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Rua Amaro D, Bertelmann E, von Sonnleithner C. Clinical outcomes and optical performance of a new segmental refractive extended depth-of-focus intraocular lens. BMC Ophthalmol 2024; 24:320. [PMID: 39090592 PMCID: PMC11293127 DOI: 10.1186/s12886-024-03586-4] [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: 01/10/2024] [Accepted: 07/22/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND The visual performance and the optical quality of a segmental refractive extended depth-of-focus (EDoF) intraocular lens (IOL) were evaluated in a prospective, single-arm, single-center study. METHODS A total of 20 patients (40 eyes) after bilateral implantation of the refractive segmental EDoF Acunex Vario AN6V were included. Assessment procedure: refraction outcome, monocular and binocular uncorrected (UCVA) and distance-corrected visual acuity (DCVA), defocus curve, contrast sensitivity (CS), higher-order aberrations (HOAs) and patient satisfaction were evaluated 1 and 3 months after surgery. RESULTS At 3-month follow-up, mean spherical equivalent was - 0.23 ± 0.32 D. Binocular uncorrected distance visual acuity (VA) at distance, intermediate and near was - 0.08 ± 0.06 logMAR at 4 m, -0.03 ± 0.06 logMAR at 66 cm and 0.16 ± 0.06 logMAR at 40 cm, respectively. The binocular defocus curve showed a VA better than 0.20 logMAR over a range from + 1.50 to - 2.45 D. Contrast sensitivity aligned with monofocal lenses, highlighting the lens's clinical value. Aberrometry showed minimal changes in corneal aberrations. NEI-RQL-42-Questionnaire showed a high patient satisfaction for daily activities and revealed reduced dependence on glasses, particularly for near and intermediate vision. The Acunex Vario AN6V demonstrated minimal dysphotopsias, making it a promising option for those seeking spectacle independence. CONCLUSION This segmental refractive EDoF IOL provides a high degree of spectacle independence for far and intermediate distances with functional near VA. Although inducing residual coma aberrations, it showed subjectively good results with little dysphotopsias. TRIAL REGISTRATION This study protocol was reviewed and approved by ethics committee of Charité University, Berlin, Germany, with approval number EA4/126/20.
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Affiliation(s)
- David Rua Amaro
- Department of Ophthalmology, Charité Medical University, Campus Virchow, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Eckart Bertelmann
- Department of Ophthalmology, Charité Medical University, Campus Virchow, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Christoph von Sonnleithner
- Department of Ophthalmology, Charité Medical University, Campus Virchow, Augustenburger Platz 1, 13353, Berlin, Germany.
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Nguyen MTD, Yuan PHS, Bachour K, Sierra MCA, Durr GM. Visual outcomes and rotational stability of a new non-diffractive extended-vision toric intraocular lens. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024; 59:234-240. [PMID: 37321557 DOI: 10.1016/j.jcjo.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/11/2023] [Accepted: 05/19/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To evaluate visual outcomes and intraocular lens (IOL) rotational stability of patients undergoing immediate sequential bilateral cataract surgery with a non-diffractive extended-depth-of-focus toric IOL. DESIGN Non-comparative single-centre cohort study. PARTICIPANTS Twenty patients (40 eyes) with significant cataracts and corneal astigmatism who underwent immediate sequential bilateral cataract surgery with the AcrySof IQ Vivity Extended Vision Lens (Alcon Laboratories Inc, Fort Worth, Tex.). METHODS Binocular uncorrected visual acuities (UCVA) and monocular best-corrected visual acuities (BCVA) were assessed at distance (6 m), intermediate (66 cm), and near (40 cm) postoperatively at 1 week and 3 months. The rotational stability of each IOL was assessed at 1 day, 1 week, and 3 months postoperatively. A validated questionnaire (Questionnaire for Visual Disturbances [QUVID]) was used for patient-reported subjective visual disturbances preoperatively at a 3-month follow-up. RESULTS Binocular distance, intermediate, and near UCVAs (mean ± SD) were 0.00 ± 0.16, 0.09 ± 0.08, and 0.14 ± 0.11 logMAR at 1 week and 0.01 ± 0.06, 0.08 ± 0.08, and 0.14 ± 0.07 logMAR at 3 months postoperatively, respectively. Distance monocular BCVA improved from 0.22 ± 0.23 logMAR preoperatively to 0.02 ± 0.06 logMAR at 3 months. Monocular BCVAs at 3 months were 0.08 ± 0.08 logMAR at intermediate distance and 0.05 ± 0.08 logMAR at near distance. IOL rotation from the intended placement axis was 2.5 ± 1.7 degrees at 1 week and 1.7 ± 1.7 degrees at 3 months postoperatively. CONCLUSIONS The AcrySof IQ Vivity Extended Vision IOL achieved good UCVAs and BCVAs for distance, intermediate, and near vision. This IOL also provided excellent rotational stability for astigmatism correction.
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Affiliation(s)
| | - Po Hsiang Shawn Yuan
- Department of Ophthalmology, University of Montreal Hospital Centre (CHUM), Montreal, QC.
| | - Kenan Bachour
- Department of Ophthalmology, University of Montreal, Montreal, QC
| | | | - Georges M Durr
- Department of Ophthalmology, University of Montreal, Montreal, QC; Department of Ophthalmology, University of Montreal Hospital Centre (CHUM), Montreal, QC
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Inoue M, Itoh Y, Bissen-Miyajima H, Koto T. Retinal Image Quality Through an Operating Microscope With Wavefront Shaping Extended Depth of Focus Intraocular Lens in Model Eye. Am J Ophthalmol 2024; 265:117-126. [PMID: 38701877 DOI: 10.1016/j.ajo.2024.04.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/27/2024] [Accepted: 04/27/2024] [Indexed: 05/05/2024]
Abstract
PURPOSE To compare the quality of images of gratings placed in a model eye viewed through an extended depth of focus (EDoF) intraocular lens (IOL) to that of diffractive bifocal IOL or monofocal IOL. DESIGN Experimental laboratory investigation. METHODS Nondiffractive wavefront shaping EDoF (CNAET0, Alcon Laboratories), echelette-designed EDoF (ZXR00V, Johnson & Johnson Vision), diffractive bifocal IOL with low power addition (SV25T, Alcon Laboratories), or monofocal IOL (CNA0T0, Alcon Laboratories) was placed in a fluid-filled model eye. A United States Air Force Resolution Grating Target was glued to the posterior surface of the model eye and viewed through a flat or a wide-angle contact lens. The contrast of the gratings viewed through the EDoF or multifocal IOLs was compared to that through the monofocal IOL. A wavefront analyzer was used to measure the spherical power of the central 4.5 mm optics of the EDoF, multifocal, and monofocal IOLs. The distribution of the dioptric power and the dioptric power map were compared. RESULTS The gratings observed through the flat contact lens with CNAET0, ZXR00V, or SV25T were slightly blurred when viewed through the multifocal optics. The blurred area was in the circumferential area of CNAET0, the central area of SV25T, and the peripheral area of ZXR00V. The mean contrast was 0.258 ± 0.020 for CNAET0, 0.227 ± 0.025 for ZXR00V, and 0.221 ± 0.020 for SV25T for the 16.0 cyc/mm grating. The contrast was significantly lower for ZXR00V (P = .004) and SV25T (P = .004) than 0.303 ± 0.015 for CNA0T0 but the differences were not significant for CNAET0. For the wide-angle contact lens, the contrast for CNAET0 was 0.182 ± 0.009, for ZXR00V was 0.162 ± 0.011, and for SV25T was 0.163 ± 0.007 for the 16.0 cyc/mm grating, and none was significantly different from 0.188 ± 0.012 for CNA0T0. The dioptric variations of CNAET0 indicated a ring-shaped area of higher power corresponding to the circumferential blurred zone observed through the flat contact lens. CONCLUSIONS The wavefront shaping and echelette-designed EDoF-IOLs reduce the contrast of the grating more than the monofocal IOL when viewed through the flat contact lens. The degree of reduction depended on the design of the extended-focus optics. The difference was less through the wide-angle contact lens.
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Affiliation(s)
- Makoto Inoue
- From the Kyorin Eye Center (MI, YI, TK), Kyorin University School of Medicine, Mitaka, Tokyo, Japan; Department of Ophthalmology (MI, HBM), Tokyo Dental College Suidobashi Hospital, Tokyo, Japan.
| | - Yuji Itoh
- From the Kyorin Eye Center (MI, YI, TK), Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Hiroko Bissen-Miyajima
- Department of Ophthalmology (MI, HBM), Tokyo Dental College Suidobashi Hospital, Tokyo, Japan
| | - Takashi Koto
- From the Kyorin Eye Center (MI, YI, TK), Kyorin University School of Medicine, Mitaka, Tokyo, Japan
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Kim J, Kim TI, Seo KY, Tchah H, Koh K. A comparative study of two presbyopia-correcting intraocular lenses combining bifocal and extended depth-of-focus profiles. Int Ophthalmol 2024; 44:54. [PMID: 38341384 DOI: 10.1007/s10792-024-02979-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/29/2023] [Indexed: 02/12/2024]
Abstract
OBJECTIVE To compare the visual performance of two presbyopia-correcting intraocular lenses (IOLs) that combine both bifocal and extended depth-of-focus profiles, Artis® Symbiose® Plus (Symbiose Plus; Cristalens Industrie, Lannion, France) and Tecnis® Synergy® (Synergy; Johnson & Johnson Vision, Santa Ana, CA, USA). METHODS The medical records of patients with cataract bilaterally implanted with either Symbiose Plus or Synergy between January 2022 and January 2023 were assessed. The principal measures of postoperative findings included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near (40 and 33 cm) visual acuity (UNVA), objective optical quality (OOQ) parameters, distance-corrected defocus curve analysis, and surveys of subjective satisfaction. RESULTS Total of 96 eyes from 48 patients were enrolled. Each group was equally composed of 24 patients, 48 eyes. There were no significant differences between the two groups on baseline characteristics. Both IOLs displayed excellent binocular UDVA, CDVA, and UNVA (40 and 33 cm) with no statistical difference (p = 0.467(UDVA), p = 0.584(CDVA), p = 0.096(40-cm UNVA), and p = 0.621(33-cm UNVA)). However, with regard to UIVA, the Synergy group showed significantly superior results (p < 0.001). In contrast, the Symbiose Plus group showed significantly better results on OOQ parameters and patient-reported quality of vision survey outcomes (both p < 0.001). CONCLUSIONS Both IOLs provided a decent continuous range of vision from near to far distance.
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Affiliation(s)
- Jeongmin Kim
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, 136 Youngshinro, Youngdeungpo-gu, Seoul, 07301, Republic of Korea
| | - Tae-Im Kim
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Kyoung Yul Seo
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Hungwon Tchah
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, 136 Youngshinro, Youngdeungpo-gu, Seoul, 07301, Republic of Korea
| | - Kyungmin Koh
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, 136 Youngshinro, Youngdeungpo-gu, Seoul, 07301, Republic of Korea.
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Kohnen T, Lwowski C, Böhm M, Hemkeppler E, Jandewerth T. Visual Outcomes and Safety of a Refractive Corneal Inlay for Presbyopia: One-Year Results. J Refract Surg 2024; 40:e1-e9. [PMID: 38190559 DOI: 10.3928/1081597x-20231204-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
PURPOSE To determine the visual outcomes and safety 12 months after implantation of the Presbia Flexivue Microlens refractive corneal inlay. METHODS In this prospective, non-randomized trial, 22 patients with a mean age of 52.54 ± 2.86 years were implanted with the Flexivue Microlens refractive corneal inlay in the non-dominant eye at the Department of Ophthalmology, Goethe University, Frankfurt, Germany. Corrected near, intermediate, and distance (CNVA, CIVA, and CDVA) visual acuity and uncorrected near, intermediate, and distance (UNVA, UIVA, and UDVA) visual acuity, manifest refraction, subjective quality of vision, endothelial cell count, and contrast sensitivity were measured 1 day, 1 week, and 1, 3, 6, and 12 months postoperatively. RESULTS For binocular CDVA, no patient lost two or more lines and 30% lost only one line at the 12-month visit. In the eye that had surgery, 85% of the patients lost two or more lines of UDVA, which was statistically significant. Sixty-five percent of the patients gained one or more lines in binocular UIVA, and 80% achieved 20/40 or better in DCIVA. UNVA showed a statistically significant improvement, with 90% of the patients achieving 20/40 or better 12 months after implantation. A total of 85% gained two or more lines in binocular UNVA. CONCLUSIONS This refractive corneal inlay showed an improvement in binocular UNVA, UIVA, CNVA, and CIVA, whereas binocular CDVA and UDVA were not statistically affected. [J Refract Surg. 2024;40(1):e1-e9.].
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Pinheiro RL, Raimundo M, Gil JQ, Henriques J, Rosa AM, Quadrado MJ, Lobo C, Murta JN. The influence of personality on the quality of vision after multifocal intraocular lens implantation. Eur J Ophthalmol 2024; 34:154-160. [PMID: 37218212 DOI: 10.1177/11206721231176313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To assess the possible correlation between patients' personality traits and subjective perception of quality of vision (QoV), after multifocal intraocular lens (mIOL) implantation. METHODS patients who had bilateral implantation of a non-diffractive X-WAVE or a trifocal lens were assessed 6 months postoperatively. Patients answered the NEO-Five Factor Inventory (NEO-FFI-20) questionnaire ("Big Five five-factor personality model") to examine their personality. Six months following surgery, patients were asked to fill a QoV questionnaire where they graded the frequency of 10 common visual symptoms. Primary outcomes were to evaluate the correlation between personality scores and the reported frequency of visual disturbances. RESULTS The study comprised 20 patients submitted to bilateral cataract surgery, 10 with a non-diffractive X-WAVE lens (AcrySof® IQ Vivity) and 10 with a trifocal lens (AcrySof® IQ PanOptix). Mean age was 60.23 (7.06) years. Six months following surgery, patients with lower scores of conscientiousness and extroversion reported a higher frequency of visual disturbances (blurred vision, P = .015 and P = .009, seeing double images P = .018 and P = .006, and having difficulties focusing, P = .027 and P = .022, respectively). In addition, patients with high neuroticism scores had more difficulty focusing (P = .033). CONCLUSIONS In this study, personality traits such as low conscientiousness and extroversion and high neuroticism significantly influenced QoV perception 6 months after bilateral multifocal lens implantation. Patients' personality questionnaires could be a useful preoperative assessment test to a mIOL.
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Affiliation(s)
- Rosa L Pinheiro
- Department of Ophthalmology, Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Miguel Raimundo
- Department of Ophthalmology, Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculdade de Medicina, Clinical Academic Center of Coimbra, Universidade de Coimbra, Coimbra, Portugal
- Clinical Academic Center of Coimbra, Coimbra, Portugal
| | - João Q Gil
- Department of Ophthalmology, Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculdade de Medicina, Clinical Academic Center of Coimbra, Universidade de Coimbra, Coimbra, Portugal
- Clinical Academic Center of Coimbra, Coimbra, Portugal
| | - Jorge Henriques
- Department of Ophthalmology, Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculdade de Medicina, Clinical Academic Center of Coimbra, Universidade de Coimbra, Coimbra, Portugal
- Clinical Academic Center of Coimbra, Coimbra, Portugal
| | - Andreia M Rosa
- Department of Ophthalmology, Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculdade de Medicina, Clinical Academic Center of Coimbra, Universidade de Coimbra, Coimbra, Portugal
- Clinical Academic Center of Coimbra, Coimbra, Portugal
| | - Maria João Quadrado
- Department of Ophthalmology, Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculdade de Medicina, Clinical Academic Center of Coimbra, Universidade de Coimbra, Coimbra, Portugal
- Clinical Academic Center of Coimbra, Coimbra, Portugal
| | - Conceição Lobo
- Department of Ophthalmology, Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculdade de Medicina, Clinical Academic Center of Coimbra, Universidade de Coimbra, Coimbra, Portugal
- Clinical Academic Center of Coimbra, Coimbra, Portugal
| | - Joaquim N Murta
- Department of Ophthalmology, Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculdade de Medicina, Clinical Academic Center of Coimbra, Universidade de Coimbra, Coimbra, Portugal
- Clinical Academic Center of Coimbra, Coimbra, Portugal
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Sihmar Y, Singh BK, Singh VK, Kumar S, Chaudhary A, Saini S. Extended depth of focus intraocular lens versus a new monofocal intraocular lens: A prospective comparative and interventional study. Saudi J Ophthalmol 2023; 37:331-336. [PMID: 38155684 PMCID: PMC10752279 DOI: 10.4103/sjopt.sjopt_68_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/22/2023] [Accepted: 08/21/2023] [Indexed: 12/30/2023] Open
Abstract
PURPOSE To compare the visual outcome findings between a new monofocal intraocular lens (IOL) (Tecnis Eyhance) and extended depth of focus (EDOF) IOL (Appasamy Supraphob Infocus). METHODS This prospective comparative interventional study evaluated 31 patients after implantation of Tecnis Eyhance (15 patients) and Supraphob EDOF IOL (16 patients). The uncorrected and corrected distance and intermediate and near visual acuity were measured at postoperative day 1, 1 week, 4 week, and 3 months. Contrast sensitivity, incidence of halos and glares, and patient satisfaction were assessed at 3 months postoperatively. RESULTS The Tecnis Eyhance (n = 15) and Supraphob EDOF (n = 16) group were comparable with respect to all preoperative parameters including biometry, visual acuity, and cataract status. The average age distribution of participants was 56 ± 6 years. Postoperatively, both groups had similar distance and intermediate vision, but the near vision was significantly better in the EDOF group (P < 0.01) as compared to Tecnis Eyhance at 3 months. The contrast sensitivity and patient satisfaction were similar in both the groups. The incidence of halos and glares was present in the EDOF group, but it was statistically insignificant. CONCLUSION The Tecnis Eyhance and Supraphob EDOF both were effective in improving distance and intermediate vision, but the near vision was significantly better in the EDOF group. Both the groups retained good contrast sensitivity and the majority of patients were satisfied.
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Affiliation(s)
- Yogika Sihmar
- Department of Ophthalmology, M. L. N. Medical College, Prayagraj, Uttar Pradesh, India
| | - Basant K. Singh
- Department of Ophthalmology, M. L. N. Medical College, Prayagraj, Uttar Pradesh, India
| | - Vinod K. Singh
- Department of Ophthalmology, M. L. N. Medical College, Prayagraj, Uttar Pradesh, India
| | - Santosh Kumar
- Department of Ophthalmology, M. L. N. Medical College, Prayagraj, Uttar Pradesh, India
| | - Aparajita Chaudhary
- Department of Ophthalmology, M. L. N. Medical College, Prayagraj, Uttar Pradesh, India
| | - Sanchita Saini
- Department of Ophthalmology, King George’s Medical University, Lucknow, Uttar Pradesh, India
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Solomon KD, Sandoval HP, Potvin R. Visual outcomes, satisfaction, and spectacle independence with a nondiffractive extended vision intraocular lens targeted for slight monovision. J Cataract Refract Surg 2023; 49:686-690. [PMID: 37000976 DOI: 10.1097/j.jcrs.0000000000001191] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/27/2023] [Indexed: 04/03/2023]
Abstract
PURPOSE To evaluate vision, satisfaction, and spectacle independence of the AcrySof IQ Vivity intraocular lens when the nondominant eye is targeted for slight myopia. SETTING 1 clinical practice in the United States. DESIGN Prospective unmasked nonrandomized clinical trial. METHODS Patients presenting for cataract surgery interested in reducing their dependence on spectacles were enrolled, with the dominant eye targeted for emmetropia and the nondominant eye targeted for slight monovision (-0.50 diopters [D]). Visual disturbances, satisfaction, and spectacle independence were evaluated. Visual acuity (VA) was tested at distance (4 m), intermediate (66 cm), and near (40 cm) at 3 months postoperatively when uncorrected, with both eyes corrected to emmetropia and with 1 eye adjusted for monovision. 2 binocular defocus curves were also collected under the latter 2 conditions. RESULTS Data from 31 patients were analyzed. The mean refractive spherical equivalent was 0.45 D more myopic in the nondominant eye, resulting in worse uncorrected VA at distance but better uncorrected VA at near. The binocular defocus curve with monovision showed significantly better VA from -2.0 to -3.0 D, and patients reported less need for spectacles (and better vision) at near than reported with binocular emmetropia. Glare, blurred vision, and starbursts were the most reported visual disturbances. Although not correlated with the difference in refraction, glare and blurred vision were significantly correlated with overall satisfaction. CONCLUSIONS Implanting this IOL with a target of slight myopia in the nondominant eye appears to be a viable way to improve near vision, although with an increased potential for visual disturbances.
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Affiliation(s)
- Kerry D Solomon
- From the Carolina Eyecare Physicians, LLC, Mt. Pleasant, South Carolina (Solomon, Sandoval); Science in Vision, Bend, Oregon (Potvin)
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Scheepers MA, Hall B. Randomized and double-blind comparison of clinical visual outcomes of 2 EDOF intraocular lenses. J Cataract Refract Surg 2023; 49:354-359. [PMID: 36975011 DOI: 10.1097/j.jcrs.0000000000001113] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 11/29/2022] [Indexed: 03/29/2023]
Abstract
PURPOSE To assess and compare the visual disturbance profiles of 2 extended depth-of-focus (EDOF) intraocular lenses (IOLs). SETTING Private practice (West Kootenays, British Columbia, Canada). DESIGN Prospective, randomized, single-surgeon study. METHODS This was a double-blind prospective study of 138 eyes (69 patients) that underwent bilateral implantation of 1 of 2 EDOF IOLs. Participants were randomized to either the Symfony group or the Vivity group. Outcome measures included Questionnaire for Visual Disturbances; binocular corrected distance visual acuities at distance (6 m), intermediate (66 cm), and near (40 cm); and refractive outcomes. RESULTS At 3 months postoperatively, 21 patients (60%) reported not experiencing glare in the Symfony group compared with 30 (88%) in the Vivity group, a difference of 28% (P = .008). Reports of experiencing starbursts were also significantly different between the Symfony and Vivity groups (23 participants [66%] Symfony and 30 participants [88%] Vivity; P = .027). In addition, 12 participants (34%) reported "moderate" or "severe" starbursts in the Symfony group compared with 3 (9%) in the Vivity group, a difference of 25% (P = .019). Visual acuities and refractive outcomes were similar between groups. CONCLUSIONS Both EDOF lenses provide good visual outcomes at distance and intermediate with acceptable near vision. The Symfony group had increased reports of some visual disturbances, notably the frequency, severity, and bothersomeness of starbursts and glare.
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Affiliation(s)
- Marius A Scheepers
- From the University of British Columbia, Kelowna, British Columbia, Canada (Scheepers); Sengi, Penniac, New Brunswick, Canada (Hall)
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McCabe C, Berdahl J, Reiser H, Newsom TH, Cibik L, Koch D, Lemp-Hull J, Jasti S. Clinical outcomes in a U.S. registration study of a new EDOF intraocular lens with a nondiffractive design. J Cataract Refract Surg 2022; 48:1297-1304. [PMID: 35616507 PMCID: PMC9622364 DOI: 10.1097/j.jcrs.0000000000000978] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 05/23/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE To evaluate the effectiveness and safety of the DFT015 intraocular lens (IOL) (AcrySof IQ Vivity Extended Vision) compared with an aspheric monofocal control IOL (AcrySof IQ model SN60WF). SETTING 11 investigation sites in the U.S. DESIGN Prospective randomized controlled clinical study. METHODS Patients aged 22 years or older with bilateral cataracts were randomized to receive bilateral implantation of DFT015 or SN60WF. The 4 coprimary effectiveness outcomes (6 months postoperatively) were monocular photopic distance-corrected intermediate visual acuity (DCIVA), monocular photopic corrected distance visual acuity (CDVA), monocular depth of focus (DoF), and the percentage of patients achieving a DCIVA of 0.2 logMAR or better. The mean monocular photopic distance-corrected near visual acuity (DCNVA) was a secondary effectiveness outcome. Safety and patient-reported visual disturbances were evaluated through questionnaires. RESULTS 218 patients (435 eyes) completed the study. Compared with SN60WF, DFT015 demonstrated superior mean monocular photopic DCIVA ( P &lt; .001), noninferior mean monocular photopic CDVA, and superior mean monocular photopic DCNVA ( P &lt; .001) and provided an extended monocular DoF (increase of 0.54 diopters at 0.2 logMAR). With DFT015, 78 first eyes (72.9%) achieved a DCIVA of 0.2 logMAR or better at 6 months. Incidences of ocular serious adverse events and patient-reported most bothersome visual disturbances were low and consistent between groups. CONCLUSIONS DFT015 is safe and effective for the visual correction of aphakia, exceeding American National Standards Institute criteria for an extended depth-of-focus IOL by providing superior DCIVA and DCNVA, with comparable CDVA and visual disturbances to the SN60WF monofocal IOL.
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A Comparative Study of Two Extended Depth of Focus Intraocular Lenses. Eye Contact Lens 2022; 48:433-438. [PMID: 36155949 DOI: 10.1097/icl.0000000000000931] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess and compare the visual performance of two extended depth-of-focus intraocular lenses (IOLs), Tecnis Symfony (Symfony; Johnson & Johnson Vision, Santa Ana, CA) and Acrysof IQ Vivity (Vivity; Alcon Inc, Fort Worth, TX). METHODS The medical records of patients undergoing cataract surgery with Symfony or Vivity implantation from May 2021 to September 2021 and the data available for the 3-month follow-up were reviewed. The main measures of the findings were uncorrected and corrected distance (4 m) visual acuity (VA), uncorrected intermediate (66 cm) VA (UIVA) and uncorrected near (40 and 33 cm) VA (UNVA), refractive error (RE), defocus profiles analysis, optical quality parameters, and patient-reported quality of vision questionnaire results. RESULTS Of the 40 patients, 19 patients (31 eyes) were treated with the Symfony IOL and 21 (32 eyes) with the Vivity IOL. The mean age of the patients was 63.4±7.8 (range, 40-76) years in the Symfony group and 61.8±9.7 (range, 40-77) years in the Vivity group. There was no meaningful difference between the two groups in the preoperative parameters, except that the Vivity group had a better CDVA. Among the main measures of results, there was no statistically significant difference, except for the UNVA (33 cm). The Symfony group also showed a smoother defocus curve at 3 months postoperatively. CONCLUSION There was no significant difference between the two groups regarding uncorrected/corrected distance VA, UIVA, UNVA (40 cm), RE, optical quality parameters, and patient-reported quality of vision questionnaire results. The Symfony group demonstrated a significantly superior UNVA (33 cm) and a smoother defocus curve with a broad landing zone.
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Self-rated quality of vision and optical phenomena intensity of diffractive presbyopia-correcting IOLs: EDoF, trifocal vs panfocal. J Cataract Refract Surg 2022; 48:877-886. [PMID: 34753879 DOI: 10.1097/j.jcrs.0000000000000862] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 11/01/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE To investigate the self-rated quality of vision (SQV) and optical phenomena intensity of 3 diffractive multifocal intraocular lenses (mIOLs). SETTING Department of Ophthalmology, Goethe University Frankfurt, Germany. DESIGN Prospective comparative case series. METHODS Patients who had bilateral implantation of a diffractive extended depth-of-focus (EDoF), trifocal, or panfocal mIOL were assessed. Outcome parameters were SQV, symptom intensity of optical phenomena under 3 lighting conditions, quality of everyday lifestyle activities, spectacle independence (SI), and contrast sensitivity (CS). RESULTS The study comprised 108 eyes. The 3 lenses provided good total SQV under all lighting conditions. EDoF patients reported a slightly better total SQV (EDoF: 9.8 ± 6.67, trifocal: 22.2 ± 7.09, panfocal: 19.6 ± 16.25 visual analog scale, P = .041). A similar percentage of patients reported the presence of optical phenomena with no difference between mIOLs ( P > .05). EDoF, trifocal, and panfocal patients rated symptom intensity of optical phenomena mild to moderate under all lighting conditions; however, EDoF patients reported a lower symptom intensity of halos ( P < .05). Reported quality of everyday lifestyle activities and CS were comparable ( P < .05). All panfocal and trifocal patients (100%) achieved complete SI, whereas almost half (44%) of the EDoF patients used reading spectacles. CONCLUSIONS Diffractive EDoF, trifocal, and panfocal mIOLs provided good total SQV with mild to moderate intensity of optical phenomena under all lighting conditions. EDoF patients experienced the same percentage of optical phenomena but reported a weaker symptom intensity of halos and better night-driving ability. EDoF patients would all choose the same IOL, although a significant number of them needed reading spectacles, indicating that SI is not the main factor that determines patient selection of IOLs.
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Tahmaz V, Siebelmann S, Koch KR, Cursiefen C, Langenbucher A, Hoerster R. Evaluation of a Novel Non-Diffractive Extended Depth of Focus Intraocular Lens - First Results from a Prospective Study. Curr Eye Res 2022; 47:1149-1155. [PMID: 35642558 DOI: 10.1080/02713683.2022.2074046] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To evaluate a novel hydrophobic, non-diffractive, extended depth of focus (EDOF) intraocular lens (IOL) design in comparison to two monofocal aspheric lenses. METHODS Inclusion criteria for this prospective, monocentric cohort study were opacification of the crystalline lens and patients' wishes for surgery. In the case of the EDOF IOL, patients asked for a presbyopia correction. All patients received surgery on both eyes. Corrected and uncorrected distance visual acuity (CDVA, UCDVA), uncorrected and distance corrected intermediate visual acuity (UIVA, DCIVA) and defocus curves (all monocular and binocular) were compared three months postoperatively. RESULTS Fifty-six eyes were implanted with an EDOF IOL (LuxSmartTM, Bausch & Lomb GmbH, Berlin, Germany), 50 eyes with a monofocal aspheric IOL: 32 eyes with a clear IOL (Polylens® AS 61, Polytech Domilens, Roßdorf, Germany), 16 eyes with a yellow IOL (iSert® 251, Hoya Surgical Optics GmbH, Frankfurt, Germany). Three months postoperatively, UCDVA was comparable with the EDOF IOL, versus the monofocal IOL (P > 0.9). Binocular DCIVA in the EDOF IOL was significantly higher than in the monofocal IOL (P = 0.001). Monocular DCIVA better than 20/23 Snellen was achieved in 10% with the monofocal IOL and in 68% (P < 0.0001) with the EDOF IOL. Defocus curves showed a depth of focus at 20/23 Snellen of 1.6 vs. 0.83 diopters (D) in the EDOF IOL, vs. the monofocal IOL. No patient reported halos or starbursts in non-standardized questioning. CONCLUSION This non-diffractive EDOF IOL provided comparably high UCDVA and significantly higher DCIVA than the mono-focal lenses, causing only mild optical phenomena.
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Affiliation(s)
- Volkan Tahmaz
- Center of Ophthalmology, University of Cologne, Cologne, Germany
| | - Sebastian Siebelmann
- Center of Ophthalmology, University of Cologne, Cologne, Germany.,MVZ ADTC Moenchengladbach-Erkelenz, Erkelenz, Germany
| | - Konrad R Koch
- MVZ ADTC Moenchengladbach-Erkelenz, Erkelenz, Germany
| | - Claus Cursiefen
- Center of Ophthalmology, University of Cologne, Cologne, Germany
| | - Achim Langenbucher
- Department of Experimental Ophthalmology, Saarland University, Homburg, Germany
| | - Robert Hoerster
- Center of Ophthalmology, University of Cologne, Cologne, Germany.,MVZ ADTC Moenchengladbach-Erkelenz, Erkelenz, Germany
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Böhm M, Müller M, Paul J, Hemkeppler E, Kohnen T. Intraoperative OCT vs Scheimpflug and swept-source OCT measurements for anterior eye parameters. J Cataract Refract Surg 2022; 48:667-672. [PMID: 34486574 DOI: 10.1097/j.jcrs.0000000000000813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 08/27/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare agreement of anterior segment parameter measurements using an intraoperative optical coherence tomography (iOCT) of a femtosecond laser (LenSx) during interface docking to the eye with preoperative Scheimpflug tomography (Pentacam AXL) and swept-source optical coherence tomography (SS-OCT) (IOLMaster 700). SETTING Department of Ophthalmology, Goethe University, Frankfurt, Germany. DESIGN Retrospective study. METHODS Anterior segment measurements were performed in mydriasis prior to surgery using Scheimpflug tomography and SS-OCT. Postoperatively, iOCT images were analyzed using a modification of the FIJI image-processing program. Outcome measures included external anterior chamber depth (ACD), central corneal thickness (CCT), and central lens thickness (LT). RESULTS 95 eyes of 66 patients who underwent planned OCT guided femtosecond laser-assisted lens surgery were included. The ACD measured with the iOCT was -0.011 ± 0.126 mm smaller (P = .389) than that with the SS-OCT and -0.059 ± 0.185 mm than with the Scheimpflug tomography (P = .003). The SS-OCT measured a -0.047 ± 0.146 mm smaller ACD than the Scheimpflug tomography (P = .002). The measurements of CCT using the iOCT and the Scheimpflug tomography (-0.705 ± 20.837 μm, P = .742) and the LT measurements using SS-OCT and iOCT (-0.050 ± 0.089 mm, P < .001) showed no clinically relevant difference. Only the ACD between the iOCT and the Scheimpflug tomography showed a clinically relevant difference. CONCLUSIONS The comparison of the anterior segment parameters of iOCT with SS-OCT showed no clinically relevant differences regarding the ACD and the LT. However, Scheimpflug tomography vs iOCT measured a small clinically relevant difference for ACD. The iOCT showed no clinically relevant differences in anterior segment parameters compared with the SS-OCT. A small clinically relevant difference for ACD was found in comparison with that of a Scheimpflug device.
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Affiliation(s)
- Myriam Böhm
- From the Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany (Böhm, Müller, Paul, Hemkeppler, Kohnen); Harvard Medical School, Boston, Massachusetts (Böhm)
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Sevik MO, Akkaya Turhan S, Toker E. Clinical outcomes with a low add multifocal and an extended depth of focus intraocular lenses both implanted with mini-monovision. Eye (Lond) 2022; 36:1168-1177. [PMID: 34117383 PMCID: PMC9151652 DOI: 10.1038/s41433-021-01600-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To compare the visual acuity, contrast sensitivity (CS), spectacle needs, photic phenomena, and quality of life parameters of patients bilaterally implanted with a low add multifocal (MIOL) or an extended depth of focus (EDOF) intraocular lens (IOL), both with intended mini-monovision. METHODS In this prospective, randomized, comparative study, patients were randomized to receive either Tecnis +2.75 D (ZKB00) (MIOL Group, n = 15) or Tecnis Symfony (ZXR00) (EDOF Group, n = 14) for bilateral implantation with mini-monovision (-0.50 D). Binocular logMAR uncorrected visual acuities (UVA), monocular defocus curves, CS with CSV 1000-E, and Pelli-Robson Test (PRT), spectacle needs and quality of life parameters with NEI RQL-42 questionnaire were evaluated at postoperative 1, 3, and 6 months. RESULTS Results of MIOL and EDOF Groups at postoperative month 6 are as follows: distance (6 m) UVA -0.03 ± 0.05 and -0.05 ± 0.06 (p = 0.938), intermediate (60 cm) UVA, 0.04 ± 0.08 and -0.03 ± 0.07 (p = 0.046); near (40 cm) UVA, 0.22 ± 0.08 and 0.15 ± 0.07 (p = 0.046); near spectacle needs, 26.7% and 14.3% (p > 0.05), respectively. Better visual acuity was achieved in the EDOF Group between the defocus range of -0.50 and -1.75 D (p < 0.05). No significant difference was found regarding photic phenomena and CS evaluated with CSV 1000-E between the two IOL groups at 6 months after surgery (otherwise there are differences at 1 and 3 months in favor of EDOF). However, EDOF Group performed better in mesopic CS evaluated with PRT (p < 0.05). CONCLUSIONS When implanted with mini-monovision better binocular uncorrected visual performance at intermediate and near distances achieved with EDOF than low add MIOL.
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Affiliation(s)
- Mehmet Orkun Sevik
- Department of Ophthalmology, Marmara University School of Medicine, Istanbul, Turkey.
| | - Semra Akkaya Turhan
- grid.16477.330000 0001 0668 8422Department of Ophthalmology, Marmara University School of Medicine, Istanbul, Turkey
| | - Ebru Toker
- grid.16477.330000 0001 0668 8422Department of Ophthalmology, Marmara University School of Medicine, Istanbul, Turkey
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Chao CC, Lin HY, Lee CY, Mai ELC, Lian IB, Chang CK. Difference in Quality of Vision Outcome among Extended Depth of Focus, Bifocal, and Monofocal Intraocular Lens Implantation. Healthcare (Basel) 2022; 10:healthcare10061000. [PMID: 35742051 PMCID: PMC9223205 DOI: 10.3390/healthcare10061000] [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: 04/08/2022] [Revised: 05/18/2022] [Accepted: 05/24/2022] [Indexed: 02/04/2023] Open
Abstract
We aimed to compare the postoperative quality of vision among patients who received extended depth of focus (EDOF), bifocal, and monofocal intraocular lens (IOL) implantation. A retrospective study was conducted, and 87 patients who underwent cataract surgery were enrolled. Patients were categorized into different groups according to IOL design, with 24, 29, and 34 individuals constituting bifocal, EDOF, and monofocal groups. Preoperative and postoperative visual acuity (VA), biometry data, refractive status, contrast sensitivity (CS), higher-order aberrations (HOAs), and a quality of vision questionnaire that consisted of 11 questions were obtained 1 month postoperatively. The Kruskal−Wallis test and Pearson’s chi-square test were applied for statistical analyses. The postoperative CDVA was better in the EDOF group than in the bifocal group (p = 0.043), and the residual cylinder was lower in the EDOF groups than in the other two groups (both p < 0.05). The CS was worse in the EDOF group than in the other two groups (all p < 0.05), while the spherical aberration and trefoil were lower in the EDOF group than in the bifocal group (both p < 0.05). In terms of the quality of vision, the scores were better in the monofocal group than in the EDOF group in seven items (all p < 0.05), and the quality of vision in the bifocal group was better than in the EDOF group in small print reading (p = 0.042). In addition, the incidence of glare was lower in the monofocal group than in the other two groups (p < 0.001), while the spectacle dependence ratio was significantly higher in the monofocal group compared to the other two groups (p < 0.001). In conclusion, the general quality of vision was better in the monofocal group compared to the bifocal and EDOF groups, while the spectacle dependence ratio was significantly higher in the monofocal group than in the other two groups.
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Affiliation(s)
- Chen-Cheng Chao
- Nobel Eye Institute, Taipei 100008, Taiwan; (C.-C.C.); (C.-Y.L.)
- Department of Optometry, MacKay Junior College of Medicine, Nursing, and Management, Taipei 11260, Taiwan;
| | | | - Chia-Yi Lee
- Nobel Eye Institute, Taipei 100008, Taiwan; (C.-C.C.); (C.-Y.L.)
| | - Elsa Lin-Chin Mai
- Department of Optometry, MacKay Junior College of Medicine, Nursing, and Management, Taipei 11260, Taiwan;
- Department of Optometry, Yuanpei University of Medical Technology, Hsinchu 30015, Taiwan
- Department of Ophthalmology, Far Eastern Memorial Hospital, Taipei 220216, Taiwan
| | - Ie-Bin Lian
- Institute of Statistical and Information Science, National Changhua University of Education, Changhua 50007, Taiwan;
| | - Chao-Kai Chang
- Nobel Eye Institute, Taipei 100008, Taiwan; (C.-C.C.); (C.-Y.L.)
- Department of Optometry, Yuanpei University of Medical Technology, Hsinchu 30015, Taiwan
- Departament of Optometry, Da-Yeh University, Chunghua 515006, Taiwan
- Correspondence: ; Tel.: +886-2-2370-5666
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Nowik KE, Nowik K, Kanclerz P, Szaflik JP. Clinical Performance of Extended Depth of Focus (EDOF) Intraocular Lenses – A Retrospective Comparative Study of Mini Well Ready and Symfony. Clin Ophthalmol 2022; 16:1613-1621. [PMID: 35651536 PMCID: PMC9150758 DOI: 10.2147/opth.s341698] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/14/2022] [Indexed: 11/27/2022] Open
Abstract
Purpose Extended depth of focus intraocular (EDOF) IOLs form a bridge between single- and multifocal IOL design. This study aimed to compare clinical outcomes obtained after implanting two different optical designs of EDOF IOLs: the Mini Well Ready (SIFI Medtech, Catania, Italy) and Tecnis Symfony (Abbott Laboratories, Illinois, USA). Methods The retrospective observational study included 61 patients (122 eyes) who underwent bilateral implantation of the Mini Well Ready IOL (32 patients) or the Tecnis Symfony IOL (29 patients). The following preoperative and postoperative parameters were evaluated: spherical equivalent, anterior astigmatism, pupil size, monocular and binocular uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), monocular and binocular uncorrected intermediate visual acuity (UIVA) and distance-corrected intermediate visual acuity (DCIVA), monocular and binocular uncorrected near visual acuity (UNVA) and distance-corrected near visual acuity (DCNVA). In the 6 months postoperative period, defocus curve, contrast sensitivity, photopic phenomena, and posterior capsule opacification were assessed. Results The patients receiving the Tecnis Symfony had slightly better monocular and binocular UDVA and CDVA than with the Mini Well Ready IOL, the differences were not statistically significant. Whereas the UIVA, DCIVA, UNVA, DCNVA, UNVA and DCNVA values were higher in the Mini Well Ready group, the differences were not significant. There were no significant between-group differences regarding the defocus curve for the vast majority of tested vergences. Dysphotopsias postoperatively were assessed at 6 months. Conclusion Patients receiving both the Mini Well Ready and Symfony IOLs had excellent visual acuity outcomes and spectacle independence.
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Affiliation(s)
- Katarzyna Ewa Nowik
- Department of Ophthalmology, Public Ophthalmic Clinical Hospital (SPKSO), Medical University of Warsaw, Warsaw, Poland
- Correspondence: Katarzyna Ewa Nowik, Tel +48 509 873 680, Email
| | - Kamil Nowik
- Department of Ophthalmology, Public Ophthalmic Clinical Hospital (SPKSO), Medical University of Warsaw, Warsaw, Poland
| | - Piotr Kanclerz
- Department of Ophthalmology, Hygeia Clinic, Gdańsk, Poland
- Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland
| | - Jacek Paweł Szaflik
- Department of Ophthalmology, Public Ophthalmic Clinical Hospital (SPKSO), Medical University of Warsaw, Warsaw, Poland
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Shin DE, Lee H, Kim TI, Koh K. Comparison of visual results and optical quality of two presbyopia-correcting intraocular lenses: TECNIS symfony versus TECNIS synergy. Eur J Ophthalmol 2022; 32:3461-3469. [PMID: 35410507 DOI: 10.1177/11206721221093024] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE This study compared the extended depth of focus (EDOF) intraocular lens (IOL) (ZXR00; Tecnis® Symfony®, Johnson & Johnson Vision, Santa Ana, CA, USA) and a new presbyopia-correcting IOL that combines EDOF and multifocal profiles (ZFR00; Tecnis® Synergy®, Johnson & Johnson Vision, Santa Ana, CA, USA) with the same material. METHODS The medical records of patients undergoing cataract surgery with ZXR00 or ZFR00 implantation between March 2021 and July 2021 and with the data available for the 3-month visit were reviewed. The uncorrected near, intermediate, and distance visual acuity (VA), corrected distance VA, defocus curves, refractive errors (RE), optical quality parameters, and patient-reported visual performance parameters were the main outcome measures. RESULTS Among the twenty-three enrolled patients, twelve patients (21 eyes) received ZXR00 and nine patients (17 eyes) received ZFR00. The mean age of the patients was 59.6 ± 10.6 (range: 49 to 70) and 65.2 ± 8.2 (range: 45 to 82) years in ZXR00 and ZFR00 groups, respectively, without significant difference. There was not a significant difference between the two groups in terms of baseline parameters and postoperative RE. The ZFR00 group showed markedly superior intermediate and near VA (p < 0.001 for all) at 3 months postoperatively. In terms of optical quality, ZXR00 was significantly better than ZFR00 (p < 0.001). CONCLUSIONS Both IOLs had comparable distance VA. ZFR00 IOL was superior for intermediate and near visual acuity, but ZXR00 IOL was better for optical quality. Research with more participants is needed to support this finding.
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Affiliation(s)
- Da Eun Shin
- Department of Opthalmology, 224183Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Republic of Korea
| | - Hun Lee
- Department of Ophthalmology, Asan Medical Center, 571440University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Tae-Im Kim
- Department of Opthalmology, Severance Eye Hospital, 37991Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyungmin Koh
- Department of Opthalmology, 224183Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Republic of Korea
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Bala C, Poyales F, Guarro M, Mesa RR, Mearza A, Varma DK, Jasti S, Lemp-Hull J. Multicountry clinical outcomes of a new nondiffractive presbyopia-correcting IOL. J Cataract Refract Surg 2022; 48:136-143. [PMID: 34288635 PMCID: PMC8845530 DOI: 10.1097/j.jcrs.0000000000000712] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 06/07/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the effectiveness and safety of a new presbyopia-correcting intraocular lens (IOL) with a nondiffractive design, DFT015, compared with an aspheric monofocal IOL, SN60WF. SETTING 19 investigational sites in 4 countries: Australia, Canada, Spain, and the United Kingdom. DESIGN Prospective, randomized, parallel-group, controlled, assessor- and patient-masked clinical study. METHODS Participants aged ≥22 years with bilateral cataracts were randomized to DFT015 or SN60WF in a 5:4 ratio and masked until final postoperative follow-up at month 6. The primary effectiveness objective was superiority of DFT015 over SN60WF in mean monocular photopic distance-corrected intermediate visual acuity (DCIVA) at month 3. Secondary effectiveness objectives included noninferiority of DFT015 to SN60WF in mean monocular photopic corrected distance visual acuity (CDVA) and superiority in the mean monocular photopic distance-corrected near visual acuity (DCNVA) at month 3. Visual disturbances were assessed at month 6. RESULTS 282 patients were randomized to DFT015 (n = 159) or SN60WF (n = 123). All effectiveness objectives were achieved at month 3 in first eyes. For monocular photopic results in first eyes, DFT015 demonstrated superior mean DCIVA (least squares means of -0.139 logMAR in favor of DFT015, P < .001), noninferior mean CDVA (97.5% upper confidence limit [UCL] of the difference was <0.1 logMAR) and superior mean DCNVA (95% UCL of the difference was <0.0 logMAR) compared with SN60WF at month 6. DFT015 exhibited a similar visual disturbance profile to that of SN60WF. CONCLUSIONS DFT015 provided superior intermediate and near vision and a similar visual disturbance profile compared with an aspheric monofocal IOL.
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Keeping patient outcome surveys in pace with presbyopia correction technology. J Cataract Refract Surg 2022; 48:133-134. [PMID: 35082237 DOI: 10.1097/j.jcrs.0000000000000880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Nanavaty MA, Ashena Z, Gallagher S, Borkum S, Frattaroli P, Barbon E. Visual Acuity, Wavefront Aberrations, and Defocus Curves With an Enhanced Monofocal and a Monofocal Intraocular Lens: A Prospective, Randomized Study. J Refract Surg 2022; 38:10-20. [PMID: 35020542 DOI: 10.3928/1081597x-20211109-02] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare uniocular and binocular visual acuity, wavefront aberrations, and defocus curves using the TECNIS Eyhance (Johnson & Johnson) and RayOne (Rayner) intraocular lenses (IOLs). METHODS In this prospective, randomized, comparative study, 50 patients (100 eyes) were randomized to receive the same IOL bilaterally (ClinicalTrials.gov Identifier: NCT04175951). Follow-up visits were at 1 and 3 to 9 months postoperatively. Primary outcome measures were uncorrected distance (UDVA) and uncorrected intermediate (UIVA) visual acuity (logMAR) at 66 cm. Secondary outcome measures were corrected distance (CDVA) and distance-corrected intermediate (DCIVA) visual acuity at 66 cm, manifest refraction, spherical (Z40) and vertical coma (Z3-1) aberrations (total, internal eye, and corneal) at normal pupil size, defocus curves, and Catquest 9SF and Glare and Halos questionnaire on Likert scale (1 = no glare and halos and 4 = continuous). RESULTS Uniocular UDVA (P = .02), UIVA (P = .02), and binocular UIVA (P < .01) and uniocular (P = .01) and binocular (P < .01) DCIVA were better with the TECNIS Eyhance IOL at 3 to 9 months. At 3 to 9 months, both uniocular and binocular defocus curves were significantly broader with the TECNIS Eyhance IOL between -0.50 and -3.00 diopters (D). For total and internal eye, there was a statistically but clinically insignificant difference in Z40 with the TECNIS Eyhance IOL. Rasch scores improved (TECNIS Eyhance: 2.04 ± 1.34 to 2.91 ± 0.81 and RayOne:1.61 ± 1.35 to 2.97 ± 0.16) at 3 to 9 months. Refraction, Z3-1, glare, and halos were not different. CONCLUSIONS The TECNIS Eyhance IOL provided better DCIVA and broader defocus curves than the RayOne IOL. There was no difference in CDVA or patient-reported outcomes. Although there were some differences in aberrations when measured with normal pupil size, they were not clinically significant. [J Refract Surg. 2022;38(1):10-20.].
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22
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Ozturkmen C, Kesim C, Gunel Karadeniz P, Sahin A. Comparative Analysis of a New Hybrid EDOF-Multifocal Diffractive Intraocular Lens with a Trifocal Diffractive Intraocular Lens. Eur J Ophthalmol 2021; 32:2961-2966. [PMID: 34905987 DOI: 10.1177/11206721211067643] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To compare visual acuity, defocus curve and visual quality of life performances of a new hybrid refractive-diffractive intraocular lens (IOL) and a trifocal diffractive IOL. METHODS Patients who underwent cataract surgery with bilateral implantation of ZFR00V or TFNT00 IOLs were enrolled in this study. The main outcomes were defined as uncorrected distant, intermediate and near visual acuities (UDVA, UIVA and UNVA, respectively), defocus curve and VF-14 questionnaire aimed for visual performance. RESULTS Fifty patients, of whom 30 had bilateral ZFR00V implantation, were enrolled in the study. Patients with ZFR00V had significantly better UIVA than patients with TFNT00 (0.05 ± 0.03 vs. 0.07 ± 0.04 logMAR, P = 0.02). Defocus curve showed significantly higher visual acuity in intermediate range for ZFR00V IOL between -1.00 and -1.50 dioptres (all P < 0.05). All patients had good visual performance with mean VF-14 scores above 3 points with no significant difference between two IOL models. Spectacle independence was 100% for both distant and near vision in both group of patients. CONCLUSION Bilateral implantation of ZFR00V in cataract patients shows better intermediate visual acuity scores and similar daily visual performance when compared with trifocal TFNT00 IOL.
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Affiliation(s)
| | - Cem Kesim
- Department of Ophthalmology, 52979Koc University School of Medicine, Istanbul, Turkey
| | - Pinar Gunel Karadeniz
- Department of Biostatistics, Gaziantep SANKO University School of Medicine, Gaziantep, Turkey
| | - Afsun Sahin
- Department of Ophthalmology, 52979Koc University School of Medicine, Istanbul, Turkey.,52979Koc University Research Center for Translational Medicine, Istanbul, Turkey
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Coassin M, Mori T, Di Zazzo A, Poddi M, Sgrulletta R, Napolitano P, Bonini S, Orfeo V, Kohnen T. Effect of minimonovision in bilateral implantation of a novel non-diffractive extended depth-of-focus intraocular lens: Defocus curves, visual outcomes, and quality of life. Eur J Ophthalmol 2021; 32:2942-2948. [PMID: 34825597 DOI: 10.1177/11206721211064018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate overall patient satisfaction, spectacle independence, visual acuity, and prevalence of optical phenomena following bilateral implantation of a new non-diffractive extended depth-of-focus intraocular lens targeted for minimonovision. METHODS Multicenter prospective case series. Postoperative far and near visual acuity at 3 months and patient quality of life by NEI-VFQ-25 questionnaire were assessed. Postoperative evaluation included defocus curves analysis, spectacle independence assessment, and recording of photic phenomena. RESULTS The study enrolled 97 eyes of 59 patients that underwent femtosecond-assisted cataract surgery with AcrySof IQ Vivity intraocular lens implantation. Thirty subjects (60 eyes) were eligible for analysis. After 3 months, postoperative achieved binocular uncorrected visual acuity was -0.03 ± 0.06 logarithm of the minimum angle of resolution for distance, 0.06 ± 0.06 logarithm of the minimum angle of resolution for intermediate, and 0.19 ± 0.03 logarithm of the minimum angle of resolution for near. Defocus curve showed a smooth profile with no abrupt decrease of visual acuity. Minimonovision significantly improved visual acuity compared to when minimonovision was neutralized, for values of defocus curves from -1 to -3 D (p < 0.05). Twenty-six (87%) patients reported complete spectacle independence. High levels of satisfaction for distance and near vision resulted at VFQ-25 questionnaire. Only two patients complained of halos (6.7%) and one of them also of glare (3.3%). CONCLUSIONS Implantation of this new non-diffractive extended depth-of-focus intraocular lens with minimonovision resulted in satisfying far, intermediate, and near visual acuity with a consistent reduction of spectacle dependence and improvement in patient's quality of life.
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Affiliation(s)
- Marco Coassin
- Ophthalmology, 9317University Campus Bio-Medico, Roma, Italy
| | - Tommaso Mori
- Ophthalmology, 9317University Campus Bio-Medico, Roma, Italy
| | | | - Maria Poddi
- Ophthalmology, 9317University Campus Bio-Medico, Roma, Italy
| | | | | | - Stefano Bonini
- Ophthalmology, 9317University Campus Bio-Medico, Roma, Italy
| | - Vincenzo Orfeo
- 47235Clinica Mediterranea, Ophthalmology Unit, Napoli, Italy
| | - Thomas Kohnen
- Department of Ophthalmology, 144867Goethe University, Frankfurt, Germany
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Ozturkmen C, Kesim C, Karadeniz PG, Sahin A. Visual acuity, defocus curve and patient satisfaction of a new hybrid EDOF-multifocal diffractive intraocular lens. Eur J Ophthalmol 2021; 32:2988-2993. [PMID: 34766507 DOI: 10.1177/11206721211057338] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Purpose: To evaluate the visual acuity, defocus curve and visual quality of life following bilateral implantation of a new hybrid extended depth of focus (EDOF)-multifocal diffractive intraocular lens (IOL). Methods: Patients who underwent cataract surgery with bilateral implantation of Tecnis Synergy IOL were enrolled in this study. The main outcomes were defined as uncorrected distant, intermediate and near visual acuities (UDVA, UIVA and UNVA, respectively), defocus curve and VF-14 questionnaire aimed for visual performance. Results: The mean ± SD values for binocular UDVA, UIVA and UNVA were -0.01 ± 0.04, 0.05 ± 0.03 and 0.03 ± 0.05 logMAR, respectively. Defocus curve showed a continuous vision above 0.16 logMAR between +0.50 D and -2.50 D. Patients had good visual performance with mean VF-14 scores above 3 points. Driving at night (3.47 ± 0.64) was found to be the most difficult task to perform. Spectacle independence was 100% for both distant and near vision. Conclusion: Bilateral implantation of Tecnis Synergy IOL in cataract patients shows good visual acuity and performance, covering a good visual range without any need of spectacles.
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Affiliation(s)
| | - Cem Kesim
- Department of Ophthalmology, 52979Koc University School of Medicine, Istanbul, Turkey
| | | | - Afsun Sahin
- Department of Ophthalmology, 52979Koc University School of Medicine, Istanbul, Turkey.,Koc University Research Center for Translational Medicine, Istanbul, Turkey
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Citation network analysis of the various types of multifocal intraocular lenses. ARCHIVOS DE LA SOCIEDAD ESPAÑOLA DE OFTALMOLOGÍA 2021; 96:527-544. [PMID: 34620483 DOI: 10.1016/j.oftale.2020.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/21/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE The implantation of multifocal intraocular lens (IOL) has increased in recent years, allowing patients to achieve good quality vision at all distances, independence from use of glasses, and consequently, an increase in quality of life. The main purpose of this study was to analyse the links between publications and authors via citation networks, as well to as identify the different research areas and determine the most cited publications. MATERIAL AND METHODS The publication search was performed through the Web of Science database, using the terms «Multifocal intraocular lens», «Bifocal intraocular lens», «Trifocal intraocular lens», «Diffractive intraocular lens», «Refractive intraocular lens», «Accommodative intraocular lens» and «Extended depth of focus intraocular lens», for a time interval from 1989 to August 2020. The software used to analyse the publications was the Citation Network Explorer. RESULTS A total of 1293 publications were found, with 11,730 citations generated in the network, and 2019 had the highest number of publications of any year. The most cited publication was «European multicenter study of the AcrySof ReSTOR apodized diffractive intraocular lens» by Kohnen et al., published in 2006. Four groups about different research areas in this field were found using the Clustering functionality: visual quality, IOL designs, ocular aberrations, or defocus curves. CONCLUSIONS The citation network offers an objective and comprehensive analysis of the main articles on the different designs and classes of multifocal IOL.
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Ota Y, Minami K, Oki S, Bissen‐Miyajima H, Okamoto K, Nakashima M, Tsubota K. Subjective and objective refractions in eyes with extended-depth-of-focus intraocular lenses using echelette optics: clinical and experimental study. Acta Ophthalmol 2021; 99:e837-e843. [PMID: 33191658 PMCID: PMC8518701 DOI: 10.1111/aos.14660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/11/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE To evaluate differences in subjective and objective refractions in eyes with extended-depth-of-focus intraocular lenses (EDOF IOLs) using echelette optics, and the effect of the light wavelength used during examinations. METHODS In the prospective study, subjective and objective refractions of 128 eyes of 64 patients were examined 3 months after implantation of the EDOF IOLs (ZXR00V, Johnson & Johnson Surgival Vision). Objective refractions were measured using an autorefractor with a near-infrared (NIR) light source. Clinical differences in the spherical, cylindrical and spherical equivalent (SE) refractions between the subjective and objective refractions were evaluated. Then, lens powers of monofocal, EDOF and diffractive bifocal IOLs in the use of a 850-nm light source were measured experimentally for using a lensmeter, and the differences from the monofocal IOLs were calculated. RESULTS The mean objective refractions were more myopic (p < 0.001) than the subjective refractions; the differences in the spherical, cylindrical and SE refractions were -0.71, -0.26 and -0.84 dioptre, respectively. Experimental investigation resulted that there was the mean difference of 0.83 D with the EDOF from monofocal IOLs at 850 nm, while the difference was -0.20 D with bifocal IOLs. CONCLUSIONS The diffractive EDOF IOLs using echelette gratings inherently induced constant differences in the subjective and objective refractions, which arose from the chromatic difference in IOL powers for the visible and NIR lights.
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Affiliation(s)
- Yuka Ota
- Department of OphthalmologyTokyo Dental Collage Suidobashi HospitalTokyoJapan
- Department of OphthalmologyKeio University School of MedicineTokyoJapan
| | - Keiichiro Minami
- Department of OphthalmologyTokyo Dental Collage Suidobashi HospitalTokyoJapan
| | - Shinichi Oki
- Department of OphthalmologyTokyo Dental Collage Suidobashi HospitalTokyoJapan
| | | | | | | | - Kazuo Tsubota
- Department of OphthalmologyKeio University School of MedicineTokyoJapan
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Visual and patient-reported factors leading to satisfaction after implantation of diffractive EDOF and trifocal intraocular lenses. J Cataract Refract Surg 2021; 48:421-428. [PMID: 34417785 DOI: 10.1097/j.jcrs.0000000000000780] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/06/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate factors that influence postoperative satisfaction in patients with diffractive EDOF and multifocal IOLs. SETTING Department of Ophthalmology, Goethe University Frankfurt, Germany. DESIGN Observational case study. METHODS Patients were evaluated after implantation of a diffractive EDOF (Symfony, J&J, USA; AT LARA, CZM, Germany) or tri-/quadrifocal (AT LISAtri, CZM, Germany; Panoptix, Alcon, USA) 3 months postoperatively. A subjective refraction was performed, uncorrected and corrected visual acuity was tested for distance (UDVA, CDVA), intermediate (at 60 & 80cm, UIVA, DCIVA), and near (at 40cm, UNVA, DCNVA). A test for contrast sensitivity was done and the patients filled out two different questionnaires on daily activities and optical phenomena. Parameters with a potential correlation to the postoperative overall satisfaction were investigated. RESULTS We included 94 patients with a mean age of 66 years ± 19. Patients with a better UDVA and UIVA at 60cm were more likely to choose the same IOL again. The intensity of subjective optical phenomena and the visual quality at different tasks of daily living influenced the overall satisfaction. UIVA at 80cm, UNVA, and corrected VA demonstrated no significant influence on patient satisfaction. The uncorrected visual acuity at specific distances had a direct impact on the subjective visual quality regarding the task performed at those distances. CONCLUSION For patients with diffractive EDOF and multifocal IOLs, the UDVA and UIVA at 60cm seem to be more important than the UNVA and UIVA at 80cm. Subjective visual quality and optical phenomena influence patient satisfaction, as well.
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Clinical Outcomes after Mix-and-Match Implantation of Extended Depth of Focus and Diffractive Multifocal Intraocular Lenses. J Ophthalmol 2021; 2021:8881794. [PMID: 34394981 PMCID: PMC8355972 DOI: 10.1155/2021/8881794] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/24/2021] [Accepted: 07/28/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose To evaluate the clinical outcomes after bilateral mix-and-match cataract surgery using extended depth of focus (EDOF) and diffractive multifocal (DMF) intraocular lenses (IOLs). Setting. Asan Medical Center, Seoul, South Korea. Design Prospective clinical study. Methods Thirty-seven patients underwent TECNIS Symfony EDOF IOL (ZXR00) implantation in the dominant eye, and TECNIS +3.25 DMF IOL (ZLB00) implantation in the nondominant eye. Patients were followed up for 3 months; uncorrected and corrected distance visual acuity (UDVA and CDVA), uncorrected intermediate and near visual acuity (UIVA and UNVA), contrast sensitivity, defocus curves, stereopsis, and patient satisfaction were assessed. Results At 3 months, the mean logarithm of the minimum angle of resolution (logMAR) of UDVA was 0.07 ± 0.09 in EDOF IOL eyes, 0.12 ± 0.11 in DMF IOL eyes, and 0.02 ± 0.05 in both eyes. UIVA was 0.11 ± 0.11 in EDOF IOL eyes, 0.16 ± 0.12 in DMF IOL eyes, and 0.04 ± 0.07 in both eyes. UNVA was 0.25 ± 0.15 in EDOF IOL eyes, 0.22 ± 0.16 in DMF IOL eyes, and 0.13 ± 0.13 in both eyes. Thirty patients (81.1%) were more than satisfied with near vision, and 8 patients (21.6%) complained of severe glare and halo. Spectacle independence for near vision was achieved in 34 patients (91.9%), and 31 patients (83.8%) had better than a 50-second arc of stereopsis. Conclusion Mix-and-match cataract surgery with EDOF and DMF IOL implantation provided good visual outcomes for all distances. Additionally, excellent patient satisfaction was achieved with a high level of spectacle independence and acceptable photic phenomena.
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Abstract
The extended depth-of-focus intraocular lenses (EDOF IOLs) represent one of the most exciting advancements in the field of lens surgery. EDOF IOLs promise an excellent visual experience, minimizing visual disturbances (ie, halos and glare) commonly associated with multifocal IOLs. The pros and cons of EDOF IOLs should be evaluated in comparison with other more traditional multifocal or monofocal IOLs. The aim of this review is to provide the most current information regarding EDOF IOLs for power calculating formulas, refractive outcomes, incidence of photic phenomena, and patient satisfaction.
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Near visual acuity and patient-reported outcomes in presbyopic patients after bilateral multifocal aspheric laser in situ keratomileusis excimer laser surgery. J Cataract Refract Surg 2021; 46:944-952. [PMID: 32773548 DOI: 10.1097/j.jcrs.0000000000000198] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine improvement of near visual acuity by bilateral multifocal aspheric laser in situ keratomileusis (LASIK) treatments in presbyopic patients. SETTING Goethe-University, Frankfurt, Germany. DESIGN Prospective, nonrandomized trial. METHODS Thirty presbyopic patients underwent LASIK treatment with a multifocal aspheric ablation profile using an excimer laser (PresbyMAX). The first 15 patients received a multifocal aspheric ablation profile combined with micromonovision. For the consecutive 15 patients, less depth of focus was included on the distance eye (hybrid). Outcome parameters were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected and distance-corrected intermediate visual acuities, uncorrected near visual acuity (UNVA), and distance-corrected near visual acuity (DCNVA); manifest refraction spherical equivalent; subjective quality of vision; and spectacle independence. RESULTS The data of 29 patients were analyzed and showed that binocular CDVA changed from -0.16 ± 0.10 logarithm of the minimum angle of resolution (logMAR) preoperatively to 0.05 ± 0.20 logMAR UDVA and -0.06 ± 0.14 logMAR CDVA (P = .000, P = .001) 1 year postoperatively. Near visual acuity improved from 0.47 ± 0.13 logMAR (DCNVA) and 0.48 ± 0.26 logMAR (UNVA) to 0.19 ± 0.19 logMAR (DCNVA, P < .001) and 0.05 ± 0.15 logMAR (UNVA, P < .001). The hybrid and the μ-monovision group did not differ statistically except for a better DCNVA in the µ-monovision patients (0.21 ± 0.15 logMAR vs 0.34 ± 0.17 logMAR, P = .034). Of the hybrid and µ-monovision patients, 21 (72%) and 12 (41%) had a binocular CDVA and UDVA of 20/20 or better, 8 patients (28%) lost 1 line, 3 (10%) lost 2 lines, 4 (14%) lost 3 lines, and 2 (7%) lost 4 lines of CDVA. CONCLUSIONS The PresbyMAX laser seemed to satisfy most of the patients, although they experienced a loss of CDVA. The gain of near visual acuity and therefore reported less need of spectacles seemed to compensate for this loss.
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Nondiffractive wavefront-shaping extended range-of-vision intraocular lens. J Cataract Refract Surg 2021; 46:1312-1313. [PMID: 32898097 DOI: 10.1097/j.jcrs.0000000000000247] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Visual outcomes and safety of the TECNIS Symfony intraocular lens: results of a pivotal clinical trial. J Cataract Refract Surg 2021; 48:288-297. [PMID: 34269326 PMCID: PMC8865208 DOI: 10.1097/j.jcrs.0000000000000747] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 07/05/2021] [Indexed: 12/02/2022]
Abstract
Randomized comparison of the TECNIS Symfony (ZXR00) and the TECNIS 1-piece monofocal (ZCB00) intraocular lenses in cataract surgery demonstrates improved intermediate and near vision with TECNIS Symfony. To compare the effectiveness and safety of the TECNIS Symfony intraocular lens (IOL; ZXR00) with the TECNIS 1-piece monofocal IOL (ZCB00).
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Lwowski C, Van Keer K, Adas M, Schwarz L, Hinzelmann L, Pawlowicz K, Kohnen T. Ray-tracing Calculation Using Scheimpflug Tomography of Diffractive Extended Depth of Focus IOLs Following Myopic LASIK. J Refract Surg 2021; 37:231-239. [PMID: 34038658 DOI: 10.3928/1081597x-20210114-02] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate a ray-tracing formula for intraocular lens (IOL) calculation of diffractive extended depth of focus IOLs after myopic laser in situ keratomileusis (LASIK) compared to formulas from an established online calculator. METHODS This retrospective, consecutive case series included patients after cataract surgery with implantation of an extended depth of focus (EDOF) IOL (AT LARA, Carl Zeiss Meditec; Symfony, Johnson & Johnson) and a history of myopic LASIK. Preoperative assessments included biometry (IOLMaster; Carl Zeiss Meditec) and corneal tomography, including true net power (TNP) (Pentacam; Oculus Optikgeräte GmbH). To evaluate the measurements, the simulated keratometry values (SimK) were compared to the TNP. Regarding IOL calculation, the mean prediction error, mean and median absolute prediction error (MAE and MedAE), and number of eyes within ±0.50, ±1.00, and ±2.00 diopters (D) from the Haigis-L, Shammas, and Barrett True K No History formulas to the Potvin-Hill and Haigis with TNP (Pentacam) formulas were compared. RESULTS Thirty-six eyes matched the inclusion criteria with a mean spherical equivalent of -6.26 ± 3.25 diopters (D) preoperatively and -0.79 ± 0.75 D postoperatively. The mean difference from SimK and TNP was significantly different from zero (P < .001; -1.24 ± 0.81 D). The best performing formulas by MedAE were the Potvin-Hill and Barrett True K No History (0.39 ± 0.78 and 0.64 ± 1.00 D). The formula with the most eyes within ±0.50 D was the Potvin-Hill (64%), followed by the Barrett True K No History (44%). For MAE and percentage of eyes within ±0.50 D, the Potvin-Hill formula was significantly better than the Haigis-L, Shammas, and Haigis-TNP formulas (P < .05). CONCLUSIONS Calculation of IOLs in patients who had LASIK remains less predicable than calculations for virgin eyes. Using ray-tracing to calculate diffractive EDOF IOLs after myopic LASIK, the Potvin-Hill formula outperformed established formulas in terms of the percentage within target refraction and the MAE. [J Refract Surg. 2021;37(4):231-239.].
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Comparison of the intermediate distance of a trifocal IOL with an extended depth-of-focus IOL: results of a prospective randomized trial. J Cataract Refract Surg 2021; 46:193-203. [PMID: 32126031 DOI: 10.1097/j.jcrs.0000000000000012] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare visual outcomes, reading ability, and visual quality between the Symfony extended depth-of-focus intraocular lens (IOL) and the trifocal AT LISA tri 839MP IOL. SETTING University Eye Clinic Maastricht, The Netherlands. DESIGN Prospective randomized controlled trial. METHODS Patients were randomly assigned to bilateral Symfony IOL or AT LISA tri 839MP IOL implantation. The primary outcome measure was uncorrected intermediate visual acuity (UIVA measured at 66 cm). Secondary outcomes included uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), reading ability, and comparison of defocus curves, contrast sensitivity, optical adverse effects, and quality of vision. RESULTS The study enrolled 60 eyes of 30 patients. The mean UIVA was -0.02 ± 0.03 (SD) vs 0.01 ± 0.03 logarithm of the minimal angle of resolution (logMAR) in the Symfony and AT LISA tri 839MP groups, respectively (P = .047). The UDVA was 0.01 ± 0.12 and -0.05 ± 0.07 logMAR (P = .11) and the UNVA was 0.09 ± 0.05 and 0.04 ± 0.07 logMAR (P = .052) in the Symfony and AT LISA tri 839MP groups, respectively. Reading ability was similar in both groups at 40 cm and 66 cm (P = .87 and P = .14, respectively). Less than 10% of patients in both groups experienced disabling glare. Patients experienced disabling halos in the AT LISA tri 839 MP group compared to the Symfony group in 39% and 21% of cases, respectively (P = .12). The mean score for visual functioning was 88.0 ± 14.1 n the trifocal group and 88.2 ± 10.9 for the EDOF group (P = .96). CONCLUSIONS The UIVA was better in the Symfony group than in the AT LISA tri 839MP group. No significant differences were seen in the binocular UNVA and UDVA, contrast sensitivity, reading ability, incidence of photopic phenomena, and patient satisfaction.
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Abstract
The extended depth-of-focus (EDOF) intraocular lens (IOL) is an emerging technology that is designed to improve range of vision, especially at intermediate distances. In this review, we describe the clinical performance of 4 emerging EDOF IOL technologies; that is, small aperture, bioanalogic, diffractive optics, and nondiffractive optical manipulations. The American Academy of Ophthalmology generated a consensus statement for EDOF IOLs that provided benchmarks and recommendations for classifying an implant as an EDOF IOL as well as standardized testing criteria for evaluating performance. Although many types of EDOF technologies are being developed, there are important differences in their performance that require further testing and evaluation.
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Tran DB, Owyang A, Hwang J, Potvin R. Visual Acuity, Quality of Vision, and Patient-Reported Outcomes After Bilateral Implantation with a Trifocal or Extended Depth of Focus Intraocular Lens. Clin Ophthalmol 2021; 15:403-412. [PMID: 33568894 PMCID: PMC7868299 DOI: 10.2147/opth.s295503] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/20/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose To evaluate the visual acuity, quality of vision and patient reported outcomes for patients that were either bilaterally implanted with a trifocal intraocular lens (IOL) or an extended depth of focus (EDOF) IOL. Design Single site, prospective, non-interventional, masked, two-arm comparative study. Methods Subjects who had prior uncomplicated cataract surgery with bilateral implantation of one of the lenses above were evaluated. Subjects in each group were assessed during a single visit. The uncorrected and best distance-corrected binocular near (40 cm), intermediate (60 cm), and distance visual acuity (VA) were measured, along with a spectacle independence questionnaire, a quality of vision questionnaire and contrast sensitivity measured in both mesopic and photopic conditions. Results The study included 23 EDOF and 25 trifocal subjects. Binocular Uncorrected VAs were similar at distance and intermediate, but about 1.5 lines better at near with the trifocal (p < 0.001). Binocular best corrected distance – VA was significantly better with the EDOF lens (0.5 lines, p < 0.001), though the mean VA was better than 20/20 in both groups. Distance-corrected intermediate and near VA were significantly better with the trifocal IOL (1 line and 1.5 lines respectively, p < 0.001). Significantly more trifocal subjects had 20/25 or better VA at all three test distances (64% vs 4%, p<0.001). Patient reported spectacle independence was significantly higher in the trifocal group, driven primarily by differences in near vision. Mesopic and photopic binocular contrast sensitivity, satisfaction and subjective quality of vision scores were similar between groups. Conclusion The trifocal IOL provided significantly better near vision (1.5 lines) with slightly worse distance vision (0.5 lines), while providing similar contrast sensitivity and visual quality. It may be the preferred choice for patients desiring more spectacle independence.
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Affiliation(s)
- Dan B Tran
- Coastal Vision Medical Group, Orange, CA, USA
| | | | - Jin Hwang
- Coastal Vision Medical Group, Orange, CA, USA
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Kohnen T, Suryakumar R. Measures of visual disturbance in patients receiving extended depth-of-focus or trifocal intraocular lenses. J Cataract Refract Surg 2021; 47:245-255. [PMID: 32818348 DOI: 10.1097/j.jcrs.0000000000000364] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 07/14/2020] [Indexed: 02/07/2023]
Abstract
The degree of visual disturbance associated with a particular model of intraocular lens (IOL) depends on several factors, including IOL optic, material, and mechanics. Characterization of visual disturbance profiles is paramount for informing clinical IOL selection. Although many studies evaluating presbyopia-correcting IOLs include subjective assessment of visual symptoms, the types of patient-reported outcome measures (PROMs) used to capture these outcomes are inconsistent across studies, complicating data contextualization. Furthermore, some tools produce more meaningful results than others. This review presents a discussion on the scientific literature published on the subjective and semiobjective (halo and glare simulator, light-distortion analyzer, vision monitor, and halometers) methods used to assess visual disturbances in patients implanted with trifocal or extended depth-of-focus IOLs, highlighting their advantages and limitations. It underscores the importance of between-study comparisons and the need for standardized PROMs in clinical IOL research to provide more accurate information for IOL selection.
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Affiliation(s)
- Thomas Kohnen
- From the Department of Ophthalmology (Kohnen), Goethe University Frankfurt, Frankfurt, Germany; and Alcon Vision LLC (Suryakumar), Fort Worth, Texas, USA
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Visual outcome, optical quality, and patient satisfaction with a new monofocal IOL, enhanced for intermediate vision: preliminary results. J Cataract Refract Surg 2021; 46:378-387. [PMID: 32050218 DOI: 10.1097/j.jcrs.0000000000000061] [Citation(s) in RCA: 99] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare visual outcomes, contrast sensitivity, optical quality, spectacle independence, and visual disturbances in patients implanted with 2 models of monofocal intraocular lenses (IOLs). SETTING Eye Clinic, Department of NEUROFARBA, University of Florence, Italy. DESIGN Prospective case series METHODS:: Patients without ocular comorbidities and corneal astigmatism less than 0.75 diopters (D) had cataract surgery with bilateral implantation of either of 2 monofocal IOLs, the Tecnis ZCB00 or the Tecnis Eyhance ICB00 (Johnson & Johnson Vision Care, Inc.). Six months postoperatively, monocular and binocular uncorrected and corrected (at 4 m) distance visual acuities, as well as uncorrected (UIVA), distance corrected, and corrected intermediate (at 66 cm) and near (at 40 cm) visual acuities were measured. Photopic contrast sensitivity, binocular defocus curve, objective scatter index (OSI), Strehl ratio, modulation transfer function (MTF) cutoff, halo and glare perception, and spectacle independence were also evaluated. RESULTS A total of 80 eyes of 40 patients were evaluated in this study. Although monocular and binocular uncorrected and corrected distance and near visual acuities were similar between groups, monocular and binocular UIVA were significantly higher in the Eyhance group. There were no statistically significant differences between the 2 groups in terms of photopic contrast sensitivity, OSI, MTF cutoff, Strehl ratio, and glare and halo perception. The ICB00 IOL provided better spectacle independence than the ZCB00 IOL for intermediate distance. CONCLUSIONS In patients without ocular comorbidities, the Eyhance ICB00 IOL provided better UIVA and higher intermediate spectacle independence without impairment of far vision and visual quality, compared with the ZCB00 IOL.
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Quality of view through extended depth of focus intraocular lens in a model eye. Jpn J Ophthalmol 2021; 65:569-580. [PMID: 33496889 DOI: 10.1007/s10384-021-00813-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 12/03/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To compare the quality of images viewed through an extended depth of focus (EDF) intraocular lens (IOL) to that through multifocal or monofocal IOL. STUDY DESIGN Experimental study METHODS: EDF IOL (Symfony®, ZXR00V, Johnson & Johnson Vision), diffractive multifocal (ZLB00, + 3.25D or ZMB00, + 4.0D), or monofocal (ZCB00V) IOL with a spherical power of + 20.0 diopter (D) was placed in a fluid-filled model eye with corneal aberrations similar to those of human eyes. A United States Air Force Resolution Grating Target was glued to the posterior surface of the model eye and viewed through a flat contact lens, a 60D or 128D wide-angle non-contact lens (Resight®) or wide-angle contact lens (MiniQuad®). The contrast of the grating images recorded with the EDF and multifocal IOLs were compared to those through the monofocal IOL. RESULTS The grating images viewed through the flat contact lens were slightly blurred when viewed through the EDF IOL but clearer than those through the multifocal IOLs with very blurred images in the periphery. The contrast of the images viewed through the EDF and multifocal IOLs through the flat contact lens was significantly lower than through the monofocal IOL (P < 0.02). The contrast of the images viewed through the EDF IOL with 60D or 128D wide-angle non-contact lens was significantly lower than through the monofocal IOL (P < 0.05) but not with wide-angle contact lens. CONCLUSION Our results suggest that vitreous surgeons can accomplish a clearer view during vitrectomy in EDF IOL-implanted eyes with a wide-angle viewing contact lens and a flat contact lens than in multifocal IOL-implanted eyes.
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Martinez-Perez C, Alvarez-Peregrina C, Villa-Collar C, Arance-Gil A, Sánchez-Tena MA. Citation network analysis of the various types of multifocal intraocular lenses. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2021; 96:S0365-6691(20)30492-5. [PMID: 33495051 DOI: 10.1016/j.oftal.2020.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/16/2020] [Accepted: 11/21/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND OBJECTIVE The implantation of multifocal intraocular lens (IOL) has increased in recent years, allowing patients to achieve good quality vision at all distances, independence from use of glasses, and consequently, an increase in quality of life. The main purpose of this study was to analyse the links between publications and authors via citation networks, as well to as identify the different research areas and determine the most cited publications. MATERIAL AND METHODS The publication search was performed through the Web of Science database, using the terms «Multifocal intraocular lens», «Bifocal intraocular lens», «Trifocal intraocular lens», «Diffractive intraocular lens», «Refractive intraocular lens», «Accommodative intraocular lens» and «Extended depth of focus intraocular lens», for a time interval from 1989 to August 2020. The software used to analyse the publications was the Citation Network Explorer. RESULTS A total of 1293 publications were found, with 11730 citations generated in the network, and 2019 had the highest number of publications of any year. The most cited publication was «European multicenter study of the AcrySof ReSTOR apodized diffractive intraocular lens» by Kohnen et al., published in 2006. Four groups about different research areas in this field were found using the Clustering functionality: visual quality, IOL designs, ocular aberrations, or defocus curves. CONCLUSIONS The citation network offers an objective and comprehensive analysis of the main articles on the different designs and classes of multifocal IOL.
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Affiliation(s)
- C Martinez-Perez
- Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, España.
| | - C Alvarez-Peregrina
- Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, España
| | - C Villa-Collar
- Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, España
| | - A Arance-Gil
- Hospital Universitario HM Montepríncipe, Madrid, España
| | - M A Sánchez-Tena
- Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, España
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Visual performance after bilateral toric extended depth-of-focus IOL exchange targeted for micromonovision. J Cataract Refract Surg 2020; 46:1346-1352. [PMID: 33060471 DOI: 10.1097/j.jcrs.0000000000000290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE To evaluate overall patient satisfaction, spectacle independence, binocular visual acuity, rotational stability, prevalence of optical phenomena, and decentration and tilt after bilateral toric extended depth-of-focus intraocular lens (EDOF IOL) implantation targeted for micromonovision. SETTING Department of Ophthalmology, Hanusch Hospital, Vienna, Austria. DESIGN Prospective case series. METHODS The study included 52 eyes of 26 patients with regular corneal astigmatism from 0.75 to 2.60 diopters (D) that were implanted bilaterally with a toric EDOF IOL targeted for micromonovision. Postoperative visual acuity, astigmatism reduction, rotation, tilt, decentration, spectacle independence, patient satisfaction, and photic phenomena were assessed. RESULTS For the 52 eyes studied, binocular means expressed in logarithm of the minimum angle resolution for postoperative corrected distance, uncorrected distance, uncorrected intermediate, and uncorrected near visual acuities were -0.10 (±0.12), -0.01 (±0.13), 0.01 (±0.14), and 0.13 (±0.14), respectively. Mean refractive astigmatism reduction was 1.31 ± 0.67 D resulting in a mean refractive cylinder of 0.47 ± 0.46 D at the 3-month visit. Mean postoperative rotation was 3.5 ± 3.5 degrees, at the 3-month time point. Most prevalent dysphotopsia were halos, starburst, and glare affecting 6 (23%), 6 (23%), and 5 (19%) of 26 patients, respectively; 20 (77%) of 26 patients reported spectacle independence, with 19 (95%), 19 (95%), and 14 (70%) of 20 patients questioned being satisfied with distance, intermediate, and near vision, respectively. CONCLUSIONS Toric EDOF IOL implantation targeted for micromonovision resulted in reliable reduction of preoperative astigmatism with a high degree of postoperative rotational predictability and centration, enabling functional distance, intermediate, and near vision, which manifested itself in high patient satisfaction.
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Sandoval HP, Potvin R, Solomon KD. Visual Acuity, Defocus Curve, Reading Speed and Patient Satisfaction with a Combined Extended Depth of Focus Intraocular Lens and Multifocal Intraocular Lens Modality. Clin Ophthalmol 2020; 14:2667-2677. [PMID: 32982159 PMCID: PMC7501984 DOI: 10.2147/opth.s276120] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 08/29/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the vision, defocus curve, reading speed and patient satisfaction after implantation of an extended depth of focus (EDOF) IOL in one eye and a diffractive multifocal in the fellow eye. Setting One clinical practice in the USA. Design Prospective unmasked non-randomized clinical trial. Methods Subjects presenting for routine cataract surgery interested in reducing their dependence on spectacles were enrolled. Study endpoints included uncorrected and distance-corrected binocular distance (4 m), intermediate (66 cm) and near (40 cm) visual acuity at 3 months. Additional endpoints included the residual refraction, spectacle independence, overall satisfaction with vision, visual symptoms, reading speed and defocus curve. Results With a best distance correction, 77% (30/39) of subjects had 20/25 or better VA at distance, intermediate and near and nearly all subjects had 20/32 or better VA at all three distances. Defocus curve results showed mean continuous vision of 20/25 or better from plano to −2.50 D. Nearly 80% (31/39) of subjects had 20/25 visual acuity from 0.00 D to −2.50 D. The critical print size was between 0.3 and 0.4 logMAR (20/40 to 20/50 Snellen Equivalent). Spectacle independence was 100% at distance, 95% at intermediate and approximately 70% at near. The percentage of subjects who were “not at all” or “slightly” bothered by visual disturbances ranged from 64% (16/25) for Halos to 88% (22/25) for Starbursts. Conclusions EDOF/bifocal IOL blended implantation results in at least 20/25 mean visual acuity from distance to near with good spectacle independence and low reports of severe visual disturbances.
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Ang RE, Picache GCS, Rivera MCR, Lopez LRL, Cruz EM. A Comparative Evaluation of Visual, Refractive, and Patient-Reported Outcomes of Three Extended Depth of Focus (EDOF) Intraocular Lenses. Clin Ophthalmol 2020; 14:2339-2351. [PMID: 32921975 PMCID: PMC7457879 DOI: 10.2147/opth.s255285] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 07/03/2020] [Indexed: 01/19/2023] Open
Abstract
Objective To compare visual, refractive, and patient-reported outcomes of patients implanted with one of three types of extended depth of focus (EDOF) intraocular lenses. Setting Asian Eye Institute, Philippines. Design Retrospective cohort study. Methods Subjects implanted with Symfony (Johnson and Johnson, USA), IC-8 (AcuFocus, USA), and WIOL (Medicem, Czech Republic) EDOF intraocular lenses were recruited. Spherical equivalent, uncorrected and corrected visual acuity, defocus curve, and modulation-transfer function, Strehl ratio, and visual Strehl optical transfer function values, photic phenomena, and questionnaire answers were measured and assessed. Results A total of 32 eyes with the Symfony lens, 30 with the IC-8 lens, and 32 with the WIOL lens were included in the study. Mean postoperative spherical equivalent was -0.24 D for the Symfony, -0.17 D for the IC-8, and 0.27 D for WIOL. There were no significant differences in postoperative monocular and binocular uncorrected and corrected visual acuity. On a monocular defocus curve, the IC-8 and Symfony showed significantly better vision than WIOL. The Symfony had significantly better modulation-transfer function, Strehl ratio, and visual Strehl optical transfer function. No difference was seen among the three lenses with regard to glare or starburst, while patient satisfaction remained high in all groups for far, intermediate, and near vision. Conclusion All eyes implanted with the three EDOF designs achieved excellent far and intermediate vision, with acceptable near vision. The IC-8 and Symfony exhibited a better range of vision on defocus-curve testing. The Symfony showed superior results in quality of vision. Patient satisfaction was high in all three EDOF groups.
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Affiliation(s)
- Robert Edward Ang
- Asian Eye Institute, Rockwell Center, Makati, Philippines.,Department of Ophthalmology, Cardinal Santos Medical Center, San Juan, Philippines
| | - Gian Carlo S Picache
- Department of Ophthalmology, Cardinal Santos Medical Center, San Juan, Philippines
| | | | | | - Emerson M Cruz
- Asian Eye Institute, Rockwell Center, Makati, Philippines
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Prediction accuracy of IOL calculation formulas using the ASCRS online calculator for a diffractive extended depth-of-focus IOL after myopic laser in situ keratomileusis. J Cataract Refract Surg 2020; 46:1240-1246. [DOI: 10.1097/j.jcrs.0000000000000238] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Barnett V, Barsam A. Update on Laser Vision Correction Versus Intraocular Lens Options. CURRENT OPHTHALMOLOGY REPORTS 2020. [DOI: 10.1007/s40135-020-00242-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gundersen KG, Potvin R. Comparing Visual Acuity, Low Contrast Acuity and Contrast Sensitivity After Trifocal Toric and Extended Depth of Focus Toric Intraocular Lens Implantation. Clin Ophthalmol 2020; 14:1071-1078. [PMID: 32368005 PMCID: PMC7183779 DOI: 10.2147/opth.s253250] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 04/15/2020] [Indexed: 12/20/2022] Open
Abstract
Purpose The aim of this study was to compare visual acuity at various distances (far, intermediate and near), low contrast acuity and contrast sensitivity after trifocal toric and extended depth of focus (EDOF) toric intraocular lens (IOL) implantation. Patients and Methods This was a non-interventional two-arm comparative study of visual outcomes after uncomplicated bilateral cataract or refractive lens exchange surgery with IOL implantation between 6 months and 5 years before a single diagnostic examination visit. There was no masking and no control group. Subjects had to have uncorrected distance visual acuity (UDVA) of 20/40 (0.3 logMAR) or better measured at the time of their study visit. Clinical evaluations included the manifest refraction, visual acuity (VA) at distance, intermediate (60 cm) and near (40 cm), low contrast (10%) VA and contrast sensitivity. Results A total of 50 bilaterally implanted patients (25 trifocal, 25 EDOF) were examined; the two groups had similar characteristics, including corneal astigmatism. Postoperative refractive outcomes were also similar. There were no statistically significant differences in distance or intermediate VA between groups, but the trifocal group had significantly better near VA both uncorrected (p = 0.009) and distance-corrected (p = 0.014). There were no statistically significant differences in the low contrast acuity measures between IOLs at either distance or 40 cm, with or without glare. Contrast sensitivity in mesopic and photopic conditions was similar. Conclusion The trifocal and EDOF toric IOLs performed similarly for all measures except near VA, where the trifocal toric provided significantly better acuity. For subjects interested in reducing spectacle independence at near, this may be an important consideration.
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Koo YH, Lee CS, Kim JS, Shin MC, Kim EC, Kim MS, Hwang HS. Measuring Defocus Curves of Monofocal, Multifocal and Extended Depth-of-focus Intraocular Lenses Using Optical Bench Test. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2020. [DOI: 10.3341/jkos.2020.61.2.153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yong Ho Koo
- Department of Ophthalmology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Chang Su Lee
- Department of Electronic Engineering, College of Engineering, The University of Suwon, Hwaseong, Korea
| | - Jin Soo Kim
- Department of Ophthalmology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Min Chul Shin
- Department of Ophthalmology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Eun Chul Kim
- Department of Ophthalmology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Man Soo Kim
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ho Sik Hwang
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Hienert J, Findl O. IOLs mit erweiterter Tiefenschärfe. SPEKTRUM DER AUGENHEILKUNDE 2019. [DOI: 10.1007/s00717-019-00441-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kim EC. Surgical treatment of presbyopia II. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2019. [DOI: 10.5124/jkma.2019.62.12.623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Eun Chul Kim
- Department of Ophthalmology, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
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