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Khoramnia R, Naujokaitis T, Baur ID, Hassel O, Henningsen N, Reitemeyer E, Chychko L, Łabuz G, Auffarth GU. Functional outcomes after refractive lens exchange with implantation of a glistening-free diffractive trifocal intraocular lens. Am J Ophthalmol 2024:S0002-9394(24)00351-9. [PMID: 39117256 DOI: 10.1016/j.ajo.2024.07.037] [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: 05/16/2024] [Revised: 07/25/2024] [Accepted: 07/26/2024] [Indexed: 08/10/2024]
Abstract
PURPOSE To evaluate visual outcomes and patient-reported results after bilateral femtosecond-laser assisted refractive lens exchange (RLE) with the implantation of a diffractive trifocal intraocular lens (IOL). DESIGN Prospective interventional case series METHODS: A study of 27 patients (54 eyes) implanted with the Clareon PanOptix (Alcon) multifocal IOL during femtosecond laser assisted RLE in a university hospital setting. The uncorrected (UDVA) and corrected (CDVA) distance visual acuity, uncorrected (UIVA) and distance-corrected (DCIVA) intermediate visual acuity at 60cm, uncorrected (UNVA) and distance-corrected (DCNVA) near visual acuity at 40cm and 33cm were evaluated at three months postoperatively and compared with the preoperative values. In addition, we assessed the postoperative defocus curve, mesopic and photopic contrast sensitivity, and patient-reported spectacle independence. RESULTS The mean postoperative binocular UDVA was -0.02±0.06 logMAR and CDVA was -0.11±0.05 logMAR. The UIVA was -0.07±0.05 logMAR and DCIVA was -0.07±0.07 logMAR. The UNVA at 40cm was 0.03±0.09 logMAR and DCNVA was -0.02±0.06 logMAR; and, at 33cm UNVA was 0.14±0.10 logMAR and DCNVA was 0.11±0.08 logMAR. In comparison to the preoperative binocular CDVA (-0.12±0.08 logMAR), no statistically significant change was observed (p=1.0), while all the other binocular visual acuities improved (p<0.01). In the mean binocular defocus curve, the visual acuity was better than 0.10 logMAR in the range between +0.5 D and -3.0 D. The mean contrast sensitivity was within the normal range, and most patients reported complete spectacle independence. CONCLUSION The RLE surgery improved uncorrected visual acuity at far, intermediate and near distances without negatively affecting the CDVA. Patients achieved a high level of spectacle independence.
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Affiliation(s)
- Ramin Khoramnia
- International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, INF 400, 69120 Heidelberg, Germany.
| | - Tadas Naujokaitis
- International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, INF 400, 69120 Heidelberg, Germany
| | - Isabella D Baur
- International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, INF 400, 69120 Heidelberg, Germany
| | - Oliver Hassel
- International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, INF 400, 69120 Heidelberg, Germany
| | - Nikola Henningsen
- International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, INF 400, 69120 Heidelberg, Germany
| | - Emanuel Reitemeyer
- International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, INF 400, 69120 Heidelberg, Germany
| | - Lizaveta Chychko
- International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, INF 400, 69120 Heidelberg, Germany
| | - Grzegorz Łabuz
- International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, INF 400, 69120 Heidelberg, Germany
| | - Gerd U Auffarth
- International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, INF 400, 69120 Heidelberg, Germany
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Cano-Ortiz A, Sánchez-Ventosa Á, Villalba-González M, González-Cruces T, Prados-Carmona JJ, Díaz-Mesa V, Piñero DP, Villarrubia-Cuadrado A. Clinical and Patient Reported Outcomes of an Optimized Trifocal Intraocular Lens. J Clin Med 2024; 13:4133. [PMID: 39064176 PMCID: PMC11277831 DOI: 10.3390/jcm13144133] [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: 05/04/2024] [Revised: 07/10/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024] Open
Abstract
Background/Objectives: To evaluate the clinical and patient-reported outcomes (PROMs) obtained with an optimized version of a previously investigated trifocal IOL. Methods: Prospective non-comparative single-center study enrolling 29 patients (55-71 years) undergoing bilateral cataract surgery with implantation of the trifocal diffractive IOL Liberty 677CMY (Medicontur Medical Engineering Ltd., Zsámbék, Hungary). Visual and refractive outcomes as well as PROMs were evaluated during a 3-month follow-up: measurement of uncorrected and corrected distance (UDVA, CDVA), intermediate (UIVA, DCIVA) and near visual acuities (UNVA, DCNVA), defocus curve, patient satisfaction, photic phenomena perception, spectacle independence, and difficulty in performing some vision-related activities. Results: A total of 100%, 92%, and 80% of patients achieved a postoperative binocular UDVA, UIVA, and UNVA of 20/25 or better, respectively. Likewise, 100%, 80%, and 84% of patients achieved a postoperative binocular CDVA, DCIVA, and DCNVA of 20/25 or better, respectively. In the defocus curve, all mean visual acuity values were better than 0.15 logMAR for all defocus levels. A total of 95.8%, 95.8%, and 91.7% of patients referred to be satisfied with their distance, intermediate, and near visual vision, respectively. Mean overall Catquest Rasch calibrated score was -3.12 ± 0.98. Most of the patients were spectacle independent: far (95.8%), intermediate (95.8%) or near vision (91.7%). No bothersome or minimal to moderately bothersome halo, starburst, and glare was perceived by 83.3%, 83.4%, and 83.3% of patients, respectively. Conclusions: The trifocal IOL evaluated provides a visual acuity improvement, with high levels of spectacle independence, patient satisfaction, and perceived visual quality associated.
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Affiliation(s)
- Antonio Cano-Ortiz
- Department of Anterior Segment, Cornea and Refractive Surgery, Hospital Arruzafa, 14012 Cordoba, Spain; (Á.S.-V.); (M.V.-G.); (T.G.-C.); (V.D.-M.); (A.V.-C.)
| | - Álvaro Sánchez-Ventosa
- Department of Anterior Segment, Cornea and Refractive Surgery, Hospital Arruzafa, 14012 Cordoba, Spain; (Á.S.-V.); (M.V.-G.); (T.G.-C.); (V.D.-M.); (A.V.-C.)
| | - Marta Villalba-González
- Department of Anterior Segment, Cornea and Refractive Surgery, Hospital Arruzafa, 14012 Cordoba, Spain; (Á.S.-V.); (M.V.-G.); (T.G.-C.); (V.D.-M.); (A.V.-C.)
| | - Timoteo González-Cruces
- Department of Anterior Segment, Cornea and Refractive Surgery, Hospital Arruzafa, 14012 Cordoba, Spain; (Á.S.-V.); (M.V.-G.); (T.G.-C.); (V.D.-M.); (A.V.-C.)
| | | | - Vanesa Díaz-Mesa
- Department of Anterior Segment, Cornea and Refractive Surgery, Hospital Arruzafa, 14012 Cordoba, Spain; (Á.S.-V.); (M.V.-G.); (T.G.-C.); (V.D.-M.); (A.V.-C.)
| | - David P. Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, 03690 Alicante, Spain
| | - Alberto Villarrubia-Cuadrado
- Department of Anterior Segment, Cornea and Refractive Surgery, Hospital Arruzafa, 14012 Cordoba, Spain; (Á.S.-V.); (M.V.-G.); (T.G.-C.); (V.D.-M.); (A.V.-C.)
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Orbegozo J, Pérez A, Basterra I, Noguera H, González L, Lauzirika G, Piñero DP. Clinical outcomes of a toric continuous range of vision presbyopia-correcting intraocular lens. J Cataract Refract Surg 2024; 50:724-732. [PMID: 38530027 DOI: 10.1097/j.jcrs.0000000000001428] [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: 11/03/2023] [Accepted: 02/12/2024] [Indexed: 03/27/2024]
Abstract
PURPOSE To evaluate the clinical outcomes of the toric version of a presbyopia-correcting intraocular lens (IOL) based on the combination of a diffractive-based extended depth-of-focus (EDOF) pattern and a diffractive multifocal platform. SETTING Miranza COI Bilbao, Bilbao, Spain. DESIGN Prospective case series. METHODS 35 patients (51 to 84 years) with corneal astigmatism ranging from 0.75 to 2.19 diopters (D) undergoing bilateral cataract surgery with implantation of the Synergy Toric II IOL were evaluated during a 3-month follow-up. Visual acuity, refraction, defocus curve, and patient-reported outcomes with the Catquest-9SF questionnaire were analyzed. A vectorial analysis was used to analyze the accuracy of astigmatic correction. RESULTS Mean 3-month monocular postoperative uncorrected distance, intermediate (80 cm) and near (40 cm) visual acuities were 0.06 ± 0.11 logMAR, 0.13 ± 0.12 logMAR, and 0.13 ± 0.09 logMAR, respectively. Mean monocular distance-corrected intermediate (80 cm) and near visual acuity (40 cm) were 0.11 ± 0.12 logMAR and 0.10 ± 0.10 logMAR, respectively. Mean binocular defocus curve showed visual acuities of 0.10 logMAR or better for defocus levels from +0.50 to -2.50 D. Residual cylinder was within ±0.50 D in 97.0% of eyes. The surgically induced astigmatism prediction error ranged between -0.49 D and 0.50 D, with a mean value of 0.04 ± 0.16 D. Mean absolute IOL rotation was 3.79 ± 2.94 degrees. Significant improvements were found in all Rasch-calibrated scores obtained with Catquest-9SF ( P < .001). CONCLUSIONS The implantation of the toric presbyopia-correcting IOL evaluated provides an efficacious astigmatic correction while providing a fully restoration of the visual function across different distances.
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Affiliation(s)
- Javier Orbegozo
- From the Centro Oftalmológico Integral Bilbao Berri SL, Miranza COI Bilbao, Bilbao, Spain (Orbegozo, Pérez, Basterra, Noguera); R&D Department of Miranza Group, Barcelona, Spain (González, Lauzirika); Instituto de Microcirugía Ocular (IMO) Barcelona, Miranza Group, Barcelona, Spain (González); Miranza Begitek, Donostia-San Sebastián, Spain (Lauzirika); Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain (Piñero)
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Soscia WL, DeRojas JO, Mathews PM, Brutsky A, Solomon KD, Potvin R, Sandoval HP. Clinical performance after implantation of an EDOF intraocular lens in the dominant eye and a presbyopia-correcting intraocular lens in the nondominant eye. J Cataract Refract Surg 2024; 50:578-584. [PMID: 38305420 PMCID: PMC11146179 DOI: 10.1097/j.jcrs.0000000000001412] [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: 08/25/2023] [Revised: 01/09/2024] [Accepted: 01/29/2024] [Indexed: 02/03/2024]
Abstract
PURPOSE To evaluate subjective and objective outcomes after combined implantation of an extended depth-of-focus (EDOF) intraocular lens (IOL) and a combined technology multifocal lens (CT-IOL). SETTING 2 clinical practices (Carolina Eyecare Physicians, Center For Sight) in the United States. DESIGN Prospective, unmasked, multicenter, nonrandomized bilateral eye study. METHODS Patients interested in reducing their dependence on spectacles were implanted with an EDOF IOL in the dominant eye and a CT-IOL in the nondominant eye. Refractive and visual acuity (VA) data at various distances (4 m, 66 cm, 40 cm, and 33 cm) were collected 3 months postsurgery, along with the distance-corrected binocular defocus curve and responses to questionnaires related to spectacle independence, visual disturbances, and overall visual function. RESULTS Data from 37 participants were analyzed. The distance-corrected binocular defocus curve showed a mean VA better than 0.1 logMAR (20/25) at all vergences from +1.00 to -2.50 diopters (D). 36 participants (97%) had an uncorrected binocular VA of 0.3 logMAR or better, at all test distances. 70% of participants (26/37) reported never wearing spectacles at any distance, and 84% (31/37) were "completely" or "mostly" satisfied with their overall vision after surgery. Halos were the disturbance reported most frequently and reported as most bothersome, with difficulty driving at night the most common visual function issue. Difficulty reading was the next most reported issue. Overall eyesight was rated as "excellent" or "good" by 92% (34/37) of participants. CONCLUSIONS This combined EDOF/CT-IOL approach was well-tolerated by participants and provided some potential benefits relative to bilateral implantation of either lens.
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Affiliation(s)
- William L. Soscia
- From the Center For Sight/US Eye, Sarasota, Florida (Soscia, DeRojas, Mathews, Brutsky); Carolina Eyecare Physicians/US Eye, Mt. Pleasant, South Carolina (Solomon, Sandoval); Science in Vision, Frisco, Texas (Potvin)
| | - Joaquin O. DeRojas
- From the Center For Sight/US Eye, Sarasota, Florida (Soscia, DeRojas, Mathews, Brutsky); Carolina Eyecare Physicians/US Eye, Mt. Pleasant, South Carolina (Solomon, Sandoval); Science in Vision, Frisco, Texas (Potvin)
| | - Priya M. Mathews
- From the Center For Sight/US Eye, Sarasota, Florida (Soscia, DeRojas, Mathews, Brutsky); Carolina Eyecare Physicians/US Eye, Mt. Pleasant, South Carolina (Solomon, Sandoval); Science in Vision, Frisco, Texas (Potvin)
| | - Amy Brutsky
- From the Center For Sight/US Eye, Sarasota, Florida (Soscia, DeRojas, Mathews, Brutsky); Carolina Eyecare Physicians/US Eye, Mt. Pleasant, South Carolina (Solomon, Sandoval); Science in Vision, Frisco, Texas (Potvin)
| | - Kerry D. Solomon
- From the Center For Sight/US Eye, Sarasota, Florida (Soscia, DeRojas, Mathews, Brutsky); Carolina Eyecare Physicians/US Eye, Mt. Pleasant, South Carolina (Solomon, Sandoval); Science in Vision, Frisco, Texas (Potvin)
| | - Richard Potvin
- From the Center For Sight/US Eye, Sarasota, Florida (Soscia, DeRojas, Mathews, Brutsky); Carolina Eyecare Physicians/US Eye, Mt. Pleasant, South Carolina (Solomon, Sandoval); Science in Vision, Frisco, Texas (Potvin)
| | - Helga P. Sandoval
- From the Center For Sight/US Eye, Sarasota, Florida (Soscia, DeRojas, Mathews, Brutsky); Carolina Eyecare Physicians/US Eye, Mt. Pleasant, South Carolina (Solomon, Sandoval); Science in Vision, Frisco, Texas (Potvin)
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Li J, Sun B, Zhang Y, Hao Y, Wang Z, Liu C, Jiang S. Comparative efficacy and safety of all kinds of intraocular lenses in presbyopia-correcting cataract surgery: a systematic review and meta-analysis. BMC Ophthalmol 2024; 24:172. [PMID: 38627651 PMCID: PMC11020619 DOI: 10.1186/s12886-024-03446-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 04/10/2024] [Indexed: 04/19/2024] Open
Abstract
PURPOSE To assess the efficacy and safety of various intraocular lenses (IOLs), including standard monofocal, bifocal, trifocal, extended depth of focus (EDOF), and enhanced monofocal IOLs, post-cataract surgery through a network meta-analysis. METHODS A systematic search of PubMed, Cochrane Library, and Web of Science was conducted to identify relevant studies from the past 5 years. Parameters such as binocular visual acuities, spectacle independence, contrast sensitivity (CS), and optical quality were used to evaluate efficacy and safety. Data from the selected studies were analyzed using Review Manager 5.4 and STATA 17.0 software. RESULTS Twenty-eight Randomized Controlled Trials (RCTs) comprising 2465 subjects were included. Trifocal IOLs exhibited superior uncorrected near visual acuity (UNVA) compared to monofocal IOLs (MD: -0.35; 95% CI: -0.48, -0.22). Both trifocal (AcrySof IQ PanOptix IOLs group MD: -0.13; 95% CI: -0.21, -0.06) and EDOF IOLs (MD: -0.13; 95% CI: -0.17, -0.09) showed better uncorrected intermediate visual acuity (UIVA) than monofocal IOLs. Trifocal IOLs ranked highest in spectacle independence at various distances (AT LISAtri 839MP group: SUCRA 97.5% for distance, 80.7% for intermediate; AcrySof IQ PanOptix group: SUCRA 83.0% for near). CONCLUSIONS For cataract patients who want to treat presbyopia, trifocal IOLs demonstrated better visual acuity and spectacle independence at near distances. Different types of trifocal IOL characteristics differ. EDOF and enhanced monofocal IOLs have improved visual quality at intermediate distances.Therefore, It is very important to select the appropriate IOLs based on the lens characteristics and patient needs.
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Affiliation(s)
- Jinyu Li
- Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Binzhou Medical University, Jinbu Street, Muping area, Yantai, Shandong Province, 264000, China
| | - Bin Sun
- Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Binzhou Medical University, Jinbu Street, Muping area, Yantai, Shandong Province, 264000, China
| | - Yuexin Zhang
- Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Binzhou Medical University, Jinbu Street, Muping area, Yantai, Shandong Province, 264000, China
| | - Yansong Hao
- Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Binzhou Medical University, Jinbu Street, Muping area, Yantai, Shandong Province, 264000, China
| | - Ze Wang
- Department of Ophthalmology, Shijiazhuang People's Hospital, Shi Jiazhuang, 050200, China
| | - Chengjiang Liu
- Department of General Medicine, Affiliated Anqing First People's Hospital of Anhui Medical University, Anhui, 246000, China
| | - Shanhao Jiang
- Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Binzhou Medical University, Jinbu Street, Muping area, Yantai, Shandong Province, 264000, China.
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Kaymak H, Potvin R, Neller K, Klabe K, Anello RD. Customizing Clinical Outcomes with Implantation of Two Diffractive Trifocal IOLs of Identical Design but Differing Light Distributions to the Far, Intermediate and Near Foci. Clin Ophthalmol 2024; 18:1009-1022. [PMID: 38584723 PMCID: PMC10999202 DOI: 10.2147/opth.s456007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/12/2024] [Indexed: 04/09/2024] Open
Abstract
Purpose To evaluate clinical outcomes after bilateral or contralateral implantation of the Gemetric™ (G) and Gemetric™ Plus (GPlus) diffractive trifocal intraocular lenses (IOLs). Methods This was a prospective, randomized, multi-center open-label study comparing clinical results and subjective patient responses around 6 months after implantation of the study lenses (toric and non-toric) in three different groups (bilateral G, bilateral GPlus and contralateral G/GPlus implantation). Results included the manifest refraction, uncorrected and distance corrected monocular and binocular visual acuity (VA) at distance, intermediate and near; the defocus curve; contrast sensitivity; and patient reported outcomes regarding spectacle independence, satisfaction and visual disturbances. Results There was no statistically significant difference in the mean refraction spherical equivalent between the two lens models (p = 0.33) or between the toric and non-toric lenses (p = 0.06). Monocular VA was better at distance with the G lens and better at near with the GPlus lens (p < 0.01). Mean binocular VA was better than 0.1 logMAR at all distances for all groups, both uncorrected and distance corrected. The mean binocular distance corrected VA was better than 0.15 logMAR from 0.0 D to -3.50 D for all groups. All VA data for the contralateral group was as good or better than for the bilateral GPlus group. Questionnaire results showed no difference between groups for the frequency, severity, or degree of bother of visual disturbances (p > 0.24). Conclusion The two diffractive trifocal IOLs studied here may be used either bilaterally or contralaterally for the correction of presbyopia in cataract patients, providing excellent visual acuity with low levels of visual disturbances and high rates of overall spectacle independence. Bilateral Gemetric implantation resulted in slightly better distance and intermediate vision while contralateral implantation provided slightly better near vision. There was no apparent advantage to implanting the GPlus IOL bilaterally.
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Affiliation(s)
- Hakan Kaymak
- Internationale Innovative Ophthalmochirurgie GbR, Duesseldorf, Germany
- Institute of Experimental Ophthalmology, Saarland University, Homburg/Saar, Germany
| | | | - Kai Neller
- Internationale Innovative Ophthalmochirurgie GbR, Duesseldorf, Germany
- Institute of Experimental Ophthalmology, Saarland University, Homburg/Saar, Germany
| | - Karsten Klabe
- Internationale Innovative Ophthalmochirurgie GbR, Duesseldorf, Germany
| | | | - On behalf of the NINO Study Group
- Internationale Innovative Ophthalmochirurgie GbR, Duesseldorf, Germany
- Institute of Experimental Ophthalmology, Saarland University, Homburg/Saar, Germany
- Science in Vision, Frisco, TX, USA
- Global Clinical and Medical Affairs, Hoya Surgical Optics, Irvine, CA, USA
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Łabuz G, Khoramnia R, Yan W, van den Berg TJTP, Auffarth GU, Naujokaitis T, Tandogan T. Characterizing glare effects associated with diffractive optics in presbyopia-correcting intraocular lenses. J Cataract Refract Surg 2024; 50:413-419. [PMID: 38237073 DOI: 10.1097/j.jcrs.0000000000001398] [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: 10/05/2023] [Accepted: 01/08/2024] [Indexed: 03/26/2024]
Abstract
PURPOSE To objectively quantify glare of intraocular lenses (IOLs) using a diffractive principle to extend the visual range and to identify models with increased susceptibility to inducing glare. SETTING David J Apple Laboratory, Heidelberg, Germany. DESIGN Laboratory investigation. METHODS Glare was assessed by means of a straylight parameter with a standard C-Quant intended for 7 degrees. In addition, 2 C-Quant modifications were used to test lower angles (ie, 2.5 degrees and 3.5 degrees). The following IOL models were assessed: PanOptix, AT Lisa Tri, Synergy, and Triumf, the latter 2 with chromatic aberration correction at distance. Straylight from trifocal IOLs was compared against a monofocal W-60R lens. The C-Quant test was performed through the studied IOLs by using additional optical components attached to their ocular. RESULTS Straylight (deg 2 sr -1 ) of the control was <1 at all tested angles, with the trifocal models showing comparable straylight at 7 degrees. At 3.5 degrees, Triumf's straylight increased to 15.5 ± 0.6, followed by Synergy (6.2 ± 1.1), PanOptix (4.1 ± 0.3), and AT Lisa Tri (2.0 ± 0.8). The chromatic aberration-correcting models demonstrated correspondingly higher straylight (Synergy: 18.8 ± 1.3; Triumf: 17.3 ± 0.5) at 2.5 degrees compared with PanOptix (4.3 ± 0.4), AT Lisa Tri (2.1 ± 0.1), and monofocal IOLs yielding minimal or no increase. CONCLUSIONS Trifocal IOLs induced increased straylight, but it was limited to lower angles, which may cause difficulties detecting these effects using a standard clinical approach. The latest IOL designs featuring chromatic aberration correction at far focus seem more susceptible than the established trifocal IOLs to inducing a glare phenomenon.
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Affiliation(s)
- Grzegorz Łabuz
- From the The David J Apple Center for Vision Research, Department of Ophthalmology, University Hospital Heidelberg, Heidelberg, Germany (Łabuz, Khoramnia, Yan, Auffarth, Naujokaitis, Tandogan); Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands (van den Berg); Augenklinik Pallas, Olten, Switzerland (Tandogan)
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Gabrić K, Gabrić N, Piñero DP, Gabrić I. Comparative Analysis of the Clinical Outcomes of Two Toric Presbyopia-Correcting Intraocular Lenses. Ophthalmol Ther 2024; 13:775-790. [PMID: 38240999 PMCID: PMC10853117 DOI: 10.1007/s40123-023-00878-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 12/20/2023] [Indexed: 02/10/2024] Open
Abstract
INTRODUCTION To evaluate and compare the clinical outcomes of two toric presbyopia-correcting intraocular lenses (IOLs). METHODS Non-randomized prospective comparative study including 86 eyes of 51 patients (age 43-83 years) that underwent cataract surgery with implantation of one of the following two IOLs: TECNIS Toric Synergy (Johnson & Johnson Vision) (Synergy group) or AT LISA tri toric 939MP (Carl Zeiss Meditec) (ATLISA group). Visual and refractive outcomes were evaluated during a 6-month follow-up. RESULTS At 6 months after surgery, all eyes achieved uncorrected distance visual acuity 20/25 or better in both groups, whereas 96.2% and 100% of eyes achieved uncorrected near visual acuity (UNVA) 20/25 or better in the ATLISA and Synergy groups, respectively. All eyes achieved postoperative mesopic UNVA 20/30 or better in both IOL groups; 96.2% and 100% of eyes had a manifest cylinder ≤ 0.50 D at 6 months in ATLISA and Synergy groups, respectively. Mean magnitude of error was 0.04 ± 0.20 and - 0.04 ± 0.09 D in ATLISA and Synergy groups, respectively (p = 0.05). In the defocus curve, significant differences were found between IOL groups for most of distance-corrected visual acuities, except those corresponding to defocus of 0 D (p = 0.268) and - 1 D (p = 0.361). CONCLUSIONS The two toric presbyopia-correcting IOLs evaluated provide an efficacious astigmatic correction combined with a successful distance, intermediate and near visual rehabilitation. The visual performance seems to be better for most visual demands with the TECNIS Toric Synergy IOL, especially for distances closer than 40 cm.
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Affiliation(s)
- Krešimir Gabrić
- University Eye Clinic Svjetlost, Heinzelova Ul. 39, 10000, Zagreb, Croatia
| | - Nikica Gabrić
- University Eye Clinic Svjetlost, Heinzelova Ul. 39, 10000, Zagreb, Croatia
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - Ivan Gabrić
- University Eye Clinic Svjetlost, Heinzelova Ul. 39, 10000, Zagreb, Croatia.
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Tañá-Sanz S, Tañá-Sanz P, Rodríguez-Carrillo MD, Ruiz-Santos M, de Toledo CÁ, Tañá-Rivero P. Clinical Outcomes of a Bi-Aspheric Trifocal Diffractive Intraocular Lens. Clin Ophthalmol 2024; 18:27-40. [PMID: 38192579 PMCID: PMC10773246 DOI: 10.2147/opth.s445128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 12/20/2023] [Indexed: 01/10/2024] Open
Abstract
Purpose To assess refractive and visual outcomes post-cataract surgery with bilateral implantation of a bi-aspheric diffractive trifocal intraocular lens (IOL). Methods A total of 24 patients who underwent bilateral implantation with the Asqelio Trifocal IOL TFLIO130C were evaluated at the 6 months postoperative mark. Key outcome measures included refractive error, photopic monocular and binocular uncorrected and corrected distance visual acuity (UDVA, CDVA), uncorrected and corrected intermediate visual acuity (UIVA, CDIVA) at 60 cm, and uncorrected and corrected near visual acuity (UNVA, CDNVA) at 40 cm. Additionally, monocular and binocular CDNVA were assessed under mesopic conditions. Monocular and binocular defocus curves, and binocular contrast sensitivity under photopic and mesopic conditions, with and without glare, were measured. Catquest-9SF and visual symptoms questionnaires were also administered. Results Postoperative average values of binocular logMAR photopic CDVA, photopic CDIVA, photopic CDNVA and mesopic CDNVA were -0.01±0.06, 0.03±0.09, 0.02±0.05 and 0.19±0.13, respectively. About 100% of patients showed cumulative CDVA and CDNVA ≥20/25, and CDIVA ≥20/32. The average absolute depth-of-focus was about 4.50D. The average postoperative spherical equivalent was 0.05±0.30D and 100% and 93.75% eyes were within ±1.00D and ±0.50D, respectively. Contrast sensitivity was either within or above normal levels under both photopic and mesopic conditions, both with and without glare, except for 12 cpd under mesopic conditions with glare where the mean falls just below the normal range. Questionnaires revealed that 87.5% of patients were either satisfied or very satisfied with their vision after the surgery, and higher percentages for no difficulty in performing different activities, ranging from 70.83% to 95.83%, were reported. Conclusion This study demonstrates that the bi-aspheric diffractive trifocal IOL yields very good visual performance across distances, fostering high satisfaction levels and minimal difficulties in daily activities.
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Affiliation(s)
| | - Pedro Tañá-Sanz
- Cataract and Surgery Department, Oftalvist Alicante, Alicante, Spain
| | | | - María Ruiz-Santos
- Cataract and Surgery Department, Oftalvist Alicante, Alicante, Spain
| | | | - Pedro Tañá-Rivero
- Cataract and Surgery Department, Oftalvist Alicante, Alicante, Spain
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10
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Nomura Y, Ota Y, Fujita Y, Nishimura T, Bissen-Miyajima H, Minami K. Clinical outcomes in eyes with diffractive continuous depth-of-focus intraocular lenses enhanced for near vision: comparison with trifocal intraocular lenses. BMC Ophthalmol 2023; 23:475. [PMID: 37990206 PMCID: PMC10664304 DOI: 10.1186/s12886-023-03207-6] [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: 09/08/2023] [Accepted: 11/07/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND To prospectively evaluate visual functions and patient satisfaction after bilateral implantation of diffractive continuous depth-of-focus intraocular lens (CDF IOL) compared with trifocal IOLs. METHODS This investigator-initiated study was approved by a certified local review board (registered: jRCTs032210305). CDF IOL (Synergy, J&J, group S) and trifocal IOL (AcrySof PanOptix, Alcon, group P) were implanted bilaterally in 30 patients each. Three months postoperatively, binocular outcomes of uncorrected (BUCVA) and distance-corrected (BDCVA) visual acuities at distances of 0.3, 0.4, 0.5, 0.7, and 5 m were measured. Contrast sensitivities were binocularly measured using CSV-1000 (2.5 m) and Pelli-Robson charts at distances of 0.4 and 1 m. Symptoms of glare, halo, starburst, and waxy vision, and satisfaction for near, intermediate, and far visions were assessed with questionnaires. Differences between the two groups were examined. RESULTS Twenty-seven patients each completed the follow-up. The mean age of the group S was lower than that of the group P (P < 0.001). The BUCVA at 0.4 m was better in the S group, while the mean manifest refraction of the P group showed a significant hyperopic shift (P < 0.001). BDCVA was significantly better in the S group. The contrast sensitivity results at three distances showed no discernible differences. Although more patients in the S group reported significant glare and halo, their satisfaction with near vision was higher. CONCLUSIONS The binocular visual function of patients with CDF IOLs was comparable to or better than that of patients with trifocal IOLs. The patients were satisfied with near vision, despite the enhanced glare and halo. Understanding the differences between the two types of presbyopia-correcting IOLs is important to ensure patient satisfaction. TRIAL REGISTRATION This clinical trial was registered in the Japan Registry for Clinical Research (identifier: jRCTs032210305) on September 13, 2021.
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Affiliation(s)
| | - Yuka Ota
- Department of Ophthalmology, Tokyo Dental College Suidobashi Hospital, Tokyo, Japan
| | | | | | | | - Keiichiro Minami
- Department of Ophthalmology, Tokyo Dental College Suidobashi Hospital, Tokyo, Japan.
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11
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Pastor-Pascual F, Orts-Vila P, Tañá-Sanz P, Tañá-Sanz S, Tañá-Rivero P. Clinical Performance of a New Trifocal IOL with a 7.0 mm Optical Zone. Clin Ophthalmol 2023; 17:3397-3407. [PMID: 37954911 PMCID: PMC10638909 DOI: 10.2147/opth.s435076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/22/2023] [Indexed: 11/14/2023] Open
Abstract
Purpose To evaluate the refractive and visual outcomes following cataract surgery and implantation of a diffractive trifocal intraocular lens (IOL) with a 7.0 mm optical zone. Methods A total of 23 patients who underwent bilateral implantation with the Triva-aXAY IOL were analyzed at 6 months post-surgery. The main outcome measures were refractive error, monocular and binocular uncorrected and corrected-distance visual acuity (UDVA, CDVA), uncorrected and corrected-distance intermediate visual acuity (UIVA, CDIVA) at 60 cm, uncorrected and corrected-distance near visual acuity (UNVA, CDNVA) at 40 cm, and binocular defocus curve. Patients also completed the Catquest-9SF questionnaire. Results All eyes were within ±1.00D, and 91.30% of eyes within ±0.50D, with a mean postoperative spherical equivalent of -0.14±0.29D. Similarly, 95.65% of patients showed a binocular UDVA ≥20/25, compared to 100% for CDVA, and the mean binocular UDVA and CDVA were 0.02±0.06 and 0.00±0.05 logMAR, respectively. At intermediate vision, 65.22% of patients showed a binocular UIVA ≥20/25, compared to 86.96% for CDIVA, and the mean binocular UIVA and CDIVA were 0.07±0.06 and 0.06±0.06 logMAR, respectively. At near, 95.65% of patients showed a binocular UNVA and CDNVA ≥20/25, with a mean binocular UDNVA and CDNVA of 0.04±0.07 and 0.02±0.05 logMAR, respectively. Finally, 95.65% of patients reported being quite satisfied to very satisfied with their vision and about 74% did not report any difficulty with their vision in their everyday life. Between 65.22% and 100% of patients reported no difficulty performing different tasks. Conclusion Our study shows good visual and refractive outcomes with high satisfaction in patients implanted with the Triva-aXAY IOL with a 7.0 mm optical zone.
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Affiliation(s)
| | - Paz Orts-Vila
- Cataract and Refractive Surgery Department, Oftalvist Alicante, Alicante, Spain
| | - Pedro Tañá-Sanz
- Cataract and Refractive Surgery Department, Oftalvist Alicante, Alicante, Spain
| | - Santiago Tañá-Sanz
- Cataract and Refractive Surgery Department, Oftalvist Alicante, Alicante, Spain
| | - Pedro Tañá-Rivero
- Cataract and Refractive Surgery Department, Oftalvist Alicante, Alicante, Spain
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12
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Keskin Perk FFN, Taneri S, Tanriverdi C, Haciagaoglu S, Karaca ZY, Kilic A. Increasing depth of focus with allogeneic presbyopic inlays: 3-year results. J Cataract Refract Surg 2023; 49:1005-1010. [PMID: 37487178 DOI: 10.1097/j.jcrs.0000000000001270] [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: 08/10/2022] [Accepted: 07/19/2023] [Indexed: 07/26/2023]
Abstract
PURPOSE To demonstrate the safety and efficacy of allogenic corneal inlays designed to increase the depth of focus (DoF) in treated eyes. SETTINGS Medipol University Hospital, Istanbul, Turkey. DESIGN Prospective case series. METHODS This study includes 50 eyes of 25 patients with a follow-up of 3 years. Emmetropic patients with presbyopia had implantation of allogenic corneal inlays in the nondominant eye. The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and uncorrected near visual acuity (UNVA) were evaluated in all eyes. A subjective visual acuity test system (Multifocal Lens Analyzer 3.0 application) was used to analyze the DoF by measuring the defocus curves. RESULTS No significant difference between the treated and fellow eyes in UDVA and CDVA was found, whereas UNVA was significantly better in the treated eyes ( P = .20, P = .07, P < .01, respectively). Comparing to the preoperative CDVA, there was a 1-line decrease in CDVA in 6 (%24) patients. The mean defocus curves reveal a DoF of 1.1 diopters (D) for the untreated eye at the logMAR = 0.2 threshold. By contrast, the mean DoF of the treated eye and binocularly was 2.8 D. The areas under the curve were significantly better in the near, intermediate, and total distances in the treated eyes, whereas it was better for the far distances in the untreated eyes. All values were significant ( P = .023 total, P < .01 others). CONCLUSIONS Allogenic presbyopic inlay implantation may be safe and provided a clinically and statistically significant increase in the DoF leading to good far, intermediate, and near-visual acuity in emmetropic presbyopic patients.
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Affiliation(s)
- Fatma Feyza Nur Keskin Perk
- From the Department of Ophthalmology, Istanbul Medipol University, Faculty of Medicine, Istanbul, Turkey (Keskin Perk, Tanriverdi, Haciagaoglu, Karaca, Kilic); Department of Ophthalmology, St. Franziscus Hospital, Münster, Germany (Taneri)
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13
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Khoramnia R, Baur ID, Łabuz G, Köppe MK, Hallak MK, Auffarth GU. Functional outcomes after bilateral refractive lens exchange with a continuous-range-of-vision intraocular lens. J Cataract Refract Surg 2023; 49:1011-1017. [PMID: 37464558 DOI: 10.1097/j.jcrs.0000000000001265] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 07/12/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE To clinically evaluate a diffractive continuous-range-of-vision intraocular lens (IOL) that combines bifocal and extended depth-of-focus technologies in refractive lens exchange (RLE) patients. SETTING University eye clinic. DESIGN Prospective interventional clinical study. METHODS Bilateral implantation of the TECNIS Synergy IOL was performed during a RLE procedure in 28 patients. At 3 months postoperatively, uncorrected (UDVA) and corrected (CDVA) distance visual acuities, uncorrected (UIVA) and distance-corrected (DCIVA) intermediate visual acuities at 80 cm, and uncorrected (UNVA) and distance-corrected (DCNVA) near visual acuities at 40 cm were assessed. Defocus curve testing and contrast sensitivity testing were also performed. RESULTS Binocular UDVA and CDVA of 56 eyes (28 patients) were -0.06 ± 0.07 logMAR and -0.13 ± 0.05 logMAR, respectively. UIVA and DCIVA were -0.06 ± 0.05 logMAR and -0.08 ± 0.06 logMAR, and UNVA and DCNVA were -0.01 ± 0.07 logMAR and -0.04 ± 0.07 logMAR. The defocus curve revealed a visual acuity of 0.10 logMAR or better from +0.50 to -3.00 diopters (D). Photopic contrast sensitivity at spatial frequencies 3.0, 6.0, 12.0, and 18.0 was 1.68 ± 0.20, 1.77 ± 0.19, 1.45 ± 0.18, and 1.02 ± 0.19 log units, respectively. Mesopic contrast sensitivity at the same frequencies was 1.56 ± 0.20, 1.44 ± 0.25, 0.92 ± 0.38, and 0.44 ± 0.37, respectively. CONCLUSIONS The Synergy IOL provided very good distance, intermediate, and near visual outcomes. A visual acuity of 0.10 logMAR or better was achieved from +0.50 to -3.0 D. Contrast sensitivity was within the normal range.
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Affiliation(s)
- Ramin Khoramnia
- From the International Vision Correction Research Center, University Eye Clinic of Heidelberg, Heidelberg, Germany
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14
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De Rojas JO, Sandoval HP, Potvin R, Solomon KD. Visual Outcomes, Quality of Vision, Patient Satisfaction and Spectacle Independence After Bilateral Implantation of the Synergy™ Intraocular Lens. Clin Ophthalmol 2023; 17:2277-2285. [PMID: 37581096 PMCID: PMC10423583 DOI: 10.2147/opth.s421185] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 06/26/2023] [Indexed: 08/16/2023] Open
Abstract
Purpose To evaluate vision, visual quality, patient satisfaction and spectacle independence after bilateral implantation of the TECNIS Synergy™ intraocular lens. Setting Two clinical practices in the USA. Design Ambispective unmasked non-randomized clinical trial. Methods Patients with a history of uneventful bilateral femtosecond laser assisted cataract surgery with the study IOL implanted, targeted for emmetropia, at least 3 months prior to the study visit were enrolled. Monocular and binocular visual acuity (VA) were measured at distance, intermediate and near, along with binocular mesopic VA. Low contrast binocular VA and reading speed in mesopic and photopic conditions were also measured. Patient satisfaction, spectacle independence, visual symptoms, and functional vision questionnaires were completed. Results Results from 52 subjects were available for analysis. Mean binocular unaided visual acuity was ~0.1 logMAR (20/20) from distance to 33 cm, with 81% of subjects having 0.2 logMAR (20/25) vision or better at all test distances and 92% reporting never needing glasses at any distance. Average reading speed at 40 cm was only 10 words/minute slower in dim light (p = 0.03). Mesopic and low contrast acuity appeared good. Halos were the most frequent and bothersome visual disturbances, with the greatest effect on driving at night. Eighty-eight percent of subjects reported being "completely" or "mostly" satisfied with their overall unaided vision. Conclusion This hybrid technology IOL provided a range of binocular visual acuity from distance to 33 cm and good functional vision, even in dim light. Patients should be advised of the likelihood of visual disturbances, particularly halos.
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15
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Baur ID, Labuz G, Yildirim TM, Auffarth GU, Khoramnia R. Reversible Multifocality Achieved Through Polypseudophakia. Klin Monbl Augenheilkd 2023; 240:981-988. [PMID: 37391182 DOI: 10.1055/a-2079-1692] [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: 07/02/2023]
Abstract
Simultaneous implantation of a monofocal or monofocal toric intraocular lens (IOL) into the capsular bag and a multifocal IOL into the ciliary sulcus, referred to as duet procedure, allows us to create multifocality that is more easily reversible than the implantation of a capsular bag-fixated multifocal IOL. The optical quality and results after the duet procedure are equivalent to those of a capsular bag-fixated multifocal IOL. Patients who cannot tolerate the side effects of multifocal optics or who develop an ocular condition leading to loss of function such as age-related macular degeneration (AMD) or glaucoma in the course of their lives may benefit from the reversibility of the procedure.
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Affiliation(s)
- Isabella Diana Baur
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Univ.-Augenklinik Heidelberg, Deutschland
| | - Grzegorz Labuz
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Univ.-Augenklinik Heidelberg, Deutschland
| | - Timur Mert Yildirim
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Univ.-Augenklinik Heidelberg, Deutschland
| | - Gerd U Auffarth
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Univ.-Augenklinik Heidelberg, Deutschland
| | - Ramin Khoramnia
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Univ.-Augenklinik Heidelberg, Deutschland
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16
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Mencucci R, Favuzza E, Ribeiro F. Editorial: Addressing the unmet needs of cataract patients: when quality of vision can make the difference in quality of life. Front Med (Lausanne) 2023; 10:1232243. [PMID: 37457565 PMCID: PMC10344353 DOI: 10.3389/fmed.2023.1232243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 06/14/2023] [Indexed: 07/18/2023] Open
Affiliation(s)
- Rita Mencucci
- Eye Clinic, Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Eleonora Favuzza
- Eye Clinic, Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
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17
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Moshirfar M, Stoakes IM, Theis JS, Porter KB, Santos JM, Martheswaran T, Payne CJ, Hoopes PC. Assessing Visual Outcomes: A Comparative Study of US-FDA Premarket Approval Data for Multifocal and EDOF Lens Implants in Cataract Surgery. J Clin Med 2023; 12:4365. [PMID: 37445400 DOI: 10.3390/jcm12134365] [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: 06/05/2023] [Revised: 06/21/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
This study compares the efficacy, safety, and patient-reported outcomes of three intraocular implants (IOL): Tecnis Synergy IOL, AcrySof IQ PanOptix Trifocal, and Tecnis Symfony EDOF IOL. Participants achieving 20/20 or better uncorrected binocular visual acuity were as follows: Synergy-67% distance, 64% intermediate, and 47% near; PanOptix-73% distance, 73% intermediate, and 50% near; and Symfony-63% distance, 75% intermediate, and 22% near. Symfony demonstrated superior intermediate visual acuity compared to Synergy (p = 0.0182) for those achieving 20/25 or better. Both Synergy and PanOptix showed superiority over Symfony for near visual acuity (p < 0.0001). Halos were statistically more common in Synergy participants compared to PanOptix (p = 0.0013) and Symfony (p < 0.0001). Each trial lens outperformed its monofocal IOL in terms of independence from glasses or contacts, with Synergy and PanOptix showing statistical significance over Symfony. Comparing contrast sensitivities and defocus curves was challenging due to data variance and as such, standardization of United States Food and Drug Administration (US-FDA) data reporting is key for better comparison of outcomes among different IOL platforms.
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Affiliation(s)
- Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA
- John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
- Utah Lions Eye Bank, Murray, UT 84107, USA
| | - Isabella M Stoakes
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA
- Pacific Northwest University of Health Sciences, College of Osteopathic Medicine, Yakima, WA 98901, USA
| | - Joshua S Theis
- University of Arizona School of Medicine, Phoenix, AZ 85004, USA
| | - Kaiden B Porter
- University of Arizona School of Medicine, Phoenix, AZ 85004, USA
| | - Jordan M Santos
- University of Arizona School of Medicine, Phoenix, AZ 85004, USA
| | | | - Carter J Payne
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA
- Case Western Reserve School of Medicine, Cleveland, OH 44106, USA
| | - Phillip C Hoopes
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA
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18
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Yan W, Łabuz G, Khoramnia R, Auffarth GU. Trifocal Intraocular Lens Selection: Predicting Visual Function From Optical Quality Measurements. J Refract Surg 2023; 39:111-118. [PMID: 36779464 DOI: 10.3928/1081597x-20221207-02] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
PURPOSE To apply in vitro quality metrics to assess and compare three trifocal intraocular lenses (IOLs). METHODS The optical performance of the AT LISA tri 839MP (Carl Zeiss Meditec AG), AcrySof IQ PanOptix (Alcon Laboratories, Inc), and TECNIS Synergy (Johnson & Johnson Vision) was compared. The modulation transfer function (MTF) metrics were obtained using an optical bench set-up. A polychromatic light source and a model cornea inducing chromatic and spherical aberrations were used to mimic in vivo characteristics. The area under the MTF was calculated at each defocus position, which served as a parameter in a nonlinear formula applied to predict postoperative visual acuity (VA). RESULTS All of the studied IOLs had a predicted VA of 0.2 logMAR or better throughout the range of 0.00 to -3.00 diopters (D). Simulated VA differences between the IOLs were negligible (< 0.01 logMAR) at the far point. Although the three models were comparable at -1.00 D, at -2.00 D the AT LISA tri 839MP's VA was 0.06 and 0.08 logMAR worse than with the TECNIS Synergy and AcrySof IQ PanOptix, respectively. At near focus, the AcrySof IQ PanOptix's estimated VA was 0.06 logMAR (40 cm); for the AT LISA tri 839MP and TECNIS Synergy, it was 0.06 and 0.03 logMAR, respectively, at 36 cm. CONCLUSIONS Although simulated distance VA was comparable between the studied models, differences can be found in the intermediate focus' position and quality and the expected reading distance. Therefore, simulations of defocus curves from optical quality metrics provide insight into IOL characteristics and highlight differences between the IOLs, which may guide the selection of a trifocal lens based on patients' needs. [J Refract Surg. 2023;39(2):111-118.].
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19
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Ribeiro F, Ferreira TB, Silva D, Matos AC, Gaspar S, Piñero DP. Analysis of Daily Visual Habits in a Presbyopic Population. J Ophthalmol 2023; 2023:6440954. [PMID: 37089413 PMCID: PMC10118895 DOI: 10.1155/2023/6440954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 03/20/2023] [Accepted: 03/27/2023] [Indexed: 04/25/2023] Open
Abstract
Purpose To evaluate and report the visual habits and requirements of a sample of presbyopic patients using an advanced sensor. Methods Transversal study collecting clinical data from 40 presbyopes candidates for presbyopia-correction intraocular lens (IOL) implantation with mean age of 61.0 years (43-80 years). A complete ophthalmological examination was performed in all patients including visual, refractive, an ocular biometric analysis. Furthermore, patients were instructed about the use of the Vivior Monitor system (Vivior AG, Zürich, Switzerland), which consists of a series of sensors attached to the rim of the patient's glasses that capture information about the visual behavior of the patient. This device was worn for a period of 36 hours or more. The data collected were transferred to a database and analyzed. Results Mean percentages of time dedicated to distance, intermediate, and near vision were 27.25 ± 11.93% (5-65%), 30.23 ± 9.36% (12-50%), and 42.53 ± 14.96% (13-78%), respectively. Mean percentages of time performing activities under photopic, mesopic, and scotopic conditions were 37.08 ± 23.20% (5-87%), 33.65 ± 13.84% (6-67%), and 29.28 ± 17.03% (4-65%). The percentage of time with digital screens ranged from 2% to 48%. Age was significantly correlated with the percentage of time dedicated to distance vision (r = 0.317, p=0.047) and to activities performed under photopic conditions (r = -0.344, p=0.030). Conclusions Distance and illumination conditions used to perform different daily life visual activities vary significantly among presbyopes, with a trend to the dedication of more time to intermediate and near visual activities performed under photopic and mesopic conditions. Data interpretation should be done with care until a proper validation of the device used.
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Affiliation(s)
- Filomena Ribeiro
- Hospital da Luz Lisboa, Lisbon, Portugal
- Lisbon University, Lisbon, Portugal
- Visual Sciences Research Centre, Lisbon, Portugal
| | | | | | | | | | - David P. Piñero
- Department of Optics Pharmacology and Anatomy, University of Alicante, Alicante, Spain
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Moshirfar M, Stapley SR, Corbin WM, Bundogji N, Conley M, Darquea IM, Ronquillo YC, Hoopes PC. Comparative Visual Outcome Analysis of a Diffractive Multifocal Intraocular Lens and a New Diffractive Multifocal Lens with Extended Depth of Focus. J Clin Med 2022; 11:jcm11247374. [PMID: 36555990 PMCID: PMC9781237 DOI: 10.3390/jcm11247374] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/02/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
This study compares the visual and refractive performance of the TECNIS Synergy (DFR00V-DFW150-225-300-375) multifocal intraocular lens (IOL) and the AcrySof IQ PanOptix (TFAT00-30-40-50-60) multifocal IOL. Patients who underwent phacoemulsification and cataract extraction and received either a multifocal Synergy or PanOptix IOL were included. Monocular uncorrected distance (UDVA), intermediate (UIVA), near (UNVA), and corrected distance (CDVA) visual acuities were assessed at three and six months postoperatively. Secondary outcome measures of photic phenomena were also assessed. A total of 140 patients (224 eyes) were included in this study, with 69 patients (105 eyes) in the Synergy group and 71 patients (119 eyes) in the PanOptix group. There were no statistically significant differences in UIVA or CDVA measurements across all time points. When assessing UDVA, at three months postoperatively, there were more eyes in the PanOptix group with vision better than 20/40 (p = 0.04). At three and six months postoperatively, the average UNVA was superior in the Synergy group (p = 0.01, 0.002). While the Synergy group reported more night vision disturbances at one and three months (p = 0.01, 0.03), the PanOptix group had more night vision disturbances at six months (p = 0.02). Although not statistically significant, the AcrySof IQ PanOptix multifocal IOL demonstrated better UDVA and UIVA sooner postoperatively than the TECNIS Synergy multifocal IOL. The Synergy IOL provided statistically better UNVA compared to the PanOptix IOL at three and six months postoperatively. Synergy patients reported more early photic phenomena than PanOptix patients, which later diminished.
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Affiliation(s)
- Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA
- John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT 84112, USA
- Utah Lions Eye Bank, Murray, UT 84107, USA
- Correspondence: ; Tel.: +1-(801)-563-0200
| | - Seth R. Stapley
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ 85308, USA
| | - Wyatt M. Corbin
- Stritch School of Medicine, Loyola University Chicago, Chicago, IL 60153, USA
| | - Nour Bundogji
- John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT 84112, USA
| | - Matthew Conley
- School of Medicine, University of Utah, Salt Lake City, UT 84132, USA
| | - Ines M. Darquea
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA
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Current Advances and Future of Premium IOLs. CURRENT SURGERY REPORTS 2022. [DOI: 10.1007/s40137-022-00333-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Villarrubia Cuadrado A, Sánchez Ventosa Á, Palacín Miranda E, López Pérez MD, González-Cruces T, Morales López P, Piñero DP, Cano-Ortiz A. Early patient-reported outcomes of cataract surgery with implantation of the trifocal liberty 677MY intraocular lens: A pilot study. Eur J Ophthalmol 2022; 33:11206721221136428. [PMID: 36314450 DOI: 10.1177/11206721221136428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
PURPOSE To report our first clinical and patient-reported outcomes in the early postoperative period with a new model of trifocal diffractive intraocular lens (IOL). METHODS Pilot prospective analysis of the results of 26 eyes of 13 patients (age, 44-79 years) undergoing cataract surgery with implantation of the trifocal diffractive IOL Liberty 677MY (Medicontur Medical Engineering Ltd., Zsámbék, Hungary). The following clinical outcomes were evaluated during the first postoperative month: measurement of distance, intermediate and near visual acuity, binocular defocus curve, and level of spectacle independence, patient satisfaction, perception of photic phenomena, and difficulty in performing several vision-related daily tasks by means of a questionnaire. RESULTS Mean binocular LogMAR uncorrected distance, intermediate and near visual acuities were -0.03 ± 0.13, 0.21 ± 0.16, and 0.16 ± 0.09, respectively. Furthermore, 100.0%, 84.6% and 92.3% of patients achieved a binocular corrected distance, distance-corrected intermediate and distance-corrected near visual acuity of 20/32 or better, respectively. In the defocus curve, visual acuities were better than 0.2 logMAR for defocus levels between +1.00 and -3.00 D. Spectacle independence was referred by all patients, with any of them reporting dissatisfaction with the outcome of the surgery. The postoperative vision did not lead to difficulties in the daily life in 92.3% of patients. Bothersome halos, glare or starbursts were only reported by only 7.7% of patients. CONCLUSIONS The trifocal IOL evaluated provides a successful visual rehabilitation with minimal photic phenomena associated, leading to high levels of spectacle independence and patient satisfaction.
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Affiliation(s)
| | - Álvaro Sánchez Ventosa
- Department of Anterior Segment, Cornea and Refractive Surgery, 221798Hospital La Arruzafa, Cordoba, Spain
| | - Elisa Palacín Miranda
- Department of Anterior Segment, Cornea and Refractive Surgery, 221798Hospital La Arruzafa, Cordoba, Spain
| | - Maria Dolores López Pérez
- Department of Anterior Segment, Cornea and Refractive Surgery, 221798Hospital La Arruzafa, Cordoba, Spain
| | - Timoteo González-Cruces
- Department of Anterior Segment, Cornea and Refractive Surgery, 221798Hospital La Arruzafa, Cordoba, Spain
| | - Pablo Morales López
- Ophatlmology Department, David Bitran Ophtalmology Institut, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - Antonio Cano-Ortiz
- Department of Anterior Segment, Cornea and Refractive Surgery, 221798Hospital La Arruzafa, Cordoba, Spain
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Shin DE, Lee H, Koh K. Comparative analysis of a presbyopia-correcting intraocular lens that combines extended depth-of-focus and bifocal profiles with a standard monofocal intraocular lens. BMC Ophthalmol 2022; 22:302. [PMID: 35836144 PMCID: PMC9284875 DOI: 10.1186/s12886-022-02516-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 06/21/2022] [Indexed: 12/01/2022] Open
Abstract
Background Recently, a new presbyopia-correcting intraocular lens (IOL) that combines extended depth-of-focus and bifocal profiles (ZFR00: Tecnis® Synergy®, Johnson & Johnson Vision, Santa Ana, CA, USA) has been established and several studies have been reported. We attempted to compare the performance with a standard IOL (ZCB00: Tecnis® monofocal, Johnson & Johnson Vision, Santa Ana, CA, USA) manufactured using the same material from the same company, which has been extensively used worldwide. Methods The medical records of patients undergoing cataract surgery with ZCB00 or ZFR00 implantation between March 2021 and September 2021 and with available 3-month visit data were reviewed. Uncorrected near, intermediate, and distance visual acuity (VA), corrected distance VA, and optical quality were the main outcome measures. Results This study included forty-six patients (64 eyes), with twenty-one patients (32 eyes) implanted with ZCB00 and twenty-five patients (32 eyes) implanted with ZFR00. The average age of the patients was 66.0 ± 10.1 (range: 40 to 82) and 65.1 ± 4.7 (range: 59 to 77) years in the ZCB00 and ZFR00 groups, respectively. The preoperative characteristics did not differ significantly between the two groups. Compared to the ZCB00 group, the ZFR00 group demonstrated significantly superior intermediate and near VA (p < 0.001) at 3 months postoperatively. The ZFR00 group showed significantly lower objective measured optical quality than that in the ZCB00 group. Conclusions The ZFR00 exhibited a continuous range of vision and a smooth defocus curve, while the ZCB00 provided superior objective optical quality. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-022-02516-6.
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Affiliation(s)
- Da Eun Shin
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, 136 Youngshinro, Youngdeungpo-gu, Seoul, 07301, Republic of Korea
| | - Hun Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 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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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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