1
|
Mendicute J, Lauzirika G, Illarramendi I, Martínez-Soroa I. Visual, Refractive, Functional, and Patient Satisfaction Outcomes After Implantation of a New Trifocal Diffractive Intraocular Lens. Clin Ophthalmol 2024; 18:2785-2795. [PMID: 39386176 PMCID: PMC11463180 DOI: 10.2147/opth.s480311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 09/20/2024] [Indexed: 10/12/2024] Open
Abstract
Purpose To describe the visual, refractive, functional, and patient satisfaction outcomes of the Clareon® PanOptix® trifocal intraocular lens (IOL). Patients and Methods This was a prospective longitudinal descriptive study. Patients who underwent cataract surgery with implantation of Clareon® PanOptix® (Alcon Laboratories, Inc.) were included. Monocular refractive outcomes and visual acuity at distance, intermediate, and near were evaluated 1- and 6-months post-op. Binocular contrast sensitivity (M&S® Technologies), binocular defocus curve, and patient satisfaction with the IOL Satisfaction (IOLSAT) and Questionnaire for Visual Disturbance (QUVID) questionaries were assessed at 6-month post-op. Results Seventy-six Clareon® PanOptix® were implanted bilaterally in 38 patients. The mean age of the patients was 67.63±5.18 years. At 1-month post-op, the monocular Corrected Distance Visual Acuity (CDVA), CIVA and CNVA were 0.00±0.09, 0.02±0.17, and 0.12±0.12 LogMAR, respectively, and CDVA and CNVA were stable at 6-month post-op (p>0.05). No statistical differences were found in post-op spherical equivalent at 1 and 6 months (-0.08±0.27 D and -0.05±0.24 D; p=0.351). A 100% of eyes were within ±0.5 D at 1 month and 6-month post-op. Binocular defocus curve shows three peaks of maximum visual acuity (VA) at 0D (-0.04±0.08 LogMAR), at -1.50D, and -2.50 D (0.01±0.10 LogMAR and 0.03±0.07 LogMAR, respectively). Contrast sensitivity decreased at high spatial frequencies. In patient satisfaction, IOLSAT questionary reveals 78.94% patients "Never" or "Rarely" Needing Glasses and according QUVID questionnaire, 100% of patients report no hazy vision. Conclusion The PanOptix® IOL platform with the new material Clareon® provides good visual outcomes for distance, intermediate, and near vision, with adequate contrast sensitivity and low visual disturbances.
Collapse
Affiliation(s)
- Javier Mendicute
- Miranza Begitek, Donostia - San Sebastián, 20012, Spain
- Donostia University Hospital, Donostia - San Sebastián, 20014, Spain
| | - Gorka Lauzirika
- Miranza Begitek, Donostia - San Sebastián, 20012, Spain
- R&D Department of Miranza Group, Donostia - San Sebastián, Spain
| | | | - Itziar Martínez-Soroa
- Miranza Begitek, Donostia - San Sebastián, 20012, Spain
- Donostia University Hospital, Donostia - San Sebastián, 20014, Spain
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Bouvarel H, Agard E, Billant J, Levron A, Chudzinski R, Plas H, Bernier R, Sejournet L, Chaperon M, Dot C. Long-term real-life outcomes of the Clareon® hydrophobic intraocular lens: the Clarte study in 191 eyes : 3-years real-life outcomes of the Clareon® intraocular lens. BMC Ophthalmol 2024; 24:133. [PMID: 38532367 PMCID: PMC10964544 DOI: 10.1186/s12886-024-03393-x] [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: 12/06/2023] [Accepted: 03/13/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND To describe and analyze the real-life refractive, functional and safety outcomes of the Clareon® intraocular lens (IOL) after 3 years. METHODS Data was collected retrospectively for observational purposes between July 2017 and December 2019 in the ophthalmology department of Desgenettes military hospital in Lyon, France. Eyes that underwent cataract surgery with Claeron® implantation were consecutively included. Patients with a systemic or ocular condition that could affect the visual outcome were excluded. Postoperative corrected (CDVA) and uncorrected (UDVA) distance visual acuities as well as capsule and IOL transparency were assessed at 1 month and 3 years. RESULTS A total of 326 eyes were analyzed at one month and 191 eyes were reassessed at the 3-year follow-up visit. At 3 years, the mean CDVA was 0.003 LogMAR (95% confidence interval [CI]: -0.003 to -0.01) and the mean UDVA was 0.075 (95% CI: 0.054 to 0.095). Three quarters of the patients had an UDVA ≥ 0.097 logMAR (20/25 Snellen equivalent) and 50% had an UDVA ≥ 0 (20/20). The absence of glistening was reported in 95.3% of cases and 4.7% [9] of patients experienced a clinically significant posterior capsular opacification (PCO) for which Nd:YAG treatment was required. CONCLUSIONS This real-life study reports high-performance and stable long-term refractive outcomes of the Clareon® IOL with good safety in terms of PCO and glistening.
Collapse
Affiliation(s)
- Hugo Bouvarel
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France.
| | - Emilie Agard
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
| | - Jérémy Billant
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
| | - Antoine Levron
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
| | - Roman Chudzinski
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
| | - Hélène Plas
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
| | - Raphaël Bernier
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
| | - Lucas Sejournet
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
| | - Mayeul Chaperon
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
| | - Corinne Dot
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
- French Military Medical Academy, Val-de-Grâce, Paris, France
| |
Collapse
|
4
|
Mao Y, Liang X, Zhao J, Jiang L, Liang Q, Ngai T, Gong X, Wu M. 3D monitoring of the microphase separations inside the intraocular lens. Acta Biomater 2024; 177:178-188. [PMID: 38307480 DOI: 10.1016/j.actbio.2024.01.035] [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: 10/23/2023] [Revised: 01/09/2024] [Accepted: 01/23/2024] [Indexed: 02/04/2024]
Abstract
Glistenings often occur after implanting the intraocular lens (IOL) due to the formation of numerous microvacuoles (MVs) and may lead to deterioration of vision quality. Previous studies showed the formation of MVs was associated with the hydrophobicity of IOL materials. Yet, the mechanism remains an open question due to the complexity of IOL polymer networks. In this study, two commercialized IOLs with similar hydrophobicity are found distinct in the formation of MVs. The 3D growth kinetics of MVs during cooling processes are captured for the first time by digital holographic microscopy (DHM) and the components of MVs are measured by DHM and Raman spectroscopy. The results reveal that the growth of MVs stems from the microphase separation of water and surrounding IOL polymers. A polymer swelling model is thus proposed to describe the microphase separation process which is found dependent on the elasticity of IOL polymer networks. The total volume of MVs is determined by the IOL hydrophobicity, while the elastic force of IOL polymer networks determines the number density and size of MVs. This study demonstrates an approach for characterizing the phase separation of crosslinked polymeric materials in biosystems and sheds lights on the refinement of IOL materials. STATEMENT OF SIGNIFICANCE: Glistenings due to the formation of numerous microvacuoles (MVs) in intraocular lens (IOL) can occur after IOL implantation, which may induce poor quality of vision. However, the underlying mechanism of MVs formation is still an open question. This study establishes an in-situ 3D imaging platform to monitor growth kinetics of the MVs in IOLs, which allows to uncover the mechanism of glistenings formation resulting from the microphase separation. The findings imply the material hydrophobicity influences the total volume of MVs, while the local elasticity of IOL polymer networks determines the number density and the size of MVs. This study offers a new approach for characterizing phase separation in crosslinking biosystems and sheds lights on the refinement of IOL materials.
Collapse
Affiliation(s)
- Yan Mao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, PR China
| | - Xiao Liang
- Faculty of Material Science and Engineering, South China University of Technology, Guangzhou 510640, PR China
| | - Junpeng Zhao
- Faculty of Material Science and Engineering, South China University of Technology, Guangzhou 510640, PR China
| | - Lingxiang Jiang
- South China Advanced Institute for Soft Matter Science and Technology (AISMST), School of Emergent Soft Matter, South China University of Technology, Guangzhou 510640, PR China
| | - Qingyou Liang
- Faculty of Material Science and Engineering, South China University of Technology, Guangzhou 510640, PR China; Analytical and Testing Center, South China University of Technology, Guangzhou 510640, PR China
| | - To Ngai
- Department of Chemistry, The Chinese University of Hong Kong, Hong Kong 999077, PR China
| | - Xiangjun Gong
- Faculty of Material Science and Engineering, South China University of Technology, Guangzhou 510640, PR China; Guangdong Provincial Key Laboratory of Luminescence from Molecular Aggregates, South China University of Technology, Guangzhou 510640, PR China.
| | - Mingxing Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, PR China.
| |
Collapse
|
5
|
Fernández-Vigo JI, Serrano González-Peramato MT, Nunila Gómez-de-Liaño C, Sánchez-Guillén I, Fernández-Vigo JÁ, Macarro-Merino A. Glistening on intraocular lenses: A review. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:493-506. [PMID: 37369324 DOI: 10.1016/j.oftale.2023.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023]
Abstract
The glistening in intraocular lenses (IOLs) is a phenomenon in which tiny water-filled microvacuoles (MVs) form within the IOL material, causing light to scatter and create a sparkling or shimmering effect. The presence of glistening is common in many types of IOL materials and models and has been extensively studied in recent years to determine its incidence, risk factors, evolution, and possible clinical relevance. Classically, it has been studied in vitro in the laboratory or by means of photography obtained with a slit lamp, but these were techniques that required either specific technology or an expert explorer, complex image processing, and required a lot of time. In recent years, proposals based on the Scheimpflug camera and optical coherence tomography have emerged to try to simplify the analysis of glistening in IOLs. It has been described that the manufacturing process, the hydrophobic acrylic material, or the time since surgery are risk factors for the appearance of glistening. In addition, many issues related to this phenomenon are still unknown, such as not knowing from what number of points or their size they may have relevance to visual function since different optical phenomena related to glistening have been described on the IOLs.
Collapse
Affiliation(s)
- J I Fernández-Vigo
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain; Centro Internacional de Oftalmología Avanzada, Madrid, Spain.
| | | | - C Nunila Gómez-de-Liaño
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - I Sánchez-Guillén
- Servicio de Oftalmología, Hospital Perpetuo Socorro, Badajoz, Spain; Centro Internacional de Oftalmología Avanzada, Badajoz, Spain
| | - J Á Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain; Centro Internacional de Oftalmología Avanzada, Badajoz, Spain; Departamento de Oftalmología, Facultad de Medicina, Universidad de Extremadura, Badajoz, Spain
| | - A Macarro-Merino
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain; Centro Internacional de Oftalmología Avanzada, Badajoz, Spain
| |
Collapse
|
6
|
Objective Classification of Glistening in Implanted Intraocular Lenses Using Optical Coherence Tomography: Proposal for a New Classification and Grading System. J Clin Med 2023; 12:jcm12062351. [PMID: 36983351 PMCID: PMC10057385 DOI: 10.3390/jcm12062351] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/10/2023] [Accepted: 03/15/2023] [Indexed: 03/22/2023] Open
Abstract
Purpose: To propose a classification of the glistening in intraocular lenses (IOL) using swept-source optical coherence tomography (SS-OCT) by means of a simple, objective and reproducible method that allows the quantification of the presence and severity of glistening. Methods: A cross-sectional study on a sample of 150 eyes of 150 patients who underwent cataract surgery in at least 600 days before the exam and attended a routine examination. Each subject was examined by SS-OCT after pupil dilation, identifying the presence of glistening or hyperreflective foci (HRF) in the central area of the IOL. The degree of glistening was classified into four categories: 0: ≤5 HRF; 1: 6 to 15 HRF; 2: 16 to 30 HRF; and 3: >30 HRF. The intra and interobserver reproducibility (intraclass correlation coefficient, ICC) in the quantification and classification of the glistening were calculated. The correlation between the horizontal and vertical scan of the IOL was also assessed. Results: Glistening was present in the IOL in 42.7% of the patients. The mean number of HRF or glistening microvacuoles was 10.4 ± 26.2 (range 0 to 239). In total, 63.3% of the IOLs had a grade 0, 20% grade a 1, 6.7% grade a 2 and 10% a grade 3. The intraobserver and interobserver reproducibility were very high, both for the absolute quantification of the glistening (ICC ≥ 0.994) and for the severity scale (ICC ≥ 0.967). There was an excellent correlation in the quantification of the IOL glistening between the horizontal and vertical scans (R ≥ 0.834; p < 0.001). Conclusions: The use of SS-OCT makes it possible to identify, quantify and classify IOL glistening in a simple, objective and reproducible way. This technique could provide relevant information for the study of the glistening on IOLs.
Collapse
|
7
|
Lee YW, Choi CY, Moon K, Jeong YJ, An SI, Lee JM, Lee JH, Seong MC. Clinical outcomes of new multifocal intraocular lenses with hydroxyethyl methacrylate and comparative results of contrast sensitivity, objective scatter, and subjective photic phenomena. BMC Ophthalmol 2022; 22:379. [PMID: 36131264 PMCID: PMC9494844 DOI: 10.1186/s12886-022-02600-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 09/08/2022] [Indexed: 11/19/2022] Open
Abstract
Background We investigate the performance of new hydrophobic diffractive multifocal intraocular lenses (IOL) with hydroxyethyl methacrylate (HEMA) and compare their optical quality, contrast sensitivity, and subjective photic phenomena. Methods Medical records of patients who underwent routine simple cataract surgery and insertion of an existing multifocal IOL (TFNT, TF group) or a new multifocal IOL (CNWT, CN group) were retrospectively reviewed. Clinical data was collected 2 months postoperatively and included optical quality analysis system (OQAS) indices, contrast sensitivity, and subjective degrees of photic phenomena. Results One hundred thirty-five eyes of 135 patients were included (CN group, 71; TF group, 64). There was no significant difference between the two groups in the visual acuity and defocus curve. The indices of OQAS did not show a significant difference between groups. Contrast sensitivity was significantly better in the CN group at all degrees, including the area under the log contrast sensitivity function (p = 0.01). The subjective photic phenomena survey showed better results for the CN group, with the proportion of patients reporting no photic phenomena as 9.9% and 3.1% in the CN and TF groups, respectively. The proportion of patients who reported severe photic phenomena was 11.3% in the CN group and 25.0% in the TF group. Although the follow-up period was only 2 months, glistening, surface scattering, and posterior capsule opacity were not observed in any patient. Conclusions The new multifocal IOL with HEMA is safe, and provides stable visual acuity as well as superior contrast sensitivity and lower subjective photic phenomena, over the prior IOL.
Collapse
Affiliation(s)
- Yong Woo Lee
- Department of Ophthalmology, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Republic of Korea.,Hanyang University School of Medicine, Seoul, Republic of Korea.,Seoulbalgeunsesang Eye Clinic, Seoul, Republic of Korea
| | - Chul Young Choi
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kun Moon
- Seoulbalgeunsesang Eye Clinic, Seoul, Republic of Korea
| | | | - Sang Il An
- Seoulbalgeunsesang Eye Clinic, Seoul, Republic of Korea
| | - Je Myung Lee
- Seoulbalgeunsesang Eye Clinic, Seoul, Republic of Korea
| | - Jong Ho Lee
- Seoulbalgeunsesang Eye Clinic, Seoul, Republic of Korea
| | - Min Cheol Seong
- Hanyang University School of Medicine, Seoul, Republic of Korea. .,Department of Ophthalmology, Hanyang University Guri Hospital, 153, Gyeongchun-ro, Guri-si, Gyeonggi-do, 11923, Republic of Korea.
| |
Collapse
|
8
|
Khoramnia R, Yildirim TM, Weindler J, Naujokaitis T, Dzhambazova M, Auffarth GU. Preloaded injectors used in a clinical study: videographic assessment and laboratory analysis of injector nozzle damage. J Cataract Refract Surg 2021; 47:1338-1344. [PMID: 34469394 DOI: 10.1097/j.jcrs.0000000000000587] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/14/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate quality and duration of implantation of 2 preloaded intraocular lens (IOL) injectors and assess postimplantation damage. SETTING The David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany. DESIGN Prospective, randomized, comparative study with laboratory investigation. METHODS Implantation videos and postuse injectors from 60 paired eyes of 30 bilateral cataract patients were included. Patient eyes were randomly assigned for implantation with 2 different preloaded injectors: the AutonoMe with a Clareon IOL (Alcon Laboratories, Inc.) and the iSert with a Vivinex IOL (Hoya Corp.). Videos were reviewed for events during the implantation procedure, and the duration of each step of implantation. Injector nozzles were examined under light and scanning electron microscopy. Damage was graded and correlated with the IOL power. Three months postoperatively IOLs were assessed for material changes. RESULTS IOL delivery was without any critical events in 60 of the 60 eyes. The implantation took 56 seconds with the AutonoMe and 44 seconds with the iSert (P < .05). Most AutonoMe injectors (29; 97%) showed no damage or slight deformation. In most of the iSert injectors (25; 80%), short or extended cracks were present, and damage lengths correlated with the IOL power. All IOLs were free of material changes, including glistenings, 3 months postoperatively. CONCLUSIONS Both preloaded IOL injectors allowed a safe and convenient IOL delivery. Implantation of the Clareon IOL took, on average, slightly longer than that of the Vivinex IOL, mostly due to a slower IOL unfolding. The AutonoMe showed less nozzle tip damage than that of the iSert.
Collapse
Affiliation(s)
- Ramin Khoramnia
- From the The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | | | | | | | | | | |
Collapse
|
9
|
Tandogan T, Auffarth GU, Choi CY, Son HS, Khoramnia R. Comparative analysis of in vitro accelerated glistening formation in foldable hydrophobic intraocular lenses. Int Ophthalmol 2021; 41:3073-3080. [PMID: 34013467 PMCID: PMC8364527 DOI: 10.1007/s10792-021-01870-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 04/15/2021] [Indexed: 01/30/2023]
Abstract
PURPOSE To analyse and compare the propensity to form glistenings in 4 different types of hydrophobic acrylic intraocular lenses (IOLs): Alcon AcrySof ® MA60AC, HOYA iSert® PC-60AD, Bausch&Lomb enVista, and Kowa Avansee™ PU6A. METHODS We used an accelerated laboratory method to create glistenings. IOLs were first immersed in saline at 45 °C for 24 h and then at 37 °C for 2.5 h. Microvacuole (MV) density and size were documented and calculated using an image analysis program. RESULTS Median density of glistenings [MV/mm2] for Alcon AcrySof ® MA60AC was 623 (range 507-804), for HOYA iSert® PC-60AD 1358 (range 684-2699), for Bausch&Lomb enVista 2 (range 1-2), and for Kowa Avansee™ PU6A 1 (range 1-4). The prevailing MV size was: 0-5 µm for Hoya IOLs, 5-10 µm for Alcon IOLs, 20-50 µm for Bausch&Lomb IOLs, and 5-50 µm for Kowa IOLs. CONCLUSIONS Glistenings could be induced in all studied IOLs using the accelerated laboratory method. The Alcon AcrySof ® MA60AC and HOYA iSert® PC-60AD IOLs showed MV of high density, while the glistenings in the Hoya IOLs were smaller in size compared to the Alcon IOLs. The MV density was minimal in the Bausch&Lomb enVista and Kowa Avansee™ PU6A IOLs. The propensity of the Alcon AcrySof ® MA60AC IOLs to form glistenings in vitro correlated with the findings of clinical results that are already published.
Collapse
Affiliation(s)
- Tamer Tandogan
- The David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, INF 400, 69120 Heidelberg, Germany
| | - Gerd U. Auffarth
- The David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, INF 400, 69120 Heidelberg, Germany
| | - Chul Young Choi
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyeck-Soo Son
- The David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, INF 400, 69120 Heidelberg, Germany
| | - Ramin Khoramnia
- The David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, INF 400, 69120 Heidelberg, Germany
| |
Collapse
|
10
|
In vitro glistening formation in IOLs: automated method for assessing the volumetric density and depth distribution of microvacuoles. J Cataract Refract Surg 2021; 46:1178-1183. [PMID: 32511108 DOI: 10.1097/j.jcrs.0000000000000272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To develop a method to measure the depth profile of microvacuoles (MVs) in intraocular lenses (IOLs) and to characterize, after accelerated aging, the glistening of an acrylic hydrophobic IOL. SETTING University of Milano-Bicocca, Milan, Italy. DESIGN In vitro study. METHODS A heat treatment was applied in vitro to Basis V IOLs exposed to deionized water (24 hours at 45 ± 1°C, rapid cooling, and 24 hours at 24 ± 1°C). Thirty images (area 1.2 mm) of each IOL were acquired by a microscope, focusing on sequential planes every 23 ± 2 μm. By tracking the traces of each MV in consecutive images, the coordinates of the MV centroids along the IOL thickness were construed by an automated procedure, and in the generated single-focus stacked image, MVs were counted by an automated method. RESULTS MV density was found normally distributed along the IOL depth profile (Jarque-Bera test). In focus-stacked images, the MV automated counting was found accurate within 5% vs manual counting, and MV volume density of the order of 10 mm was estimated. It was observed that stacks of 15 images provided a 4% lower MV volume density compared with the stacking of 30 images. CONCLUSIONS The assessment of the number of MVs by the acquisition of a single image of an IOL was influenced by the distance of the selected plane from the IOL surface. The decrease in MV density approaching the IOL edges can be explained as a consequence of the diffusion of water toward the external environment after accelerated aging.
Collapse
|
11
|
Yildirim TM, Schickhardt SK, Wang Q, Friedmann E, Khoramnia R, Auffarth GU. Quantitative evaluation of microvacuole formation in five intraocular lens models made of different hydrophobic materials. PLoS One 2021; 16:e0250860. [PMID: 33930084 PMCID: PMC8087009 DOI: 10.1371/journal.pone.0250860] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 04/15/2021] [Indexed: 11/29/2022] Open
Abstract
In this laboratory study, we assessed the resistance to microvacuole (glistening) formation in hydrophobic intraocular lenses (IOLs). Glistenings were induced in five lenses each of five different hydrophobic acrylic IOL models, using an established in vitro laboratory model: 800C (Rayner, Worthing, UK), AcrySof SN60WF (Alcon, Fort Worth, USA), Tecnis ZCB00 (Johnson & Johnson Vision, Santa Ana, USA), Vivinex XY1 (Hoya, Tokyo, Japan) and CT Lucia 611P (Zeiss, Oberkochen, Germany). We evaluated the number of microvacuoles per square millimeter (MV/mm2) in the central part of each IOL. Results were analyzed statistically, and mean glistening numbers were ranked, with the highest in the SN60WF which had 66.0 (±45.5) MVs/mm, followed by the 611P with 30.7 (±8.4) MVs/mm2. The 800C and XY1 showed comparable values of 2.0 (±3.6) and 2.7 (±2.4) MVs/mm2, respectively. ZCB00 had the lowest number with 0.9 (±0.6) MVs/mm2. This study shows that the resistance to glistening formation differs depending on the hydrophobic acrylic copolymer composition of the IOL material. Some IOLs from current clinical use are still prone to develop glistenings whereas others, including the ZCB00, 800C and XY1 show high resistance to microvacuole formation.
Collapse
Affiliation(s)
- Timur M. Yildirim
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Sonja K. Schickhardt
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Qiang Wang
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
- Department of Ophthalmology, The Third Affiliated Hospital of Wenzhou Medical University, Rui’an, Zhejiang, China
| | - Elfriede Friedmann
- Faculty of Mathematics and Natural Sciences, University of Kassel, Kassel, Germany
| | - Ramin Khoramnia
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Gerd U. Auffarth
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
12
|
Lehmann R, Maxwell A, Lubeck DM, Fong R, Walters TR, Fakadej A. Effectiveness and Safety of the Clareon Monofocal Intraocular Lens: Outcomes from a 12-Month Single-Arm Clinical Study in a Large Sample. Clin Ophthalmol 2021; 15:1647-1657. [PMID: 33907378 PMCID: PMC8068507 DOI: 10.2147/opth.s295008] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/30/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose This study assessed effectiveness and safety of the novel Clareon intraocular lens (IOL; model SY60CL; Alcon Vision LLC). Patients and Methods This was a prospective, single-arm, unmasked clinical trial at 16 investigative clinical sites in the United States. Included were adults ≥22 years who required cataract extraction by phacoemulsification. Following phacoemulsification, 350 subjects received SY60CL IOL unilaterally; 342 completed the study. Monocular best corrected distance visual acuity (CDVA) and uncorrected distance visual acuity (UDVA) were evaluated. The primary effectiveness endpoint was the percentage of subjects with CDVA ≤0.3 logMAR at month 12. Safety was assessed by monitoring adverse events (AEs). Visual acuity and safety outcomes were compared with historical safety and performance endpoint (SPE) rates. Results At 12 months post-implantation, 99.7% of subjects receiving the SY60CL IOL achieved monocular CDVA ≤0.3 logMAR (primary effectiveness endpoint; 1-sided 95% upper confidence limit >SPE rate); 99.7% and 86.8% of subjects achieved monocular CDVA of ≤0.34 (20/40 Snellen or better) and ≤0.04 logMAR (20/20 Snellen or better), respectively. At 12 months, >95% of subjects achieved mean monocular UDVA ≤0.3 logMAR; 97.1% and 57.6% of subjects achieved monocular CDVA of ≤0.34 and ≤0.04 logMAR, respectively. Mean monocular CDVA and UDVA were -0.05 and 0.04 logMAR, respectively. AEs were within SPE limits. The most common nonserious ocular AE was posterior capsule opacification (5.4%). Serious AEs were <1%, and no serious ocular AEs were assessed as related to the device. There were no observations for IOL glistenings at 12 months. Conclusion Results of this study supported effectiveness and safety of the SY60CL IOL. Visual acuity outcomes with the SY60CL IOL exceeded the SPE rates for monocular CDVA and AEs were within the limit of historic SPE rates. (Model number SY60WF is the Clareon lens approved by the FDA.).
Collapse
Affiliation(s)
| | | | | | - Raymond Fong
- Manhattan Eye, Ear, and Throat Hospital, Lenox Hill Hospital, New York, NY, USA
| | | | - Anna Fakadej
- Carolina Eye Associates, PA, Southern Pines, NC, USA
| |
Collapse
|
13
|
Tandogan T, Auffarth GU, Son HS, Merz P, Choi CY, Khoramnia R. In-vitro glistening formation in six different foldable hydrophobic intraocular lenses. BMC Ophthalmol 2021; 21:126. [PMID: 33685428 PMCID: PMC7938589 DOI: 10.1186/s12886-021-01879-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/18/2021] [Indexed: 11/26/2022] Open
Abstract
Background Glistenings describe small, refractile microvacuoles that may arise within the intraocular lens (IOL) material and reduce the patients’ quality of vision. Lenses composed of hydrophobic acrylic material are particularly affected by glistening formation. In this study, we compared the tendency of glistening formation in six different types of hydrophobic acrylic intraocular lenses (IOLs). Methods We used a well-established accelerated laboratory method to develop glistenings in the following IOLs: Vivinex XY1 (Hoya), AcrySof SN60WF (Alcon), Tecnis ZCB00 (AMO), Avansee PN6A (Kowa), Aktis SP NS-60YG (Nidek), and CT Lucia 601P (Zeiss). IOLs were first immersed in saline at 45 °C for 24 h and then at 37 °C for 2.5 h in a water bath. Microvacuole (MV) density and size (Miyata grading) were documented and calculated using an image analysis program. Results The mean glistening density [MV/mm2] and mean Miyata grading (in brackets) were: Vivinex: 11.6 ± 5.7 (0), SN60WF: 264.4 ± 110.3 (2.6), Tecnis: 6.0 ± 2.8 (0), Avansee: 2.2 ± 0.7 (0), Aktis: 851.4 ± 59.4 (3+) and CT Lucia: 71.0 ± 71.6 (1). Conclusions While all tested IOLs showed glistenings with the accelerated laboratory method, the Aktis and SN60WF showed the highest microvacuole density, followed by the CT Lucia. In comparison, the Vivinex, Tecnis, and Avansee IOLs showed far fewer number of glistenings.
Collapse
Affiliation(s)
- Tamer Tandogan
- The David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, INF 400, 69120, Heidelberg, Germany
| | - Gerd U Auffarth
- The David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, INF 400, 69120, Heidelberg, Germany.
| | - Hyeck-Soo Son
- The David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, INF 400, 69120, Heidelberg, Germany
| | - Patrick Merz
- The David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, INF 400, 69120, Heidelberg, Germany
| | - Chul Young Choi
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul, South Korea
| | - Ramin Khoramnia
- The David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, INF 400, 69120, Heidelberg, Germany
| |
Collapse
|
14
|
Abstract
PURPOSE OF REVIEW Phacoemulsification cataract surgery is one of the most commonly performed surgical procedure worldwide. In the majority of cases, intraocular lenses (IOLs) are implanted. Due to the increasing life expectancy and the fact that cataract surgery is performed in earlier stages, the anticipated IOL duration in the eye has increased over the last decades. The aim of this study was to review the types and describe the characteristics of late intraocular lens opacifications. RECENT FINDINGS Calcification was the most commonly reported type of opacification in hydrophilic IOLs; it usually negatively impacted the visual function and required IOL explantation. Glistening manifested in hydrophobic acrylic lenses and was frequent in some IOL models. In most cases glistening and subsurface nanoglistenigs do not lead to a decline in visual acuity or require IOL exchange. Current studies indicate that fluid-related phenomena may induce straylight, leading to a decrease of comfort and quality of vision. SUMMARY Several reports on late IOL opacifications have been published in recent years. In some cases, particularly in glistening, the development of the opacifications might be related to IOL aging. The influence of the fluid-related microvacuoles on the quality of vision requires further research.
Collapse
Affiliation(s)
- Piotr Kanclerz
- Department of Ophthalmology, Hygeia Clinic, Gdańsk, Poland
| | - Timur M Yildirim
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Ramin Khoramnia
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
15
|
Grzybowski A, Markeviciute A, Zemaitiene R. A narrative review of intraocular lens opacifications: update 2020. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1547. [PMID: 33313292 PMCID: PMC7729367 DOI: 10.21037/atm-20-4207] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The opacifications of intraocular lenses (IOLs) can significantly impact patients visual quality. Despite the identification of specific risk factors, manufacturing changes, opacifications are not eliminated. Likewise, more attention in recent studies was paid to possible new risk factors, however one of the most important purposes of the studies remains opacifications effect on visual performance, which could be disturbed in different aspects. The aim of this review is to discuss the main risk factors of IOLs opacification in particular IOL types, and its impact on vision quality. Different risk factors were discussed in the study, including the material of IOLs, the impact of the breakdown of blood-aqueous barrier (BAB), and certain surgeries that can be associated with opacification formation. Glistenings occur more often in a hydrophobic material, however, the changes in water content of the IOLs can significantly reduce the formation of glistenings. The studies showed a significant effect of intraocular injection of exogenous air or gas during Descemet-stripping endothelial keratoplasty, Descemet-stripping automated endothelial keratoplasty, Descemet membrane endothelial keratoplasty, and pars plana vitrectomy on calcification formation. It raises a concern, as the incidence of these surgeries is increasing. Visual acuity decreases significantly after the calcification in IOLs occurs, and it usually causes IOLs exchange. However, disability glare seems to be more affected in patients with IOLs, which were affected by glistenings than visual acuity. Disability glare is associated with increased levels of straylight, which was widely evaluated in recent studies and it was reported to be a susceptible measurement to detect the presence of IOLs pathology. For future researches, it should be noticed that disability glare and straylight are more appropriate in evaluating IOLs opacification effect on visual quality than visual acuity. While reviewing the main risk factors of IOLs opacifications particular attention must be paid on calcification occurrence in hydrophilic acrylic IOLs after surgeries with intraocular injection of exogenous air or gas.
Collapse
Affiliation(s)
- Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland.,Institute for Research in Ophthalmology, Poznan, Poland
| | - Agne Markeviciute
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Reda Zemaitiene
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| |
Collapse
|
16
|
Argay A, Vamosi P. The assessment of the impact of glistening on visual performance in relation to tear film quality. PLoS One 2020; 15:e0240440. [PMID: 33044979 PMCID: PMC7549795 DOI: 10.1371/journal.pone.0240440] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 09/25/2020] [Indexed: 11/24/2022] Open
Abstract
Background The aim of our case control study was to evaluate the impact of glistening and tear film quality on visual performance after implantation of two different hydrophobic acrylic intraocular lenses (IOLs). Materials and methods In our retrospective study we included cataract patients operated between January 1, 2011 and December 31, 2012, with follow-up controls between January 2016 and December 2019. Z-Flex 860FAB (Medicontur) and AcrySof IQ SN60WF (Alcon) monofocal IOLs were implanted during standard phacoemulsification. Best corrected distance visual acuity (BCDVA) and contrast sensitivity were monitored over the post-operative period of up to 6 years. Glistening was evaluated semi-quantitatively with slit-lamp biomicroscopy and quantitatively using Pentacam HR (Oculus). Using HD Analyzer OQAS (Visiometrics), total intraocular light diffusion was interpreted with the objective scatter index (OSI) and tear film quality was evaluated with the tear film related objective scatter index (TF-OSI). Results 26 eyes implanted with the Z-Flex and 25 eyes with the AcrySof IQ IOLs were included in the analysis. The slit-lamp evaluation of patients with the Z-Flex IOL (0.57 ± 0.60) revealed significantly less glistening (p<0.0001), compared to the AcrySof IQ group (1.82 ± 0.90), and these observations were confirmed by the Pentacam HR analyses, as well (Z-Flex group: 35.1 ± 1.63, Acrysof IQ: 39.6 ± 3.69, p<0.0001). TF-OSI differed between the two sets of patients remarkably (1.53 ± 1.03 vs. 2.51 ± 1.76 for AcrySof IQ and Z-Flex groups, respectively, p = 0.043). Both groups of patients provided similar results of BCDVA and contrast sensitivity. Conclusion Glistening and tear film quality both contribute to visual performance outcomes after cataract surgery. In our study the advantage of less glistening in the Z-Flex IOL might have been masked by the adverse effects of the more pronounced tear film insufficiency of these patients, compared to the AcrySof IQ group. Among other factors, tear film quality should also be taken into consideration when comparing the impact of glistening on visual quality of patients implanted with different IOLs.
Collapse
Affiliation(s)
- Amanda Argay
- Department of Ophthalmology, Péterfy Sándor Hospital and Traumatology Center, Budapest, Hungary
| | - Peter Vamosi
- Department of Ophthalmology, Péterfy Sándor Hospital and Traumatology Center, Budapest, Hungary
- * E-mail:
| |
Collapse
|
17
|
Leydolt C, Schartmüller D, Schwarzenbacher L, Röggla V, Schriefl S, Menapace R. Posterior Capsule Opacification With Two Hydrophobic Acrylic Intraocular Lenses: 3-Year Results of a Randomized Trial. Am J Ophthalmol 2020; 217:224-231. [PMID: 32335056 DOI: 10.1016/j.ajo.2020.04.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the incidence and intensity of posterior capsule opacification (PCO) and neodymium-yttrium-aluminum-garnet (Nd:YAG) capsulotomy rates between 2 similar open-loop single-piece hydrophobic acrylic intraocular lenses (IOLs) that differ in the proprietary material characteristics and design features, over a period of 3 years. DESIGN Randomized, prospective, patient- and examiner-masked clinical trial with intraindividual comparison. METHODS Setting: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. PATIENT POPULATION Eighty patients (160 eyes) had bilateral cataract surgery and received a Vivinex XY1 IOL in 1 eye and an AcrySof SN60WF IOL in the other eye. OBSERVATION PROCEDURES Follow-up examinations were performed 3 years after surgery. Digital retroillumination images were taken of each eye. The amount of PCO (score: 0-10) was assessed subjectively at the slit lamp and objectively using automated image analysis software (AQUA). MAIN OUTCOME MEASURE PCO score (scale, 0-10). RESULTS The mean objective PCO score of the Vivinex XY1 IOLs was 0.9 ± 0.8 compared to the PCO score of 1.4 ± 1.1 for the AcrySof SN60WF IOLs (P < .001). Three years postoperatively, 11.4% of patients had an Nd:YAG capsulotomy in the Vivinex XY1 eye and 18.6% had a capsulotomy in the AcrySof SN60WF eye (P = .23). CONCLUSION The new hydrophobic acrylic Vivinex XY1 IOL showed significantly lower PCO rates and lower YAG rates compared to the AcrySof SN60WF IOL. The interaction of various factors such as hydrophobic material, smooth optic surface, and sharp posterior optic edge plays a key role in PCO development.
Collapse
|
18
|
Mid-term and long-term clinical assessments of a new 1-piece hydrophobic acrylic IOL with hydroxyethyl methacrylate. J Cataract Refract Surg 2020; 46:682-687. [DOI: 10.1097/j.jcrs.0000000000000142] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
19
|
Visual and refractive outcomes and glistenings occurrence after implantation of 2 hydrophobic acrylic aspheric monofocal IOLs. J Cataract Refract Surg 2020; 46:986-994. [PMID: 32271271 DOI: 10.1097/j.jcrs.0000000000000201] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare the Clareon IOL with the Tecnis PCB00 IOL in terms of visual performance, refractive outcomes, glistenings occurrence, and quality-of-life outcomes. SETTING Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom. DESIGN Single-center, single-masked, prospective, randomized controlled trial. METHODS One hundred thirty-nine patients with bilateral cataracts were randomized to receive the Clareon (C IOL) or Tecnis (T IOL) IOL. Visual acuity, refraction, central corneal thickness (CCT), endothelial cell loss, contrast sensitivity, mesopic gap acuity, evaluation of glistenings, and rates of perioperative and postoperative complications were recorded. Quality-of-life outcomes were measured with the EuroQOL-5 dimensions questionnaire and the patient-reported outcome measures (PROMs) questionnaire. Optimized A-constants were available for the T IOL but not for the C IOL. RESULTS Seventy-one patients (140 eyes) received the C IOLs and 68 patients (134 eyes) received the T IOLs. Data were analyzed for the first implanted eye. At 12 months, mean uncorrected distance visual acuity (logarithm of the minimum angle of resolution) was 0.02 ± 0.10 and 0.01 ± 0.08 (mean ± SD; P = .49; 95% CI, -0.02 to 0.04) in the C IOL and T IOL groups, respectively. Corrected distance visual acuity was -0.02 ± 0.09 and -0.03 ± 0.06, respectively (P = .45; 95% CI, -0.02 to 0.04). The increase in CCT was 14 ± 19 and 16 ± 28 μm, respectively (P = .63; 95% CI, -10.16 to 6.16). Mean absolute refraction spherical equivalent error from target refraction was 0.41 ± 0.28 for the C IOL and 0.25 ± 0.2 for the T IOL groups (P = .002; 95% CI, 0.08 to 0.24). Glistenings were minimal (median grade 0), with no difference in grades between groups (P = .2). PROMs improved postoperatively and were similar in both groups. CONCLUSIONS There were no differences in visual outcomes between the Clareon IOL and Tecnis PCB00 IOL. Glistenings were rarely observed in either IOL with no difference in grades. There was no difference in perioperative or postoperative complications. Surgeon optimization of the A-constant for the Clareon IOL is recommended.
Collapse
|
20
|
Bedar MS, Kellner U. [Clinical experience with the Clareon® IOL and the AutonoMe® implantation system]. Ophthalmologe 2020; 117:1100-1104. [PMID: 32112221 DOI: 10.1007/s00347-020-01075-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The AutonoMe® implantation system with a preloaded, monofocal, aspherical, hydrophobic Clareon® intraocular lens (IOL) has recently become available. The aim of this analysis was the most comprehensive review of intraoperative and postoperative outcomes to date. METHODS Prospective evaluation of intraoperative features in all eyes scheduled to have cataract surgery with Clareon® IOL implantation using the AutonoMe® implantation system between December 2017 and September 2018 with follow-up at 4-6 weeks. Inclusion of all patients, regardless of comorbidities and accompanying ocular surgery. RESULTS A total of 391 eyes were evaluated for the intraoperative analysis and 144 eyes were evaluated for postoperative follow-up. There was one IOL-associated intraoperative complication in which the posterior haptic was not correctly loaded and should not have been implanted. The best corrected distance visual acuity (BCDVA) increased from a mean of 0.33 logMAR (SD 0.21) preoperatively to 0.09 logMAR (SD 0.21) postoperatively, independent of ocular comorbidities. The BCDVA in patients without ocular comorbidities increased from 0.27 logMAR (SD 0.13) preoperatively to 0.03 logMAR (SD 0.05) postoperatively. Using the SRK®/T formula 87.5% of all eyes had a refractive error of ≤0.5 D and 98.0% had a refractive error of ≤1 D 4-6 weeks after surgery. CONCLUSION This study showed that using the recommended safety guidelines, the AutonoMe® system enables safe implantation of the IOL. The Clareon® IOL showed good postoperative visual outcomes and refraction results using the SRK®/T formula.
Collapse
Affiliation(s)
- Mohammad Seleman Bedar
- AugenZentrum Siegburg, MVZ Augenärztliches Diagnostik & Therapiecentrum Siegburg GmbH, Europaplatz 3, 53721, Siegburg, Deutschland.
| | - Ulrich Kellner
- AugenZentrum Siegburg, MVZ Augenärztliches Diagnostik & Therapiecentrum Siegburg GmbH, Europaplatz 3, 53721, Siegburg, Deutschland
- RetinaScience, Bonn, Deutschland
| |
Collapse
|
21
|
Łabuz G, Reus NJ, van den Berg TJTP. Light scattering levels from intraocular lenses extracted from donor eyes. J Cataract Refract Surg 2019; 43:1207-1212. [PMID: 28991619 DOI: 10.1016/j.jcrs.2017.06.044] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 05/23/2017] [Accepted: 06/24/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess light scatter levels of intraocular lenses (IOLs) extracted from donor eyes to understand straylight elevation documented earlier in pseudophakic population studies and identify potential sources of light scattering in IOLs. SETTING Rotterdam Ophthalmic Institute, Rotterdam, the Netherlands. DESIGN Experimental study. METHODS Light scattering in 74 donor IOLs was measured with the C-Quant device adapted for in vitro analysis of IOLs. Straylight was assessed at a 2.5-degree and 7.0-degree scatter angle, and results were compared with the straylight of a 20-year-old crystalline lens, a 70-year-old crystalline lens, and a lens with cataract. To identify potential changes to the IOL material, the IOLs were examined with a light microscope and a slitlamp. RESULTS At 2.5 degrees and 7.0 degrees, the straylight parameter was 5.78 deg2/steradian (sr) ± 4.70 (SD) and 5.06 ± 4.01 deg2/sr, respectively. Forty-one percent of IOLs showed lower straylight than the 20-year-old lens. In 14%, the scattering intensity was higher than in the 70-year-old lens; none showed straylight comparable to that of the cataractous lens. Increased straylight was associated with surface deposits, snowflake-like degeneration, and glistenings. The incidence of IOL-related complications differed between the IOL groups. CONCLUSIONS Microscopic structural alterations of IOLs play a major role in straylight elevations in pseudophakic eyes. A clear correlation with degeneration and/or alteration of implanted IOLs was found. Although these IOL-related complications would likely not affect visual acuity, they give rise to straylight and thus can cause disability glare and other symptoms.
Collapse
Affiliation(s)
- Grzegorz Łabuz
- From the Rotterdam Ophthalmic Institute (Łabuz), Rotterdam, the Department of Ophthalmology (Reus), Amphia Hospital, Breda, and the Netherlands Institute for Neuroscience (van den Berg), Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands.
| | - Nicolaas J Reus
- From the Rotterdam Ophthalmic Institute (Łabuz), Rotterdam, the Department of Ophthalmology (Reus), Amphia Hospital, Breda, and the Netherlands Institute for Neuroscience (van den Berg), Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
| | - Thomas J T P van den Berg
- From the Rotterdam Ophthalmic Institute (Łabuz), Rotterdam, the Department of Ophthalmology (Reus), Amphia Hospital, Breda, and the Netherlands Institute for Neuroscience (van den Berg), Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
| |
Collapse
|
22
|
Stanojcic N, Hull C, O'Brart DP. Clinical and material degradations of intraocular lenses: A review. Eur J Ophthalmol 2019; 30:823-839. [PMID: 31387387 DOI: 10.1177/1120672119867818] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To review the published scientific literature concerning clinical and material degradations of intraocular lenses after implantation in cataract surgery. METHODS A search was undertaken using the following databases: CENTRAL (including Cochrane Eyes and Vision Trials Register; The Cochrane Library: Issue 2 of 12 February 2019), Ovid MEDLINE (R) without Revisions (1996 to February week 2, 2019), Ovid MEDLINE (R) (1946 to February week 2, 2019), Ovid MEDLINE (R) Daily Update 19 February 2019, MEDLINE and MEDLINE non-indexed items, Embase (1980-2019, week 7), Embase (1974-2019, 19 February), Ovid MEDLINE (R) and Epub Ahead of Print, in-Process & Other Non-Indexed Citations and Daily (1946 to 19 February 2019), Web of Science (all years), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrial.gov) and the WHO International Clinical Trials Registry Platform (www.who.int/ictrp/search/en). Only published articles in English were selected. Search terms/keywords included 'IOL' or 'intraocular lens', combined with 'opacification', degradation, glistenings, nanoglistenings, whitening, transmittance, light scatter, discolouration/discoloration, performance, quality, material, biocompatibility, calcification, explantation and ultraviolet/UV radiation. Relevant in-article references not returned in our searches were also considered. RESULTS After review of the available articles, the authors included 122 publications in this review, based on the quality of their methodology and their originality. The studies included in this review were randomized controlled trials, cohort studies, case-controlled studies, case series, case reports, laboratory studies and review papers. Differing material degradations of intraocular lenses have been described and their associated pathophysiology studied. Reported anomalies include photochemical alterations, water vacuoles, internal and surface calcific deposits, surface coatings and discolouration. The nature of such changes has been shown to depend on the type of intraocular lenses material used and/or manufacturing processes and storage conditions employed. Changes in the intraocular lens can also be influenced by surgical technique, coexisting ocular pathologies and topical and systemic medications. The clinical significance of these degradations is variable, with some resulting in significant visual disturbance and the need for intraocular lens explantation and others producing only minimal visual impairments. Failure to recognize the precise nature of the problem may lead to unnecessary laser capsulotomy procedures. CONCLUSION Clinical degradations of intraocular lenses are uncommon but have been reported following the implantation of intraocular lenses made of differing biomaterials. Their correct identification and thorough investigation to determine the underlying cause is necessary for optimal patient management and the prevention of such problems. Choosing a lens made of a particular material may be important in patients with certain ocular conditions.
Collapse
Affiliation(s)
- Nick Stanojcic
- Department of Ophthalmology, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.,King's College London Frost Eye Research Unit, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Christopher Hull
- Division of Optometry and Visual Sciences, School of Health Science, City, University of London, London, UK
| | - David Ps O'Brart
- Department of Ophthalmology, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.,King's College London Frost Eye Research Unit, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| |
Collapse
|
23
|
Stanojcic N, O'Brart DPS, Maycock N, Hull CC. Effects of intraocular lens glistenings on visual function: a prospective study and presentation of a new glistenings grading methodology. BMJ Open Ophthalmol 2019; 4:e000266. [PMID: 31179397 PMCID: PMC6528773 DOI: 10.1136/bmjophth-2018-000266] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective To investigate the effect of intraocular lens (IOL) glistenings on visual performance and evaluate a new glistenings grading methodology. Methods and Analysis Thirty-four patients (34 eyes) were recruited. Corrected distance visual acuity (CDVA), mesopic gap acuity (MGA), functional contrast sensitivity (FCS) and forward light scatter were measured (Advanced Vision and Optometric Tests, City Occupational, London, UK). The IOL centre was imaged and glistenings density graded by three observers using the Miyata scale and a new system. Inter-rater reliability, association between the two grading scales, and correlations between glistenings grades and visual performance parameters were evaluated. Results The intraclass correlation coefficient between graders for the new grading system was 0.769 (95% Confidence Interval [CI] 0.636 to 0.868). There was a significant association between the Miyata scale and the new grading system for all graders (rs=0.533–0.895, p≤0.001). There was no association between CDVA or MGA and glistenings grade (rs=− 0.098, p=0.583 and rs=0.171, p=0.359, respectively). There was no association between FCS at mesopic light levels and glistenings grade (rs=−0.032, p=0.864), or the straylight parameter and glistenings grade (rs=0.021, p=0.916). No association was found between the integrated straylight parameter and glistenings grade (rs=0.078, p=0.701). Conclusion The new glistenings grading scale was highly reproducible. In this cohort, glistenings in the same hydrophobic acrylic IOL after cataract surgery were not associated with changes in visual function, as assessed by a series of tests not previously used in glistenings research.
Collapse
Affiliation(s)
- Nick Stanojcic
- Department of Ophthalmology, St Thomas' Hospital, London, UK
| | | | - Nick Maycock
- Department of Ophthalmology, Queen Alexandra Hospital, Portsmouth, UK
| | - Chistopher C Hull
- Centre for Applied Vision Research, School of Health Sciences, City, University of London, London, UK
| |
Collapse
|
24
|
Łabuz G, Knebel D, Auffarth GU, Fang H, van den Berg TJ, Yildirim TM, Son HS, Khoramnia R. Glistening Formation and Light Scattering in Six Hydrophobic-Acrylic Intraocular Lenses. Am J Ophthalmol 2018; 196:112-120. [PMID: 30189220 DOI: 10.1016/j.ajo.2018.08.032] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/16/2018] [Accepted: 08/24/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE To study the glistening formation in various hydrophobic-acrylic intraocular lens (IOL) models, and to evaluate the effect of glistenings on light scattering in these IOLs. DESIGN Laboratory investigation. METHODS The susceptibility of the hydrophobic-acrylic material to develop glistenings was evaluated in 6 IOL models. Accelerated lens aging was induced by immersing the IOLs in a solution at 45 C for 24 hours and cooled to 37 C for 2.5 hours. Light microscopy and image acquisition were performed. Glistening statistics-that is, microvacuoles' (MV) number and size-were derived from image analysis. Light scattering was measured using a clinical device featuring an adaptation for in vitro IOL assessment. RESULTS The number of glistenings differed among the studied IOLs and ranged from 0 to 3532 MV/mm2. In 1 model, glistenings were found only at the periphery, with diffuse light scattering observed centrally despite the absence of microvacuoles. The mean size of glistenings ranged from 5.2 to 10.2 μm. The mean straylight parameter of the IOLs increased from 0.6 to 5.0 deg2/sr after accelerated aging. Straylight elevation demonstrated a proportional relationship with the glistening number. CONCLUSIONS We showed that hydrophobic-acrylic lenses differ in their resistance to glistenings, as one group proved to be glistening-free, but the other models revealed varying grades of glistenings. Moreover, we demonstrated that the presence of glistenings results in increased straylight, and that straylight proportionally depends on the glistenings number irrespective of the IOL model. However, more research is needed to confirm that the relationship we found holds for all hydrophobic-acrylic IOLs.
Collapse
Affiliation(s)
- Grzegorz Łabuz
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Dominik Knebel
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Gerd U Auffarth
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany.
| | - Hui Fang
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Thomas Jtp van den Berg
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, Netherlands
| | - Timur M Yildirim
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Hyeck-Soo Son
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Ramin Khoramnia
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
25
|
Borkenstein AF, Borkenstein EM. Long-term clinical results and scanning electron microscopic analysis of the aspheric, hydrophobic, acrylic intraocular lens CT LUCIA 611P(Y). Clin Ophthalmol 2018; 12:1219-1227. [PMID: 30013315 PMCID: PMC6038869 DOI: 10.2147/opth.s167895] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose The aim of this study was to evaluate the clinical outcomes of a novel designed hydrophobic, acrylic, monofocal, fully preloaded intraocular lens (IOL; CT LUCIA 611P) 1 year after implantation. Scanning electron microscopic analysis regarding the optic-haptic junction and sharp edges of the IOL was performed. Patients and methods This is a noninterventional, observational prospective study of cataract patients who underwent implantation of the CT LUCIA 611P. Ninety-six eyes of 54 subjects were enrolled. Follow-up included visual acuity assessment, slit lamp examination with special focus on appearance of glistenings and evaluation of posterior capsule opacification (PCO). Scanning electron microscopic analysis of the new designed optic-haptic junction and edges of the IOL was performed. Results Best-corrected distance visual acuity increased from mean 0.48 logMAR (range 0.86-0.34) preoperatively to mean 0.02 logMAR (range 0.14 to -0.10) 1 year after surgery. Thirty-eight of 42 subjects' eyes (90.5%), which underwent bilateral surgery with implantation of the IOL, never required glasses for distance again, while 4 (9.5%) required glasses only in rare cases (eg, driving at night). The spherical equivalent was within ±0.50 D in 88 of 96 subjects (91.7%) and within ±0.75 D in 96.9% of cases. Target refraction ±1.00 D was achieved in 100% of subject eyes. No glistenings were reported in any case. From the surgeons' perspective, the wider, thicker optic-haptic transition of the IOL resulted in significantly increased stiffness, which enabled improved centering of the IOL and enhanced rotational stability and refractive predictability and stability and PCO prevention. Conclusion The results of this long-term observational study demonstrate the safety and efficacy of the IOL. Because of the completely new designed thicker and stiffer optic-haptic junction regarding improved characteristics of the IOL (stability in the capsular bag), some special attention has to be addressed to the slightly different behavior of the lens during implantation and unfolding process.
Collapse
|
26
|
[Posterior capsule opacification, glistenings and visual outcomes: 3 years after implantation of a new hydrophobic IOL]. J Fr Ophtalmol 2018; 41:513-520. [PMID: 29934027 DOI: 10.1016/j.jfo.2017.11.022] [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: 08/04/2017] [Revised: 11/20/2017] [Accepted: 11/21/2017] [Indexed: 11/23/2022]
Abstract
PURPOSE To evaluate the visual outcomes, the incidence of glistenings and posterior capsule opacification in a series of consecutive eyes with a new blue light-filtering hydrophobic acrylic intraocular lens (IOL) SETTING: Service d'ophtalmologie, clinique Beausoleil, avenue de Lodève, Montpellier. DESIGN Retrospective, cross-sectional study. METHODS This study included a series of 66 eyes that underwent routine cataract surgery with PODEye (PhysIOL SA, Liège, Belgium) monofocal IOL implantation between May 2011 and November 2011. These eyes were compared for glistenings with patients implanted with Acrysof material IOL (Alcon, Fort Worth, USA) who had a routine postoperative examination between January 2015 and August 2015. The safety of the IOL was assessed by visual acuity outcomes, as well as rotational stability, centration and postoperative medication. The incidence and severity of glistenings were evaluated with the slit lamp. Glistenings and PCO were graded subjectively (0=absent; 1=moderate; 2=dense). Follow-up was 3 years. RESULTS The mean visual acuity after PODEye implantation was 0.98±0.05 (n=50) in decimal notation at 1 year, 0.98±0.06 at 1 week, (n=66), 1.00±0.01 at 3 weeks (n=64) and 0.99±0.02 at 3 months (n=59). The IOL displayed stable positioning in all axes. Glistenings of grade 2 were absent in the G-Free/PODEye group, whereas they were significantly present in the Acrysof group. One out of 43 eyes at 3-year follow-up underwent YAG capulotomy at 37 months. Sixty-six percent of eyes had no PCO (grade 0) at 3 years. CONCLUSIONS The PODEye IOL was safe and stable. Glistenings grade 2 or more were not found with this blue light-filtering hydrophobic acrylic IOL. PCO occurrence was low at three years.
Collapse
|
27
|
Biomaterial Influence on Intraocular Lens Performance: An Overview. J Ophthalmol 2018; 2018:2687385. [PMID: 29736282 PMCID: PMC5874989 DOI: 10.1155/2018/2687385] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 12/08/2017] [Accepted: 01/02/2018] [Indexed: 11/18/2022] Open
Abstract
There is strong evidence that the IOL material is the factor having the greatest impact on posterior capsule opacification (PCO), anterior capsule opacification (ACO) development, and glistening formation after cataract surgery, even though there are other IOL features—such as haptic material and design and edge and optic design—that also have some influence. We reviewed the published literature describing the adverse events that are mainly related to the intraocular lens (IOL) material, such as PCO, ACO, and the subsequent capsule contraction, as well as glistening formation. The adverse events presented in this overview are the most common ones in clinical practice, and therefore, they are generally included in the clinical protocols for IOL evaluation.
Collapse
|
28
|
Oshika T, Ando H, Inoue Y, Eguchi S, Sato Y, Sugita T, Nishimura T, Hayashi K, Fujita Y, Miyata A, Sasaki N, Miyata K. Influence of surface light scattering and glistenings of intraocular lenses on visual function 15 to 20 years after surgery. J Cataract Refract Surg 2018; 44:219-225. [DOI: 10.1016/j.jcrs.2017.12.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 11/29/2017] [Accepted: 12/03/2017] [Indexed: 11/16/2022]
|
29
|
Tortolano L, Saunier J, Hammami S, Manerlax K, Matmati H, Do B, Jubeli E, Fattal E, Yagoubi N. Restructuration kinetics of amphiphilic intraocular lenses during aging. Colloids Surf B Biointerfaces 2018; 161:420-432. [PMID: 29121615 DOI: 10.1016/j.colsurfb.2017.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 10/11/2017] [Accepted: 11/02/2017] [Indexed: 12/11/2022]
|
30
|
Straylight from glistenings in intraocular lenses: In vitro study. J Cataract Refract Surg 2017; 43:102-108. [DOI: 10.1016/j.jcrs.2016.10.027] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 10/20/2016] [Accepted: 10/20/2016] [Indexed: 11/15/2022]
|
31
|
DeHoog E, Doraiswamy A. Evaluation of loss in optical quality of multifocal intraocular lenses with glistenings. J Cataract Refract Surg 2016; 42:606-12. [PMID: 27113885 DOI: 10.1016/j.jcrs.2015.10.071] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 10/07/2015] [Accepted: 10/18/2015] [Indexed: 11/26/2022]
|
32
|
Henriksen BS, Kinard K, Olson RJ. Effect of intraocular lens glistening size on visual quality. J Cataract Refract Surg 2016; 41:1190-8. [PMID: 26189379 DOI: 10.1016/j.jcrs.2014.09.051] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 09/19/2014] [Accepted: 09/24/2014] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine whether intraocular glistenings have an impact on light scatter and visual function. SETTING John A. Moran Eye Center Laboratories, University of Utah, Salt Lake City, Utah, USA. DESIGN Retrospective cohort study. METHODS Pseudophakic patients with visual acuity no worse than 0.02 logMAR and no ocular pathology were enrolled. All had received a single-piece high-refractive-index acrylic intraocular lens (IOL). All IOLs were photographed, and glistenings were analyzed for size and density. Outcome measures included logMAR corrected distance visual acuity (CDVA), mesopic 10% contrast logMAR CDVA with and without glare, and straylight determination with a straylight meter (C Quant log). RESULTS All 79 patients had glistenings within 2 diameter groups: 6 to 25 μm and over 25 μm. Linear regression for the nonstratified group was significant for IOL glistening size versus contrast visual acuity with glare. Linear regression for the 6 to 25 μm group was significant for a measure of severity index (%area) versus the straylight meter measurements, %area/size versus straylight meter measurements, IOL age versus CDVA, IOL age versus contrast visual acuity, and IOL age versus contrast visual acuity with glare. Linear regression for the over 25 μm group was significant for IOL age versus glistening size and %area/size versus contrast visual acuity, and density versus CDVA and contrast visual acuity with glare. CONCLUSIONS Glistening %area, at a key size, correlated with random light scatter. The age of the IOL likely affects glistening size and visual parameters. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
Collapse
Affiliation(s)
- Bradley S Henriksen
- From the Department of Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Krista Kinard
- From the Department of Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Randall J Olson
- From the Department of Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah School of Medicine, Salt Lake City, Utah, USA.
| |
Collapse
|
33
|
Biwer H, Schuber E, Honig M, Spratte B, Baumeister M, Kohnen T. Objective classification of glistenings in implanted intraocular lenses using Scheimpflug tomography. J Cataract Refract Surg 2015; 41:2644-51. [DOI: 10.1016/j.jcrs.2015.06.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 06/03/2015] [Accepted: 06/03/2015] [Indexed: 10/22/2022]
|
34
|
|
35
|
Radmall BR, Floyd A, Oakey Z, Olson RJ. Refractive index and its impact on pseudophakic dysphotopsia. Clin Ophthalmol 2015; 9:1353-8. [PMID: 26229427 PMCID: PMC4516203 DOI: 10.2147/opth.s86980] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose It has been shown that the biggest dissatisfier for uncomplicated cataract surgery patients is pseudophakic dysphotopsia (PD). While edge design of an intraocular lens (IOL) impacts this problem, refractive index is still controversial as to its impact. This retrospective cohort study was designed to determine the role of increasing refractive index in PD. Patients and methods This study was conducted at the John A. Moran Eye Center, University of Utah, USA. A retrospective chart review identified patients who received one of two hydrophobic acrylic single piece IOLs (AcrySof WF SP [SN60WF] or Tecnis SP [ZCB00]), which differed mainly by refractive index (1.55 versus 1.47). Eighty-seven patients who had received implantation of a one-piece hydrophobic acrylic IOL were enrolled. Patients were included if the surgery had been uncomplicated and took place at least a year before study participation. All eligible patients had 20/20 best corrected vision, without any disease known to impact visual quality. In addition to conducting a record review, the enrolled patients were surveyed for PD, using a modified National Eye Institute Visual Function questionnaire, as well as for overall satisfaction with visual quality. Results Statistical analysis demonstrated no difference between the two cohorts regarding PD, general visual function, and overall visual satisfaction. Conclusion The study suggests that with the two IOLs assessed, increasing the refractive index does not increase incidence of PD or decrease overall visual satisfaction.
Collapse
Affiliation(s)
- Bryce R Radmall
- Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA
| | - Anne Floyd
- Department of Ophthalmology, Louisiana State University Health Sciences Center, Shreveport, LA, USA
| | - Zack Oakey
- Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, CA, USA
| | - Randall J Olson
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
36
|
Garff K, Jensen JD, Cahoon J, Gupta I, Stagg B, Zaugg BE, Barlow WR, Olson RJ. Impact of micropulsed ultrasound power settings on the efficiency and chatter associated with lens-fragment removal. J Cataract Refract Surg 2015; 41:1264-7. [PMID: 26100958 DOI: 10.1016/j.jcrs.2014.09.049] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 09/04/2014] [Accepted: 09/09/2014] [Indexed: 11/18/2022]
Abstract
PURPOSE To determine the optimum power settings in micropulsed ultrasound (US). SETTING John A. Moran Eye Center Laboratories, University of Utah, Salt Lake City, Utah, USA. DESIGN Experimental study. METHODS Pig lenses hardened to be comparable to dense human cataracts were cut into 2.0 mm cubes and removed using micropulsed longitudinal US with previously optimized settings (6 milliseconds on and 6 milliseconds off and using a 0.9 mm 30-degree beveled bent phaco tip). The aspiration was set at 40 mL/min and the vacuum level at 550 mm Hg. Twenty lens cubes were tested with the power set from 10% to 100% in increments of 10%. Primary outcome measures were efficiency time (time to lens removal) and chatter (number of times the lens fragment visibly bounced off the tip). RESULTS Efficiency time decreased with increasing power. There was a correlation between power and efficiency time (R(2) = 0.41, P = .046), which was more substantial between 30% and 100% power (R(2) = 0.71, P = .004). The mean number of chatter events did not differ significantly between power settings (R(2) = 0.012, P = .1195). CONCLUSIONS There was a 5-fold increase in efficiency between 10% power and 20% power, which likely indicates that there is a minimum power threshold for efficient breakup of the lens. Between 20% and 100% power, there was a linear, strong, and statistically significant improvement in efficiency in these lens fragments. In addition, with micropulsed US there was little chatter or microchatter throughout the power range. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
Collapse
Affiliation(s)
- Kevin Garff
- From the Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA
| | - Jason D Jensen
- From the Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA
| | - Judd Cahoon
- From the Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA
| | - Isha Gupta
- From the Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA
| | - Brian Stagg
- From the Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA
| | - Brian E Zaugg
- From the Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA
| | - William R Barlow
- From the Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA
| | - Randall J Olson
- From the Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.
| |
Collapse
|
37
|
Chang A, Kugelberg M. Glistenings 9 years after phacoemulsification in hydrophobic and hydrophilic acrylic intraocular lenses. J Cataract Refract Surg 2015; 41:1199-204. [PMID: 26100954 DOI: 10.1016/j.jcrs.2014.09.038] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 08/27/2014] [Accepted: 09/07/2014] [Indexed: 11/27/2022]
Abstract
PURPOSE To compare the development of glistenings after implantation of a hydrophobic acrylic intraocular lens (IOL) (AcrySof SA60AT) and a hydrophilic IOL (BL27) and evaluate the effect on corrected distance visual acuity (CDVA) and contrast sensitivity 9 years postoperatively. SETTING St. Erik Eye Hospital, Stockholm, Sweden. DESIGN Prospective randomized clinical trial. METHODS One of 3 experienced cataract surgeons performed standard phacoemulsification in 1 eye of each patient. The patients were randomized to implantation of a hydrophobic acrylic IOL or a hydrophilic acrylic IOL. Both IOLs had sharp posterior edges. The CDVA and contrast sensitivity were measured 9 years postoperatively. Scheimpflug images of the IOLs were obtained to analyze glistenings, which were graded subjectively at the slitlamp and quantified objectively with digital image analysis using computer software. RESULTS Seventy-eight of the 120 patients were available for the 9-year follow-up examination. Patients with the hydrophilic IOL had statistically significantly fewer glistenings (P < .001). The development of glistenings was not correlated with IOL power, CDVA, or contrast sensitivity. CONCLUSIONS After 9 years, the hydrophobic IOL developed more glistenings than the hydrophilic IOL. Glistenings did not affect CDVA or contrast sensitivity. FINANCIAL DISCLOSURE Neither author has a financial or proprietary interest in any material or method mentioned.
Collapse
Affiliation(s)
- Anthony Chang
- From the St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden.
| | - Maria Kugelberg
- From the St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
38
|
van der Mooren M, Steinert R, Tyson F, Langeslag MJ, Piers PA. Explanted multifocal intraocular lenses. J Cataract Refract Surg 2015; 41:873-7. [DOI: 10.1016/j.jcrs.2015.02.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 12/03/2014] [Accepted: 12/04/2014] [Indexed: 10/23/2022]
|
39
|
Artigas JM, Felipe A, Navea A, García-Domene MC, Pons Á, Mataix J. Determination of scattering in intraocular lenses by spectrophotometric measurements. JOURNAL OF BIOMEDICAL OPTICS 2014; 19:127006. [PMID: 25539187 DOI: 10.1117/1.jbo.19.12.127006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 11/21/2014] [Indexed: 06/04/2023]
Abstract
This study presents a method for measuring scattering in explanted intraocular lenses (IOLs). Currently, determining scattering in IOLs is usually performed by Scheimpflug cameras and the results are expressed in the units used by this apparatus. The method we propose uses a spectrophotometer and this makes it possible to measure the total transmission of the IOL by using an integrating sphere; the direct transmission is determined by the double-beam mode. The difference between these two transmissions gives a value of the scattering in percentage values of light lost. In addition, by obtaining the spectral transmission curve, information about the most scattered wavelengths is also obtained. The IOL power introduces errors when directly measured, particularly with high powers. This problem can be overcome if a tailor-made cuvette is used that shortens the distance between the IOL and the condensing lens of the spectrophotometer when the IOL powers are below 24 diopters. We checked the effectiveness of this method by measuring the scattering of three explanted IOLs from cornea donors. This method, however, does not make it possible to ascertain whether the scattering measured is caused by surface light scattering or internal light scattering.
Collapse
Affiliation(s)
- José M Artigas
- Universidad de Valencia, Faculty of Physics, Optics Department, C/Dr. Moliner, 50 E46100, Burjassot, Valencia, SpainbFisabio Oftalmología Médica (FOM), Bifurcación Pío Baroja-General Avilés, s/n E46015-Valencia, Spain
| | - Adelina Felipe
- Universidad de Valencia, Faculty of Physics, Optics Department, C/Dr. Moliner, 50 E46100, Burjassot, Valencia, SpainbFisabio Oftalmología Médica (FOM), Bifurcación Pío Baroja-General Avilés, s/n E46015-Valencia, Spain
| | - Amparo Navea
- Fisabio Oftalmología Médica (FOM), Bifurcación Pío Baroja-General Avilés, s/n E46015-Valencia, Spain
| | - M Carmen García-Domene
- Universidad de Valencia, Faculty of Physics, Optics Department, C/Dr. Moliner, 50 E46100, Burjassot, Valencia, SpainbFisabio Oftalmología Médica (FOM), Bifurcación Pío Baroja-General Avilés, s/n E46015-Valencia, Spain
| | - Álvaro Pons
- Universidad de Valencia, Faculty of Physics, Optics Department, C/Dr. Moliner, 50 E46100, Burjassot, Valencia, Spain
| | - Jorge Mataix
- Fisabio Oftalmología Médica (FOM), Bifurcación Pío Baroja-General Avilés, s/n E46015-Valencia, Spain
| |
Collapse
|
40
|
Schweitzer C, Orignac I, Praud D, Chatoux O, Colin J. Glistening in glaucomatous eyes: visual performances and risk factors. Acta Ophthalmol 2014; 92:529-34. [PMID: 24119141 DOI: 10.1111/aos.12276] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 08/22/2013] [Indexed: 11/27/2022]
Abstract
PURPOSE To analyse risk factors and visual performances of glaucomatous eyes with glistening in the intra-ocular lens (IOL). METHODS Prospective study performed between November 2010 and April 2011 and involving 67 consecutive glaucomatous eyes (47 patients), who previously had a phacoemulsification with a hydrophobic acrylic IOL implanted in the capsular bag. Glistening was classified in three groups of severity grade: G0 (<50 microvacuoles per mm(2) ), G1 (50-150 microvacuoles per mm(2) ), and G2 (>150 microvacuoles per mm(2) ). All eyes underwent a best-corrected visual acuity evaluation (BCVA, LogMAR scale), a complete clinical examination, a visual field test, a contrast sensitivity evaluation and a wavefront analysis of high-order aberrations (HOAs) using a Shack-Hartmann aberrometer. Eyes with a posterior capsular opacification and a BCVA>0.30 LogMAR were excluded. RESULTS Twenty six eyes (38.8%) had a grade 0, 12 eyes (17.9%) a grade 1 and 29 eyes (43.3%) a grade 2 of glistening severity grade. The mean follow-up after cataract surgery was 35.2 ± 24.2 months and was significantly higher for G1 and G2 groups (p < 0.001). A higher number of topical glaucoma medication were associated with a higher glistening severity grade (p < 0.05). G1 and G2 groups had significantly lower mean contrast sensitivity values at high spatial frequencies and significantly higher loss variance (LV) values of the visual field test (p < 0.05). There was no significant difference in mean BCVA between groups (p = 0.455). CONCLUSIONS In glaucomatous eyes, glistening increased with time was associated with the number of topical glaucoma medications daily instilled and altered visual performances. It should be a consideration for glaucoma patients who are more likely to develop glistening within the IOL optic.
Collapse
Affiliation(s)
- Cedric Schweitzer
- Ophthalmology Department; University Hospital Pellegrin; Bordeaux Cedex France
| | - Isabelle Orignac
- Ophthalmology Department; University Hospital Hotel-Dieu; Nantes Cedex France
| | - Delphine Praud
- Ophthalmology Department; University Hospital Pellegrin; Bordeaux Cedex France
| | - Olivier Chatoux
- Ophthalmology Department; University Hospital Pellegrin; Bordeaux Cedex France
| | - Joseph Colin
- Ophthalmology Department; University Hospital Pellegrin; Bordeaux Cedex France
| |
Collapse
|
41
|
Xi L, Liu Y, Zhao F, Chen C, Cheng B. Analysis of glistenings in hydrophobic acrylic intraocular lenses on visual performance. Int J Ophthalmol 2014; 7:446-51. [PMID: 24967189 DOI: 10.3980/j.issn.2222-3959.2014.03.11] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Accepted: 04/05/2014] [Indexed: 11/02/2022] Open
Abstract
AIM To assess patients' visual performance with glistenings in one piece soft hydrophobic acrylic intraocular lenses (IOLs) (Alcon) 2 years postoperatively. METHODS This cross section trial included 120 eyes with one piece IOL at 2 years postoperatively. Glistening was classified in 4 groups, ranging from 0 (none) to 3 (most evident) according to their severity in IOLs optics observed under a slit lamp. All eyes underwent a uncorrected and best-corrected visual acuity evaluation (UCVA and BCVA, LogMAR scale), a complete clinical examination, a contrast sensitivity (CS) evaluation by F.A.C.T chart, and a visual field test by Humphrey Field Analyzer ‖ (HFA). One-way ANOVA was used for quantitative data, while Pearson χ (2) test was used for qualitative data to analyze the visual function of 4 glistening groups. RESULTS Totally 120 eyes were enrolled with 30 eyes in each glistening group. There was no statistical correlation between glistening grades and patients' age, IOLs power, postoperative UCVA and BCVA (P>0.05). Quantificationally, CS values among each group were not statistically different. However, qualitative analysis showed there were more eyes in grade 3 group than in grade 0 group having abnormally declined CS at high spatial frequency (10% vs 36.7% at 18 cpd, P=0.029; 6.7% vs 26.7% at 12 cpd, P=0.013). Mean deviation (MD) of the visual field test was -2.14±2.31, -1.97±2.23, -3.02±3.17, -4.12±3.38 in group 0 to 3 respectively. There was a significant decrease in the most serious glistenings group (P =0.018). CONCLUSION Glistenings may potentially have an impact on contrast sensitivity at high spatial frequency and MD in visual field test.
Collapse
Affiliation(s)
- Lei Xi
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Yi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Feng Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Chuan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Bing Cheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| |
Collapse
|
42
|
Posterior capsule opacification and neodymium:YAG rates with 2 single-piece hydrophobic acrylic intraocular lenses: three-year results. J Cataract Refract Surg 2014; 39:1886-92. [PMID: 24427796 DOI: 10.1016/j.jcrs.2013.06.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE To compare the incidence and intensity of posterior capsule opacification (PCO) between 2 similar 1-piece foldable hydrophobic acrylic intraocular lenses (IOLs) over 3 years. SETTING Department of Ophthalmology, Medical University Vienna, Vienna, Austria. DESIGN Randomized prospective patient- and examiner-masked clinical trial with intraindividual comparison. METHODS Patients with bilateral age-related cataract had cataract surgery and implantation of a Tecnis ZCB00 continuous-optic-edge IOL in 1 eye and an Acrysof SA60AT interrupted-optic-edge IOL in the other eye. Postoperative examinations were performed at 6 months and 3 years. Digital retroillumination images were taken of each eye. The amount of PCO (score 0 to 10) was assessed subjectively at the slitlamp and objectively using automated image-analysis software. RESULTS The study comprised 54 patients (108 eyes). The mean objective PCO score was 1.3 ± 1.7 (SD) for the continuous-optic-edge IOLs and 0.9 ± 1.3 for the interrupted-optic-edge IOLs (P=.10). Three years postoperatively, a neodymium:YAG (Nd:YAG) capsulotomy was performed in 26.1% of eyes with the continuous-optic-edge IOL and 21.7% with the interrupted-optic-edge IOL (P=.56). There was no significant difference in corrected distance visual acuity, capsulorhexis–IOL overlap, capsule folds, or anterior capsule opacification 3 years after surgery. CONCLUSIONS Both IOLs had comparable PCO and Nd:YAG rates 3 years postoperatively. The optimized barrier function of the continuous-optic-edge IOL and the material properties of the interrupted-optic-edge IOL seemingly outbalanced the effect on lens epithelial cell migration and proliferation beneath the optic.
Collapse
|
43
|
Post-DSAEK optical changes: a comprehensive prospective analysis on the role of ocular wavefront aberrations, haze, and corneal thickness. Cornea 2014; 32:1567-77. [PMID: 24162748 DOI: 10.1097/ico.0b013e3182a9b182] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim was to assess the visual impact of ocular wavefront aberrations, corneal thickness, and corneal light scatter prospectively after performing a Descemet stripping automated endothelial keratoplasty (DSAEK) in humans. METHODS Data were obtained prospectively from 20 eyes preoperatively and at 1, 3, 6, and 12 months post-DSAEK. At each visit, the best spectacle-corrected visual acuity and visual acuity with glare (brightness acuity testing) were recorded, and ocular wavefront measurements and corneal optical coherence tomography (OCT) were performed. The magnitude and the sign of individual Zernike terms [higher-order aberrations (HOAs)] were determined. Epithelial, host stromal, donor stromal, and total corneal thicknesses were quantified. The brightness and intensity profiles of OCT images were generated to quantify light scatter in the whole cornea, subepithelial region, anterior and posterior host stroma, interface, and donor stroma. RESULTS The mean best spectacle-corrected visual acuity and glare disability at low light levels improved from 1 to 12 months post-DSAEK. All corneal thicknesses and ocular lower-order aberrations and HOAs were found to be stable from 1 to 12 months, whereas total corneal, host stromal, and interface brightness intensities decreased significantly over the same period. A repeated measures analysis of variance performed across the follow-up period revealed that the change in scatter, but not the change in the HOAs, could account for the variability occurring in the acuity from 1 to 12 months post-DSAEK. CONCLUSIONS Although ocular HOAs and scatter are both elevated over normal values post-DSAEK, our results demonstrate that the improvements in visual performance occurring over the first year post-DSAEK are associated with decreasing light scatter. In contrast, there were no significant changes in the ocular HOAs during this time. Because corneal light scatter decreased between 1 and 12 months despite there being stable corneal thicknesses over the same period, we conclude that factors that induced light scatter, other than tissue thickness or swelling (corneal edema), significantly impacted the visual improvements that occurred over time post-DSAEK. A better understanding of the cellular and extracellular matrix changes of the subepithelial region and interface, incurred by the surgical creation of a lamellar host-graft interface, and the subsequent healing of these tissues, is warranted.
Collapse
|
44
|
Comparison of the Retinal Straylight in Pseudophakic Eyes with PMMA, Hydrophobic Acrylic, and Hydrophilic Acrylic Spherical Intraocular Lens. J Ophthalmol 2014; 2014:340759. [PMID: 24724015 PMCID: PMC3960563 DOI: 10.1155/2014/340759] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 01/28/2014] [Indexed: 11/21/2022] Open
Abstract
Purpose. To investigate the intraocular straylight value after cataract surgery.
Methods. In this study, 76 eyes from 62 patients were subdivided into three groups. A hydrophobic acrylic, a hydrophilic acrylic, and a PMMA IOL were respectively, implanted in 24 eyes, 28 eyes, and 24 eyes. Straylight was measured using C-Quant at 1 week and 1 month postoperatively in natural and dilated pupils. Results. The hydrophilic acrylic IOLs showed significantly lower straylight values than those of the hydrophobic acrylic IOLs in dilated pupils at 1 week and 1 month after surgery (P < 0.05). However, the straylight values of the hydrophilic acrylic IOLs were the lowest among the three IOL groups. No significant difference was observed in straylight between 1 week and 1 month postoperatively in each group with natural and dilated pupils (P > 0.05). Moreover, no significant difference was found in straylight between natural and dilated pupils in each group at 1 week and 1 month postoperatively (P > 0.05). Conclusions. Although the hydrophobic acrylic IOL induced more intraocular straylight, straylight differences among the 3 IOLs were minimal. Pupil size showed no effect on intraocular straylight; the intraocular straylight was stable 1 week after surgery.
Collapse
|
45
|
Heiner P, Ligabue E, Fan A, Lam D. Safety and effectiveness of a single-piece hydrophobic acrylic intraocular lens (enVista®) - results of a European and Asian-Pacific study. Clin Ophthalmol 2014; 8:629-35. [PMID: 24729678 PMCID: PMC3974695 DOI: 10.2147/opth.s56135] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the safety and effectiveness of a single-piece hydrophobic acrylic intraocular lens (IOL) (enVista® MX60; Bausch and Lomb Incorporated, Rochester, NY, USA) following implantation to correct aphakia subsequent to extracapsular cataract extraction in adults. Subjects and methods This was an open-label, non-interventional, observational study conducted in 19 university and private-practice settings in Europe and the Asia-Pacific region to investigate clinical outcomes of the MX60 IOL in standard practice. Eligible subjects were at least 18 years of age and had undergone standard phacoemulsification and extracapsular cataract extraction with implantation of the MX60 IOL. The primary safety endpoint was the occurrence of adverse events, and the primary effectiveness endpoints included visual and refractive outcomes and stability, with data collected up to 2 years post-procedure. Results In this multicenter study, pooled data of 255 eyes were collected and analyzed. Excellent visual and refractive outcomes and stability were demonstrated. At postoperative visit 4 (61–180 days postoperative), 62.2% of subjects achieved a Snellen best-corrected distance visual acuity (CDVA) of 20/20 (decimal 1.00), and 97.8% of subjects achieved a CDVA of 20/40 (decimal 0.50) or better. One eye (1.0%) underwent neodymium:yttrium aluminum garnet capsulotomy at 12 months post-procedure. No glistenings of any grade were reported for any subject at any visit. Adverse events were infrequent and were consistent with incidences generally reported with cataract surgery. Conclusion This study, which enrolled all comers, provided evidence of the excellent safety and effectiveness of the MX60 IOL in standard practice. Favorable clinical outcomes included outstanding visual and refractive outcomes and stability. No glistenings were reported at any postoperative visit.
Collapse
Affiliation(s)
| | | | - Alex Fan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Dennis Lam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| |
Collapse
|
46
|
Rullo J, Lloyd JC. Clinically significant deterioration in the quality of vision as a result of subsurface nanoglistenings in a hydrophobic acrylic intraocular lens. J Cataract Refract Surg 2014; 40:336-7. [DOI: 10.1016/j.jcrs.2013.12.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Indexed: 11/25/2022]
|
47
|
Packer M. Multifocal intraocular lens technology: biomaterial, optical design and review of clinical outcomes. EXPERT REVIEW OF OPHTHALMOLOGY 2014. [DOI: 10.1586/eop.11.40] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
48
|
Kang MJ, Hwang HB, Chung SK. Effect of Glistening-Free Intraocular Lens on Intraocular Straylight. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2014. [DOI: 10.3341/jkos.2014.55.7.1001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Min Ji Kang
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hyung Bin Hwang
- Department of Ophthalmology and Visual Science, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Sung Kun Chung
- Department of Ophthalmology and Visual Science, St. Paul's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| |
Collapse
|
49
|
Beiko GH, Grzybowski A. Glistenings in hydrophobic acrylic intraocular lenses do affect visual function. Clin Ophthalmol 2013; 7:2271-4. [PMID: 24348015 PMCID: PMC3848924 DOI: 10.2147/opth.s52489] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- George Hh Beiko
- Department of Surgery, McMaster University, Hamilton, ON, Canada ; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
| | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland ; Department of Ophthalmology, Poznan City Hospital, Poznan, Poland
| |
Collapse
|
50
|
Packer M, Fry L, Lavery KT, Lehmann R, McDonald J, Nichamin L, Bearie B, Hayashida J, Altmann GE, Khodai O. Safety and effectiveness of a glistening-free single-piece hydrophobic acrylic intraocular lens (enVista). Clin Ophthalmol 2013; 7:1905-12. [PMID: 24109169 PMCID: PMC3792945 DOI: 10.2147/opth.s50499] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose To evaluate the safety and effectiveness of a single-piece hydrophobic acrylic intraocular lens (IOL; enVista model MX60; Bausch & Lomb, Rochester, NY, USA) when used to correct aphakia following cataract extraction in adults. Methods This was a prospective case series (NCT01230060) conducted in private practices in the US. Eligible subjects were adult patients with age-related cataract amenable to treatment with standard phacoemulsification/extracapsular cataract extraction. With follow-up of 6 months, primary safety and effectiveness end points included the rates of US Food and Drug Administration (FDA)-defined cumulative and persistent adverse events and the percentage of subjects who achieved best-corrected visual acuity (BCVA) of 20/40 or better at final visit. To evaluate rotational stability, subjects were randomized (1:1:1:1) to have the lens implanted in one of four axis positions in 45° increments. Results A total of 122 subjects were enrolled. The rate of cumulative and persistent adverse events did not significantly exceed historical controls, as per FDA draft guidance. At the final postoperative visit, all subjects (100%) achieved a BCVA of 20/40 compared with the FDA historical control of 96.7%. Rotation of the IOL between the two final follow-up visits was ≤5° for 100% of eyes, and refractive stability was demonstrated. A low evaluation of posterior capsule opacification score was demonstrated, and no glistenings of any grade were reported for any subject at any visit. Conclusion This study demonstrated the safety and effectiveness of the MX60 IOL. Favorable clinical outcomes included preserved BCVA, excellent rotational and refractive stability, no glistenings, and a low evaluation of posterior capsule opacification score.
Collapse
Affiliation(s)
- Mark Packer
- Department of Ophthalmology, Oregon Health and Science University, Eugene, OR, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|