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He Y, Zhu B, Li B, Zou H, Ma Y. Stereopsis Following Implantation of Presbyopia-Correcting Intraocular Lenses: A Narrative Review. Ophthalmol Ther 2024; 13:2331-2341. [PMID: 39095681 DOI: 10.1007/s40123-024-01004-y] [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: 05/25/2024] [Accepted: 07/16/2024] [Indexed: 08/04/2024] Open
Abstract
Recent advancements in cataract surgery have broadened its scope from mere vision restoration to include correction of refractive errors and presbyopia. This evolution has introduced multifocal and extended depth-of-focus (EDOF) intraocular lenses (IOLs), allowing enhanced vision across multiple distances. However, the influence of these advanced IOLs on stereopsis remains controversial. Factors influencing stereopsis after surgery include visual acuity, interocular differences, residual astigmatism, and the type of IOL, etc. Binocular vision integration and neuroadaptation further affect stereopsis, especially in cases of presbyopia-correcting IOLs. It is widely acknowledged that bilateral implantation of presbyopia-correcting IOLs yield superior stereopsis compared to unilateral implantation. However, there remains no consensus on whether binocular implantation of multifocal or monofocal IOLs provides superior stereopsis. Most studies suggest no significant difference in stereopsis between these two types of implants. Among different types of multifocal IOLs, refractive multifocal IOLs may offer better stereopsis than diffractive multifocal IOLs when implanted bilaterally. Emerging EDOF and hybrid multifocal-EDOF IOLs also demonstrate promising postoperative stereopsis. Additionally, a mix-and-match strategy with different types of IOLs implanted in each eye may result in interocular differences in visual acuity at certain distances, potentially affecting stereopsis. Nevertheless, with appropriate selection, most patients can achieve satisfactory postoperative stereopsis. This review synthesizes current literature on the effects of presbyopia-correcting IOLs on postoperative stereopsis recovery following cataract surgery. Studies on stereopsis outcomes with different IOLs have yielded mixed results, urging further investigation for optimized surgical strategies and patient outcomes.
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Affiliation(s)
- Yongyuan He
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100, Haining Road, Shanghai, 200080, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
- Shanghai Eye Disease Prevention and Treatment Center/Shanghai Eye Hospital, School of Medicine, Tongji University, No. 1440, Hongqiao Road, Shanghai, 200336, China
| | - Bijun Zhu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100, Haining Road, Shanghai, 200080, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Baojiang Li
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100, Haining Road, Shanghai, 200080, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Haidong Zou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100, Haining Road, Shanghai, 200080, China.
- National Clinical Research Center for Eye Diseases, Shanghai, China.
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China.
- Shanghai Eye Disease Prevention and Treatment Center/Shanghai Eye Hospital, School of Medicine, Tongji University, No. 1440, Hongqiao Road, Shanghai, 200336, China.
| | - Yingyan Ma
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100, Haining Road, Shanghai, 200080, China.
- National Clinical Research Center for Eye Diseases, Shanghai, China.
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China.
- Shanghai Eye Disease Prevention and Treatment Center/Shanghai Eye Hospital, School of Medicine, Tongji University, No. 1440, Hongqiao Road, Shanghai, 200336, China.
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Termote K, Van Schoor R, Krolo I, Oellerich S, Cools W, Delbeke H, Ni Dhubhghaill S. Combination of a monofocal and one type of extended depth-of-focus (zonal refractive) intraocular lens (COMEDI) in bilateral cataract surgery protocol: a monocentric, randomised, parallel group trial in cataract surgery. BMJ Open Ophthalmol 2024; 9:e001572. [PMID: 39103234 PMCID: PMC11308891 DOI: 10.1136/bmjophth-2023-001572] [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: 11/11/2023] [Accepted: 06/28/2024] [Indexed: 08/07/2024] Open
Abstract
INTRODUCTION Modern intraocular lens (IOL) designs for cataract treatment can be broadly classified into three focal range categories; monofocal, extended depth-of-focus (EDOF) and multifocal IOLs.Monofocal IOLs allow spectacle independence for one focus, typically distance. In contrast, EDOF IOLs provide a greater range of vision, extending spectacle independence to intermediate distance, while multifocal IOLs enable spectacle independence at all distances with the drawback of positive dysphotopsias and reduced contrast perception.EDOF lenses are an attractive compromise with fewer dysphotopic side effects than multifocals. The purpose of this study is to assess whether implanting an EDOF IOL in the second eye of a patient who received a monofocal IOL in the first eye can improve spectacle independence while maintaining the same optical quality as bilateral monofocal IOL implantation. METHODS AND ANALYSIS This study compares combined monofocal and EDOF IOL implantation versus bilateral monofocal IOL implantation in terms of clinical and patient-reported outcomes in a monocentric, randomised, patient-masked and assessor-masked, parallel group trial in 88 bilateral cataract patients. The primary outcome measure is binocular photopic distance corrected intermediate visual acuity. The secondary outcome measures include (un)corrected distance and near visual acuity, reading speed at intermediate distance, quality of visual function assessments, patient-reported spectacle independence, contrast sensitivity, aberrometry, stereopsis and straylight measurement at the 3-month follow-up. ETHICS AND DISSEMINATION The protocol was approved by the ethical committee of the University Hospital of Brussels (BUN 23219_EDOF). TRIAL REGISTRATION NUMBER NCT06002399.
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Affiliation(s)
- Karolien Termote
- Department of Ophthalmology, University Hospital Brussels, Jette, Belgium
- Department of Medicine and Pharmacology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Roger Van Schoor
- Department of Ophthalmology, University Hospital Brussels, Jette, Belgium
- Department of Medicine and Pharmacology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Iva Krolo
- Department of Ophthalmology, University Hospital Brussels, Jette, Belgium
- Department of Medicine and Pharmacology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Silke Oellerich
- Department of Ophthalmology, University Hospital Brussels, Jette, Belgium
- Department of Medicine and Pharmacology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Wilfried Cools
- Interfaculty Center for Data Processing and Statistics, Vrije Universiteit Brussel, Brussels, Belgium
| | - Heleen Delbeke
- Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium
- Department of Neurosciences, Research Group Ophthalmology, Biomedical Sciences Group, KU Leuven, Leuven, Belgium
| | - Sorcha Ni Dhubhghaill
- Department of Ophthalmology, University Hospital Brussels, Jette, Belgium
- Department of Medicine and Pharmacology, Vrije Universiteit Brussel, Brussels, Belgium
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Khoramnia R, Naujokaitis T, Łabuz G, Auffarth GU. [Complex optical systems for individualized correction of presbyopia]. DIE OPHTHALMOLOGIE 2024:10.1007/s00347-024-02076-8. [PMID: 39017699 DOI: 10.1007/s00347-024-02076-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 06/13/2024] [Accepted: 06/13/2024] [Indexed: 07/18/2024]
Abstract
A multitude of available intraocular lens (IOL) models enable a personalized approach to presbyopia correction in order to meet each patient's needs. This review article discusses more complex approaches which can be useful in selected cases. The concept of reversible trifocality enables correction of presbyopia using a supplementary intraocular lens (IOL), which can be removed if necessary (e.g., intolerance to multifocal optics). The use of capsulotomy-fixated IOLs enables high precision for positioning of the lens and better stability compared to conventional capsular bag-fixated IOLs, which can be particularly advantageous in multifocal optics. The mix and match concept enables a combination of different IOLs with various optical principles to achieve the desired binocular effect. Binocular IOL systems, which consist of two complementary IOLs, can be seen as a further development of the mix and match concept. Knowledge of the available options and their application can further improve correction of presbyopia.
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Affiliation(s)
- Ramin Khoramnia
- Universitäts-Augenklinik Heidelberg, INF 400, 69120, Heidelberg, Deutschland.
| | - Tadas Naujokaitis
- Universitäts-Augenklinik Heidelberg, INF 400, 69120, Heidelberg, Deutschland
| | - Grzegorz Łabuz
- Universitäts-Augenklinik Heidelberg, INF 400, 69120, Heidelberg, Deutschland
| | - Gerd U Auffarth
- Universitäts-Augenklinik Heidelberg, INF 400, 69120, Heidelberg, Deutschland
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Kim J, Kim TI, Seo KY, Tchah H, Koh K. A comparative study of two presbyopia-correcting intraocular lenses combining bifocal and extended depth-of-focus profiles. Int Ophthalmol 2024; 44:54. [PMID: 38341384 DOI: 10.1007/s10792-024-02979-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/29/2023] [Indexed: 02/12/2024]
Abstract
OBJECTIVE To compare the visual performance of two presbyopia-correcting intraocular lenses (IOLs) that combine both bifocal and extended depth-of-focus profiles, Artis® Symbiose® Plus (Symbiose Plus; Cristalens Industrie, Lannion, France) and Tecnis® Synergy® (Synergy; Johnson & Johnson Vision, Santa Ana, CA, USA). METHODS The medical records of patients with cataract bilaterally implanted with either Symbiose Plus or Synergy between January 2022 and January 2023 were assessed. The principal measures of postoperative findings included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near (40 and 33 cm) visual acuity (UNVA), objective optical quality (OOQ) parameters, distance-corrected defocus curve analysis, and surveys of subjective satisfaction. RESULTS Total of 96 eyes from 48 patients were enrolled. Each group was equally composed of 24 patients, 48 eyes. There were no significant differences between the two groups on baseline characteristics. Both IOLs displayed excellent binocular UDVA, CDVA, and UNVA (40 and 33 cm) with no statistical difference (p = 0.467(UDVA), p = 0.584(CDVA), p = 0.096(40-cm UNVA), and p = 0.621(33-cm UNVA)). However, with regard to UIVA, the Synergy group showed significantly superior results (p < 0.001). In contrast, the Symbiose Plus group showed significantly better results on OOQ parameters and patient-reported quality of vision survey outcomes (both p < 0.001). CONCLUSIONS Both IOLs provided a decent continuous range of vision from near to far distance.
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Affiliation(s)
- Jeongmin Kim
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, 136 Youngshinro, Youngdeungpo-gu, Seoul, 07301, Republic of Korea
| | - Tae-Im Kim
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Kyoung Yul Seo
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Hungwon Tchah
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, 136 Youngshinro, Youngdeungpo-gu, Seoul, 07301, Republic of Korea
| | - Kyungmin Koh
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, 136 Youngshinro, Youngdeungpo-gu, Seoul, 07301, Republic of Korea.
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