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Tañá-Rivero P, Tañá-Sanz P, Tañá-Sanz S, Montés-Micó R, Cerviño A. Recognition vs resolution charts for defocus curve determination in trifocal intraocular lenses. J Cataract Refract Surg 2024; 50:942-946. [PMID: 38780434 PMCID: PMC11338032 DOI: 10.1097/j.jcrs.0000000000001491] [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: 11/15/2023] [Revised: 04/16/2024] [Accepted: 05/19/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE To determine the impact of optotype choice on the determination of defocus curve in patients with cataract implanted with presbyopia-correcting intraocular lens (IOL). SETTING Oftalvist Alicante, Alicante, Spain. DESIGN Observational case-control study. METHODS Patients implanted with Asqelio Trifocal IOL participated in this study. Uncorrected and corrected distance visual acuity (VA) and subjective refraction were determined. Monocular defocus curves were obtained 6 months postoperatively with the Clinical Trial Suite system using either Early Treatment Diabetic Retinopathy Study (ETDRS) or Landolt C charts under photopic conditions (85 cd/m 2 ), and range of vergence from +2.00 to -5.00 diopters (D) in 0.50 D steps. RESULTS A total of 49 patients were enrolled in the study, 24 in the ETDRS group (7 male, 17 female) and 25 in the Landolt C group (5 male, 20 female). Nonsignificant differences were found between patients conforming both groups, except for preoperative intraocular pressure and white-to-white distance. All patients were within ±1.00 D from intended refraction after surgery. 75% of patients in the ETDRS group and 84% in the Landolt C group were within ±0.50 D. Average difference between the groups across vergences provided by the defocus curve was 0.12 ± 0.05 logMAR units, significant for all vergences ( P < .05). Differences in VA were significant for distance, intermediate, and near between both groups, except for uncorrected distance VA. CONCLUSIONS Defocus curves created using Landolt C charts yield significantly lower through-focus outcomes than those created with standard ETDRS charts. This should be taken into account when comparing the performance of presbyopia-correcting systems across studies where recognition charts might have been used because of patient characteristics.
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Affiliation(s)
- Pedro Tañá-Rivero
- From the Oftalvist Alicante, Alicante, Spain (Tañá-Rivero, P. Tañá-Sanz, S. Tañá-Sanz); Department of Optics and Optometry and Vision Science, University of Valencia, Valencia, Spain (Montés-Micó, Cerviño)
| | - Pedro Tañá-Sanz
- From the Oftalvist Alicante, Alicante, Spain (Tañá-Rivero, P. Tañá-Sanz, S. Tañá-Sanz); Department of Optics and Optometry and Vision Science, University of Valencia, Valencia, Spain (Montés-Micó, Cerviño)
| | - Santiago Tañá-Sanz
- From the Oftalvist Alicante, Alicante, Spain (Tañá-Rivero, P. Tañá-Sanz, S. Tañá-Sanz); Department of Optics and Optometry and Vision Science, University of Valencia, Valencia, Spain (Montés-Micó, Cerviño)
| | - Robert Montés-Micó
- From the Oftalvist Alicante, Alicante, Spain (Tañá-Rivero, P. Tañá-Sanz, S. Tañá-Sanz); Department of Optics and Optometry and Vision Science, University of Valencia, Valencia, Spain (Montés-Micó, Cerviño)
| | - Alejandro Cerviño
- From the Oftalvist Alicante, Alicante, Spain (Tañá-Rivero, P. Tañá-Sanz, S. Tañá-Sanz); Department of Optics and Optometry and Vision Science, University of Valencia, Valencia, Spain (Montés-Micó, Cerviño)
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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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Ribeiro F, Dick HB, Kohnen T, Findl O, Nuijts R, Cochener B, Fernández J. Evidence-based functional classification of simultaneous vision intraocular lenses: seeking a global consensus by the ESCRS Functional Vision Working Group. J Cataract Refract Surg 2024; 50:794-798. [PMID: 39083407 DOI: 10.1097/j.jcrs.0000000000001502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Affiliation(s)
- Filomena Ribeiro
- From the Hospital da Luz, Lisbon, Portugal (Ribeiro); Universidade de Lisboa, Lisbon, Portugal (Ribeiro); University Eye Hospital Bochum, Bochum, Germany (Dick); Department of Ophthalmology, Goethe University, Frankfurt, Germany (Kohnen); Vienna Institute for Research in Ocular Surgery (VIROS), A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Findl); University Eye Clinic Maastricht, Maastricht University Medical Centre, Maastricht, the Netherlands (Nuijts); Univ Bretagne Occidentale, Brest, France (Cochener); Service d'Ophtalmologie, CHRU Brest, Brest, France (Cochener); Qvision, Department of Ophthalmology of VITHAS Almería Hospital, Almería, Spain (Fernández)
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Llovet-Rausell A, Ortega-Usobiaga J, Albarrán-Diego C, Beltrán-Sanz J, Bilbao-Calabuig R, Llovet-Osuna F. Visual Outcomes and Patient Satisfaction After Bilateral Refractive Lens Exchange With a Trifocal Intraocular Lens in 5,226 Patients With Presbyopia. J Refract Surg 2024; 40:e468-e479. [PMID: 39007809 DOI: 10.3928/1081597x-20240517-01] [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: 07/16/2024]
Abstract
PURPOSE To assess visual and refractive outcomes and visual function after bilateral RayOne Trifocal toric and nontoric intraocular lens (IOL) (Rayner) implantation in patients with presbyopia. METHODS Charts of patients with presbyopia who underwent refractive lens exchange with bilateral implantation of the RayOne Trifocal IOL (toric and non-toric) were retrospectively reviewed. Visual and refractive outcomes were evaluated at 3 months. Patient satisfaction, spectacle independence, and visual disturbance profile were assessed by questionnaires. RESULTS A total of 5,226 patients were assigned to one of two groups: 1,010 patients had toric IOL implantation (toric group) and 4,216 patients received the non-toric model (non-toric group). Mean ± standard deviation visual acuity at 3 months for the toric group was binocular uncorrected distance visual acuity (UDVA) of 0.07 ± 0.11 logMAR, monocular corrected distance visual acuity (CDVA) of 0.05 ± 0.07 logMAR, binocular uncorrected near visual acuity (UNVA) at 40 cm of 0.10 ± 0.09 logMAR, binocular uncorrected intermediate visual acuity (UIVA) at 40 cm of 0.13 ± 0.12 logMAR, postoperative spherical equivalent (SE) of -0.21 ± 0.47 diopters (D), and cylinder of -0.34 ± 0.40 D. The non-toric group had binocular UDVA of 0.04 ± 0.08 logMAR, monocular CDVA of 0.05 ± 0.07 logMAR, binocular UNVA of 0.10 ± 0.08 logMAR, binocular UIVA of 0.13 ± 0.11 logMAR, SE of -0.08 ± 0.38 D, and cylinder of -0.28 ± 0.34 D. No statistically significant differences were found in achieving spectacle independence and there were high levels of satisfaction in both groups. CONCLUSIONS In this retrospective analysis with more than 5,000 patients, both the toric and non-toric RayOne Trifocal IOL models provided good visual performance at all distances, resulting in excellent levels of spectacle independence and patient satisfaction. [J Refract Surg. 2024;40(7):e468-e479.].
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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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García-Bella J, Burgos-Blasco B, Vidal-Villegas B, Garzón N, Villanueva C, García-Feijoo J. Visual and refractive outcomes after bilateral implantation of an enhanced monofocal intraocular lens: prospective study. J Cataract Refract Surg 2024; 50:585-590. [PMID: 38350145 PMCID: PMC11146183 DOI: 10.1097/j.jcrs.0000000000001422] [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: 07/31/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/15/2024]
Abstract
PURPOSE To evaluate visual and refractive outcomes, as well as patient satisfaction after bilateral implantation of an enhanced monofocal intraocular lens (IOL) with emmetropia as a target refraction. SETTING San Carlos Hospital, Madrid, Spain. DESIGN Prospective, monocentric, noncomparative study. METHODS Adults 21 years or older suitable for cataract surgery and with corneal astigmatism <1.50 diopters (D) were bilaterally implanted with the RayOne EMV IOL and followed up for 3 months. Outcomes measures included refraction, monocular and binocular uncorrected distance visual acuity, corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity, distance-corrected intermediate visual acuity (DCIVA), and defocus curve, aberrometry, and satisfaction. Visual symptoms were assessed using the CatQuest-9SF questionnaire. RESULTS 50 eyes of 25 patients were included. At month 3, the mean manifest spherical equivalent was -0.39 ± 0.28 D, with all eyes within 1.00 D. Binocularly, uncorrected, at distance, 68% of patients could read ≤0.0 logMAR and 95% ≤0.2 logMAR; at intermediate 59% of patients could read ≤0.1 and 100% ≤0.2 logMAR. Mean monocular CDVA was -0.03 ± 0.06 logMAR and mean monocular DCIVA was 0.28 ± 0.07 logMAR. Binocular defocus curve demonstrated a visual acuity ≤0.2 logMAR over a 2 D range from +1.00 D to -1.25 D. Satisfaction was good in 96% of patients. CONCLUSIONS Bilateral implantation of an enhanced monofocal IOL with emmetropia as a target provided excellent binocular CDVA and good DCIVA, with a high level of satisfaction.
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Affiliation(s)
- Javier García-Bella
- From the Department of Ophthalmology, Clinico San Carlos Hospital, Madrid, Spain (García-Bella, Burgos-Blasco, Vidal-Villegas, Villanueva, García-Feijoo); Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain (Garzón, Villanueva)
| | - Bárbara Burgos-Blasco
- From the Department of Ophthalmology, Clinico San Carlos Hospital, Madrid, Spain (García-Bella, Burgos-Blasco, Vidal-Villegas, Villanueva, García-Feijoo); Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain (Garzón, Villanueva)
| | - Beatriz Vidal-Villegas
- From the Department of Ophthalmology, Clinico San Carlos Hospital, Madrid, Spain (García-Bella, Burgos-Blasco, Vidal-Villegas, Villanueva, García-Feijoo); Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain (Garzón, Villanueva)
| | - Nuria Garzón
- From the Department of Ophthalmology, Clinico San Carlos Hospital, Madrid, Spain (García-Bella, Burgos-Blasco, Vidal-Villegas, Villanueva, García-Feijoo); Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain (Garzón, Villanueva)
| | - Celia Villanueva
- From the Department of Ophthalmology, Clinico San Carlos Hospital, Madrid, Spain (García-Bella, Burgos-Blasco, Vidal-Villegas, Villanueva, García-Feijoo); Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain (Garzón, Villanueva)
| | - Julián García-Feijoo
- From the Department of Ophthalmology, Clinico San Carlos Hospital, Madrid, Spain (García-Bella, Burgos-Blasco, Vidal-Villegas, Villanueva, García-Feijoo); Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain (Garzón, Villanueva)
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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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Hida WT, Moscovici BK, Cortez CM, Colombo-Barboza GN, Tzelikis PFDM, Motta AFP, De Medeiros AL, Nose W, Carricondo PC. Comparison of visual outcomes of bilateral dual-technology diffractive intraocular lens vs blended enhanced monofocal with dual-technology intraocular lens. J Cataract Refract Surg 2024; 50:401-406. [PMID: 38085244 DOI: 10.1097/j.jcrs.0000000000001374] [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: 08/29/2023] [Accepted: 11/21/2023] [Indexed: 03/26/2024]
Abstract
PURPOSE To compare clinical outcomes after implantation of TECNIS Synergy (ZFR00V) intraocular lenses (IOLs) in both eyes and implantation of the TECNIS Synergy and TECNIS Eyhance (ICB00) combination in patients undergoing cataract surgery. SETTING Department of Cataract, Hospital Oftalmológico de Brasilia (HOB), Brasília, Brazil. DESIGN Prospective, interventional, randomized, parallel-group study. METHODS Patients were categorized into 2 groups: Group 1: ZFR00V IOL was implanted in both eyes. Group 2: An ICB00 IOL was implanted in the dominant eye, and a ZFR00V IOL was implanted in the nondominant eye. RESULTS Visual acuity was similar between the 2 groups (95% CI <0.1 logMAR). A superior visual acuity of ≥ 20/25 (at -2.00 to -2.50 diopters [D]) was achieved in Group 1 (bilateral ZFR00V) than in Group 2 (combination of ZFR00V/ICB00). The binocular defocus curve demonstrated better visual acuity at 40 cm (-2.00 D) and 50 cm (-2.50 D) in Group 1 than in Group 2 ( P < .05). Similar contrast sensitivity values were observed between the 2 groups. Patients in Group 1 reported higher satisfaction (completely satisfied) than those in Group 2 ( P < .05). However, halos and glare were more pronounced in Group 1 than in Group 2 ( P < .05). CONCLUSIONS Both presbyopia-correcting IOL combinations showed similar binocular visual acuity results. Group 1 demonstrated enhanced visual acuity in the defocus curve at 40 cm (-2.00 D) and 50 cm (-2.50 D). Comparable contrast sensitivity outcomes were observed in both groups. Patients were more completely satisfied in Group 1 than in Group 2, despite the higher frequency of postoperative nighttime halos and glare.
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Affiliation(s)
- Wilson Takashi Hida
- From the Department of Ophthalmology, Hospital Oftalmológico de Brasília (HOB), Brasília, Brazil (Hida, Cortez, Tzelikis); Department of Ophthalmology, University of Sao Paulo (HC-FMUSP), Sao Paulo, Brazil (Hida, Carricondo); Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil (Moscovici, Nose); Department of Ophthalmology, Hospital Visão Laser, Santos, Brazil (Moscovici, Colombo-Barboza, Tzelikis); Department of Ophthalmology, Renato Ambrosio Research Center (CEORA), Brasília, Brazil (Cortez, Tzelikis, Motta, De Medeiros)
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Fernández J, Ribeiro F, Rocha-de-Lossada C, Rodríguez-Vallejo M. Functional Classification of Intraocular Lenses Based on Defocus Curves: A Scoping Review and Cluster Analysis. J Refract Surg 2024; 40:e108-e116. [PMID: 38346117 DOI: 10.3928/1081597x-20231212-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
PURPOSE To explore a potential functional classification of intraocular lenses (IOLs) based on monocular visual acuity defocus curves (VADCs) as a primary end-point. METHODS A systematic literature search was conducted using PubMed. Two independent reviewers screened the literature for inclusion and data extraction. Inclusion criteria were full-text primary clinical studies of IOLs, published in English from 2010 onward, involving patients undergoing cataract or refractive lens exchange. A cluster analysis was conducted to explore similarities in the range of field (RoF) and increase of visual acuity from intermediate to near (ΔVA). RESULTS A total of 107 studies were ultimately included from the 436 identified in the systematic search, with an additional 5 studies added through the snowballing technique search. The cluster analysis was conducted using 69 reports that included monocular VADCs. Two main categories were identified based on the achieved RoF for 0.2 and 0.3 logMAR: full (FRoF) and partial (PRoF) RoF IOLs. Three subcategories were identified for FRoF depending on ΔVA: continuous (FRoF-C), smooth (FRoF-Sm), and steep (FRoF-St). On the other hand, PRoF IOLs shared the characteristic of monotonous decrease in visual acuity and were subclassified into two subcategories depending on the achieved RoF: narrowed (PRoF-N) and extended (PRoF-Ex). An additional subcategory was added to PRoF, enhanced (PRoF-En), for 7 reports alternating between PRoF-N and PRoF-Ex depending on the use of 0.2 or 0.3 logMAR as a cut-off for calculating the RoF. CONCLUSIONS IOLs can be functionally classified into six types depending on the RoF and shape of the monocular VADC. [J Refract Surg. 2024;40(2):e108-e116.].
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Fernández J, Burguera N, Rocha-de-Lossada C, Zamorano-Martín F, Rodríguez-Vallejo M. Screening of positive dysphotopsia before multifocal intraocular lens implantation. Indian J Ophthalmol 2024; 72:S211-S217. [PMID: 38271416 DOI: 10.4103/ijo.ijo_1038_23] [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: 04/20/2023] [Accepted: 09/26/2023] [Indexed: 01/27/2024] Open
Abstract
PURPOSE To assess the photic phenomena (PP) and positive dysphotopsia in candidates for presbyopia or cataract surgery and to evaluate their relationship with cataract grading systems. DESIGN Retrospective observational. METHODS Monocular data for 82 subjects measured during the preoperative screening were retrospectively retrieved from our database. The evaluated variables consisted of two methods for PP measurement: light distortion index (LDI) and parameters obtained from a simulator, both of which were combined with subjective bother related to PP. The cutoff for LDI that better predicted patients passing from slightly to moderately bothersome was estimated. The relationships between LDI and the following objective cataract grading methods were also assessed: objective scatter index (OSI), dysfunctional lens index (DLI), and Pentacam Nucleus Staging (PNS). RESULTS LDI was the best method for measuring PP, which showed a significant correlation with the bothersome question (rho = 0.34, P = 0.002) and also with OSI (rho = 0.67, P < 0.0005), DLI (rho = -0.29, P = 0.007), and PNS (rho = 0.48, P < 0.0005). The number/percentage of patients who found it bothersome was as follows: "Not at all" (18/22%), "Slightly" (41/50%), "Moderately" (15/18.3%), and "Very" (8/9.7%). The cutoff value that predicted the transition from slightly to moderately bothersome was ≥15.20% according to LDI, which could be estimated with the following values for grading: ≥2.8 for OSI, ≤7.6 for DLI, and ≥2 for PNS. CONCLUSIONS Patients reporting moderately or higher bothersome levels in the preoperative period and with LDI <15.20%, <2.8 for OSI, >7.6 for DLI, and <2 for PNS might deserve special attention in the multifocal intraocular lens selection.
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Affiliation(s)
- Joaquín Fernández
- Department of Ophthalmology, VITHAS Almería Hospital, Qvision, 04120, Almería, Spain
| | - Noemí Burguera
- Department of Ophthalmology, VITHAS Almería Hospital, Qvision, 04120, Almería, Spain
| | - Carlos Rocha-de-Lossada
- Department of Ophthalmology, VITHAS Almería Hospital, Qvision, 04120, Almería, Spain
- Ophthalmology Department, VITHAS Málaga, 29016 Málaga, Spain
- Hospital Regional Universitario de Málaga, Plaza del Hospital Civil, Spain
- Departamento de Cirugía, Universidad de Sevilla, Área de Oftalmología, Doctor Fedriani, Spain
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Fernández J, Burguera N, Maldonado-Carmona C, Ginel J, Sáez-Martín Á, Rodríguez-Vallejo M. Simulations of Multifocal Vision in Patients With Previous Monofocal Intraocular Lens Implantation. J Refract Surg 2023; 39:831-839. [PMID: 38063826 DOI: 10.3928/1081597x-20231101-02] [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: 12/18/2023]
Abstract
PURPOSE To evaluate the effectiveness and patient acceptance of multifocal vision simulation in patients with previous monofocal intraocular lens (IOL) implantation, and to explore their willingness-to-pay (WTP) and willingness-to-accept (WTA) based on the perceived advantages and disadvantages of multifocal vision. METHODS Seventeen patients with previous monofocal IOL implantation participated in this cross-sectional study. The SimVis Gekko device (2EyesVision SL) was used to simulate monofocal (Evaluation B) and multifocal (Evaluation C) visual experiences, compared to their existing vision (Evaluation A). Visual acuity at three distances and defocus curves were measured. Patients responded to inquiries about visual quality in each evaluation, bothersomeness of photic phenomena, probability to select the visual experience, and the monetary value they associated with enhanced WTP or diminished WTA visual quality. RESULTS The simulations underestimated the visual acuity reported for the IOL in existing literature by one or two lines, depending on the testing distance. This underestimation was more pronounced in defocus curves. However, 70.6% of patients were likely or very likely to opt for multifocal vision, indicating they perceived the benefits of multifocality. The WTP for multifocal vision was twice that of monofocal vision, and the WTP/WTA ratio exceeded 1, suggesting the perceived vision benefits outweighed potential drawbacks. CONCLUSIONS Despite underestimating the expected postoperative visual performance, the multifocal simulation enabled patients to perceive the benefits of multifocal vision to some extent. This system could be beneficial in avoiding potential postoperative complaints, but the possible rise in false-positive results should be considered and evaluated in future research. [J Refract Surg. 2023;39(12):831-839.].
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12
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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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Fernández J, Srinivasan S, Burguera N, Martínez J, Rodríguez-Vallejo M. One-year follow-up of a multifocal intraocular lens with optimized elevated phase shift. J Cataract Refract Surg 2023; 49:1018-1024. [PMID: 37464551 DOI: 10.1097/j.jcrs.0000000000001266] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/13/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE To evaluate the standard outcomes of a multifocal intraocular lens (mIOL) with optimized elevated phase shift (EPS). SETTING Qvision, Ophthalmology Department, VITHAS Almería, Spain. DESIGN Retrospective observational. METHODS 41 patients, consecutively operated on cataracts or refractive lens exchange with the implantation of the Liberty 640PM (EPS 2.0) and followed during 12 months, were included in the analysis. Retrieved variables were visual acuities at far, intermediate, and near distances; defocus curves (VADC); and prediction error of 4 formulas optimized for IOLMaster 500 and Pentacam AXL Wave. Patient-reported outcomes were also obtained for assessing spectacle independence, satisfaction, bothersome to dysphotopsia, difficulties in daily life tasks, and decision to be operated with the same mIOL. RESULTS The median monocular efficacy with best distance correction was 0, 0.1, and 0.1 logMAR at far, intermediate, and near distances, respectively, with patients achieving binocularly a median of 0 logMAR at the 3 distances. VADC showed a depth of field of 3 diopters (D) above 0.2 logMAR with a median increase of 0.07 logMAR from -1.5 to -2.5 D. Complete spectacle independence was achieved at far distance, whereas 97.6% and 85.4% was achieved at intermediate and near distances, respectively. 7.3% of patients were bothered by dysphotopsia, and 92.6% of patients were likely to be operated again. CONCLUSIONS EPS 2.0 restored patients' vision in the full range of the depth of field with a nearly monotone decrease of visual performance from far to near, achieving high rates of spectacle independence at all distances and with low positive dysphotopsia rates ( ClinicalTrials.gov Identifier: NCT05735990).
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Affiliation(s)
- Joaquín Fernández
- From the Qvision, Department of Ophthalmology, VITHAS Almería Hospital, Almería, Spain (Fernández, Burguera, Martínez, Rodríguez-Vallejo); Department of Ophthalmology, University Hospital Ayr, Ayr, Scotland (Srinivasan)
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Lajara-Blesa J, Rodríguez-Izquierdo MÁ, Vallés-San-Leandro L, Jutley G, de Los Remedios Ortega-García M, Zapata-Díaz JF. Standard Clinical Outcomes, Light Distortion, Stereopsis, and a Quality-of-Life Assessment of a New Binocular System of Complementary IOLs. J Refract Surg 2023; 39:654-661. [PMID: 37824303 DOI: 10.3928/1081597x-20230908-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
PURPOSE To evaluate the visual outcome, light distortion index (LDI), and quality of life (QoL) of patients implanted with two complementary intraocular lenses (IOLs) to treat cataract and presbyopia. METHODS Twenty-seven consecutive patients with cataract were treated with the implantation of the Artis Symbiose Mid (Mid) IOL (Cristalens Industrie) in the distance-dominant eye and the Artis Symbiose Plus (Plus) IOL (Cristalens Industrie) in the contralateral eye following phacoemulsification. The primary objective was to ascertain the monocular and binocular defocus curves. Secondary endpoints included uncorrected distance visual acuity, corrected distance visual acuity, uncorrected intermediate visual acuity, and distance-corrected intermediate visual acuity at 90 and 70 cm, uncorrected near visual acuity and distance-corrected visual acuity at 40 cm, contrast sensitivity, LDI with a halometer, stereopsis, and patients' QoL with the validated Visual Function Index (VF-14) questionnaire. These measurements were collected in two visits, at 4.14 ± 3.13 and 10.30 ± 3.14 months postoperatively. RESULTS Statistically significant differences in the monocular defocus curves were found at the defocus steps of -1.00, -1.25, -1.50, -1.75, -2.50, -2.75, -3.00, -3.50 diopters and the -4.00 diopters (P < .050). The mean binocular defocus curve was 0 logMAR or better from the +0.50 to the -2.50 D defocus steps. Contrast sensitivity was within normal values. The LDI was 12.57 (6.61)% for the Mid eyes, 14.99 ± 5.70% for the Plus eyes, and 10.36 ± 4.42% binocularly. The patients' stereopsis was 40.0 (12.5) arc-seconds. The QoL score was 95.99 (7.14) at 10 months. CONCLUSIONS The implantation of the Artis Symbiose IOLs was a safe and effective treatment for presbyopia compensation in patients with cataract. Both IOLs are complementary and may produce a binocular depth-of-field of 3.00 diopters over 0 logMAR when used together. [J Refract Surg. 2023;39(10):654-661.].
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Corbelli E, Iuliano L, Codenotti M, Fasce F, Bandello F. Comparative analysis of visual outcomes with 2 enhanced monofocal intraocular lenses. J Cataract Refract Surg 2023; 49:929-935. [PMID: 37322813 DOI: 10.1097/j.jcrs.0000000000001239] [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: 03/16/2023] [Accepted: 06/13/2023] [Indexed: 06/17/2023]
Abstract
PURPOSE To compare the visual performance, spectacle independence, and subjective visual quality of 2 enhanced monofocal intraocular lenses (IOLs): Eyhance ICB00 and ZOE Primus-HD. SETTING Ophthalmology Department, San Raffaele Scientific Institute, Milan, Italy. DESIGN Prospective case series. METHODS Patients without ocular comorbidities and corneal astigmatism <0.75 diopters (D) undergoing cataract surgery with bilateral implantation of enhanced monofocal Eyhance and ZOE were included. 6 months postoperatively, the following parameters were analyzed: subjective and objective refraction; monocular and binocular corrected (4 m) and uncorrected (UDVA) distance visual acuities; corrected distance, intermediate (66 cm), and near (40 cm) visual acuities, as well as uncorrected intermediate (UIVA) and uncorrected near (UNVA) visual acuities; photopic contrast sensitivity; binocular defocus curve; halo and glare perception; and spectacle independence. RESULTS 100 eyes of 50 patients were evaluated (25 patients per IOL group). The 2 IOLs showed superimposable visual performances, without significant differences in terms of refractive and visual outcomes, defocus curves, contrast sensitivity, scores of vision quality, and spectacle independence. Of note, monocular and binocular UDVA was excellent in both groups. The 2 IOL models achieved satisfactory binocular UIVA, with more than 70% of patients reaching a binocular UIVA of ≤0.1 logMAR. Up to 84% of patients eventually declared to feel comfortable frequently while staying at intermediate distance. CONCLUSIONS The general visual outcome of the Eyhance ICB00 and the ZOE Primus-HD enhanced monofocal IOLs is similar, with special reference to the satisfactory spectacle independence for intermediate distance.
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Affiliation(s)
- Eleonora Corbelli
- From the Department of Ophthalmology, Vita-Salute University, IRCCS San Raffaele Scientific Institute, Milan, Italy
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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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Ang RET. Long-term trifocal toric intraocular lens outcomes in Asian eyes after cataract surgery. J Cataract Refract Surg 2023; 49:832-839. [PMID: 37482666 DOI: 10.1097/j.jcrs.0000000000001195] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/05/2023] [Indexed: 07/25/2023]
Abstract
PURPOSE To determine the visual and refractive outcomes of trifocal toric intraocular lens (IOL) implantation in Asian eyes with cataract and astigmatism. SETTING Asian Eye Institute, Makati City, Philippines. DESIGN Prospective study. METHODS 187 eyes were implanted with the FineVision POD FT IOL and followed for 2 years. The measurements included subjective refraction, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), distance-corrected intermediate visual acuity (DCIVA), uncorrected near visual acuity (UNVA), distance-corrected near visual acuity (DCNVA), defocus curve, photopic and mesopic contrast sensitivity, and rotational stability. RESULTS The mean spherical equivalent and cylinder values were, respectively, -0.07 ± 0.34 diopters (D) and -0.48 ± 0.31 D at the 2-year follow-up. At this same follow-up, 69.4% of patients had monocular CDVA and 79.3% had binocular UDVA ≤0.0 logMAR. For intermediate vision, monocular DCIVA reached 74.1%, while binocular UIVA was 86.2% ≤ 0.1 logMAR. Near vision showed 63% for monocular DCNVA and 70.7% for binocular UNVA ≤0.1 logMAR. The mean values at this follow-up were 0.02 ± 0.08, 0.08 ± 0.10, and 0.10 ± 0.12 logMAR for CDVA, DCIVA, and DCNVA, respectively. At the visual acuity threshold of ≤0.20 logMAR, the binocular defocus curve extended up to -3.75 D. Stable contrast sensitivity values were obtained at the different follow-ups. The mean IOL rotation was ≤2 degrees. CONCLUSIONS The FineVision POD FT IOL yielded good visual outcomes at far, near, and intermediate distances with accurate refractive outcomes and good rotational stability in Asian eyes.
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Rocha-de-Lossada C, García-Lorente M, La Cruz DZD, Rodríguez-Calvo-de-Mora M, Fernández J. Supplemental Toric Intraocular Lenses in the Ciliary Sulcus for Correction of Residual Refractive Astigmatism: A Review. Ophthalmol Ther 2023; 12:1813-1826. [PMID: 37145259 PMCID: PMC10287861 DOI: 10.1007/s40123-023-00721-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 04/17/2023] [Indexed: 05/06/2023] Open
Abstract
PURPOSE This study conducted a critical review of the peer-reviewed literature on the use of supplemental toric intraocular lenses (STIOL) in the ciliary sulcus to correct residual refractive astigmatism. METHODS This review used PubMed as a database from 1 January 2010 to 13 March 2023. According to the inclusion and exclusion criteria defined, 14 articles were selected for the current review. RESULTS The data of 155 eyes were analyzed. Most of the studies reviewed had a short follow-up and poor or limited design, including case reports, case series, and retrospective cohorts. The follow-up period ranged from 43 days to 4.5 years. STIOL rotation was the most frequently described complication in the literature, with a mean rotation of 30.48 ± 19.90°. These patients required repositioning in 50 of 155 eyes (32.25%). Moreover, four eyes (2.58%) required scleral fixation sutures and two eyes (1.29%) iris fixation. Other complications were high intraocular pressure (3 eyes, 1.93%), transient corneal edema (2 eyes, 1.29%), corneal decompensation (2 eyes, 1.29%), and pigment dispersion (1 eye, 0.64%). From the total, 57.41% of eyes (89 eyes from 155) achieved within ± 0.50D of target refractive astigmatism. It is important to highlight that at least 52 eyes out of the 155 (33.54%) had an abnormal cornea with irregular astigmatism. CONCLUSION STIOL seem to offer good visual and refractive outcomes. However, STIOL showed variable rotational stability, especially in some platforms. Further studies with a more robust design, methodology, and standardized analysis methods are needed to confirm these trends.
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Affiliation(s)
- Carlos Rocha-de-Lossada
- Ophthalmology Department, Clínica QVision, Vithas Almería, Almería, Spain.
- Ophthalmology Department, Vithas Málaga, Malaga, Spain.
- Ophthalmology Department, Hospital Regional Universitario Málaga, Malaga, Spain.
- Departamento de Cirugía, Área de Oftalmología, Universidad de Sevilla, Seville, Spain.
| | | | - Diego Zamora-de La Cruz
- Anterior Segment Department, Instituto de Oftalmología Fundación Conde de Valenciana, Mexico City, Mexico
- Anterior Segment Department, Hospital Mexiquense de Salud Visual, ISEM, Naucalpan de Juárez, Mexico
| | - Marina Rodríguez-Calvo-de-Mora
- Ophthalmology Department, Clínica QVision, Vithas Almería, Almería, Spain
- Ophthalmology Department, Vithas Málaga, Malaga, Spain
- Ophthalmology Department, Hospital Regional Universitario Málaga, Malaga, Spain
| | - Joaquín Fernández
- Ophthalmology Department, Clínica QVision, Vithas Almería, Almería, Spain
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Donoso R, Torres A, Klagges J, Mercado Y, Gonzalez T, Astudillo M, Norambuena H, Medina E. Enhanced vs conventional monofocal intraocular lens clinical results in patients with cataract: randomized clinical trial. J Cataract Refract Surg 2023; 49:818-825. [PMID: 37232418 DOI: 10.1097/j.jcrs.0000000000001224] [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: 07/14/2022] [Accepted: 05/17/2023] [Indexed: 05/27/2023]
Abstract
PURPOSE To compare clinical outcomes between an enhanced and a conventional monofocal intraocular lens (IOL) after cataract surgery. SETTING Ophthalmology Unit, Hospital del Salvador, University of Chile (tertiary care hospital). DESIGN Double-masked, prospective randomized controlled trial. METHODS 66 healthy adults with corneal astigmatism less than 1.50 diopters and axial length between 21 and 27 mm were randomly allocated (1:1) for bilateral phacoemulsification with either an enhanced monofocal IOL (ICB00) or a conventional aspheric monofocal IOL (ZCB00) implant. The refractive target was emmetropia in both eyes. Visual acuities, defocus curves, Catquest-9SF, and quality of vision (QoV) were measured 3 months postoperatively. RESULTS Binocular uncorrected intermediate visual acuity was improved in patients implanted with the enhanced monofocal lens (0.37 ± 0.12) compared with the conventional monofocal (0.45 ± 0.10) ( P < .01). There were no significant differences in corrected distance visual acuity (CDVA), Catquest-9SF, or QoV scores. CONCLUSIONS The enhanced monofocal IOL provided 1 additional line of intermediate visual acuity after cataract surgery. There was no significant change in either CDVA or QoV.
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Affiliation(s)
- Rodrigo Donoso
- From the Hospital del Salvador, Universidad de Chile, Santiago, Chile
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Shouchane-Blum K, Reitblat O, Dadon J, Bahar I, Sella R. Evaluating Changes in Apparent Chord Mu after Pharmacological Pupil Dilatation. Ophthalmic Res 2023; 66:921-927. [PMID: 37231882 DOI: 10.1159/000530905] [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: 01/16/2023] [Accepted: 04/24/2023] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Preoperative measurements of apparent chord mu length above 0.6 mm have been associated with higher risks for photic phenomena after cataract surgery with multifocal intraocular lenses (MFIOLs). METHODS This retrospective study evaluated patients scheduled for elective cataract surgery at a single tertiary medical center between 2021 and 2022. Pupil diameter and apparent chord mu length were analyzed for eyes with biometry measurements from IOLMaster 700 (Carl Zeiss Meditec, AG) under photopic light conditions, before and after pharmacological pupil dilatation. Exclusion criteria were visual acuity worse than 20/100, prior intraocular surgery, refractive surgery, iris-related procedures, or pupil abnormalities affecting dilatation. Apparent chord mu lengths before and after pupil dilatation were compared. In addition, multivariate linear regression analysis, using a stepwise method, was conducted to assess possible predictors of apparent chord values. RESULTS Included were 87 eyes of 87 patients. Mean chord mu length increased after pupillary dilatation from 0.32 ± 0.17 mm to 0.41 ± 0.17 mm for right eyes (p < 0.001) and from 0.29 ± 0.16 mm to 0.40 ± 0.22 mm for left eyes (p < 0.001). Seven eyes (8.0%) had an apparent chord mu of 0.6 mm and above pre-dilatation. Fourteen eyes (16.1%) with an apparent chord mu under 0.6 mm pre-dilatation had apparent chord mu of 0.6 mm or above post-dilatation. CONCLUSION Apparent chord mu length significantly increases after pharmacological pupillary dilatation. Pupil size and dilatation status should always be considered during patient selection for a planned MFIOL using apparent chord mu length as a reference marker.
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Affiliation(s)
- Karny Shouchane-Blum
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Rabin Medical Center, Petah-Tikva, Israel
| | - Olga Reitblat
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Rabin Medical Center, Petah-Tikva, Israel
| | - Judith Dadon
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Rabin Medical Center, Petah-Tikva, Israel
| | - Irit Bahar
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Rabin Medical Center, Petah-Tikva, Israel
| | - Ruti Sella
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Rabin Medical Center, Petah-Tikva, Israel
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Mori Y, Miyata K, Suzuki H, Noguchi S, Ichikawa K, Maeda N. Clinical Performance of a Hydrophobic Acrylic Diffractive Trifocal Intraocular Lens in a Japanese Population. Ophthalmol Ther 2023; 12:867-878. [PMID: 36542257 PMCID: PMC9768760 DOI: 10.1007/s40123-022-00634-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION In this study, clinical performance of a hydrophobic acrylic diffractive trifocal intraocular lens (IOL) with double C-loop haptics was evaluated in Japanese cataract eyes. METHODS Twenty-three patients had bilateral cataract surgery with the implantation of a trifocal IOL with double C-loop haptics. Postoperative examinations at 6 months included assessing uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA) at 5 m, uncorrected intermediate visual acuity (UIVA), distance-corrected intermediate visual acuity (DCIVA) at 80 cm, uncorrected near visual acuity (UNVA) and distance-corrected near visual acuity (DCNVA) at 40 cm. Binocular defocus, contrast sensitivity, spectacle independence, symptoms of photic phenomena and quality of vision (QOV) were also observed. RESULTS Twenty-three patients received 46 IOLs binocularly. Manifest refraction spherical equivalent was - 0.227 ± 0.385 D (mean ± standard deviation) at 6 months postoperatively. Binocular UDVA, binocular UIVA and binocular UNVA were - 0.101 ± 0.065, - 0.021 ± 0.079 and 0.022 ± 0.095 logMAR units, respectively. Binocular CDVA, binocular DCIVA and binocular DCNVA were - 0.151 ± 0.044, - 0.042 ± 0.067 and - 0.011 ± 0.080 logMAR, respectively. Binocular CDVA of 0.00 logMAR or better was obtained in the defocus from - 3.0 D until + 0.5 D. Only 8.7% of patients required the use of spectacles postoperatively. There were no symptoms of glare, halo and light disturbance in 78.3%, 56.5% and 69.6% of patients, respectively. QOV scores significantly improved postoperatively (P < 0.0001). CONCLUSION The hydrophobic acrylic trifocal IOL with double C-loop haptics provides good visual performance at all distances and produces high spectacle independence rate and patient satisfaction. TRIAL REGISTRATION NUMBER NCT04699266 (Clinicaltrials.gov).
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Affiliation(s)
- Yosai Mori
- Miyata Eye Hospital, 6-3, Kuraharacho, Miyakonojo, Miyazaki, 885-0051, Japan.
| | - Kazunori Miyata
- Miyata Eye Hospital, 6-3, Kuraharacho, Miyakonojo, Miyazaki, 885-0051, Japan
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Fernández J, Alonso-Aliste F, Burguera N, Hernández-Lucena J, Amián-Cordero J, Rodríguez-Vallejo M. Effectiveness of SMILE Combined with Micro-Monovision in Presbyopic Patients: A Pilot Study. Life (Basel) 2023; 13:life13030838. [PMID: 36983993 PMCID: PMC10051050 DOI: 10.3390/life13030838] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/14/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
Binocular summation along all defocus range after a micro-monovision procedure has scarcely been studied. The aim of this pilot study was to evaluate the efficacy of SMILE combined with different levels of micro-monovision in presbyopic patients and to assess the binocular summation effect on contrast sensitivity defocus curves (CSDC) at the 6-month follow-up. Efficacy was assessed on the basis of visual acuity (VA) and stereopsis at far, intermediate, and near distances. Patient-reported outcomes (PROs) and binocular CSDC were also evaluated. Six patients completed the study with a programmed median anisometropia of 0.81 Diopter. The median binocular uncorrected VA was better than 0 logMAR at the three evaluated distances, and stereopsis was not impaired in any patient, achieving a median of ≤119 arcsec at any distance. CSDC increased binocularly after surgery, significantly in the range of -2 to -3 D (p < 0.05). No clinically relevant changes were observed in PROs compared with the preoperative period, and all patients achieved spectacle independence at intermediate/near distance and were likely or very likely to undergo the same surgery. In conclusion, micro-monovision with SMILE could be an effective procedure, with results that might be comparable to other laser correction techniques specifically designed for presbyopia correction.
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Affiliation(s)
- Joaquín Fernández
- Qvision, Ophthalmology Department, VITHAS Almería, 04120 Almería, Spain
| | | | - Noemí Burguera
- Qvision, Ophthalmology Department, VITHAS Almería, 04120 Almería, Spain
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Fernández J, Rocha-De-Lossada C, Rodríguez-Vallejo M. Recommendations for Writing Clinical Research Manuscripts: From Monofocal to Multifocal Intraocular Lenses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:17036. [PMID: 36554917 PMCID: PMC9778824 DOI: 10.3390/ijerph192417036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
Writing a manuscript is not an easy task, and publishing in peer-reviewed journals might prove difficult if the methodology is not appropriately described and results are not clearly presented [...].
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Affiliation(s)
- Joaquín Fernández
- Ophthalmology Department, Qvision, VITHAS Almería, 04120 Almería, Spain
| | - Carlos Rocha-De-Lossada
- Ophthalmology Department, Qvision, VITHAS Almería, 04120 Almería, Spain
- Ophthalmology Department, VITHAS Málaga, 29016 Málaga, Spain
- Hospital Regional Universitario de Málaga, Plaza del Hospital Civil, S/N. 29009 Málaga, Spain
- Departamento de Cirugía, Área de Oftalmología, Universidad de Sevilla, Doctor Fedriani, S/N, 41009 Sevilla, Spain
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Reflections. J Cataract Refract Surg 2022; 48:1351. [DOI: 10.1097/j.jcrs.0000000000001093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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