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Lee MW. Visual outcomes following bilateral implantation of a non-diffractive extended depth of focus toric intraocular lens using a mini-monovision approach. Int Ophthalmol 2024; 44:334. [PMID: 39046597 DOI: 10.1007/s10792-024-03247-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 07/14/2024] [Indexed: 07/25/2024]
Abstract
PURPOSE To evaluate the clinical outcomes following bilateral implantation of the AcrySof™ IQ Vivity™ toric extended depth of focus (EDOF) intraocular lens (IOL). DESIGN Prospective interventional case series. METHODS Patients with bilateral significant cataracts and pre-existing corneal astigmatism underwent cataract surgery and implantation with the AcrySof™ IQ Vivity™ toric IOL. Dominant eyes were targeted at emmetropia and non-dominant eyes at -0.50D. Primary endpoints were binocular uncorrected distance (UDVA), intermediate (UIVA at 66 cm) and near (UNVA at 40 cm) acuities at 3 months. Secondary outcomes were corrected distance (CDVA), distance corrected intermediate (DCIVA) and distance corrected near (DCNVA), refractive predictability, rotational stability, binocular defocus curve, contrast sensitivity, Questionnaire for Visual Disturbances (QUVID) and Visual Function Index (VF-14) questionnaire scores. All visual acuities were converted to logarithm of minimum angle of resolution (logMAR) for analysis. RESULTS 30 patients underwent uneventful phacoemulsification. The mean binocular UDVA, UIVA and UNVA were 0.06 ± 0.12, 0.11 ± 0.10 and 0.26 ± 0.10 respectively. The mean refractive spherical equivalent (MRSE) for dominant and non-dominant eyes were - 0.07D ± 0.27 and - 0.12D ± 0.54 respectively. 92.4% of dominant eyes and 84.6% of non-dominant eyes within 0.50D of target. The mean IOL rotation was 3.85° ± 5.09 with 86.7% of eyes with less than 5° of rotation. 26.7%, 20% and 36.7% of patients reported starbursts, haloes and glare respectively. The mean VF-14 score was 91.77. CONCLUSION Bilateral implantation of the AcrySof™ IQ Vivity™ Toric IOL resulted in very good unaided visual acuities for far and intermediate distance with functional near vision. Dysphotopsias were reported but despite this, a high level of visual function was achieved.
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Affiliation(s)
- Mun Wai Lee
- LEC Eye Centre, 44-46, Persiaran Greenhill, 30450, Ipoh, Perak, Malaysia.
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Van Slycken M, Sallet G, Derveaux T. Supplementary Implantation of 1stQ AddOn ® Sulcus-Fixated Intraocular Lens to Treat Negative Dysphotopsia: A Retrospective Case Series. Case Rep Ophthalmol 2023; 14:540-545. [PMID: 37901624 PMCID: PMC10601885 DOI: 10.1159/000533686] [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: 06/12/2023] [Accepted: 08/16/2023] [Indexed: 10/31/2023] Open
Abstract
Negative dysphotopsia (ND) refers to the subjective perception of an arc-shaped darkness or shadow in the temporal field of vision. This condition occurs after uneventful cataract surgery with an in-the-bag intraocular lens (IOL). To address this issue, supplementary implantation of conventional three-piece IOLs in the sulcus or dedicated supplementary Rayner Sulcoflex® IOL have been used successfully. The aim of this retrospective case series was to assess the effectiveness of resolving ND using a supplementary 1stQ AddOn® (Medicontur) IOL. The 1stQ AddOn® has a different design and optic size compared to the Rayner Sulcoflex®. Patients experiencing severe and persistent ND underwent supplementary implantation of the 1stQ AddOn® IOL. The primary outcome measure was the resolution of dysphotopsia. Nine eyes received the 1stQ AddOn® IOL, with complete symptom resolution observed in 6 eyes, partial improvement in 1 eye, and no change in 2 eyes. This indicates that supplementary implantation of the 1stQ AddOn® IOL can effectively and safely treat ND, performing equally well as the Rayner Sulcoflex®. The positive impact of sulcus-fixated supplementary IOLs seems to be related to the interaction between the central optic and the pupil margin.
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Affiliation(s)
- Maxim Van Slycken
- Department of Ophthalmology, Ghent University Hospital, Ghent, Belgium
| | - Guy Sallet
- Department of Ophthalmology, Ooginstituut, Aalst, Belgium
| | - Thierry Derveaux
- Department of Ophthalmology, Ghent University Hospital, Ghent, Belgium
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Pusnik A, Petrovski G, Lumi X. Dysphotopsias or Unwanted Visual Phenomena after Cataract Surgery. Life (Basel) 2022; 13:53. [PMID: 36676002 PMCID: PMC9866410 DOI: 10.3390/life13010053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022] Open
Abstract
Dysphotopsias are unwanted visual phenomena that occur after cataract surgery. They represent some of the most common reasons for patient dissatisfaction after uncomplicated surgery for cataract phacoemulsification with in-the-bag intraocular lens (IOL) implantation. Depending on the form of the optical phenomenon and the effect it poses on vision, dysphotopsias are divided into positive and negative type. Positive dysphotopsias are usually described by patients as glare, light streaks, starbursts, light arcs, rings, haloes, or flashes of light. Negative dysphotopsias are manifested as an arc-shaped shadow or line usually located in the temporal part of the visual field, similar to a temporal scotoma. In addition to their different clinical manifestations, positive and negative dysphotopsia also have different risk factors. Even though up to 67% of patients may experience positive dysphotopsia immediately after surgery, only 2.2% of the cases have persistent symptoms up to a year postoperatively. Surgical intervention may be indicated in 0.07% of cases. The incidence of negative dysphotopsias is up to 26% of all patients; however, by one year postoperatively, the symptoms usually persist in 0.13 to 3% of patients. For both types of dysphotopsia, preoperative patients' education, accurate preoperative diagnostics, and use of an appropriate IOL design and material is mandatory. Despite all these measures, dysphotopsias may occur, and when noninvasive measures fail to improve symptoms, a surgical approach may be considered.
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Affiliation(s)
- Ambroz Pusnik
- Eye Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | - Goran Petrovski
- Center for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Oslo University Hospital, 0450 Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
- Department of Ophthalmology, University of Split School of Medicine and University Hospital Centre, 21000 Split, Croatia
| | - Xhevat Lumi
- Eye Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Center for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Oslo University Hospital, 0450 Oslo, Norway
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
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van Vught L, Que I, Luyten GPM, Beenakker JWM. Effect of anatomical differences and intraocular lens design on negative dysphotopsia. J Cataract Refract Surg 2022; 48:1446-1452. [PMID: 36449675 DOI: 10.1097/j.jcrs.0000000000001054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/30/2022] [Indexed: 12/05/2022]
Abstract
PURPOSE To assess the effect of ocular anatomy and intraocular lens (IOL) design on negative dysphotopsia (ND). SETTING Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands. DESIGN Ray-tracing study based on clinical data. METHODS Ray-tracing simulations were performed to assess the effect of anatomical differences and differences in IOL design on the peripheral retinal illumination. To that end, eye models that incorporate clinically measured anatomical differences between eyes of patients with ND and eyes of pseudophakic controls were created. The anatomical differences included pupil size, pupil centration, and iris tilt. The simulations were performed with different IOL designs, including a simple biconvex IOL design and a more complex clinical IOL design with a convex-concave anterior surface. Both IOL designs were analyzed using a clear edge and a frosted edge. As ND is generally considered to be caused by a discontinuity in peripheral retinal illumination, this illumination profile was determined for each eye model and the severity of the discontinuity was compared between eye models. RESULTS The peripheral retinal illumination consistently showed a more severe discontinuity in illumination with ND-specific anatomy. This difference was the least pronounced, 8%, with the frosted edge clinical IOL and the most pronounced, 18%, with the clear edge biconvex IOL. CONCLUSIONS These results show that small differences in the ocular anatomy or IOL design affect the peripheral retinal illumination. Therewith, they can increase the severity of ND by up to 18%.
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Affiliation(s)
- Luc van Vught
- From the Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands (van Vught, Luyten, Beenakker); C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (van Vught, Beenakker); Translational Nanobiomaterials and Imaging Group, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (Que); Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands (Beenakker)
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Evaluation of Visual and Patient-Reported Outcomes, Spectacle Dependence after Bilateral Implantation with a Non-Diffractive Extended Depth of Focus Intraocular Lens Compared to Other Intraocular Lenses. J Clin Med 2022; 11:jcm11175246. [PMID: 36079174 PMCID: PMC9456700 DOI: 10.3390/jcm11175246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/29/2022] [Accepted: 09/03/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose: To evaluate postoperative outcomes, spectacle dependance and the occurrence of the photic phenomena in patients after cataract surgery following the implantation of a non-diffractive extended depth of focus (EDOF) intraocular lens was compared to monofocal and multifocal lenses. Methods: We enrolled patients with bilateral cataracts who wanted to reduce their dependence on glasses in the study. They were followed for 6 months. The study group in which the EDOF lens was implanted consisted of 70 eyes in 35 patients. The control groups consisted of: 52 eyes in 26 patients in whom a multifocal was implanted and 52 eyes in 26 patients with implanted monofocal lens. After a total of 2 weeks, 2 months and 6 months post-surgery the following were evaluated: uncorrected and corrected visual acuity at 4 m, 80 cm, 40 cm, manifest refraction expressed as mean refractive spherical equivalent (MRSE), contrast sensitivity, intraocular pressure. A questionnaire on independence from ocular correction, the occurrence of photic phenomena, and patient satisfaction was also completed. Results: Monocular and binocular visual acuity and MRSE 6 months after the procedure were compared between three groups. All of the main analyses, except for comparisons of uncorrected distance visual acuity (both monocular and binocular) level, were significant. Contrast sensitivity was lower among patients with multifocal lens than among patients with EDOF lens. Halo and glare after 6 months were seen more often among patients with multifocal lens than among patients with the other lens (65% of eyes with multifocal lens vs. 6% of eyes with EDOF lens and 0% of eyes with monofocal lens). Glasses were needed by 35% of patients with EDOF lens, and by 96% of patients with monofocal lens and in none of the patients with multifocal lens. Conclusions: Most patients qualify for the implantation of a non-diffractive EDOF lens. Post-operative visual acuity improves at any distance. The best monocular visual acuity for intermediate distances is provided by an EDOF lens, and for near distance by a multifocal lens. The EDOF lens definitely increases independence from spectacle correction compared to monofocal lenses; however, the greatest degree of independence from spectacles is provided by multifocal lenses. The incidence of photic phenomena is slightly higher than that of a monofocal lens, and much lower for a multifocal lens.
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Rozendal LRW, van Vught L, Luyten GPM, Beenakker JWM. The Value of Static Perimetry in the Diagnosis and Follow-up of Negative Dysphotopsia. Optom Vis Sci 2022; 99:645-651. [PMID: 35930259 PMCID: PMC9365255 DOI: 10.1097/opx.0000000000001918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE There is a clinical need for a quantitative test to objectively diagnose negative dysphotopsia, especially because the diagnosis is generally assessed using patients' subjective descriptions. In the search of a clinical test to objectify the shadow experienced in negative dysphotopsia, this study excludes static perimetry as suitable evaluation method. PURPOSE This study aimed to evaluate the value of static perimetry in the objective assessment and follow-up of negative dysphotopsia. METHODS Peripheral 60-4 full-threshold visual field tests were performed in 27 patients with negative dysphotopsia and 33 pseudophakic controls. In addition, 11 patients with negative dysphotopsia repeated the test after an intraocular lens exchange. Both the total peripheral visual field and the averaged peripheral visual field from 50 to 60° eccentricity were compared between patients and controls, and pre-operatively and post-operatively in patients who had an intraocular lens exchange. RESULTS The peripheral visual fields from 30 to 60° did not show significant differences between patients with negative dysphotopsia and pseudophakic controls. Analysis of the peripheral visual field from 50 to 60° showed a median [Q1, Q3] of 20.0 [17.1, 22.5] dB in the negative dysphotopsia group compared with 20.1 [15.5, 21.3] dB in the control group (P = .43). Although 82% of patients treated with an intraocular lens exchange subjectively reported improvement of their negative dysphotopsia complaints post-operatively, there were no significant differences in their total peripheral visual field or averaged peripheral visual field from 50 to 60° (P = .92). CONCLUSIONS Full-threshold static perimetry with a Goldmann size III stimulus up to 60° eccentricity does not show significant differences between patients with negative dysphotopsia and pseudophakic controls or between measurements before and after intraocular lens exchange. Therefore, this type of static perimetry cannot be used as a quantitative objective test for diagnosis or follow-up of patients with negative dysphotopsia.
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Affiliation(s)
- Lisa R. W. Rozendal
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Luc van Vught
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Radiology, C. J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Jan-Willem M. Beenakker
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Radiology, C. J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, the Netherlands
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Self-rated quality of vision and optical phenomena intensity of diffractive presbyopia-correcting IOLs: EDoF, trifocal vs panfocal. J Cataract Refract Surg 2022; 48:877-886. [PMID: 34753879 DOI: 10.1097/j.jcrs.0000000000000862] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 11/01/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE To investigate the self-rated quality of vision (SQV) and optical phenomena intensity of 3 diffractive multifocal intraocular lenses (mIOLs). SETTING Department of Ophthalmology, Goethe University Frankfurt, Germany. DESIGN Prospective comparative case series. METHODS Patients who had bilateral implantation of a diffractive extended depth-of-focus (EDoF), trifocal, or panfocal mIOL were assessed. Outcome parameters were SQV, symptom intensity of optical phenomena under 3 lighting conditions, quality of everyday lifestyle activities, spectacle independence (SI), and contrast sensitivity (CS). RESULTS The study comprised 108 eyes. The 3 lenses provided good total SQV under all lighting conditions. EDoF patients reported a slightly better total SQV (EDoF: 9.8 ± 6.67, trifocal: 22.2 ± 7.09, panfocal: 19.6 ± 16.25 visual analog scale, P = .041). A similar percentage of patients reported the presence of optical phenomena with no difference between mIOLs ( P > .05). EDoF, trifocal, and panfocal patients rated symptom intensity of optical phenomena mild to moderate under all lighting conditions; however, EDoF patients reported a lower symptom intensity of halos ( P < .05). Reported quality of everyday lifestyle activities and CS were comparable ( P < .05). All panfocal and trifocal patients (100%) achieved complete SI, whereas almost half (44%) of the EDoF patients used reading spectacles. CONCLUSIONS Diffractive EDoF, trifocal, and panfocal mIOLs provided good total SQV with mild to moderate intensity of optical phenomena under all lighting conditions. EDoF patients experienced the same percentage of optical phenomena but reported a weaker symptom intensity of halos and better night-driving ability. EDoF patients would all choose the same IOL, although a significant number of them needed reading spectacles, indicating that SI is not the main factor that determines patient selection of IOLs.
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Rementería-Capelo LA, Lorente P, Carrillo V, Sánchez-Pina JM, Ruiz-Alcocer J, Contreras I. Patient Satisfaction and Visual Performance in Patients with Ocular Pathology after Bilateral Implantation of a New Extended Depth of Focus Intraocular Lens. J Ophthalmol 2022; 2022:4659309. [PMID: 35529167 PMCID: PMC9071907 DOI: 10.1155/2022/4659309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/16/2022] [Indexed: 11/21/2022] Open
Abstract
Aim To evaluate visual results and patient-perceived outcomes in patients with ocular pathologies implanted with a new extended depth-of-focus intraocular lens (IOL). Methods Patients with ocular pathology undergoing cataract surgery and bilaterally implanted with Vivity® IOLs were evaluated three months after surgery. The control group included patients with no ocular pathologies. Binocular defocus curves, corrected and uncorrected mono- and binocular distance visual acuity (DVA), and binocular contrast sensitivity were measured. Patients completed the Catquest-9SF questionnaire and reported on dysphotopsia and their need for spectacle-correction. Results Twenty-five patients were included in each group. Monocular uncorrected DVA was better in the control group (-0.01 ± 0.07) compared with the study group (0.03 ± 0.08), p=0.027. There were no other statistically significant differences in DVA, with an uncorrected binocular acuity of -0.06 ± 0.06 for the control group and -0.05 ± 0.06 for the study group. Binocular defocus curves were similar for both groups and there were no differences in contrast sensitivity values. Pooling the refractive results, 96% of eyes were within ±0.50 D of target refraction. Seventy percent of patients in the control group reported no halos, compared with 40% in the study group, p=0.047. In both groups, 40% of patients reported being completely spectacle-independent, with the other 60% requiring glasses for near vision always or often. All patients reported being fairly or very satisfied with their vision. Conclusion Initial results of visual function after Vivity implantation in patients with ocular pathologies are encouraging, with high patient satisfaction and few difficulties for daily activities.
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Affiliation(s)
| | | | | | | | - Javier Ruiz-Alcocer
- Optics and Optometry Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Inés Contreras
- Clínica Rementería, Madrid, Spain
- Hospital Universitario Ramón y Cajal Madrid, Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, Spain
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Adre E, Tonk R. Positive and Negative Dysphotopsias: Causes, Prevention, and Best Strategies for Treatment. CURRENT OPHTHALMOLOGY REPORTS 2021. [DOI: 10.1007/s40135-021-00278-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Non-diffractive wavefront shaping extended depth of focus (EDoF) intraocular lens: visual performance and patient-reported outcome. J Cataract Refract Surg 2021; 48:144-150. [PMID: 34653094 DOI: 10.1097/j.jcrs.0000000000000826] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 09/21/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate visual performance and patient-reported outcomes after bilateral implantation of new non-diffractive wavefront shaping extended depth of focus (EDOF) intraocular lens (IOL). SETTING Department of Ophthalmology, Goethe University, Frankfurt, Germany. DESIGN Prospective, single-arm, single-center study. METHODS Patient population: We included 16 patients (32 eyes) who received bilateral implantation of a non-diffractive wavefront shaping EDOF IOL (AcrySof® IQ Vivity®, Alcon Research, TX, USA). Target refraction in both eyes was emmetropia. Observation procedure: Monocular and binocular uncorrected (UCVA) and distance-corrected (DCVA) visual acuity (VA), refractive outcome, defocus curve, contrast sensitivity (CS) were evaluated 3 months after surgery with a questionnaire on optical phenomena and spectacle independence. Main Outcome measure: Three months postoperative monocular and binocular UCVA and DCVA (logMAR); defocus curve; CS; and quality of vision (QoV) questionnaire results. RESULTS Mean spherical equivalent was -0.16 ± 0.37 D 3 month postoperatively. Binocular UDVA at distance, intermediate, and near was 0.01 ± 0.05 logMAR at 4m, 0.05 ± 0.05 logMAR at 80cm, 0.07 ± 0.06 logMAR at 66cm, and 0.25 ± 0.11 logMAR at 40cm, respectively. Despite some minor optical phenomena, 88% of patients would choose the same lens. 63% of patients reported no optical phenomena at all. Contrast sensitivity was 1.25 ± 0.41 logCS (photopic), 0.96 ± 0.24 logCS (mesopic) and 0.93 ± 0.24 (mesopic + glare). CONCLUSIONS This non-diffractive wavefront shaping EDOF IOL provides good VA at far and intermediate distance and functional near VA. It showed good QoV and CS, and high spectacle independence for distance and intermediate vision with significantly less optical phenomena than with other EDOF or MIOLs.
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van Vught L, Dekker CE, Stoel BC, Luyten GPM, Beenakker JWM. Evaluation of intraocular lens position and retinal shape in negative dysphotopsia using high-resolution magnetic resonance imaging. J Cataract Refract Surg 2021; 47:1032-1038. [PMID: 33577270 DOI: 10.1097/j.jcrs.0000000000000576] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/26/2020] [Indexed: 02/03/2023]
Abstract
PURPOSE To assess potential relationships of intraocular lens (IOL) position and retinal shape in negative dysphotopsia (ND). SETTING Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands. DESIGN Case-control study. METHODS High-resolution ocular magnetic resonance imaging (MRI) scans were performed in patients with ND and pseudophakic controls, and subsequently used to determine the displacement and tilt of the in-the-bag IOL about the pupil and iris. In addition, anterior segment tomography was used to assess the iris-IOL distance. Furthermore, the retinal shape was quantified from the MRI scans by fitting an ellipse to the segmented inner boundary of the retina. Both the IOL position and retinal shape were compared between groups to assess their potential role in the etiology of ND. RESULTS In total, 37 patients with ND and 26 pseudophakic controls were included in the study. The mean displacement and tilt of the IOL were less than 0.1 mm and 0.5 degrees, respectively, in both groups and all directions. The corresponding mean iris-IOL distance was 1.1 mm in both groups. Neither of these values differed statistically significantly between groups (all P values >.6). The retinal shape showed large variations but was not statistically significantly different between the groups in both the left-right (P = .10) and the anterior-posterior (P = .56) directions. CONCLUSIONS In this study, the in-the-bag IOL position and retinal shape did not statistically significantly differ between patients with ND and the general pseudophakic population. Given the large variation in retinal shape between subjects, however, it could still be an important factor in a multifactorial origin of ND.
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Affiliation(s)
- Luc van Vught
- From the Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands (van Vught, Luyten, Beenakker); Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, the Netherlands (van Vught, Beenakker); Division of Image Processing (LKEB), Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (Dekker, Stoel)
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Distinct differences in anterior chamber configuration and peripheral aberrations in negative dysphotopsia. J Cataract Refract Surg 2021; 46:1007-1015. [PMID: 32271269 PMCID: PMC8059877 DOI: 10.1097/j.jcrs.0000000000000206] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Clinical evaluations combined with ray-tracing analyses in patients with negative dysphotopsia supported the role of an increased angle κ. Purpose: To provide insights into the anatomical characteristics associated with negative dysphotopsia using quantitative clinical data. Setting: Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands. Design: Case-control study. Methods: Anterior chamber tomography and peripheral aberrometry were measured in 27 pseudophakic patients with negative dysphotopsia and 30 pseudophakic control subjects. Based on these measurements, the total corneal power, anterior chamber depth, pupil location and diameter, iris tilt, and peripheral ocular wavefront up to 30 degrees eccentricity were compared between both groups. In addition, ray-tracing simulations using pseudophakic eye models were performed to establish a connection between these clinical measurements and current hypotheses on the etiology of negative dysphotopsia. Results: Twenty-seven patients with negative dysphotopsia and 25 pseudophakic controls were included in the analysis. The patients with negative dysphotopsia had a smaller (P = .03/P = <.01) and more decentered (P < .01) pupil than that of the pseudophakic controls. In addition, an increased temporal-tilted iris (P < .01) and an asymmetric peripheral aberration profile were observed in patients with negative dysphotopsia, of which the latter was also apparent in several ray-tracing models. The combination of these in vivo results and ray-tracing simulations indicated that patients with negative dysphotopsia had a temporal-rotated eye, which confirmed the hypothesized relation between negative dysphotopsia and an increased angle κ. Conclusions: Patients with negative dysphotopsia had a smaller pupil and an increased angle κ, which made them more susceptible to experiencing a shadow in the temporal visual field.
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Moshirfar M, Ellis J, Beesley D, McCabe SE, Lewis A, West WB, Ronquillo Y, Hoopes P. Comparison of the Visual Outcomes of an Extended Depth-of-Focus Lens and a Trifocal Lens. Clin Ophthalmol 2021; 15:3051-3063. [PMID: 34295144 PMCID: PMC8291815 DOI: 10.2147/opth.s321779] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/07/2021] [Indexed: 12/21/2022] Open
Abstract
Purpose To compare the visual performance of the AcrySof IQ PanOptix trifocal intraocular lens and the TECNIS Symfony extended depth-of-focus lens at near and distance visual ranges. Methods A total of 146 patients (221 eyes) who underwent phacoemulsification and cataract extraction and received either a PanOptix or Symfony lens from January 2019 to July 2020 were included in the study (83 PanOptix non-toric, 30 PanOptix toric, 70 Symfony non-toric, and 38 Symfony toric). Uncorrected distance (UDVA), uncorrected near (UNVA), and corrected distance (CDVA) visual acuity were assessed at one-day, one-month, and three-months postoperatively. Averages of UDVA, UNVA, and CDVA were taken to evaluate which lens was superior at near and distance visual ranges. Secondary outcome measures including glare, halo, dryness, and problems with night vision were documented at each postoperative visit. Results At one month postoperatively, the average UNVA was 0.16 ± 0.14 logMAR in the PanOptix group and 0.21 ± 0.14 logMAR in the Symfony group (P=0.007); the average UDVA for the PanOptix group was 0.09 ± 0.13 logMAR compared to the Symfony group at 0.10 ± 0.14 logMAR (P=0.67); and the average CDVA was 0.02 ± 0.05 logMAR in the PanOptix group and 0.00 ± 0.04 logMAR in the Symfony group (P=0.11). At three months postoperatively, there were no statistically significant differences in UNVA, UDVA, or CDVA between the two groups (P=0.18, 0.79, 0.68 respectively). There was no statistically significant difference in secondary outcome measures at one- and three-months (P=0.49, 0.10 respectively). Conclusion The AcrySof IQ PanOptix trifocal intraocular lens appears to afford better UNVA compared to the TECNIS Symfony extended depth-of-focus intraocular lens at one-month postoperatively, though this difference was not seen at three months postoperatively. There is no statistically significant difference in UDVA and CDVA between the two groups at postoperative day one, one-month, and three-months.
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Affiliation(s)
- Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA.,John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT, USA.,Utah Lions Eye Bank, Murray, UT, USA
| | - James Ellis
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | | | - Shannon E McCabe
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA.,Mission Hills Eye Center, Pleasant Hill, CA, USA
| | - Adam Lewis
- Kansas City University College of Osteopathic Medicine, Kansas City, MO, USA
| | - William B West
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | | | - Phillip Hoopes
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA
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14
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Dysphotopsiae and functional quality of vision after implantation of an intraocular lens with a 7.0 mm optic and plate haptic design. J Cataract Refract Surg 2021; 48:75-82. [PMID: 34224478 DOI: 10.1097/j.jcrs.0000000000000735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/18/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine the impact of IOL with 7.0 mm optic and plate haptic design on incidence of dysphotopsiae and visual functions after cataract surgery. SETTING Day-care clinic. DESIGN A prospective monocentric randomized patient-blinded comparative clinical study. METHODS Following preoperative measurements, patients underwent cataract surgery with implantation of two IOL designs - with 7.0 mm optic and plate haptics (group 1) or with 6.0 mm optic and C-loop haptics (group 2). In month 1, 3 and 12 follow-ups patients were examined, answered a questionnaire regarding satisfaction, spectacle dependence, frequency and extent of positive and negative dysphotopsiae, and underwent contrast sensitivity, mesopic vision and glare sensitivity testing. The data were analyzed as nominal, ordinal and metric with Chi-Square, Mann-Whitney-U, Wilcoxon and t-tests. RESULTS Group 1 comprised 57 eyes (43 patients) and group 2 comprised 63 eyes (43 patients). Corrected distance visual acuity was the same between groups throughout the study. Group 1 showed significantly lower incidence of positive and negative dysphotopsiae in month 1 follow-up (p=0.021 and 0.015, respectively) and a higher satisfaction rate in month 3 follow-up (p=0.006). Mean contrast sensitivity and mesopic vision with and without glare were the same in both groups. Positive dysphotopsiae cases in month 12 follow-up revealed lower photopic contrast sensitivity (p=0.005, 0.036 and 0.047, respectively), longer AL and greater preoperative pupil dynamics (p=0.04 and 0.06). CONCLUSIONS The IOL design with 7.0 mm optic diameter and plate haptics reduces dysphotopsiae, provides good visual acuity, contrast sensitivity, mesopic vision with and without glare and high patient satisfaction.
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15
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Nair S, Kaur M, Titiyal JS. Commentary - Should immediate sequential bilateral cataract surgery be the norm in the COVID-19 era? Indian J Ophthalmol 2021; 69:1961-1962. [PMID: 34146070 PMCID: PMC8374819 DOI: 10.4103/ijo.ijo_1343_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Sridevi Nair
- Cornea, Cataract and Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Manpreet Kaur
- Cornea, Cataract and Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Jeewan Singh Titiyal
- Cornea, Cataract and Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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16
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Masket S. Same Day Bilateral Cataract Surgery-Who Benefits? Ophthalmology 2020; 128:11-12. [PMID: 32951873 PMCID: PMC7498406 DOI: 10.1016/j.ophtha.2020.08.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/20/2020] [Indexed: 11/27/2022] Open
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17
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Masket S, Fram NR. Pseudophakic Dysphotopsia: Review of Incidence, Cause, and Treatment of Positive and Negative Dysphotopsia. Ophthalmology 2020; 128:e195-e205. [PMID: 32800744 DOI: 10.1016/j.ophtha.2020.08.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 08/08/2020] [Accepted: 08/10/2020] [Indexed: 11/16/2022] Open
Abstract
We reviewed the literature concerning positive dysphotopsia (PD) and negative dysphotopsia (ND) regarding cause, incidence, and clinical and surgical management. In addition, we summarized our surgical experience in managing dysphotopsia. A PubMed review, limited to English language articles, yielded 149 citations; multifocal (diffractive optic) and phakic intraocular lens (IOL) dysphotopsia were excluded. Overall, 39 articles were determined to be relevant for the objectives of this investigation. Regarding PD, 7 articles corroborated that the cause of PD is related primarily to internal reflection of oblique light rays that strike the square (truncated) edge of the IOL and are reflected onto the retinal surface. No round-edged foldable IOLs are available in the United States at this time, although IOLs modified with a round anterior edge and square posterior edge show a trend toward decreased incidence of PD. High index of refraction (I/R), surface reflectivity, and IOL optic design are additional causative factors for PD. Regarding the authors' surgical experience, changing the optic material to have a lower I/R improved PD symptoms in the large majority of patients. The cause of ND seems to be multifactorial and less well understood, with some disparity between clinical and laboratory findings. Four articles that explore using ray-tracing optical modeling suggest an "illumination gap," in which some temporally incident light rays to the nasal retina pass anterior to the IOL and some are refracted posteriorly by the IOL, resulting in a gap and resultant temporal shadow. However clinically, ND is associated invariably with well-centered in-the-bag IOLs. Other implicating factors include nasal anterior capsule override, haptic orientation, large-angle κ value, and high hyperopia. Persistent ND has been treated successfully or reduced with reverse (anterior) optic capture, sulcus IOL placement, piggyback IOLs, and neodymium:yttrium-aluminum-garnet nasal capsulectomy. Two articles reference a new optic edge designed to capture the anterior capsulotomy, mimicking reverse optic capture. Persistent dysphotopsia after cataract surgery is a significant cause for patient dissatisfaction. The cause and management of both ND and PD are of significance, and new IOL designs and alternative surgical strategies may help to mitigate these unintended side effects of IOL implantation.
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Affiliation(s)
- Samuel Masket
- Advanced Vision Care, Los Angeles, California, and Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Nicole R Fram
- Advanced Vision Care, Los Angeles, California, and Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California.
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18
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Donmez O, Asena BS, Kaskaloglu M, Akova YA. Patients satisfaction and clinical outcomes of binocular implantation of a new trifocal intraocular lens. Int Ophthalmol 2020; 40:1069-1075. [PMID: 32328922 DOI: 10.1007/s10792-020-01390-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 12/28/2019] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate the clinical outcomes following bilateral implantation of PanOptix intraocular lens (IOL). METHODS This study included consecutive patients scheduled to undergo cataract or refractive lens exchange surgery between October 2017 and June 2018 at two centers. Manifest refraction, uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA, 60 cm) and uncorrected near visual acuity (UNVA, 40 cm), defocus curves, presence of dysphotopsia, need for spectacles, presence of posterior capsule opacification and visual function were evaluated at 6 months after surgery. RESULTS The IOL was implanted in 138 eyes of 69 patients. The mean binocular UDVA was 0.02 ± 0.05 logMAR, UIVA 0.06 ± 0.07 logMAR and UNVA 0.05 ± 0.07 logMAR. Defocus curve showed two peaks at 0.00 D and - 1.50 D. Complete spectacle independence was reported in 94.2% of the patients. The mean VF-14 test result was 97.7 ± 2.2 (93.2-100). Only one patient (1.4%) reported seeing bothersome halos. The presence of posterior capsule opacification was noted in seven eyes (10%), whereas Nd:Yag capsulotomy was required only in one eye. CONCLUSIONS This trifocal IOL provided excellent visual outcomes at all distances with high spectacle independence and patient's satisfaction.
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Affiliation(s)
- Oya Donmez
- Department of Ophthalmology, Bayindir Hospital, Ankara, Turkey
| | | | | | - Yonca A Akova
- Department of Ophthalmology, Bayindir Hospital, Ankara, Turkey.
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19
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Intraocular lens far peripheral vision: image detail and negative dysphotopsia. J Cataract Refract Surg 2020; 46:451-458. [DOI: 10.1097/j.jcrs.0000000000000103] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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20
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Erie JC, Simpson MJ, Bandhauer MH. A modified intraocular lens design to reduce negative dysphotopsia. J Cataract Refract Surg 2019; 45:1013-1019. [DOI: 10.1016/j.jcrs.2019.01.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 12/27/2018] [Accepted: 01/15/2019] [Indexed: 12/25/2022]
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21
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Sudhir RR, Dey A, Bhattacharrya S, Bahulayan A. AcrySof IQ PanOptix Intraocular Lens Versus Extended Depth of Focus Intraocular Lens and Trifocal Intraocular Lens: A Clinical Overview. Asia Pac J Ophthalmol (Phila) 2019; 8:335-349. [PMID: 31403494 PMCID: PMC6727923 DOI: 10.1097/apo.0000000000000253] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 06/13/2019] [Indexed: 12/18/2022] Open
Abstract
AcrySof IQ PanOptix Model TFNT00 (Alcon Laboratories, Fort Worth, TX) is a 1-piece aspheric hydrophobic presbyopia-correcting intraocular lens (IOL) launched in 2015. Unlike traditional trifocal IOLs that usually have an intermediate focal point of 80 cm, the PanOptix IOL is designed to have an intermediate focal point of 60 cm (arms-length), a more natural and comfortable working distance to perform functional tasks on computers, laptops, mobiles, among others. The non-apodized PanOptix IOL uses the ENhanced LIGHT ENergy (ENLIGHTEN; Alcon Laboratories, Fort Worth, TX) optical technology that provides high (88%) utilization of light energy, low dependence on pupil size in all lighting conditions, and a more comfortable near-to-intermediate range of vision than traditional trifocal IOLs. This review provides an overview of the clinical performance of the PanOptix IOL and discusses it in the context of other commercially available trifocal IOLs, FineVision Micro F (PhysIOL, Liege, Belgium), the AT LISA tri 839MP (Carl Zeiss Meditec AG, Jena, Germany) and the extended depth of focus IOL, TECNIS Symfony (Abbott Medical Optics, Santa Ana, CA). A literature search was performed in the PubMed database to identify studies that have assessed the visual and other clinical outcomes with the PanOptix IOL. In total, 12 studies were included in this review article. Overall, the clinical evidence suggests that in general good visual outcomes, along with a high degree of spectacle independence, are achieved in patients implanted with the PanOptix, FineVision, AT LISA and Symfony IOLs. However, every MIOL has its benefits and limitations, which along with patient's needs and clinical conditions are important factors to consider while selecting an IOL to achieve best possible post-operative outcomes.
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Affiliation(s)
| | - Arindam Dey
- Alcon Laboratories (India) Private Ltd, Bangalore, India
| | | | - Amit Bahulayan
- Alcon Laboratories (India) Private Ltd, Bangalore, India
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22
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Effect of a sulcus-fixated piggyback intraocular lens on negative dysphotopsia: Ray-tracing analysis. J Cataract Refract Surg 2019; 45:443-450. [DOI: 10.1016/j.jcrs.2018.10.041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/22/2018] [Accepted: 10/25/2018] [Indexed: 11/21/2022]
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23
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Böhm M, Hemkeppler E, Herzog M, Schönbrunn S, de’Lorenzo N, Petermann K, Kohnen T. Comparison of a panfocal and trifocal diffractive intraocular lens after femtosecond laser–assisted lens surgery. J Cataract Refract Surg 2018; 44:1454-1462. [DOI: 10.1016/j.jcrs.2018.07.060] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 07/30/2018] [Accepted: 07/31/2018] [Indexed: 11/28/2022]
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24
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Ylinen P, Taipale C, Lindholm JM, Laine I, Holmström E, Tuuminen R. Postoperative management in cataract surgery: nepafenac and preservative-free diclofenac compared. Acta Ophthalmol 2018; 96:853-859. [PMID: 30284393 DOI: 10.1111/aos.13843] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 05/14/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE Current cataract surgery guidelines recommend routine use of topical nonsteroidal anti-inflammatory drugs (NSAIDs) in preventing pseudophakic cystoid macular oedema (PCME). Here, we compare the clinical efficacy and tolerability of two potent NSAIDs, nepafenac and preservative-free diclofenac following cataract surgery. METHODS Randomized, double-blind, prospective single-centre study. Ninety-six eyes of 95 patients undergoing routine cataract surgery were randomized 1:1 either to nepafenac (Nevanac, 1 mg/ml) or diclofenac (Dicloabak, 1 mg/ml) for 3 weeks. Seventy-three patients accounting for 73 eyes completed the entire follow-up. Aqueous flare and central retinal thickness (CRT) analysis were conducted preoperatively and at control visits 28 days and 3 months after surgery. A structured home questionnaire and interview were used to record any adverse effects of the topical medications, subjective visual recovery and the dispenser's ease of use. RESULTS No differences were observed between the groups for aqueous flare, CRT, speed of recovery or visual acuity gain. Seven patients (16%) on nepafenac and 20 patients (48%) on preservative-free diclofenac reported symptoms related to topical use of NSAID medications (p = 0.001). CONCLUSION No differences in clinical efficacy were found between potent NSAIDs, while tolerability might be an issue.
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Affiliation(s)
- Petteri Ylinen
- Helsinki Retina Research Group; University of Helsinki; Helsinki Finland
- Department of Ophthalmology; Helsinki University Hospital; Helsinki Finland
| | - Claudia Taipale
- Helsinki Retina Research Group; University of Helsinki; Helsinki Finland
- Department of Ophthalmology; Helsinki University Hospital; Helsinki Finland
| | - Juha-Matti Lindholm
- Helsinki Retina Research Group; University of Helsinki; Helsinki Finland
- Department of Ophthalmology; Helsinki University Hospital; Helsinki Finland
| | - Ilkka Laine
- Helsinki Retina Research Group; University of Helsinki; Helsinki Finland
- Department of Automation and Electrical Engineering; Aalto University; Helsinki Finland
| | - Emil Holmström
- Helsinki Retina Research Group; University of Helsinki; Helsinki Finland
- Transplantation Laboratory; University of Helsinki; Helsinki Finland
| | - Raimo Tuuminen
- Helsinki Retina Research Group; University of Helsinki; Helsinki Finland
- Unit of Ophthalmology; Kymenlaakso Central Hospital; Kotka Finland
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25
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Stolk-Vos AC, Visser MS, Klijn S, Timman R, Lansink P, Nuijts R, Tjia K, Zijlmans B, Kranenburg LW, Busschbach JV, Reus NJ. Effects of clinical parameters on patient-reported outcome in cataract patients: a multicentre study. Acta Ophthalmol 2018; 96:586-591. [PMID: 29575507 DOI: 10.1111/aos.13747] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 02/07/2018] [Indexed: 12/14/2022]
Abstract
PURPOSE Ophthalmologists tend to evaluate the results of cataract surgery by focusing on the clinical visual and refractive outcomes and the incidence of complications, where patients' main interest might be their ability to perform daily activities. Therefore, there appears to be a need for optimizing effective communication between patients and ophthalmologist about the outcome of cataract surgery. The aim of this multicentre study was to determine the effects of whether the surgery was performed in one or two eyes, ocular comorbidity and per- and postoperative complications on visual function experienced by patients measured with the Catquest-9SF. METHODS To measure patient-reported outcomes, Catquest-9SF data were collected between 2014 and 2015 in five Dutch hospitals. Data from 870 pairs of questionnaires - completed before and after cataract surgery - were compared with clinical data. Clinical data, retrieved from patients' medical files, consisted of one or two eye surgery, ocular comorbidity and per- and postoperative complications. RESULTS Quality of vision improved more in patients who had surgery in both eyes and had fewer postoperative complications (both p < 0.001). We found a nonsignificant trend that quality of vision was worse when ocular comorbidity was present. No significant effect of peroperative complications was observed. CONCLUSION Our results emphasize the added value of the Catquest-9SF as a tool for visual function experienced by patients; the additional information can complement clinical parameters to improve patient-centred approaches in clinical practice.
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Affiliation(s)
- Aline C. Stolk-Vos
- Rotterdam Ophthalmic Institute; Rotterdam The Netherlands
- Department of Psychiatry; Section Medical Psychology and Psychotherapy; Erasmus Medical Center; Rotterdam The Netherlands
- Section Health Services Management & Organisation; Erasmus School of Health Policy & Management; Erasmus University Rotterdam; Rotterdam The Netherlands
| | - Martijn S. Visser
- Department of Psychiatry; Section Medical Psychology and Psychotherapy; Erasmus Medical Center; Rotterdam The Netherlands
| | - Stijn Klijn
- Rotterdam Ophthalmic Institute; Rotterdam The Netherlands
| | - Reinier Timman
- Department of Psychiatry; Section Medical Psychology and Psychotherapy; Erasmus Medical Center; Rotterdam The Netherlands
| | | | - Rudy Nuijts
- Maastricht University Medical Center; Maastricht The Netherlands
| | | | - Bart Zijlmans
- The Rotterdam Eye Hospital; Rotterdam The Netherlands
| | - Leonieke W. Kranenburg
- Department of Psychiatry; Section Medical Psychology and Psychotherapy; Erasmus Medical Center; Rotterdam The Netherlands
| | - Jan V. Busschbach
- Department of Psychiatry; Section Medical Psychology and Psychotherapy; Erasmus Medical Center; Rotterdam The Netherlands
| | - Nicolaas J. Reus
- Department of Ophthalmology; Amphia Hospital; Breda The Netherlands
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26
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Pál S, Fișuș AD, Vultur F, Horvath K. The Efficacy of Questionnaire-based Evaluation in Determining the Incidence of Recent Pseudophakic Dysphotopsia. JOURNAL OF INTERDISCIPLINARY MEDICINE 2018. [DOI: 10.1515/jim-2018-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background: Dysphotopsias are optical side effects experienced by patients who underwent cataract surgery. This unwanted photic phenomenon has gained ground and is a major postoperative concern. Visual acuity is not sufficient in evaluating the postoperative visual function.
The aim of this study was to determine the efficacy of using a preexistent questionnaire in determining the presence of dysphotopsia.
Material and method: We conducted a prospective study, using the modified Visual Function Index (VF-14) and the Ocular Surface Disease Index (OSDI) surveys, completed on patients that underwent uncomplicated phacoemulsification with intraocular lens implantation between November 2016 and November 2017. Patients included in the study had no known ocular comorbidities and had no other possible postoperative explanation for these visual phenomena. Three weeks after the surgery, the questionnaire was filled up by one individual examiner.
Results: Of the 50 patients considered, 37 patients met all the inclusion criteria and were successfully enrolled in the study, with a mean age of 75.88 years. Dysphotopsia phenomena were present in 13.51% of cases; 60% of these patients described the presence of positive dysphotopsia, and 40% complained of temporal shadows. The best corrected visual acuity was over 0.8 in 75.67% of the cases.
Conclusion: Although there is no objective test to diagnose this early postoperative complication, pseudophakic dysphotopsia should not be overlooked and additional chair time is needed.
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Affiliation(s)
- Szilvia Pál
- University of Medicine and Pharmacy , Tîrgu Mureș , Romania
| | - Andreea Dana Fișuș
- University of Medicine and Pharmacy , Tîrgu Mureș , Romania
- Ophtalmology Clinic, Mureș County Hospital , Tîrgu Mureș , Romania
| | - Florina Vultur
- University of Medicine and Pharmacy , Tîrgu Mureș , Romania
- Ophtalmology Clinic, Mureș County Hospital , Tîrgu Mureș , Romania
| | - Karin Horvath
- University of Medicine and Pharmacy , Tîrgu Mureș , Romania
- Ophtalmology Clinic, Mureș County Hospital , Tîrgu Mureș , Romania
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Kohnen T, Herzog M, Hemkeppler E, Schönbrunn S, De Lorenzo N, Petermann K, Böhm M. Visual Performance of a Quadrifocal (Trifocal) Intraocular Lens Following Removal of the Crystalline Lens. Am J Ophthalmol 2017; 184:52-62. [PMID: 28923587 DOI: 10.1016/j.ajo.2017.09.016] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 09/08/2017] [Accepted: 09/09/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate visual performance after implantation of a quadrifocal intraocular lens (IOL). METHODS Setting: Department of Ophthalmology, Goethe University, Frankfurt, Germany. STUDY POPULATION Twenty-seven patients (54 eyes) received bilateral implantation of the PanOptix IOL (AcrySof IQ PanOptixTM; Alcon Research, Fort Worth, Texas, USA) pre-enrollment. Exclusion criteria were previous ocular surgeries, corneal astigmatism of >1.5 diopter (D), ocular pathologies, or corneal abnormalities. Intervention or Observational Procedure(s): Postoperative examination at 3 months including manifest refraction; uncorrected visual acuity (UCVA) and distance-corrected visual acuity (DCVA) in 4 m, 80 cm, 60 cm, and 40 cm slit-lamp examination; defocus testing; contrast sensitivity (CS) under photopic and mesopic conditions; and a questionnaire on subjective quality of vision, optical phenomena, and spectacle independence was performed. MAIN OUTCOME MEASURE(S) At 3 months postoperatively, UCVA and DCVA in 4 m, 80 cm, 60 cm, and 40 cm (logMAR), defocus curves, CS, and quality-of-vision questionnaire results. RESULTS Mean spherical equivalent was -0.04 ± 0.321 D 3 months postoperatively. Binocular UCVA at distance, intermediate (80 cm, 60 cm), and near was 0.00 ± 0.094 logMAR, 0.09 ± 0.107 logMAR, 0.00 ± 0.111 logMAR, and 0.01 ± 0.087 logMAR, respectively. Binocular defocus curve showed peaks with best visual acuity (VA) at 0.00 D (-0.07 logMAR) and -2.00 D (-0.02 logMAR). CONCLUSION Visual performance of the PanOptix IOL showed good VA at all distances; particularly good intermediate VA (logMAR > 0.1), with best VA at 60 cm; and high patient satisfaction and spectacle independence 3 months postoperatively.
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Affiliation(s)
- Thomas Kohnen
- Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany.
| | - Michael Herzog
- Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany
| | - Eva Hemkeppler
- Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany
| | - Sabrina Schönbrunn
- Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany
| | - Nina De Lorenzo
- Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany
| | - Kerstin Petermann
- Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany
| | - Myriam Böhm
- Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany
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