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Visual outcomes and safety of the TECNIS Symfony intraocular lens: results of a pivotal clinical trial. J Cataract Refract Surg 2021; 48:288-297. [PMID: 34269326 PMCID: PMC8865208 DOI: 10.1097/j.jcrs.0000000000000747] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 07/05/2021] [Indexed: 12/02/2022]
Abstract
Randomized comparison of the TECNIS Symfony (ZXR00) and the TECNIS 1-piece monofocal (ZCB00) intraocular lenses in cataract surgery demonstrates improved intermediate and near vision with TECNIS Symfony. To compare the effectiveness and safety of the TECNIS Symfony intraocular lens (IOL; ZXR00) with the TECNIS 1-piece monofocal IOL (ZCB00).
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Hyun J. Surgical treatment of presbyopia I. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2019. [DOI: 10.5124/jkma.2019.62.12.616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Joo Hyun
- Saevit Eye Hospital, Goyang, Korea
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Lee S, Jang C, Kong SJ, Kim JW, Cho YJ, Lim TH, Choi KY, Cho BJ. Comparison of Clinical Outcomes between Laser Blended Vision and Monovision Laser Refractive Surgery for Presbyopia. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2016. [DOI: 10.3341/jkos.2016.57.12.1840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Comparison of near vision, intraocular lens movement, and depth of focus with accommodating and monofocal intraocular lenses. J Cataract Refract Surg 2013; 39:1872-8. [DOI: 10.1016/j.jcrs.2013.05.049] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Efficacy of aspheric corneal ablation with the central-saving technique for presbyopic correction through early wound healing modulation. Cornea 2012; 32:30-5. [PMID: 23073487 DOI: 10.1097/ico.0b013e31825fee62] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess the long-term efficacy, refractive changes, and final visual acuity results from emmetropic presbyopic corrections when using aspheric ablation with the central-saving technique (CST) through the modulation of early wound healing. METHODS This study was a prospective comparative study. Twenty-four eyes of 12 patients with emmetropia underwent aspheric corneal ablation while preserving the central cornea (CST group) by amniotic membrane patching to protect the center of the cornea and encourage early wound healing. Twenty-two eyes of 11 patients with emmetropia were treated with the conventional presbyopic excimer laser [non-central-saving technique (NCST) group]. The wound healing time, visual acuity, manifest refraction, and corneal topography before and 2 years after the surgery were compared across both groups. RESULTS The corneal wound healing time of the CST group was faster than that of the NCST group. The time it took to achieve effective near and distance visual acuities were 1.2 ± 0.4 days and 2.3 ± 1.5 days in the CST group, whereas the same took 2.3 ± 1.2 days and 5.2 ± 2.1 days each for the NCST group. Statistically significant differences in both distance and near visual acuity were observed between the CST and NCST groups 2 years after the operation. The mean refractive error showed less regression in the CST group than in the NCST group within this same time period. CONCLUSIONS Laser corneal ablation with CST can be used effectively to treat patients with emmetropic presbyopia because it provides faster wound healing and longer lasting effective maintenance in near and far visual acuities.
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He L, Wendt M, Glasser A. Manipulation of intraocular pressure for studying the effects on accommodation. Exp Eye Res 2012; 102:76-84. [PMID: 22814297 DOI: 10.1016/j.exer.2012.07.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Revised: 06/25/2012] [Accepted: 07/08/2012] [Indexed: 10/28/2022]
Abstract
A reliable experimental system in which IOP can be manipulated or a rapid IOP change can be induced while simultaneously and continuously measuring IOP and the ocular accommodative changes would be useful for understanding the physiological effect of intraocular pressure (IOP) on the accommodative mechanism. In this study, an IOP perfusion and recording system was developed and tested using 13 enucleated pig eyes. The vitreous chamber of the pig eyes was cannulated with a needle connected to two fluid reservoirs at different heights. One reservoir was set to achieve one of three baseline pressures of 5.5 mmHg, 13.0 mmHg and 20.5 mmHg. The other reservoir was moved to achieve pressures of 1.5 mmHg, 3.0 mmHg, 4.5 mmHg and 6.0 mmHg higher than the baseline pressure. The height differential between the reservoirs determined the amplitude of IOP changes. Rapid IOP changes were induced by switching the reservoirs with a solenoid pinch-valve. Two needles, one each attached to a pressure transducer were inserted into the anterior chamber and vitreous chamber respectively. Custom developed software was used to measure the anterior chamber pressure and vitreous chamber pressure at 80 Hz. A high-resolution continuous A-scan ultrasound biometer (CUB) was used to dynamically measure changes in ocular biometry including anterior chamber depth (ACD), lens thickness (LT) and vitreous chamber depth (VCD) while the vitreous chamber pressure was manipulated. The changes in ACD, LT and VCD were analyzed as a function of the pressure change. Perfusion-induced axial biometric changes were quantified by the slopes of linear regression relationships. Both anterior chamber pressure and vitreous chamber pressure changed relatively systematically with the induced vitreous chamber pressure changes (anterior chamber: y = 0.863x + 0.030, r(2) = 0.983; vitreous chamber: y = 0.883x + 0.009, r(2) = 0.981). At perfusion pressures of 5.5, 13.0 and 20.5 mmHg, the slopes for ACD were -5.72, -2.75 and -2.36 μm/mmHg, for LT were -3.31, -1.59 and -1.03 μm/mmHg and for VCD were 19.05, 8.63 and 5.18 μm/mmHg. The system was able to manipulate and monitor IOP while axial biometry changes were recorded. This system will allow the relationship between IOP and accommodation to be studied in non-human primate eyes.
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Affiliation(s)
- Lin He
- University of Houston, College of Optometry, 4901 Calhoun Road, Houston, TX 77204, United States
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Bae K, Keum JE, Chung TY, Chung ES. LASIK for Myopia with Presbyopia Using the Aspheric Micro-Monovision Technique. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2012. [DOI: 10.3341/jkos.2012.53.1.11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Kunho Bae
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | | | - Tae-Young Chung
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eui-Sang Chung
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Pedrigi RM, Humphrey JD. Computational model of evolving lens capsule biomechanics following cataract-like surgery. Ann Biomed Eng 2010; 39:537-48. [PMID: 20665113 DOI: 10.1007/s10439-010-0133-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2010] [Accepted: 07/14/2010] [Indexed: 10/19/2022]
Abstract
Cataract surgery is an invasive procedure whereby lens fibers are removed through a permanent central hole, or capsulorhexis, in the surrounding lens capsule and replaced with an artificial intraocular lens (IOL). Remnant lens epithelial cells subsequently transdifferentiate to a more contractile and synthetic wound-healing phenotype, which causes significant structural and mechanical adaptations of the residual lens capsule. The goal of this study is to present a computational model capable of capturing salient features of the biomechanical evolution of the lens capsule following cataract-like surgery. The model is shown to predict marked long-term increases in thickness and stiffness of the lens capsule nearest the edge of the capsulorhexis comparable to reported measurements. Such models represent a first step toward understanding better the long-term interactions between the residual lens capsule and implanted IOL, thus initiating a new paradigm for the design of improved IOLs, including those having an accommodative feature.
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Affiliation(s)
- R M Pedrigi
- Department of Bioengineering, Royal School of Mines, Imperial College London, London, SW7 2AZ, UK.
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Ale J, Manns F, Ho A. Evaluation of the performance of accommodating IOLs using a paraxial optics analysis. Ophthalmic Physiol Opt 2010; 30:132-42. [PMID: 20444117 DOI: 10.1111/j.1475-1313.2009.00694.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE We employed an analytical approach to evaluate the key parameters for the potential design optimisation of accommodating intra-ocular lenses (AIOL) and to use these parameters to predict their accommodative performance. METHODS Paraxial thin-lens equations to predict the accommodative performances of single-element (1E) and two-element (2E) AIOLs were developed. 2E-AIOLs with either mobile front or back lens elements were analysed as well as 1E-AIOL for their accommodative performance. A paraxial model including key ocular components (corneal surfaces, pupil and retina) as well as AIOL was used to evaluate the key control parameters and optimal design configurations. A range of variants of the model, representing varying powers of front and back optical elements and with either front or back optical element mobile was tested. RESULTS Optimal accommodative performance of 2E-AIOL is governed by the power combinations of its optical elements; design variants with higher positive front element power produced greater accommodative efficacy, while mobility of the front element contributed more to the accommodative performance than the back element. The performance of 1E-AIOL is primarily governed by the power of the AIOL; the higher the AIOL power, the better the accommodative performance. CONCLUSIONS From an accommodative performance standpoint, the optimal design of 2E-AIOL should comprise a high plus power front element. Considering the maximum potential amounts of element translation available clinically, 2E-AIOLs are predicted to offer higher accommodative performance compared to 1E-AIOL.
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Affiliation(s)
- Jit Ale
- Institute for Eye Research, University of New South Wales, Barker Street, Sydney, NSW 2052, Australia.
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Chun YS, Lee HI, Dausch D, Kim JC. Long-Term Results of Presbyopic Corneal Surface Ablation with Eximer Laser. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2008. [DOI: 10.3341/jkos.2008.49.7.1061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yeoun Sook Chun
- Department of Ophthalmology, Chung-Ang University Yongsan Hospital, Seoul, Korea
| | | | - Dieter Dausch
- Department of Ophthalmology, Chung-Ang University Yongsan Hospital, Seoul, Korea
| | - Jae Chan Kim
- Department of Ophthalmology, Chung-Ang University Yongsan Hospital, Seoul, Korea
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Ho A, Manns F, Parel JM. Predicting the performance of accommodating intraocular lenses using ray tracing. J Cataract Refract Surg 2006; 32:129-36. [PMID: 16516791 DOI: 10.1016/j.jcrs.2005.07.047] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2005] [Indexed: 10/24/2022]
Abstract
PURPOSE To predict and compare the amount of accommodation achievable by pseudophakic accommodating intraocular lenses (IOLs) using optical ray-tracing analysis. SETTING Computational laboratory. METHODS Two-element IOLs (2E-IOL, with mobile front or back optical elements) were compared with single-element IOLs (1E-IOL). Modeling using computer-assisted ray tracing of both IOL types assumed lens elements were equiconvex/equiconcave. The 4 possible combinations of configurations representing a wide range of varying positive and negative power (up to +40 diopters [D]) of front and back optical elements were evaluated. RESULTS The 1E-IOLs offered limited amplitude of accommodation with axial shift (approximately 1.2 D/mm). For 2E-IOLs, configurations with high positive-power front elements returned the best amplitude of accommodation (up to approximately 3.0 D/mm when the front element power was +40 D). CONCLUSIONS Considering the maximum potential amounts of axial shifts available, 1E-IOLs were predicted to provide 1.0 D of accommodation or less and 2E-IOLs were predicted to provide up to 3.0 D to 4.0 D depending on design configuration and amount of axial shift achievable. Potential issues relating to accommodative aniseikonia and spherical aberration have been identified.
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Affiliation(s)
- Arthur Ho
- Vision Cooperative Research Centre, Sydney, NSW, Australia.
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Hunter JJ, Campbell MCW, Geraghty E. Optical analysis of an accommodating intraocular lens. J Cataract Refract Surg 2006; 32:269-78. [PMID: 16565004 DOI: 10.1016/j.jcrs.2005.08.060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2005] [Indexed: 11/16/2022]
Abstract
PURPOSE To model the feasibility of an accommodating intraocular lens (IOL) that allows near vision by means of an anterior translation within the capsular bag. SETTING University of Waterloo, Waterloo, Ontario, Canada. METHODS Model eyes were constructed and analyzed based on experimental data using Code V, a computerized optical design tool. The potential near vision of IOLs of different powers was calculated as they were moved anteriorly within the capsular bag. The conditions under which a spherical lens performs well and when an aspheric design should be considered were determined. RESULTS Accommodation (the dioptric change from the far to the near point) varies linearly with lens movement and is sensitive to corneal and IOL powers. Simple equations were derived and accurately predicted induced accommodation. Retinal image quality varies significantly with pupil size and IOL power. However, image quality is minimally affected by the amount of induced accommodation. CONCLUSIONS From an optical standpoint accommodation with adequate image quality can be achieved by anterior movement of a spherical IOL within the capsular bag.
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Glasser A, Wendt M, Ostrin L. Accommodative changes in lens diameter in rhesus monkeys. Invest Ophthalmol Vis Sci 2006; 47:278-86. [PMID: 16384974 PMCID: PMC2915931 DOI: 10.1167/iovs.05-0890] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Some debate surrounds the accommodative mechanism in primates, particularly whether the lens equatorial diameter increases or decreases during accommodation. This study has been undertaken to measure the relationship between changes in lens diameter and refraction during accommodation in rhesus monkeys. METHODS Photorefraction was used to measure accommodation, and goniovideography was used to measure accommodative changes in lens diameter in the iridectomized eyes of two rhesus monkeys. Accommodation was stimulated through the full amplitude available to each eye by stimulation of the Edinger-Westphal nucleus of the brain. Dynamic measurement of refractive changes followed by dynamic measurements of changes in lens diameter for the same stimulus current amplitudes allow the relationship between refraction and lens diameter to be determined. RESULTS Lens diameter decreased relatively linearly during accommodation by 0.055 mm/diopter (D), resulting in an overall decrease in lens diameter of approximately 7% of the unaccommodated lens diameter for approximately 12 D of accommodation. CONCLUSIONS The rhesus monkey lens diameter decreases systematically with the refractive change during accommodation in accordance with the Helmholtz accommodative mechanism and in contrast to the accommodative mechanism originally proposed by Tscherning.
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Affiliation(s)
- Adrian Glasser
- College of Optometry, University of Houston, Houston, Texas 77204-2020, USA.
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Schachar RA. Biometric changes in pseudophakic eyes. Ophthalmology 2005; 112:2241; author reply 2241-2. [PMID: 16325720 DOI: 10.1016/j.ophtha.2005.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2005] [Accepted: 09/08/2005] [Indexed: 11/29/2022] Open
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Heatley CJ, Spalton DJ, Hancox J, Kumar A, Marshall J. Fellow eye comparison between the 1CU accommodative intraocular lens and the Acrysof MA30 monofocal intraocular lens. Am J Ophthalmol 2005; 140:207-13. [PMID: 15992754 DOI: 10.1016/j.ajo.2005.02.057] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2005] [Revised: 02/27/2005] [Accepted: 02/28/2005] [Indexed: 10/25/2022]
Abstract
PURPOSE To examine the near visual clinical performance of an accommodative intraocular lens (IOL) when compared with a standard monofocal IOL in a fellow eye comparison. DESIGN Prospective, randomized fellow eye comparison. METHODS Thirty patients (60 eyes) with bilateral cataracts but otherwise normal eyes were recruited from a single university hospital cataract waiting list. Patients were randomized to receive either the 1CU accommodative IOL in their first eye or the Acrysof MA30 monofocal IOL. The alternative lens was then implanted in the second eye 4 to 6 weeks later. At all follow-up visits, a full assessment was made of distance, near and reading visual performance, and accommodative amplitude. RESULTS Data are available for all patients at 6 months and 20 patients at 1 year. At 6 months, no difference was found in distance-corrected visual acuity between the two IOLs. Of the 1CU eyes, nine patients (30%) could read J6 or better at a reading speed of 80 words/min or better. In these nine patients, the mean difference in the amplitude of accommodation between the two eyes was 0.71 diopters. CONCLUSIONS No measurable variable distinguished eyes that developed functional reading vision from those that did not. The accommodative IOL appears to produce improved near vision in some eyes, but it does not work in all eyes, and in eyes where there is apparent accommodation, there is a discrepancy between subjective reading performance and the modest measured increase of accommodative amplitude.
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