VF-14 QOL). Results Binocular UDVA, UIVA, and UNVA were 20/25 or better in 100% (21/21), 100% (21/21), 90% (19/21) of subjects. The absolute prediction error was 0.50 D or less in 79% (33/42) of eyes, and 81% (34/42) and 86% (36/42) of eyes achieved ≤0.5 D of residual astigmatism and manifest refraction spherical equivalent, respectively. On the modified VF-14 QOL, driving at night, reading small print, and reading a newspaper or book were the tasks that had the lowest percentages of subjects reporting no difficulty or a little difficulty. Conclusion Implantation with trifocal and trifocal toric IOLs using intraoperative aberrometry can provide high refractive precision, leading to excellent visual performance and low visual task difficulty at all ranges (distance, intermediate, and near).
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Affiliation(s)
- Ashley Brissette
- Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA
| | - Brigette Cole
- Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA
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Li J, Sun B, Zhang Y, Hao Y, Wang Z, Liu C, Jiang S. Comparative efficacy and safety of all kinds of intraocular lenses in presbyopia-correcting cataract surgery: a systematic review and meta-analysis. BMC Ophthalmol 2024; 24:172. [PMID: 38627651 PMCID: PMC11020619 DOI: 10.1186/s12886-024-03446-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 04/10/2024] [Indexed: 04/19/2024] Open
Abstract
PURPOSE To assess the efficacy and safety of various intraocular lenses (IOLs), including standard monofocal, bifocal, trifocal, extended depth of focus (EDOF), and enhanced monofocal IOLs, post-cataract surgery through a network meta-analysis. METHODS A systematic search of PubMed, Cochrane Library, and Web of Science was conducted to identify relevant studies from the past 5 years. Parameters such as binocular visual acuities, spectacle independence, contrast sensitivity (CS), and optical quality were used to evaluate efficacy and safety. Data from the selected studies were analyzed using Review Manager 5.4 and STATA 17.0 software. RESULTS Twenty-eight Randomized Controlled Trials (RCTs) comprising 2465 subjects were included. Trifocal IOLs exhibited superior uncorrected near visual acuity (UNVA) compared to monofocal IOLs (MD: -0.35; 95% CI: -0.48, -0.22). Both trifocal (AcrySof IQ PanOptix IOLs group MD: -0.13; 95% CI: -0.21, -0.06) and EDOF IOLs (MD: -0.13; 95% CI: -0.17, -0.09) showed better uncorrected intermediate visual acuity (UIVA) than monofocal IOLs. Trifocal IOLs ranked highest in spectacle independence at various distances (AT LISAtri 839MP group: SUCRA 97.5% for distance, 80.7% for intermediate; AcrySof IQ PanOptix group: SUCRA 83.0% for near). CONCLUSIONS For cataract patients who want to treat presbyopia, trifocal IOLs demonstrated better visual acuity and spectacle independence at near distances. Different types of trifocal IOL characteristics differ. EDOF and enhanced monofocal IOLs have improved visual quality at intermediate distances.Therefore, It is very important to select the appropriate IOLs based on the lens characteristics and patient needs.
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Affiliation(s)
- Jinyu Li
- Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Binzhou Medical University, Jinbu Street, Muping area, Yantai, Shandong Province, 264000, China
| | - Bin Sun
- Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Binzhou Medical University, Jinbu Street, Muping area, Yantai, Shandong Province, 264000, China
| | - Yuexin Zhang
- Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Binzhou Medical University, Jinbu Street, Muping area, Yantai, Shandong Province, 264000, China
| | - Yansong Hao
- Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Binzhou Medical University, Jinbu Street, Muping area, Yantai, Shandong Province, 264000, China
| | - Ze Wang
- Department of Ophthalmology, Shijiazhuang People's Hospital, Shi Jiazhuang, 050200, China
| | - Chengjiang Liu
- Department of General Medicine, Affiliated Anqing First People's Hospital of Anhui Medical University, Anhui, 246000, China
| | - Shanhao Jiang
- Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Binzhou Medical University, Jinbu Street, Muping area, Yantai, Shandong Province, 264000, China.
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De la Paz M, Tsai LM. Outcomes and predictive factors in multifocal and extended depth of focus intraocular lens implantation. Curr Opin Ophthalmol 2024; 35:28-33. [PMID: 37910172 DOI: 10.1097/icu.0000000000001013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
PURPOSE OF REVIEW Options for addressing presbyopia with intraocular lens (IOL) implantation have become more varied and sophisticated. We reviewed recent literature on multifocal and extended depth of focus (EDOF) IOLs in order to provide insight on their respective advantages, with emphasis on the visual outcomes of each design. RECENT FINDINGS Increased patient age, spectral domain optical coherence tomography (SD-OCT) abnormalities, abnormal optical axis measurements, and better preoperative visual acuity have been implicated as predictors of worse postoperative vision or visual quality in multifocal IOLs. Despite differences in objective outcomes, patient-reported outcomes such as satisfaction are consistently similar between multifocal and EDOF IOLs. EDOFs may have slightly lower rates of spectacle independence than trifocals, but there is more support for their use in the setting of with other ocular conditions. SUMMARY Multifocal and EDOF IOLs are both viable options for patients who wish to preserve near vision. Given their similar objective performance in many aspects, enabling patients to make informed decisions based on their expectations and visual requirements is critical to postoperative satisfaction. Evidence for advanced technology IOL implantation in pediatric patients remains inconclusive.
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Affiliation(s)
- Matthew De la Paz
- Department of Ophthalmology, Washington University School of Medicine, St. Louis, Missouri, USA
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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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Li Y, Li X, Jiang X, Wang Y, Wu T, Xia H, Li X. Comparison of dynamic visual acuity after implantation of toric bifocal or trifocal intraocular lens in age-related cataract patients: a randomized controlled trial. Front Neurosci 2023; 17:1287626. [PMID: 38178838 PMCID: PMC10765614 DOI: 10.3389/fnins.2023.1287626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 11/20/2023] [Indexed: 01/06/2024] Open
Abstract
Purpose To investigate the dynamic visual acuity (DVA) after implantation of toric bifocal or trifocal intraocular lens in age-related cataract patients. Methods This was a prospective randomized controlled trial. Of one hundred and twenty-four patients enrolled and randomized to receive unilateral phacoemulsification and toric trifocal (939 M/MP, Carl Zeiss Meditec AG, Jena, Germany) or toric bifocal (909 M, Carl Zeiss Meditec AG, Jena, Germany) intraocular lenses (IOL) implantation, ninety-nine patients completed the follow-up and were included in final analysis. Postoperatively, uncorrected and corrected distance (UDVA and CDVA), intermediate (UIVA and DCIVA) and near (UNVA and DCNVA) static visual acuity, manifest refraction and uncorrected and corrected distance DVA (UDDVA and CDDVA) at 20, 40 and 80 degrees per second (dps) were evaluated at one week, one month and three months. Results Three months postoperatively, the UDVA were 0.13 ± 0.11 and 0.14 ± 0.13 in the toric trifocal and bifocal IOL group, respectively. Significant better UIVA (trifocal, 0.17 ± 0.13 vs. bifocal, 0.23 ± 0.13, p = 0.037) and DCIVA (trifocal, 0.16 ± 0.11 vs. bifocal, 0.20 ± 0.12, p = 0.048) were observed in patients implanting toric trifocal than bifocal IOL at three months postoperatively. Patients implanted with toric bifocal IOL obtained better CDDVA at 80 dps (0.5607 ± 0.2032) than the trifocal group (0.6573 ± 0.2450, p = 0.039) at three months. Postoperative UDDVA and CDDVA at 20, 40 and 80 dps were significantly associated with age (p < 0.05, respectively) and postoperative static visual acuity (p < 0.05, respectively). Conclusion Toric trifocal IOL provides better static intermediate visual acuity, and toric bifocal IOL implantation provides better distance dynamic visual acuity at high speed.
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Affiliation(s)
- Yuanting Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerves, Beijing, China
| | - Xiaodan Li
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
- Beijing Key Laboratory of Sports Injuries, Beijing, China
- Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, Beijing, China
| | - Xiaodan Jiang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerves, Beijing, China
| | - Yuexin Wang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerves, Beijing, China
| | - Tingyi Wu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerves, Beijing, China
| | - Huaqin Xia
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerves, Beijing, China
| | - Xuemin Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerves, Beijing, China
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Baur ID, Auffarth GU, Köppe MK, Łabuz G, Khoramnia R. Rotational Stability of Toric Capsular Bag-Fixated Intraocular Lenses in Duet Procedure for Reversible Trifocality. Am J Ophthalmol 2023; 256:156-163. [PMID: 37597721 DOI: 10.1016/j.ajo.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/21/2023]
Abstract
PURPOSE To evaluate the long-term rotational stability of capsular bag-fixated toric intraocular lenses (IOLs) in polypseudophakic eyes of patients who underwent duet procedure for reversible trifocality. DESIGN Retrospective interventional case series. METHODS We included 34 eyes of 20 patients who underwent duet procedure with implantation of a monofocal toric IOL (RayOne toric, Hoya XY1AT, or a Tecnis ZCT800) into the capsular bag and a trifocal-diffractive Sulcoflex IOL into the ciliary sulcus. All toric IOLs were implanted with image-guided navigation. The manifest refraction and uncorrected and distance corrected visual acuity at far, intermediate, and near distance were measured. The position of the axis of the toric IOL was determined with the Pentacam device (Oculus GmbH) by evaluating retroillumination images. The results were compared with the preoperatively planned axis position. RESULTS The median follow-up was 27 months. The spherical equivalent of manifest refraction was -0.04 ± 0.34 diopters (D) postoperatively, and the refractive cylinder was -0.14 ± 0.22 D on average. Binocular uncorrected and corrected distance visual acuity were 0.05 ± 0.11 logMAR and 0.02 ± 0.09 logMAR, respectively. The mean deviation from the calculated cylinder axis was 3.8° ± 3.5° with a median of 2.8° and a maximum deviation of 15.0°. Ninety-four percent of all eyes showed a deviation of less than 10°. CONCLUSIONS The long-term axial alignment of capsular bag-fixated toric IOLs in polypseudophakic eyes was comparable to the results reported for single implantation of toric IOLs. The polypseudophakic approach did not affect the rotational stability of capsular bag-fixated IOLs.
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Affiliation(s)
- Isabella D Baur
- From the Department of Ophthalmology, University Clinic Heidelberg, Heidelberg, Germany
| | - Gerd U Auffarth
- From the Department of Ophthalmology, University Clinic Heidelberg, Heidelberg, Germany
| | - Maximilian K Köppe
- From the Department of Ophthalmology, University Clinic Heidelberg, Heidelberg, Germany
| | - Grzegorz Łabuz
- From the Department of Ophthalmology, University Clinic Heidelberg, Heidelberg, Germany
| | - Ramin Khoramnia
- From the Department of Ophthalmology, University Clinic Heidelberg, Heidelberg, Germany..
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Piñero DP, Maldonado-López MJ, Molina-Martin A, García-Sánchez N, Ramón ML, Rincón JL, Holgueras A, Arenillas JF, Planchuelo-Gómez Á, Leal-Vega L, Coco-Martín MB. Randomised placebo-controlled clinical trial evaluating the impact of a new visual rehabilitation program on neuroadaptation in patients implanted with trifocal intraocular lenses. Int Ophthalmol 2023; 43:4035-4053. [PMID: 37464228 PMCID: PMC10520183 DOI: 10.1007/s10792-023-02809-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 06/29/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE To evaluate the efficacy of a new visual training program for improving the visual function in patients implanted with trifocal intraocular lenses (IOLs). METHODS Randomised placebo-controlled clinical trial enrolling 60 subjects (age, 47-75 years) undergoing cataract surgery with implantation of trifocal diffractive IOL. Home-based active visual training was prescribed immediately after surgery to all of them (20 sessions, 30 min): 31 subjects using a serious game based on Gabor patches (study group) and 29 using a placebo software (placebo group). Visual acuity, contrast sensitivity (CS), and perception of visual disturbances (QoV questionnaire) were evaluated before and after training. Likewise, in a small subgroup, resting-state functional magnetic resonance imaging (rs-fMRI) analysis was performed. RESULTS No significant differences were found between groups in compliance time (p = 0.70). After training, only significant improvements in monocular uncorrected intermediate visual acuity were found in the study group (p ≤ 0.01), although differences between groups did not reach statistical significance (p ≥ 0.11). Likewise, significantly better binocular far CS values were found in the study group for the spatial frequencies of 6 (p = 0.01) and 12 cpd (p = 0.03). More visual symptoms of the QoV questionnaire experienced a significant change in the level of bothersomeness in the study group. Rs-fMRI revealed the presence significant changes reflecting higher functional connectivity after the training with the serious game. CONCLUSIONS A 3-week visual training program based on the use of Gabor patches after bilateral implantation of trifocal diffractive IOLs may be beneficial for optimising the visual function, with neural changes associated suggesting an acceleration of neuroadaptation. Trial registration ClinicalTrials.gov, NCT04985097. Registered 02 August 2021, https://clinicaltrials.gov/(NCT04985097 ).
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Affiliation(s)
- David P Piñero
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig S/N, 03016, San Vicente del Raspeig, Alicante, Spain.
- Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain.
| | - Miguel J Maldonado-López
- Grupo de Cirugía Refractiva y Rehabilitación Visual, Instituto Universitario de Oftalmobiología Aplicada (IOBA), University of Valladolid, Valladolid, Spain
| | - Ainhoa Molina-Martin
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig S/N, 03016, San Vicente del Raspeig, Alicante, Spain
| | | | - María L Ramón
- Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain
| | - José L Rincón
- Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain
| | - Alfredo Holgueras
- Grupo de Cirugía Refractiva y Rehabilitación Visual, Instituto Universitario de Oftalmobiología Aplicada (IOBA), University of Valladolid, Valladolid, Spain
| | - Juan F Arenillas
- Group of Applied Clinical Neurosciences and Advanced Data Analysis, Department of Medicine, Dermatology and Toxicology, University of Valladolid, Valladolid, Spain
- Stroke Unit and Stroke Program, Department of Neurology, University Clinical Hospital, University of Valladolid, Valladolid, Spain
| | | | - Luis Leal-Vega
- Grupo de Cirugía Refractiva y Rehabilitación Visual, Instituto Universitario de Oftalmobiología Aplicada (IOBA), University of Valladolid, Valladolid, Spain
| | - María Begoña Coco-Martín
- Grupo de Cirugía Refractiva y Rehabilitación Visual, Instituto Universitario de Oftalmobiología Aplicada (IOBA), University of Valladolid, Valladolid, Spain
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Khoramnia R, Baur ID, Łabuz G, Köppe MK, Hallak MK, Auffarth GU. Functional outcomes after bilateral refractive lens exchange with a continuous-range-of-vision intraocular lens. J Cataract Refract Surg 2023; 49:1011-1017. [PMID: 37464558 DOI: 10.1097/j.jcrs.0000000000001265] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 07/12/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE To clinically evaluate a diffractive continuous-range-of-vision intraocular lens (IOL) that combines bifocal and extended depth-of-focus technologies in refractive lens exchange (RLE) patients. SETTING University eye clinic. DESIGN Prospective interventional clinical study. METHODS Bilateral implantation of the TECNIS Synergy IOL was performed during a RLE procedure in 28 patients. At 3 months postoperatively, uncorrected (UDVA) and corrected (CDVA) distance visual acuities, uncorrected (UIVA) and distance-corrected (DCIVA) intermediate visual acuities at 80 cm, and uncorrected (UNVA) and distance-corrected (DCNVA) near visual acuities at 40 cm were assessed. Defocus curve testing and contrast sensitivity testing were also performed. RESULTS Binocular UDVA and CDVA of 56 eyes (28 patients) were -0.06 ± 0.07 logMAR and -0.13 ± 0.05 logMAR, respectively. UIVA and DCIVA were -0.06 ± 0.05 logMAR and -0.08 ± 0.06 logMAR, and UNVA and DCNVA were -0.01 ± 0.07 logMAR and -0.04 ± 0.07 logMAR. The defocus curve revealed a visual acuity of 0.10 logMAR or better from +0.50 to -3.00 diopters (D). Photopic contrast sensitivity at spatial frequencies 3.0, 6.0, 12.0, and 18.0 was 1.68 ± 0.20, 1.77 ± 0.19, 1.45 ± 0.18, and 1.02 ± 0.19 log units, respectively. Mesopic contrast sensitivity at the same frequencies was 1.56 ± 0.20, 1.44 ± 0.25, 0.92 ± 0.38, and 0.44 ± 0.37, respectively. CONCLUSIONS The Synergy IOL provided very good distance, intermediate, and near visual outcomes. A visual acuity of 0.10 logMAR or better was achieved from +0.50 to -3.0 D. Contrast sensitivity was within the normal range.
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Affiliation(s)
- Ramin Khoramnia
- From the International Vision Correction Research Center, University Eye Clinic of Heidelberg, Heidelberg, Germany
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11
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Fernández J, Burguera N, Rocha-de-Lossada C, Rachwani-Anil R, Rodríguez-Vallejo M. Influence of a multifocal intraocular lens centration and eye angles on light distortion and ocular scatter index. Graefes Arch Clin Exp Ophthalmol 2023; 261:2291-2299. [PMID: 36884063 DOI: 10.1007/s00417-023-06028-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/10/2023] [Accepted: 02/04/2023] [Indexed: 03/09/2023] Open
Abstract
PURPOSE To assess how eye axes and multifocal intraocular lens (MIOL) centration may impact the light distortion index (LDI) and ocular scatter index (OSI). METHODS Fifty-eight subjects implanted with the trifocal MIOL Q-Flex M 640PM or Liberty 677MY (Medicontur) were included in this retrospective analysis. The following variables were collected with the Pentacam Wave (Oculus) considering the vertex normal as the coordinates center: chord-mu to the center of the pupil, chord-alpha to the geometrical center of the cornea, and chord-MIOL to the center of the diffractive ring. These measurements were correlated with OSI (HD Analyzer, Visiometrics) and LDI (light distortion analyzer, CEORLab). RESULTS Chord-MIOL centroid was 0.12 mm at 62°, chord-mu was 0.09 mm at 174°, and chord-alpha was 0.38 mm at 188°. A relationship was found between OSI and LDI, rho = 0.58, p < 0.0005). No relationships were found between chord-mu or chord-alpha and the LDI or OSI, neither for the total magnitude, nor the decomposition in orthogonal components (p > 0.05). The LDI was significantly correlated with the temporal centration of the MIOL versus the vertex normal (rho = 0.32, p = 0.02). CONCLUSIONS As opposed to what has been previously described, the temporal centration of the MIOL was related to a decrease in the LDI. Future studies with extreme values of the included variables are required to establish cut-offs for considering these variables as exclusion criteria in the implantation of a MIOL.
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Affiliation(s)
- Joaquín Fernández
- Qvision, Department of Ophthalmology, VITHAS Almería Hospital, 04120, Almería, Spain
| | - Noemí Burguera
- Qvision, Department of Ophthalmology, VITHAS Almería Hospital, 04120, Almería, Spain
| | - Carlos Rocha-de-Lossada
- Qvision, Department of Ophthalmology, VITHAS Almería Hospital, 04120, Almería, Spain
- Hospital Regional Universitario de Málaga, Plaza del Hospital Civil, S/N, 29009, Málaga, Spain
- Departamento de Cirugía, Área de Oftalmología, Universidad de Sevilla, Doctor Fedriani, S/N, 41009, Sevilla, Spain
| | - Rahul Rachwani-Anil
- Hospital Norte de Málaga, Avenida Poeta Muñoz Rojas, S/N, Antequera, 29200, Málaga, Spain
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12
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Henderson BA, Aramberri J, Vann R, Abulafia A, Ainslie-Garcia M, Berdahl J, Ferko N, Gundersen KG, Goto S, Gupta P, Multack S, Persaud E, Raoof D, Savini G, Shammas HJ, Wang L, Wang WZ. The Current Burden and Future Solutions for Preoperative Cataract-Refractive Evaluation Diagnostic Devices: A Modified Delphi Study. Clin Ophthalmol 2023; 17:2109-2124. [PMID: 37521152 PMCID: PMC10378607 DOI: 10.2147/opth.s412847] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/11/2023] [Indexed: 08/01/2023] Open
Abstract
Purpose To obtain consensus on the key areas of burden associated with existing devices and to understand the requirements for a comprehensive next-generation diagnostic device to be able to solve current challenges and provide more accurate prediction of intraocular lens (IOL) power and presbyopia correction IOL success. Patients and Methods Thirteen expert refractive cataract surgeons including three steering committee (SC) members constituted the voting panel. Three rounds of voting included a Round 1 structured electronic questionnaire, Round 2 virtual face-to-face meeting, and Round 3 electronic questionnaire to obtain consensus on topics related to current limitations and future solutions for preoperative cataract-refractive diagnostic devices. Results Forty statements reached consensus including current limitations (n = 17) and potential solutions (n = 23) associated with preoperative diagnostic devices. Consistent with existing evidence, the panel reported unmet needs in measurement accuracy and validation, IOL power prediction, workflow, training, and surgical planning. A device that facilitates more accurate corneal measurement, effective IOL power prediction formulas for atypical eyes, simplified staff training, and improved decision-making process for surgeons regarding IOL selection is expected to help alleviate current burdens. Conclusion Using a modified Delphi process, consensus was achieved on key unmet needs of existing preoperative diagnostic devices and requirements for a comprehensive next-generation device to provide better objective and subjective outcomes for surgeons, technicians, and patients.
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Affiliation(s)
- Bonnie An Henderson
- Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, USA
| | | | - Robin Vann
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Adi Abulafia
- Department of Ophthalmology, Shaare Zedek Medical Center, Hadassah Faculty of Medicine, the Hebrew University, Jerusalem, Israel
| | | | | | | | | | - So Goto
- Herbert Wertheim School Optometry and Vision Science, University of California, Berkeley, CA, USA
- Department of Ophthalmology, National Hospital Organization, Tokyo Medical Center, Meguro-ku, Tokyo, Japan
| | - Preeya Gupta
- Triangle Eye Consultants, Raleigh, NC, USA
- Department of Ophthalmology, Tulane University, New Orleans, LA, USA
| | - Samuel Multack
- Laser and Cataract Institute, Frankfort, IL, USA
- Advocate South Suburban Hospital, Hazel Crest, IL, USA
- Advocate Trinity Hospital, Chicago, IL, USA
| | | | - Duna Raoof
- NVISION Eye Center, Newport Beach, CA, USA
| | | | - H John Shammas
- Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA
| | - Li Wang
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX, 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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Mori Y, Miyata K, Suzuki H, Noguchi S, Ichikawa K, Maeda N. Clinical Performance of a Hydrophobic Acrylic Diffractive Trifocal Intraocular Lens in a Japanese Population. Ophthalmol Ther 2023; 12:867-878. [PMID: 36542257 PMCID: PMC9768760 DOI: 10.1007/s40123-022-00634-4] [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: 10/22/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION In this study, clinical performance of a hydrophobic acrylic diffractive trifocal intraocular lens (IOL) with double C-loop haptics was evaluated in Japanese cataract eyes. METHODS Twenty-three patients had bilateral cataract surgery with the implantation of a trifocal IOL with double C-loop haptics. Postoperative examinations at 6 months included assessing uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA) at 5 m, uncorrected intermediate visual acuity (UIVA), distance-corrected intermediate visual acuity (DCIVA) at 80 cm, uncorrected near visual acuity (UNVA) and distance-corrected near visual acuity (DCNVA) at 40 cm. Binocular defocus, contrast sensitivity, spectacle independence, symptoms of photic phenomena and quality of vision (QOV) were also observed. RESULTS Twenty-three patients received 46 IOLs binocularly. Manifest refraction spherical equivalent was - 0.227 ± 0.385 D (mean ± standard deviation) at 6 months postoperatively. Binocular UDVA, binocular UIVA and binocular UNVA were - 0.101 ± 0.065, - 0.021 ± 0.079 and 0.022 ± 0.095 logMAR units, respectively. Binocular CDVA, binocular DCIVA and binocular DCNVA were - 0.151 ± 0.044, - 0.042 ± 0.067 and - 0.011 ± 0.080 logMAR, respectively. Binocular CDVA of 0.00 logMAR or better was obtained in the defocus from - 3.0 D until + 0.5 D. Only 8.7% of patients required the use of spectacles postoperatively. There were no symptoms of glare, halo and light disturbance in 78.3%, 56.5% and 69.6% of patients, respectively. QOV scores significantly improved postoperatively (P < 0.0001). CONCLUSION The hydrophobic acrylic trifocal IOL with double C-loop haptics provides good visual performance at all distances and produces high spectacle independence rate and patient satisfaction. TRIAL REGISTRATION NUMBER NCT04699266 (Clinicaltrials.gov).
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Affiliation(s)
- Yosai Mori
- Miyata Eye Hospital, 6-3, Kuraharacho, Miyakonojo, Miyazaki, 885-0051, Japan.
| | - Kazunori Miyata
- Miyata Eye Hospital, 6-3, Kuraharacho, Miyakonojo, Miyazaki, 885-0051, Japan
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Zhu D, Ren S, Mills K, Hull J, Dhariwal M. Rate of Complete Spectacle Independence with a Trifocal Intraocular Lens: A Systematic Literature Review and Meta-Analysis. Ophthalmol Ther 2023; 12:1157-1171. [PMID: 36745314 PMCID: PMC10011212 DOI: 10.1007/s40123-023-00657-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 01/13/2023] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION A systematic literature review and meta-analysis was conducted to identify and obtain a precise single summary estimate on complete spectacle independence after bilateral implantation of a trifocal intraocular lens (IOL) (AcrySof PanOptix, TFNTXX/TFATXX) for patients undergoing cataract surgery. METHODS A search was conducted in PubMed from January 2017 to September 2021. Relevant congress presentations were also searched to include data from completed studies not yet published. Search terms included the intervention (TFNTXX, TFATXX, PanOptix) and outcomes of interest (patient-reported spectacle independence rates). A Bayesian random-effects meta-analysis was conducted, providing a pooled estimate (median and its 95% credible interval) of complete spectacle independence rates among cataract surgery patients. Subgroup analyses evaluated spectacle independence after cataract surgery across different working distances (near, intermediate, far). RESULTS Nineteen unique clinical studies were identified. Based on a meta-analysis of 13 studies (N = 513 patients), the complete spectacle independence rate after cataract surgery with TFNTXX/TFATXX IOL was 91.6% (95% credible interval 86.8-95.9%). Additionally, the spectacle independence rates at each focal point (N = 13 studies, 603 patients) were 89.6% (near), 96.3% (intermediate), and 95.9% (far). CONCLUSIONS This meta-analysis demonstrated that at least nine out of ten patients receiving TFNTXX/TFATXX trifocal IOL during cataract surgery can expect to achieve complete spectacle independence. This study provides informative data for clinicians and patients to feel confident in the use of trifocal intraocular lenses as presbyopia-correcting IOLs that offer high rates of complete spectacle independence.
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Affiliation(s)
- Dagny Zhu
- NVISION Eye Centers, 17980 Castleton Street, Rowland Heights, CA, 91748, USA.
| | - Shijie Ren
- The University of Sheffield, Sheffield, UK.,ConnectHEOR Limited, London, UK
| | | | | | - Mukesh Dhariwal
- Alcon Vision LLC, Forth Worth, TX, USA.,Health Economics and Outcomes Research, Alcon Vision LLC, Fort Worth, Texas, 76134, USA
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Tañá-Rivero P, Orts-Vila P, Aguilar-Córcoles S, Tañá-Sanz P, Tañá-Sanz S. Contrast Sensitivity and Patient Reported Outcomes After Bilateral Implantation of a Bi-Aspheric Hydrophobic Trifocal Diffractive Intraocular Lens. Clin Ophthalmol 2023; 17:247-258. [PMID: 36698852 PMCID: PMC9869798 DOI: 10.2147/opth.s400136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 12/30/2022] [Indexed: 01/19/2023] Open
Abstract
Purpose To assess contrast sensitivity and patient reported outcomes after uncomplicated cataract surgery with a new bi-aspheric diffractive trifocal intraocular lens (IOL) implantation. Methods Twenty-five patients who underwent bilateral implantation with the Asqelio Trifocal TFLIO130C IOL (AST Products Inc., Billerica, MA, USA) were analyzed at 6 months post-surgery. Binocular contrast sensitivity with and without glare was measured under photopic conditions (85 cd/m2) and mesopic conditions (3 cd/m2). Patients were asked to complete the Catquest-9SF patient outcomes questionnaire and a visual symptoms questionnaire. Results Photopic contrast sensitivity values were either within or above normal levels without glare; when glare was induced, the mean sensitivity values dropped just below normal range. Mesopic contrast sensitivity values were above or within normal range both with and without glare, except for 12 cpd with glare, where the mean fell just below the normal range. Differences in binocular contrast sensitivity threshold values with and without glare were significant for all spatial frequencies tested under both photopic and mesopic conditions (p<0.05). The Catquest-9SF questionnaire outcomes showed that 88% of patients were either satisfied or very satisfied with their sight after the surgery, and in all cases, the results indicated no difficulty in performing different daily activities. The visual symptoms questionnaire indicated no relevant visual symptoms regarding frequency, intensity, or bothersomeness after implantation of the trifocal IOL. Conclusion This novel bi-aspheric diffractive trifocal IOL provides good contrast sensitivity outcomes under bright and dim lighting conditions. Patients were satisfied with the surgery, with no relevant visual symptoms.
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Affiliation(s)
- Pedro Tañá-Rivero
- Cataract Surgery Department, Oftalvist Alicante, Alicante, Spain,Correspondence: Pedro Tañá-Rivero, Cataract Surgery Department, Oftalvist Alicante, C/ Angel Lozano 11, Alicante, 03001, Spain, Tel +34 965 141 500, Email
| | - Paz Orts-Vila
- Cataract Surgery Department, Oftalvist Alicante, Alicante, Spain
| | | | - Pedro Tañá-Sanz
- Cataract Surgery Department, Oftalvist Alicante, Alicante, Spain
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Clinical Evaluation of Reading Performance in Refractive Lens Exchange With a Diffractive Continuous-Range-of-Vision Intraocular Lens. Am J Ophthalmol 2023; 250:25-37. [PMID: 36669611 DOI: 10.1016/j.ajo.2023.01.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/19/2023]
Abstract
PURPOSE Evaluation of reading performance with a novel presbyopia correcting intraocular lens (IOL) in refractive lens exchange using an electronic reading desk. DESIGN Prospective interventional before-and-after clinical study. METHODS In total, 56 eyes of 28 patients were included. Bilateral implantation of the TECNIS Synergy IOL (Johnson & Johnson Surgical Vision) during a bilateral delayed sequential refractive lens exchange procedure. Uncorrected and distance corrected reading acuity, reading distance, reading speed, and the smallest print size that could be read effectively at a set (40 cm/80 cm) and subjectively chosen near and intermediate distance were assessed using the Salzburg Reading Desk preoperatively and 6 months after surgery. RESULTS Uncorrected near reading acuity increased from 0.61 ± 0.16 logarithm of the minimum angle of resolution (logMAR) preoperatively to 0.05 ± 0.09 logMAR postoperatively at the set near distance (40 cm) and from 0.60 ± 0.11 logMAR to 0.07 ± 0.08 logMAR at the subjectively preferred distance (39.6 ± 5.3 cm and 37.7 ± 4.3 cm). Uncorrected intermediate reading acuity was 0.39 ± 0.19 logMAR preoperatively and 0.08 ± 0.07 logMAR postoperatively at the set intermediate distance (80 cm) and 0.43 ± 0.21 logMAR preoperatively and 0.07 ± 0.08 logMAR postoperatively at the preferred intermediate distance (73.5 ± 9.5 cm and 73.3 ± 5.9 cm). CONCLUSIONS Uncorrected intermediate and near reading function considerably improved after bilateral implantation of the TECNIS Synergy IOL. Patients preferred a closer near and intermediate distance to the set distances. However, reading function was comparable for the set and subjectively preferred distances.
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Kohnen T, Lapid-Gortzak R, Ramamurthy D, Bissen-Miyajima H, Maxwell A, Kim TI, Modi S. Clinical Outcomes After Bilateral Implantation of a Diffractive Trifocal Intraocular Lens: A Worldwide Pooled Analysis of Prospective Clinical Investigations. Clin Ophthalmol 2023; 17:155-163. [PMID: 36647516 PMCID: PMC9840399 DOI: 10.2147/opth.s377234] [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: 07/03/2022] [Accepted: 11/21/2022] [Indexed: 01/11/2023] Open
Abstract
Purpose To investigate visual and safety outcomes of AcrySof® IQ PanOptix® (model TFNT00), a trifocal, presbyopia-correcting intraocular lens (IOL), in patients of different ethnicities across multiple countries, based on a pooled analysis of six prospective multicenter studies. Patients and Methods This pooled analysis included adult patients from six prospective clinical studies performed across 56 centers worldwide. After cataract removal by phacoemulsification, all patients were implanted with TFNT00; follow-up duration varied from 3 to 12 months according to the studies' design. Binocular defocus curve; absolute manifest refraction spherical equivalent (MRSE); and binocular photopic uncorrected and corrected visual acuities at distance (UCDVA, BCDVA; 4-5 m), intermediate (UCIVA, DCIVA; 60-66 cm), and near (UCNVA, DCNVA; 40 cm) were measured. Results The study included 557 patients, 547 of whom were implanted bilaterally with the TFNT00 IOL (n = 1094 eyes). Binocular visual data at 1 month and 3-6 months after implantation were available for up to 546 and 542 bilaterally implanted patients, respectively. A continuous range of 0.1 logarithm of the minimum angle of resolution (logMAR) or better vision from distance (0.00 diopter [D], 4-5 m) to near (-3.00 D; optically equivalent to 33 cm) was observed 3-6 months after TFNT00 implantation. At 3-6 months, 88.2% of first eyes achieved an MRSE ≤0.50 D and 88.7% of second eyes achieved an MRSE ≤0.50 D. Overall, 99.3%, 92.3%, and 94.6% of patients bilaterally implanted with TFNT00 achieved binocular photopic BCDVA, DCIVA, and DCNVA of 0.14 logMAR or better, respectively. Ocular adverse device effects and secondary surgical interventions (SSIs) were infrequent. Conclusion This global pooled analysis showed that TFNT00 provided a continuous range of 0.1 logMAR (~20/25 Snellen) or better vision from distance to 33 cm, with a low incidence of ocular adverse device effects and SSIs.
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Affiliation(s)
- Thomas Kohnen
- Department of Ophthalmology, Goethe-University, Frankfurt, Germany,Correspondence: Thomas Kohnen, Department of Ophthalmology, Goethe University, Theodor‑Stern-Kai 7, Frankfurt, 60590, Germany, Tel +49 69 6301 6739/ 3945, Fax +49 69 6301 3893, Email
| | - Ruth Lapid-Gortzak
- Department of Ophthalmology, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | | | | | | | - Tae-Im Kim
- Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea
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Naujokaitis T, Auffarth GU, Khoramnia R, Łabuz G. Complementary system vs conventional trifocal intraocular lens: comparison of optical quality metrics and unwanted light distribution. J Cataract Refract Surg 2023; 49:84-90. [PMID: 36325833 PMCID: PMC9794130 DOI: 10.1097/j.jcrs.0000000000001082] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE To evaluate the ARTIS Symbiose complementary intraocular lens (IOL) system, consisting of the MID and PLUS models, in comparison with a conventional trifocal IOL (AcrySof IQ PanOptix). SETTING The David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany. DESIGN Laboratory investigation. METHODS Modulation and phase transfer functions were obtained in polychromatic light using an optical bench setup. Simulated visual acuity (VA) values were derived from optical quality metrics weighted by neural contrast sensitivity. United States Air Force (USAF) chart images were acquired and processed. Furthermore, the light distribution beyond the center of a polychromatic point spread function was assessed. RESULTS The peak simulated VA values of ARTIS Symbiose MID were at 0 diopters (D) of defocus (-0.02 logMAR) and at -1.5 D (0.00 logMAR); of ARTIS Symbiose PLUS, they were at 0 D of defocus (-0.01 logMAR) and at -2.5 D (0.01 logMAR). AcrySof IQ PanOptix demonstrated 3 peaks: at 0 D of defocus (-0.02 logMAR), at -1.75 D (0.03 logMAR), and at -2.5 D (0.02 logMAR). The summation of USAF chart images in the simulated binocular IOL system produced a slightly better image quality at -1.0 D and -1.5 D than AcrySof IQ PanOptix. The IOLs yielded comparable light spread across the studied range except for a localized intensity spike of the ARTIS Symbiose IOLs. CONCLUSIONS The complementary IOL system may yield better monocular intermediate VA compared with the conventional trifocal IOL. However, the effect of binocular summation in terms of VA and the perception of photic phenomena still needs to be investigated.
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Ting DSJ, Liu YC, Price ER, Swartz TS, Lwin NC, Hipsley A, Mehta JS. Improvement in Accommodation and Dynamic Range of Focus After Laser Scleral Microporation: A Potential Treatment for Presbyopia. Transl Vis Sci Technol 2022; 11:2. [DOI: 10.1167/tvst.11.12.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Darren S. J. Ting
- Academic Ophthalmology, School of Medicine, University of Nottingham, Nottingham, UK
- Department of Ophthalmology, Queen's Medical Centre, Nottingham, UK
- Singapore Eye Research Institute, Singapore
| | - Yu-Chi Liu
- Singapore Eye Research Institute, Singapore
- Singapore National Eye Centre, Singapore
- Duke–NUS Graduate Medical School, Singapore
| | | | | | | | | | - Jodhbir S. Mehta
- Singapore Eye Research Institute, Singapore
- Singapore National Eye Centre, Singapore
- Duke–NUS Graduate Medical School, Singapore
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21
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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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22
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Current Advances and Future of Premium IOLs. CURRENT SURGERY REPORTS 2022. [DOI: 10.1007/s40137-022-00333-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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23
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Cost-benefit analysis of a trifocal intraocular lens versus a monofocal intraocular lens from the patient's perspective in the United States. PLoS One 2022; 17:e0277093. [PMID: 36327344 PMCID: PMC9632823 DOI: 10.1371/journal.pone.0277093] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 10/19/2022] [Indexed: 11/05/2022] Open
Abstract
Purpose To conduct a cost-benefit analysis of AcrySof IQ PanOptix trifocal intraocular lens (TFNT00 IOL) versus AcrySof monofocal IOL (SN60AT) from the patient perspective in the United States (US). Methods A de novo Markov model was developed to estimate the mean total lifetime patient costs and vision-related quality of life (measured as quality adjusted life-years (QALYs)) with each intervention (TFNT00 and SN60AT) and the incremental differences between these two treatments. The resulting incremental quality of life gain was mapped to the US patient willingness to pay threshold of $50,000 per QALY gain to estimate the lifetime net monetary value, measured as the net monetary benefit of TFNT00 IOL. Model inputs (transition probabilities, costs, discount rate, utilities, and event rates) were derived from the FDA IDE study (NCT03280108), published literature, clinical experience, and other relevant sources. Results Bilateral cataract surgery with implantation of the advanced technology IOL (AT-IOL) TFNT00 provides improved vision-related quality of life (QALY gain of 0.67) at an incremental lifetime cost of $2,783 compared to monofocal IOL. This incremental QALY gain translated into a lifetime net monetary benefit of $30,941 at the patient willingness to pay threshold of $50,000/QALY gain. Results were most sensitive to disutility due to wearing glasses, patient out of pocket costs for bilateral AT-IOL procedure, and post-operative spectacle dependence rates. Conclusions AcrySof IQ PanOptix IOL provides greater improvement in vision related quality of life compared to no presbyopia correction with a monofocal IOL. This study shows PanOptix is a cost-beneficial treatment strategy for patients willing to pay out of pocket for cataract surgery.
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24
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Wei D, Wei L, Yanjun H, Zequan X, Lei J, Qiang W. Visual quality analysis using the Chinese Catquest-9SF scale following different spherical aberration IOL implantation. Front Public Health 2022; 10:1029002. [PMID: 36407986 PMCID: PMC9670146 DOI: 10.3389/fpubh.2022.1029002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose Based on the Chinese version of the Catquest-9SF scale, the contrast sensitivity meter and wavefront aberrometer were used to evaluate the visual quality of cataract patients implanted with different spherical aberrations IOL. Design Retrospective Observational Study. Methods Patients who had the lens implantation in our department from January 2020 to December 2021 were enrolled. All patients underwent uncorrected visual acuity, best corrected visual acuity and slit lamp microscope, high-order aberrations and contrast sensitivity test. The KR-1W wavefront analyzer (Topcon Medical System, Tokyo, Japan) was used to measure wavefront aberrations post-operation. The Chinese Catquest-9SF scale was used to score the postoperative visual satisfaction of the patients. Results 145 patients were screened according to the exclusion criteria, including 51 patients in the zero aspherical IOL (SOFTEC HD) group, 42 patients in the negative aspherical IOL (ZCB00) group, and a total of 52 patients in the spherical IOL (HQ-201HEP) group. The score was the highest in the zero spherical aberration group, followed by the negative spherical aberration group with the lowest scores in the spherical IOL group. Higher-order aberrations are relatively low in eyes implanted with the zero spherical aberration group. Contrast sensitivity with spherical lenses under glare-free and glare conditions was lower than those with aspheric lenses, and at higher frequencies the zero-aberration aspheric lens performed the best. Conclusion The Chinese Catquest-9SF scale provides an indication of visual quality after aspheric IOL implantation.
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Affiliation(s)
- Du Wei
- Department of Ophthalmology, The Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China,Department of Ophthalmology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou First People's Hospital, Xuzhou Eye Disease Prevention and Treatment Institute, Xuzhou, China
| | - Lou Wei
- Department of Ophthalmology, The Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hua Yanjun
- Department of Ophthalmology, The Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xu Zequan
- Department of Ophthalmology, The Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jin Lei
- Department of Ophthalmology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou First People's Hospital, Xuzhou Eye Disease Prevention and Treatment Institute, Xuzhou, China
| | - Wu Qiang
- Department of Ophthalmology, The Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China,*Correspondence: Wu Qiang
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25
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Dick HB, Ang RE, Corbett D, Hoffmann P, Tetz M, Villarrubia A, Palomino C, Castillo-Gomez A, Tsai L, Thomas EK, Janakiraman P. Comparison of 3-month visual outcomes of a new multifocal intraocular lens vs a trifocal intraocular lens. J Cataract Refract Surg 2022; 48:1270-1276. [PMID: 35545816 PMCID: PMC9622366 DOI: 10.1097/j.jcrs.0000000000000971] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 05/09/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE To compare the clinical performance of the TECNIS Synergy multifocal (model ZFR00V) intraocular lens (IOL) with that of the AcrySof PanOptix Trifocal (model TFNT00) IOL in patients undergoing bilateral cataract surgery. SETTING Multicenter clinical setting. DESIGN Prospective randomized comparative study. METHODS Patients aged 22 years or older were randomly assigned (2:1) to bilateral implantation with ZFR00V or TFNT00 IOLs. End points included the mean binocular distance-corrected near visual acuity (DCNVA) at 40 cm, photopic and mesopic DCNVAs at 33 cm, photopic low-contrast corrected distance visual acuity (CDVA) and mesopic CDVA, nondirected patient responses to an ocular/visual symptoms questionnaire, and safety. RESULTS Of the 150 patients implanted with IOLs, 95 of the 97 patients with ZFR00V IOLs and 52 of the 53 patients with TFNT00 IOLs completed the 3-month follow-up. Most patients in the ZFR00V and TFNT00 groups achieved 20/25 or better binocular CDVA (100% vs 96.2%) and DCNVA measured at 40 cm (88.4% vs 75.0%) and 33 cm (78.9% vs 51.9%). The mean between-group difference in binocular DCNVA at 40 cm favored ZFR00V IOLs (0.5 lines Snellen; 95% CI, 0.012 to 0.089; P ≤ .05). Similarly, the mean binocular photopic and mesopic DCNVAs at 33 cm (0.8 lines Snellen each; both P ≤ .05 vs TFNT00) and photopic high-contrast and low-contrast CDVA (0.5 lines Snellen each; both P ≤ .05 vs TFNT00) favored ZFR00V IOLs. Patient-reported ocular/visual symptoms and safety were generally similar between the 2 IOLs. CONCLUSIONS The ZFR00V IOL showed an extensive range of vision, particularly through near distances, and better mesopic performance than the TFNT00 IOL in patients undergoing cataract surgery.
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Cost-Effectiveness of Presbyopia Correction Among Seven Strategies of Bilateral Cataract Surgery Based on a Prospective Single-Blind Two-Center Trial in China. Ophthalmol Ther 2022; 11:2067-2082. [PMID: 36071311 DOI: 10.1007/s40123-022-00562-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 08/22/2022] [Indexed: 10/14/2022] Open
Abstract
INTRODUCTION The aim of this study was to explore a method to rank the cost-effectiveness of presbyopia correction in diverse strategies of bilateral cataract surgery to provide references for healthcare policymakers in rationalizing resource utilization and surgeons in customizing patient management. METHODS The cost-effectiveness analysis based on a prospective single-blind two-center clinical trial included seven strategies in bilateral cataract surgery: monofocal, monovision, diffractive bifocal, blended, refractive bifocal, trifocal, and extended depth of focus (EDOF) strategies. The effectiveness according to the objective spectacle independence rate (hereafter "rate", a novel indicator defined as the proportion of patients with binocular uncorrected distance, intermediate and near visual acuity all better than 0.1 logMAR, logarithm of the minimum angle of resolution), costs, average cost-effectiveness ratios (ACERs, $/1% rate), and incremental cost-effectiveness ratios (ICERs, $/1% incremental rate) were estimated. RESULTS In 194 participants (388 eyes), the trifocal strategy achieved the highest rate [93.10% (95% confidence interval (CI) 83.8-102.35%)]. The refractive bifocal strategy had the minimum ACER [$45.54/1% rate (95% CI 34.57-56.50)], followed by the blended [$59.10/1% rate (95% CI 31.72-86.48)], diffractive bifocal [$69.06/1% rate (95% CI 30.89-107.21)], EDOF [$72.85/1% rate (95% CI 52.02-93.70)], trifocal [$93.01/1% rate (95% CI 83.23-102.79)], monovision [$136.83/1% rate (95% CI - 55.40 to 329.14)], and monofocal [$264.45/1% rate (95% CI - 97.45 to 626.55)] strategies. Compared with the refractive bifocal strategy, the probabilities that the trifocal strategy (ICER $289.74/1% incremental rate) is very cost-effective and cost-effective were 81.7% and 93.2%, respectively, at the wiliness-to-pay threshold of one and three times China's annual disposable income per capita in 2021 per 10% incremental rates. CONCLUSIONS Cost-effectiveness analysis with ACER and ICER according to objective spectacle independence rate is a helpful tool to identify highly cost-effective presbyopia-correcting strategies in cataract surgery for clinical and policy decisions. TRIAL REGISTRATION Clinicaltrials.gov (NCT04265846).
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27
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Bala C, Athanasiov P, Holland J, Dhariwal M, Gupta A, Rathi H. A Cost-Effectiveness Analysis of AcrySof IQ Vivity Intraocular Lens (IOL) from Private Health Fund Perspective in Australia. Clin Ophthalmol 2022; 16:2403-2412. [PMID: 35942082 PMCID: PMC9356702 DOI: 10.2147/opth.s370420] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/29/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose AcrySof IQ Vivity is a unique non-diffractive extended depth of focus intraocular lens with wavefront-shaping X-WAVE technology. This study evaluated the cost-effectiveness of AcrySof IQ Vivity intraocular lens (DFT015) compared with standard aspheric monofocal intraocular lens (SN60WF), from a private health fund perspective in Australia. Methods A Markov model was developed using the following health states: well, need for spectacles (near/distance/bifocal/varifocal), very bothersome visual disturbances (glare/haloes/starbursts) – with/without spectacles, and death. Model inputs were sourced from a randomized clinical study (NCT03010254), published literature, prostheses list and clinical opinion. A lifetime horizon (up to 30 years) was considered, and cost and health outcomes were discounted at 5% per annum. Model outcomes included incremental cost–effectiveness ratio defined as incremental cost per quality adjusted life year gain. Sensitivity and scenario analyses were also conducted. Results Bilateral implantation of DFT015 intraocular lens provided quality adjusted life year gain of 0.16 at an incremental cost of AU$307 compared to bilateral SN60WF, leading to an incremental cost-effectiveness ratio of AU$1908/quality adjusted life year, well below the cost-effectiveness threshold (Range: AU$45,000-AU$75,000) typically used by Medical Services Advisory Committee in Australia. Results were most sensitive to intraocular lens costs, post-operative spectacle dependence, and disutility due to wearing glasses. Robustness of the results was further confirmed by probabilistic sensitivity analysis and scenario analyses. Conclusion AcrySof IQ Vivity intraocular lens is a highly cost-effective treatment strategy with improved vision-related quality of life outcomes for presbyopic cataract surgery patients.
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Affiliation(s)
- Chandra Bala
- personalEYES Pty Ltd, Sydney, NSW, Australia
- Correspondence: Chandra Bala, personalEYES Pty Ltd, Level 2, 33 York Street, Sydney, NSW, 2000, Australia, Tel +61-2-88337111, Fax +61-2-88337112, Email
| | | | | | | | - Amit Gupta
- Skyward Analytics Pvt Ltd, Gurgaon, India
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Baur ID, Auffarth GU, Łabuz G, Khoramnia R. [Implantation of a Toric IOL with Enhanced Depth of Focus for Unilateral Traumatic Cataract]. Klin Monbl Augenheilkd 2022. [PMID: 35580622 DOI: 10.1055/a-1809-5187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Isabella Diana Baur
- Universitäts-Augenklinik Heidelberg, Universitätsklinikum Heidelberg, Deutschland
| | - Gerd U Auffarth
- Universitäts-Augenklinik Heidelberg, Universitätsklinikum Heidelberg, Deutschland
| | - Grzegorz Łabuz
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg, Deutschland
| | - Ramin Khoramnia
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg, Deutschland
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Baur ID, Auffarth GU, Łabuz G, Khoramnia R. Clinical outcomes in patients after duet procedure for reversible trifocality using a supplementary trifocal IOL. Am J Ophthalmol 2022; 241:217-226. [PMID: 35526588 DOI: 10.1016/j.ajo.2022.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE We report the clinical outcomes of patients who had primary lens implantation in the capsular bag and subsequently a supplementary trifocal lens implanted in the ciliary sulcus (duet procedure) to create reversible trifocality. DESIGN Retrospective interventional case series. METHODS Twenty-five patients were included in this single center clinical study, who had undergone either refractive lens exchange for presbyopia correction or cataract surgery. All had lens removal by phacoemulsification and duet procedure to achieve reversible trifocality. Preoperatively and three months postoperatively, uncorrected (UDVA) and corrected distance visual acuity (CDVA) were assessed, as well as uncorrected (UNVA), distance corrected (DCNVA) and corrected near visual acuity (CNVA). At the postoperative examination, uncorrected (UIVA), distance corrected (DCIVA) and corrected intermediate visual acuity (CIVA), defocus curve testing and dysphotopsia evaluation were also performed. RESULTS Monocular UDVA and CDVA improved from 0.71 ± 0.43 logMAR and 0.12 ± 0.16 logMAR preoperatively to 0.04 ± 0.10 logMAR and -0.01 ± 0.09 logMAR postoperatively. Monocular UNVA and DCNVA were both 0.06 ± 0.08 logMAR and UIVA and DCIVA 0.00 ± 0.10 logMAR and -0.02 ± 0.10 logMAR postoperatively. Monocular defocus curve testing revealed a visual acuity of 0.2 logMAR or better from +0.75 to -3.5 diopters. CONCLUSIONS Duet procedure using a trifocal supplementary IOL provided excellent results for far, near and intermediate distance, comparable to those reported for capsular bag fixated trifocal IOLs. The duet procedure offers the advantage of an exit-strategy in cases with a future loss of function or side effects associated with the optics.
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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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Sandoval HP, Potvin R, Solomon KD. The Effects of Angle Kappa on Clinical Results and Patient-Reported Outcomes After Implantation of a Trifocal Intraocular Lens. Clin Ophthalmol 2022; 16:1321-1329. [PMID: 35510273 PMCID: PMC9058245 DOI: 10.2147/opth.s363536] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/19/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To objectively determine if angle kappa materially influenced clinical outcomes or patient-reported satisfaction and visual quality of patients implanted with a trifocal intraocular lens (IOL). Methods This was a non-interventional study of clinical outcomes. Subjects were patients choosing to be bilaterally implanted with a trifocal IOL (PanOptix®) who were then evaluated 3 months postoperative. Angle kappa (AK) was measured before surgery and at the 3-month visit. The 3-month visit included a manifest refraction, and measurement of uncorrected and distance corrected acuity at 4 m, 60 cm and 40 cm. Visual quality and satisfaction questionnaires were also administered. Results Data from 56 eyes of 28 subjects were analyzed; 26 eyes had an AK magnitude <0.3 mm, 14 had an AK from 0.3 mm to less than 4 mm and 16 had an AK ≥0.4 mm. Neither visual disturbances (eg, glare, halos, starbursts), satisfaction nor spectacle dependence were correlated to the magnitude of angle kappa. The magnitude of postoperative AK was significantly lower than preoperative (0.24 ± 0.12 mm vs 0.30 ± 0.16 mm, p < 0.01). Conclusion The magnitude of preoperative Angle Kappa had no apparent effect on the refractive, visual acuity or subjective (visual disturbances, quality of vision, satisfaction) clinical outcomes with this trifocal IOL. The magnitude of angle kappa was significantly lower after surgery.
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Affiliation(s)
| | | | - Kerry D Solomon
- Carolina Eyecare Physicians, LLC, Mt. Pleasant, SC, USA
- Correspondence: Kerry D Solomon, Carolina Eyecare Physicians, LLC, 1101 Clarity Road, Suite 100, Mt Pleasant, SC, 29464, USA, Email
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Defocus curves: Focusing on factors influencing assessment. J Cataract Refract Surg 2022; 48:961-968. [PMID: 35137697 DOI: 10.1097/j.jcrs.0000000000000906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 02/01/2022] [Indexed: 11/26/2022]
Abstract
ABSTRACT Defocus curve assessment is used to emulate defocus over a range of distances and is a valuable tool that is used to differentiate the performance of presbyopia-correcting intraocular lenses. However, defocus curves are limited by a lack of standardization, and multiple factors can impact their generation and interpretation. This review discusses key factors that influence the assessment of defocus curves, including pupil size, level of contrast, sphere versus cylinder defocus, viewing distance, monocular versus binocular assessment, use of Snellen versus logarithm of the minimum angle of resolution charts, and diopter range and step size. There are also different methods to analyze defocus curves, including the direct comparison method, range-of-focus analysis, and area under the curve analysis, which can impact result interpretation. A good understanding of these factors and standardization of the methodology are important to ensure optimal cross-study comparisons.
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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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Ison M, Scott J, Apel J, Apel A. Patient Expectation, Satisfaction and Clinical Outcomes with a New Multifocal Intraocular Lens. Clin Ophthalmol 2021; 15:4131-4140. [PMID: 34675480 PMCID: PMC8520966 DOI: 10.2147/opth.s327424] [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: 07/10/2021] [Accepted: 09/14/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To report patient expectations, visual performance and satisfaction with AcrySof IQ PanOptix multifocal intraocular lens in a heterogeneous patient group. Additionally, determine if identifiable pre-operative characteristics can predict post-operative satisfaction. Methods Data were prospectively collected for 67 consecutive patients (134 eyes) who underwent bilateral Panoptix implantation in a private ophthalmology clinic. A pre-operative questionnaire was completed regarding vision satisfaction, visual phenomena and expectations. Routine clinical parameters were collected 1 month and follow-up questionnaire administered 3 months post-operatively. Results Post-operative unaided distance vision was 20/20 (0.01 ± 0.10) and binocular near vision 20/25-2 (N5; 0.14 ± 0.06). Patients satisfied with vision increased from 6% (n=4) unaided and 48% (n=32) aided pre-operatively to 94% (n=63) unaided post-operatively (p<0.001). There was marked increase in frequency of halo from 14% (n=9) to 69% (n=46; p<0.001) but no corresponding increase in how bothersome this symptom was (p=0.193) nor the frequency of other visual phenomena. Worse post-operative vision and fluctuating vision were associated with lower post-operative satisfaction. There was no difference in satisfaction or residual astigmatism in those implanted with toric lenses. A total of 96% (n=64) of patients were spectacle-free at 3-months and would recommend this procedure to others. Conclusion This study supports the trend towards increased patient expectations of multifocal intraocular lenses, matched by excellent visual outcomes and satisfaction. Visual phenomena may be less troubling with new multifocal lenses than previously reported. A pre-operative questionnaire may be a useful education tool but could not isolate pre-operative characteristics that predict post-operative satisfaction.
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Affiliation(s)
- Matthew Ison
- Princess Alexandra Hospital, Woolloongabba, QLD, 4102, Australia.,University of Queensland, St Lucia, QLD, 4072, Australia
| | - Jane Scott
- The Eye Health Centre, Brisbane, QLD, 4000, Australia
| | - John Apel
- The Eye Health Centre, Brisbane, QLD, 4000, Australia
| | - Andrew Apel
- Princess Alexandra Hospital, Woolloongabba, QLD, 4102, Australia.,The Eye Health Centre, Brisbane, QLD, 4000, Australia
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Preliminary Evaluation of the Clinical Benefit of a Novel Visual Rehabilitation Program in Patients Implanted with Trifocal Diffractive Intraocular Lenses: A Blinded Randomized Placebo-Controlled Clinical Trial. Brain Sci 2021; 11:brainsci11091181. [PMID: 34573202 PMCID: PMC8464827 DOI: 10.3390/brainsci11091181] [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: 07/23/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 11/30/2022] Open
Abstract
The authors of this study evaluated the potential benefit on visual performance of a novel 3 week visual rehabilitation program based on the use of Gabor patches in patients undergoing bilateral cataract surgery with the implantation of two models of trifocal diffractive intraocular lens (IOL). A total of 30 patients were randomly assigned to two groups: a study group (15 patients) that used a videogame based on Gabor patches and a placebo group (15 patients) that used a videogame without specific stimuli for improving visual performance. No statistically significant differences between groups were found in distance, intermediate, and near post-training visual acuity (p ≥ 0.15). Significantly better distance contrast sensitivity (CS) was found for the spatial frequencies of 6 (p = 0.02) and 12 cpd (p = 0.01) in the study group. Likewise, significantly better values of near CS were found in the study group compared to the placebo group for the spatial frequency of 1.5 cpd (p = 0.02). In conclusion, a 3 week visual rehabilitation program based on the use of Gabor patches in the immediate postoperative period after the bilateral implantation of trifocal diffractive IOLs seems to be beneficial for improving both distance and near visual performance achieved with the implant.
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Hiraoka T, Kiuchi G, Hiraoka R, Kotsuka J, Kinoshita Y, Oshika T. Comparison of visual performance between extended depth of focus contact lens and single-vision contact lens in eyes with monofocal intraocular lens. Jpn J Ophthalmol 2021; 65:803-809. [PMID: 34350536 DOI: 10.1007/s10384-021-00862-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/28/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE To assess the visual performance of extended depth of focus (EDF) contact lenses (CL) in eyes that had undergone monofocal intraocular lens (IOL) implantation, and compare that between EDF and single-vision (SV) contact lenses. STUDY DESIGN Prospective, randomized, crossover study METHODS: Seventeen patients implanted with monofocal IOLs were enrolled. The study was conducted using 1dayPure EDOF as a test CL and 1dayPure moisture (both SEED Co., Ltd.) as a control CL. Binocular visual acuity from far to near distances, photopic and mesopic contrast sensitivity (with and without glare), and stereopsis were evaluated after wearing the two kinds of CLs in random order. The obtained results were compared between the EDF and SV CLs. RESULTS Binocular visual acuity at 0.3, 0.4, 0.7, 1, and 5 m was 0.24 ± 0.12, 0.07 ± 0.09, - 0.02 ± 0.08, - 0.02 ± 0.08, and - 0.06 ± 0.07 logMAR during the EDF CL wear, respectively, and 0.39 ± 0.17, 0.26 ± 0.15, 0.04 ± 0.12, - 0.02 ± 0.08, and - 0.09 ± 0.09 during the SV CL wear, respectively. The EDF CL showed better results than the SV CL at 0.3, 0.4, and 0.7 m (p < 0.05). There were no significant differences in contrast sensitivity between the EDF and SV CLs at 1.5 cycles per degree under all conditions; however, the sensitivity of the EDF CL was generally worse than that of the SV CL from the middle to high spatial frequencies. Stereopsis at 40 cm was significantly better in the EDF CL wear than in the SV CL wear (p < 0.05). CONCLUSIONS The EDF CL substantially improved visual acuity at near to intermediate distances in IOL-implanted eyes. However, far visual acuity decreased under low-contrast conditions, and contrast sensitivity slightly declined at the middle to high spatial frequencies.
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Affiliation(s)
- Takahiro Hiraoka
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Gaku Kiuchi
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Reia Hiraoka
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Junko Kotsuka
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yumiko Kinoshita
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tetsuro Oshika
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
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Blehm C, Potvin R. Reported Patient Satisfaction and Spectacle Independence Following Bilateral Implantation of the PanOptix ® Trifocal Intraocular Lens. Clin Ophthalmol 2021; 15:2907-2912. [PMID: 34262250 PMCID: PMC8274231 DOI: 10.2147/opth.s323337] [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: 06/04/2021] [Accepted: 06/28/2021] [Indexed: 12/28/2022] Open
Abstract
Purpose To assess the spectacle independence and satisfaction of subjects after bilateral implantation of the PanOptix® trifocal intraocular lens (IOL) at the time of cataract surgery. Design Single site, prospective, single-arm study. Methods Eligible subjects interested in a trifocal IOL to potentially reduce dependence on spectacles for near, intermediate and distance vision were enrolled and followed for 3 months after the second eye surgery. Visual acuity and refractive data were collected 1 month and 3 months postoperative, including the uncorrected and best distance-corrected binocular visual acuities at distance (4m), intermediate (60 cm) and near (40cm). A patient satisfaction and spectacle independence questionnaire were administered at the 3-month visit. Results A total of 30 subjects successfully completed the study. Eighty-five percent of eyes (51/60) had a refraction within 0.50 D of plano with ≤ 0.50 D of refractive cylinder. One subject (3%) reported needing glasses for distance work, 3 (10%) for intermediate work and 4 (13%) for near work. Ninety percent or more of all subjects reported never wearing glasses or wearing them only a little at all working distances. Ninety percent or more were able to function without glasses at all 3 working distances all or most of the time. More than ninety percent of subjects reported being “com.pletely” or “mostly” satisfied with their vision without glasses or contact lenses at all three distances and overall. Conclusion A high percentage of patients are likely to achieve spectacle independence for distance, intermediate and near vision with this trifocal IOL.
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Shatz AC, Potvin R. Spectacle Independence and Quality of Vision After Bilateral Implantation of a Trifocal Intraocular Lens. Clin Ophthalmol 2021; 15:2545-2551. [PMID: 34168428 PMCID: PMC8216748 DOI: 10.2147/opth.s318203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/08/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose To evaluate the patient-reported spectacle independence and quality of vision for patients who were bilaterally implanted with a trifocal intraocular lens (IOL). Design Single site, prospective, single-arm study. Methods Subjects presenting for cataract surgery who had an interest in reducing their dependence on glasses at multiple distances were enrolled. Subjects were bilaterally implanted with a trifocal IOL and followed for 3 months post-surgery. A spectacle independence questionnaire and a quality of vision questionnaire were administered at the 3-month visit. The binocular visual acuity at distance (4 m), intermediate (60 cm) and near (40 cm) was also measured in the uncorrected and distance-corrected state. Results All but one subject reported no need for glasses for distance and intermediate work, and most (25/29) reported no need for glasses for near work. Almost all subjects reported never wearing glasses or wearing them only a little, and being able to function without glasses at any distance all or most of the time. Ninety percent of subjects (26/29) reported being completely or mostly satisfied with their vision overall, without the use of glasses or contact lenses. The mean binocular visual acuity 1 and 3 months after surgery was better than 0.1 logMAR (20/25) at all test distances in both the uncorrected and distance-corrected states. The reported quality of vision appeared similar to previously reported data for the same IOL. Conclusion The trifocal IOL provided nearly all subjects with functional vision and spectacle independence for distance, intermediate and near work. It is a viable alternative for patients looking to reduce their overall dependence on spectacles after cataract surgery.
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Re: Modi et al.: Visual and patient-reported outcomes of a diffractive trifocal intraocular lens compared with those of a monofocal intraocular lens (Ophthalmology. 2021;128:197-207). Ophthalmology 2021; 128:e38. [PMID: 33849730 DOI: 10.1016/j.ophtha.2021.03.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 03/18/2021] [Indexed: 11/21/2022] Open
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Modi S. Reply. Ophthalmology 2021; 128:e38. [PMID: 33849731 DOI: 10.1016/j.ophtha.2021.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 11/29/2022] Open
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Ramamurthy D, Vasavada A, Padmanabhan P, Reddy JC, Shetty N, Dey A, Sudhir RR. Clinical Outcomes After Bilateral Implantation of a Trifocal Presbyopia-Correcting Intraocular Lens in an Indian Population. Clin Ophthalmol 2021; 15:213-225. [PMID: 33519183 PMCID: PMC7837564 DOI: 10.2147/opth.s279001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/15/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the effectiveness and safety of a presbyopia-correcting trifocal intraocular lens (IOL), AcrySof® IQ PanOptix® (TFNT00), in an Indian population. Patients and Methods This prospective, multicenter, observational, single-arm, post-marketing study included 67 patients undergoing cataract surgery with bilateral implantation of TFNT00 across five Indian sites. Postoperative outcomes were assessed at 3 months after second eye surgery. Effectiveness outcomes included: mean binocular and monocular visual acuity (VA) at distance (4 m), intermediate (60 cm), and near (40 cm); binocular defocus curve; manifest refraction; and subjective symptom questionnaire evaluation. Safety outcomes included the rate of ocular adverse events and mesopic contrast sensitivity. Results Mean binocular and monocular distance-corrected and uncorrected VAs of 0.1 logMAR or better (approximately 20/25 Snellen) were achieved at distance, intermediate, and near. Overall, ≥70% of patients achieved binocular 0.1 logMAR vision or better across all distances. TFNT00 maintained a mean VA of 0.1 logMAR or better at the defocus range of +0.5 diopters (D) to –2.5 D (200 cm to 40 cm). The subjective symptom questionnaire-assessed frequency of halo visual disturbances was low at Month 3; halos were reported “none of the time” to “only some of the time” in 86.6% of patients. The large majority of patients (98.5%) were “satisfied” or “very satisfied” with their near, intermediate, and distance vision at Month 3, and ≥94.0% of patients reported spectacle independence for tasks at all distances. The adverse event rate was low; no patients discontinued due to an adverse event. Conclusion TFNT00 provided a continuous range of vision of 20/25 or better for distance to near and performed effectively at an intermediate functional distance of 60 cm, resulting in high levels of spectacle independence and patient satisfaction. TFNT00 demonstrated a good safety profile and a low post-operative frequency of halo visual disturbances.
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Affiliation(s)
| | | | | | | | - Naren Shetty
- Narayana Nethralaya Eye Hospital, Rajajinagar, Bangalore, India
| | - Arindam Dey
- Alcon Laboratories (India) Private Ltd, Bangalore, India
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Thompson VM. Refractive Cataract Surgery: Premium Lens and Refractive Surgery Technology Thriving After COVID-19. Ophthalmology 2021. [DOI: 10.17925/opht.2021.15.1.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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