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Yang S, Park J, Whang WJ, Byun YS, Kim HS, Chung SH. Accuracy of Toric Intraocular Lens Calculators with Predicted and Measured Posterior Corneal Astigmatism Across Different Types of Astigmatism. Ophthalmol Ther 2024; 13:1877-1889. [PMID: 38581606 PMCID: PMC11178704 DOI: 10.1007/s40123-024-00931-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/07/2024] [Indexed: 04/08/2024] Open
Abstract
INTRODUCTION This study is a retrospective case series to compare the accuracy of the Barrett toric calculator using predicted posterior corneal astigmatism (PCA) and PCA measurements using swept-source optical coherence tomography (SS-OCT) and a Scheimpflug camera. This evaluation was conducted across different types of anterior and posterior astigmatism. METHODS A total of 146 eyes from 146 patients implanted with toric intraocular lenses were included. Mean absolute prediction error, standard deviation of prediction error, and the percentage of eyes with prediction errors within ±0.50 diopters (D) were calculated using vector analysis. Biometric measurements were conducted using the IOLMaster 700 and Pentacam HR. A subgroup analysis was conducted based on the orientation of both anterior and posterior corneal astigmatism. RESULTS The Barrett toric calculator with predicted PCA yielded the best results, with 78.1% having a prediction error ≤ 0.50 D, which was a significantly higher percentage than the Barrett formula with the two versions of measured PCA (P < 0.05). In the subgroup with a horizontally steep meridian PCA using the IOLMaster 700, the Barrett formula with predicted PCA yielded the best results, with 78.3% of cases having a prediction error of less than 0.5 D. This percentage was significantly higher than the other two measured PCA subgroups (P < 0.05). CONCLUSION The Barrett toric formula with predicted PCA demonstrated a statistically significantly higher proportion of cases with a prediction error ≤ 0.5 D compared to the two measured PCA formulas (from the IOLMaster 700 or Pentacam). This trend persisted even when the posterior corneal astigmatism was horizontally steep.
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Affiliation(s)
- Soonwon Yang
- Department of Ophthalmology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jaehyun Park
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Woong Joo Whang
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yong-Soo Byun
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Hyun Seung Kim
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - So-Hyang Chung
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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Wang L, Shao X, Fu JL, Hu JJ, Zhou KJ, Li R, Yu AY. Repeatability and Agreement of 4 Biometers Measuring Corneal Astigmatism in Eyes With Irregular Corneal Astigmatism Component. Am J Ophthalmol 2024; 265:200-212. [PMID: 38719132 DOI: 10.1016/j.ajo.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 05/01/2024] [Accepted: 05/01/2024] [Indexed: 06/04/2024]
Abstract
PURPOSE To investigate the repeatability and agreement of corneal astigmatism measurements in eyes with irregular corneal astigmatism component (ICAC) using four devices: IOLMaster 700 biometer, Lenstar 900 biometer, iTrace, and Pentacam. DESIGN Prospective cross-sectional reliability analysis. METHODS Sixty-four eyes (52 patients) with ICAC were examined three times using the four devices. The eye with ICAC in this study is defined as the cornea has a certain degree of irregular astigmatism (asymmetric and/or skewed bowtie pattern of corneal topography according to corneal topography classification), accompanied with total corneal higher-order aberrations in the 4 mm zone of 0.3 µm or greater. Corneal astigmatism was evaluated using three categories: anterior corneal astigmatism (ACA), posterior corneal astigmatism, and total corneal astigmatism (TCA). The repeatability was determined using the ∆Ast (arithmetic mean of vector differences among three repeated corneal astigmatism measurements). Bland-Altman plots and astigmatism vector analyses were employed to assess agreement. RESULTS The IOLMaster 700 (∆Ast = 0.27 ± 0.20 D) showcased higher repeatability in ACA measurements compared to iTrace (∆Ast = 0.37 ± 0.38 D, P = .040) and Pentacam (∆Ast = 0.50 ± 0.22 D, P < .001), and paralleled the performance of Lenstar 900 (∆Ast = 0.31 ± 0.26 D, P = .338). The Pentacam (∆Ast = 0.09 ± 0.07 D, P < .001) demonstrated superior repeatability in posterior corneal astigmatism, whereas the IOLMaster 700 (∆Ast = 0.33 ± 0.23 D, P < .001) excelled in TCA. The IOLMaster 700 exhibited good agreement with either Lenstar 900 or iTrace, characterized by narrow 95% limits of agreement and clinically acceptable vector differences. Conversely, vector differences between Pentacam and the other three devices in ACA and TCA measurements were clinically significant, exceeding 0.50 D (all P < .05). CONCLUSIONS In terms of repeatability of corneal astigmatism measurements in eyes with ICAC, the IOLMaster 700 and Lenstar 900 outperformed iTrace and Pentacam. While the IOLMaster 700 can be used interchangeably with either Lenstar 900 or iTrace, the Pentacam is not interchangeable with the other three devices.
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Affiliation(s)
- Lan Wang
- From the National Clinical Research Center for Ocular Diseases, Eye Hospital (L.W., X.S., J.L.F., J.J.H., K.J.Z., R.L., A.Y.Y.), Wenzhou Medical University, Wenzhou, China
| | - Xu Shao
- From the National Clinical Research Center for Ocular Diseases, Eye Hospital (L.W., X.S., J.L.F., J.J.H., K.J.Z., R.L., A.Y.Y.), Wenzhou Medical University, Wenzhou, China
| | - Jin-Ling Fu
- From the National Clinical Research Center for Ocular Diseases, Eye Hospital (L.W., X.S., J.L.F., J.J.H., K.J.Z., R.L., A.Y.Y.), Wenzhou Medical University, Wenzhou, China
| | - Jing-Jing Hu
- From the National Clinical Research Center for Ocular Diseases, Eye Hospital (L.W., X.S., J.L.F., J.J.H., K.J.Z., R.L., A.Y.Y.), Wenzhou Medical University, Wenzhou, China
| | - Kai-Jing Zhou
- From the National Clinical Research Center for Ocular Diseases, Eye Hospital (L.W., X.S., J.L.F., J.J.H., K.J.Z., R.L., A.Y.Y.), Wenzhou Medical University, Wenzhou, China
| | - Ran Li
- From the National Clinical Research Center for Ocular Diseases, Eye Hospital (L.W., X.S., J.L.F., J.J.H., K.J.Z., R.L., A.Y.Y.), Wenzhou Medical University, Wenzhou, China
| | - A-Yong Yu
- From the National Clinical Research Center for Ocular Diseases, Eye Hospital (L.W., X.S., J.L.F., J.J.H., K.J.Z., R.L., A.Y.Y.), Wenzhou Medical University, Wenzhou, China; National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital (A.Y.Y.), Wenzhou Medical University, Wenzhou, China.
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Matsumoto Y, Azuma Y, Karasawa Y, Suzuki N. Implantation of Hydrophobic Acrylic Toric Intraocular Lens with High-Water Contents Using Swept-Source Optical Coherence Tomography Biometer Integrated with a Surgical Guiding System. Clin Ophthalmol 2024; 18:1117-1124. [PMID: 38686014 PMCID: PMC11057511 DOI: 10.2147/opth.s456609] [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: 12/27/2023] [Accepted: 04/17/2024] [Indexed: 05/02/2024] Open
Abstract
Purpose To evaluate postoperative outcomes after implantation of toric intraocular lenses (IOLs) made of high-water-content hydrophobic acrylic material in Japanese patients using a swept-source optical coherence tomography (SS-OCT) biometer integrated with a surgical guiding system. Patients and Methods In this prospective observational study, toric IOL models CNW0T3 to CNW0T9 (Alcon) were implanted in 33 eyes of 33 patients and followed-up for one month. Powers and toric models were determined using an SS-OCT biometer ARGOS® Ver 1.5 (Alcon), and the IOLs were aligned using surgical guidance. Differences between planned and actual axis positions at the end of the surgery (misalignment) and rotations from the end of surgery to one month postoperatively were measured. Additionally, postoperative uncorrected visual acuity, refraction, and residual astigmatism were evaluated. Results Mean and median misalignments were 2.3° (standard deviation [SD]: 1.6, 95% confidence interval [CI]: 1.7-2.9) and 2°, and those of postoperative rotation were 2.4° (SD: 2.6, 95% CI: 1.5-3.4) and 2°, respectively. Mean postoperative refraction was 0.06 D (SD: 0.62). Prediction errors within ±0.5 and ±1.0 D were 69.7% and 93.9%, respectively. Mean residual astigmatisms were 0.19 D (SD: 0.41), and mean uncorrected visual acuity was 0.00 logMAR (SD: 0.11), and 64% of the eyes scored 20/20 or better. Conclusion Implantation of high-water-content hydrophobic acrylic toric IOLs using SS-OCT biometry integrated with a surgical guiding system effectively corrected corneal astigmatism with accurate IOL alignment in Japanese patients.
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Affiliation(s)
- Yukihiro Matsumoto
- Eye Care Clinic, Saitama, Japan
- Eye Care Clinic Tokyo, Tokyo, Japan
- Eye Care Clinic Fukushima, Fukushima, Japan
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Bian L, Ma B, Sun Z, Li W, Liu Y, Qin R, Chen J, Ma Y, Zhao L, Qi H. Prevalence data for total corneal astigmatism in cataract patients. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06488-9. [PMID: 38613688 DOI: 10.1007/s00417-024-06488-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 03/05/2024] [Accepted: 04/09/2024] [Indexed: 04/15/2024] Open
Abstract
PURPOSE To report the prevalence data for total corneal astigmatism (TCA) in cataract patients. METHODS The authors retrospectively collected and analyzed the preoperative biometric data of the patients who underwent cataract surgery in the Department of Ophthalmology, Peking University Third Hospital, from January 2019 to May 2023. RESULTS The mean age of the 10817 patients was 71 ± 10 years; the male/female ratio was 4653/6164. The mean TCA obtained by the IOLMaster 700 (Carl Zeiss Meditec AG, Jena, Germany), the Abulafia-Koch (AK) formula, and the Barrett toric calculator was 1.11 ± 0.81 diopter (D), 1.13 ± 0.75 D, and 1.12 ± 0.74 D respectively, which was significantly greater than the mean standard keratometric (K) astigmatism (0.99 ± 0.75 D) obtained by IOLMaster 700. Against-the-rule (ATR) astigmatism was dominant in all the TCA measurements, and its proportion increased with age. TCA measurements by different methods exhibit high variability, with a total of 1574 (8.9%) data sets from 1016 (9.4%) patients showing a difference larger than 0.5 D in at least one pair of TCA measurements. CONCLUSION The use of TCA rather than K astigmatism significantly influenced the choice of intraocular lenses (IOLs) as more patients would be candidates for toric IOLs. It was essential to carefully compare and select TCA obtained with multiple methods for optimal postoperative visual quality.
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Affiliation(s)
- Linbo Bian
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, 100191, China
| | - Baikai Ma
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, 100191, China
| | - Zhengze Sun
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, 100191, China
| | - Wenlong Li
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, 100191, China
| | - Yiyun Liu
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, 100191, China
| | - Rui Qin
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, 100191, China
| | - Jiawei Chen
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, 100191, China
| | - Yunke Ma
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, 100191, China
| | - Lu Zhao
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, 100191, China
| | - Hong Qi
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, 100191, China.
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Pérez-Sanz L, Vega F, Azor-Morón JA, Cuellar F, Millán MS, Garzón N. Tolerance to residual astigmatism of an isofocal intraocular lens. Graefes Arch Clin Exp Ophthalmol 2024; 262:1169-1180. [PMID: 37950754 DOI: 10.1007/s00417-023-06305-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/12/2023] [Accepted: 10/23/2023] [Indexed: 11/13/2023] Open
Abstract
PURPOSE To evaluate the impact of residual astigmatism on the optical and visual performance of an enhanced-monofocal isofocal intraocular lens (EM Isopure, BVI medical, Belgium) compared to a monofocal one (Micropure, BVI medical, Belgium). METHODS Laboratory investigation and prospective, comparative and randomized clinical study. Optical quality was assessed on an optical bench for 2.0, 3.0, and 4.5 mm pupils. The effect of residual astigmatism was investigated from through-focus images recorded with increasing amounts of regular positive astigmatism induced with a deformable mirror. To evaluate the impact of residual astigmatism, 28 eyes of 28 patients were randomly assigned to either group. Residual astigmatism was induced with positive and negative cylinder lenses at 90 and 180°. Visual acuity (VA) was measured at each step. RESULTS The optical performance of both IOLs was quite similar for 2.0 and 3.0 mm pupils. For 4.5-mm pupil, the EM Isopure showed a significant reduction of its optical quality in comparison with the monofocal IOL. When visual performance was evaluated, no statistically significant differences were found for any power of induced astigmatism. More differences were found when positive induced astigmatism was compared within each group, and VA was better when the astigmatism was induced at 180° vs. 90°. The greatest differences were found for and induced positive astigmatism of + 1.50D (p = 0.009 for Isopure and p = 0.023 for Micropure). CONCLUSIONS The tolerance to residual astigmatism of the EM Isopure lens is similar to that of a reference monofocal lens with pupils up to 3.5 mm.
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Affiliation(s)
- Lidia Pérez-Sanz
- Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, Avda. Arcos de Jalón 118, 28037, Madrid, Spain.
- Miranza IOA. C/Galileo 104, 28003, Madrid, Spain.
| | - Fidel Vega
- Grupo de Óptica Aplicada y Procesado de Imagen (GOAPI), Department of Optics and Optometry, Universitat Politècnica de Catalunya BarcelonaTech, Violinista Vellsolà 37, 08222, Terrassa, Spain
| | - Juan A Azor-Morón
- Grupo de Óptica Aplicada y Procesado de Imagen (GOAPI), Department of Optics and Optometry, Universitat Politècnica de Catalunya BarcelonaTech, Violinista Vellsolà 37, 08222, Terrassa, Spain
| | - Fátima Cuellar
- Grupo de Óptica Aplicada y Procesado de Imagen (GOAPI), Department of Optics and Optometry, Universitat Politècnica de Catalunya BarcelonaTech, Violinista Vellsolà 37, 08222, Terrassa, Spain
| | - María S Millán
- Grupo de Óptica Aplicada y Procesado de Imagen (GOAPI), Department of Optics and Optometry, Universitat Politècnica de Catalunya BarcelonaTech, Violinista Vellsolà 37, 08222, Terrassa, Spain
| | - Nuria Garzón
- Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, Avda. Arcos de Jalón 118, 28037, Madrid, Spain
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He N, Zhang X, Xie P, He J, Lv Z. Inhibition of posterior capsule opacification by adenovirus-mediated delivery of short hairpin RNAs targeting TERT in a rabbit model. Curr Eye Res 2023:1-9. [PMID: 36946600 DOI: 10.1080/02713683.2023.2194587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
PURPOSE Posterior capsule opacification (PCO) is the most common postoperative complication after cataract surgery and cannot yet be eliminated. Here, we investigated the inhibitory effects of telomerase reverse transcriptase (TERT) gene silencing on PCO in a rabbit model. METHODS After rabbit lens epithelial cells (LECs) were treated with adenovirus containing short hairpin RNAs (shRNA) targeting TERT (shTERT group), adenovirus containing scramble nonsense control shRNA (shNC group) or PBS (control group), quantitative real-time polymerase chain reaction and Western blotting were used to measure the expression levels of TERT, and a scratch assay was performed to assess the LEC migration. New Zealand white rabbits underwent sham cataract surgery followed by an injection of adenovirus carrying shTERT into their capsule bag. The intraocular pressure and anterior segment inflammation were evaluated on certain days, and EMT markers (α-SMA and E-cadherin) were evaluated by Western blotting and immunofluorescence. The telomerase activity of the capsule bag was detected by ELISA. At 28 days postoperatively, haematoxylin and eosin staining of the cornea and iris and electron microscopy of the posterior capsule were performed. RESULTS Application of shTERT to LECs downregulated the expression levels of TERT mRNA and protein. The scratch assay results showed a decrease in the migration of LECs in the shTERT group. In vivo, shTERT decreased PCO formation after cataract surgery in rabbits and downregulated the expression of EMT markers, as determined by Western blotting and immunofluorescence. In addition, telomerase activity was suppressed in the capsule bag. Despite slight inflammation in the iris, histologic results revealed no toxic effects in the cornea and iris. CONCLUSION TERT silencing effectively reduces the migration and proliferation of LECs and the formation of PCO. Our findings suggest that TERT silencing may be a potential preventive strategy for PCO.
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Affiliation(s)
- Na He
- Department of Ophthalmology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, China
| | - Xiangxiang Zhang
- Department of Ophthalmology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, China
| | - Peiling Xie
- Department of Ophthalmology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, China
| | - Jialing He
- Department of Ophthalmology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, China
| | - Zhigang Lv
- Department of Ophthalmology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, China
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Ma D, Yu W, Cai L, Shen J, Guo T, Chen X, Dong J, Zeng Q, Wang A, Hua Z, Zhu X, Zheng T, Lu Y, Yang J. Optimal Timing of Repositioning Surgery for a Plate-Haptic Toric Intraocular Lens: A Multicenter Retrospective Study. J Refract Surg 2023; 39:120-126. [PMID: 36779462 DOI: 10.3928/1081597x-20221221-02] [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: 02/14/2023]
Abstract
PURPOSE To evaluate risk factors for significant rotation and determine optimal timing for repositioning surgery following a plate-haptic toric intraocular lens (IOL) implantation. METHODS This retrospective study enrolled patients who underwent the plate-haptic toric IOL implantation at seven hospitals in Shanghai. IOL rotation and residual astigmatism were compared before and after repositioning surgery. Risk factors for significant IOL rotation after cataract surgery were identified by stepwise multiple linear regression analysis. Spearman's and linear regression analyses were performed to identify factors associated with IOL rotation after repositioning. The receiver operator characteristic (ROC) curve was used to analyze the optimal timing for repositioning surgery. RESULTS Among 2,745 eyes implanted with the toric IOL, 46 eyes (1.68%) of 45 patients underwent repositioning surgery. Axial length and lens thickness were significantly associated with IOL rotation before repositioning. After repositioning surgery, IOL rotation and residual astigmatism were significantly reduced (all P < .001). IOL rotation after repositioning was negatively associated with the timing of repositioning surgery (all P < .001). The ROC curve showed that the optimal cut-off for the timing of repositioning surgery was 15 days or greater. CONCLUSIONS The prevalence of repositioning surgery after the plate-haptic toric IOL implantation was 1.68%, and the optimal timing for repositioning surgery was recommended to be 2 to 3 weeks after cataract surgery. [J Refract Surg. 2023;39(2):120-126.].
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Chang DH, Hu J, Miller KM, Vilupuru S, Zhao W. Post-Market Evaluation of Rotational Stability and Visual Performance of a New Toric Intraocular Lens with Frosted Haptics. Clin Ophthalmol 2022; 16:4055-4064. [PMID: 36532824 PMCID: PMC9753564 DOI: 10.2147/opth.s389304] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/22/2022] [Indexed: 01/24/2024] Open
Abstract
PURPOSE To evaluate 3-month rotational stability, and visual and refractive outcomes of a toric intraocular lens (IOL) with frosted haptics. PATIENTS AND METHODS A post-market, prospective, multi-center, single-arm, open-label study conducted at seven clinical sites in the United States. Two hundred and two eyes of 133 subjects with unilateral or bilateral cataracts and corneal astigmatism were implanted with the Tecnis Toric II IOL, Models ZCU150 to 600 (Johnson & Johnson Surgical Vision, Inc.). Lens axis misalignment/rotation, visual acuity, manifest refraction, and surgeon and patient satisfaction were evaluated 3 months postoperatively. Lens rotation was determined with operative and postoperative visit photographs and was analyzed by two independent masked analysts. RESULTS Mean absolute lens rotation was 0.82° ± 1.00° and 0.94° ± 0.71° at 1 day (n = 189 eyes) and 3 months (n = 185 eyes), respectively. Absolute lens rotation was ≤5° in 98.9% and 100% of eyes at 1 day and 3 months, respectively. At 3 months, postoperative monocular uncorrected and corrected distance visual acuities were 0.004 ± 0.115 LogMAR (20/20) and -0.066 ± 0.092 LogMAR (20/17), mean spherical equivalent was -0.25 D ± 0.35 D and residual refractive cylinder was +0.27 D ± 0.33 D. Surgeons were satisfied/very satisfied with overall clinical outcomes and rotational stability in 99% of eyes, and with uncorrected distance vision in 98.5% of eyes. CONCLUSION The study results demonstrate that the Tecnis Toric II IOL has excellent rotational stability with a high percentage of study eyes being within 5° of intended orientation. The study lens demonstrated excellent uncorrected distance visual acuity, reduction of cylinder, and exceptional patient and surgeon satisfaction.
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Affiliation(s)
| | - Jerry Hu
- Texas Eye & Laser Center, Hurst, TX, USA
| | - Kevin M Miller
- Department of Ophthalmology, David Geffen School of Medicine at the University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | | | - Wuchen Zhao
- Johnson & Johnson Surgical Vision, Inc., Irvine, CA, USA
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Osawa R, Sano M, Yuguchi T, Kaiya T, Oshika T. Effects of Modified Haptics on Surgical Outcomes and Rotational Stability of Toric Intraocular Lens Implantation. J Refract Surg 2022; 38:648-653. [PMID: 36214346 DOI: 10.3928/1081597x-20220715-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
PURPOSE To assess the rotational stability of a new toric intraocular lens (IOL), TECNIS toric II (toric II), which is a modified version of the TECNIS toric IOL (toric I) with frosted haptics (Johnson & Johnson). METHODS A total of 101 eyes of 101 patients who had been treated with phacoemulsification and toric IOL implantation were included. Before and 1 day, 1 week, and 1 month after surgery, uncorrected (UDVA) and corrected (CDVA) distance visual acuity were measured. Preoperative corneal astigmatism and postoperative manifest refractive astigmatism at 1 day and 1 month were analyzed. At 1 day and 1 month postoperatively, the amount of IOL axis misalignment from the intended orientation, tilt, and decentration were measured using anterior segment optical coherence tomography. RESULTS Fifty-one eyes received the toric I IOL and 50 eyes received the toric II IOL. Toric I IOLs showed a significantly larger amount of axis misalignment than toric II IOLs at both 1 day (9.6 ± 7.6° vs 5.4 ± 4.8°, P = .003) and 1 month (9.1 ± 7.8° vs. 4.7 ± 4.2°, P = .003) postoperatively.The proportion of eyes with misalignment greater than 10° was significantly larger with toric I than toric II IOLs (P < .001). There were no significant differences between IOLs in the amount of residual astigmatism, UDVA, CDVA, and amount of tilt and decentration at 1 day and 1 month postoperatively. CONCLUSIONS The TECNIS toric II IOL with frosted haptics has significantly improved rotational stability compared to its previous model. [J Refract Surg. 2022;38(10):648-653.].
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Hasegawa Y, Honbo M, Miyata K, Oshika T. Type of residual astigmatism and uncorrected visual acuity in pseudophakic eyes. Sci Rep 2022; 12:1225. [PMID: 35075241 PMCID: PMC8786906 DOI: 10.1038/s41598-022-05311-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
It is difficult to assess the pure impact of the type of residual astigmatism (with-the-rule; WTR, against-the-rule; ATR, and oblique astigmatism) on uncorrected distance visual acuity (UDVA) in pseudophakic eyes due to different age distribution of patients between those subgroups. We conducted the current study to investigate the association between astigmatism type and UDVA in eyes after cataract surgery with consideration for various confounding factors such as age. Data were retrospectively collected from 1535 pseudophakic eyes with corrected distance visual acuity (CDVA) of 20/20 or better, and spherical equivalent between − 0.125 D and 0.0 D. They were classified based on the pattern of residual refractive astigmatism into four groups; minimum astigmatism (< 0.5 D), WTR, ATR, and oblique astigmatism groups. The stepwise multivariate regression analysis showed that the magnitude of residual refractive astigmatism (standardized partial regression coefficient β = 0.559, p < 0.001), CDVA (β = 0.381, p < 0.001), minimum astigmatism group (β = − 0.188, p < 0.001), and WTR astigmatism group (β = − 0.058, p < 0.001) were significantly associated with UDVA (r2 = 0.795). Variables excluded from the multivariate regression model include age, preoperative corneal astigmatism, axial length, anterior chamber depth, intraocular lens power, and postoperative spherical equivalent. These results indicate that UDVA is significantly better in eyes with minimum and WTR astigmatism than in those with ATR and oblique astigmatism, after adjustment for confounding parameters. In pseudophakic eyes, oblique and ATR astigmatism exerts a greater impact on UDVA than WTR astigmatism does, even after controlling for age.
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Affiliation(s)
- Yumi Hasegawa
- 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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