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Hu X, Qi J, Cheng K, He W, Zhang K, Zhao C, Lu Y, Zhu X. Effectiveness of prophylactic capsular tension ring implantation during cataract surgery in highly myopic eyes. J Cataract Refract Surg 2024; 50:1030-1036. [PMID: 39313860 DOI: 10.1097/j.jcrs.0000000000001495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/19/2024] [Indexed: 09/25/2024]
Abstract
PURPOSE To assess the effectiveness of prophylactic capsular tension ring (CTR) implantation during cataract surgery in highly myopic eyes. SETTING Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China. DESIGN Prospective cohort study. METHODS Consecutive highly myopic patients treated with cataract surgery were recruited and randomized to undergo CTR implantation or not. The outcomes compared between the 2 groups included axial lens position (ALP), intraocular lens (IOL) decentration and tilt, area of anterior capsule opening, severity of anterior capsular opacification (ACO), and posterior capsular opacification (PCO) at 1 year postoperatively. RESULTS A total of 55 highly myopic eyes with CTRs implanted and 55 without were included in the analysis. At 1 year postoperatively, no significant differences were detected between the CTR and non-CTR groups for the mean ALP, IOL decentration, or tilt (all P > .05). However, the CTR group had a significantly larger area of anterior capsule opening (23.62 ± 3.30 mm2 vs 21.85 ± 2.30 mm2, P = .003), and less severe ACO (P = .033) and PCO (PCO-3 mm: 0.06 ± 0.13 vs 0.13 ± 0.20, P = .038; PCO-C: 0.15 ± 0.18 vs 0.25 ± 0.26, P = .026) than the non-CTR group. The corrected distance visual acuity, prediction error, and higher-order aberrations did not differ between the 2 groups (all P > .05). CONCLUSIONS In highly myopic eyes, although prophylactic CTR implantation can reduce the severity of capsular contraction and opacification, it does not significantly affect postoperative IOL stability or visual outcomes.
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Affiliation(s)
- Xiaoxin Hu
- From the Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China (Hu, Qi, Cheng, He, Zhang, Zhao, Lu, Zhu); NHC Key laboratory of Myopia and Related Eye Diseases; Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China (Hu, Qi, Cheng, He, Zhang, Zhao, Lu, Zhu); Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China (Hu, Qi, Cheng, He, Zhang, Zhao, Lu, Zhu)
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Brar S, Ganesh S, Karegowda M. Clinical outcomes and rotational stability after implantation of a monofocal toric intraocular lens with textured haptics in normal vs high axial lengths. J Cataract Refract Surg 2024; 50:718-723. [PMID: 38377183 DOI: 10.1097/j.jcrs.0000000000001429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 02/11/2024] [Indexed: 02/22/2024]
Abstract
PURPOSE To compare the clinical outcomes and rotational stability after implantation of a toric intraocular lens (IOL) with textured haptics in eyes with normal vs high axial lengths (ALs). SETTING Nethradhama Superspeciality Eye Hospital, Bangalore, India. DESIGN 2-arm, retrospective comparative study. METHODS This retrospective study included 114 eyes of 114 patients who underwent femtolaser cataract surgery followed by implantation of the HOYA Vivinex Toric monofocal IOL (Model XY1A-SP), of which 62 and 52 eyes belonged to normal (≤23.9 mm) and high (≥24 mm) AL groups, respectively. 1 week and 3 months postoperatively, clinical outcomes and rotational stability of the toric IOL was evaluated. RESULTS 3 months postoperatively, % eyes achieving refractive astigmatism accuracy within ≤0.50 diopter, was 100% (n = 62) in the normal vs 94% (n = 49) in the high AL group. All eyes that is, 100% (n = 62) in the normal and 96.15% (n = 50) eyes in the high myopia group were <5 degrees of the intended axis. The mean change in postoperative rotation from 1 week to 3 months was 0.28 ± 0.09 degrees in the normal, and 0.30 ± 1.11 degrees in the high AL group ( P = .80). No significant correlation was observed between AL and white-to-white diameter with 1-week postoperative rotation values. No eye required repositioning of toric IOL for significant misalignment. CONCLUSIONS No significant differences were observed for clinical outcomes and postoperative rotational stability between eyes with normal and high ALs, suggesting excellent rotational stability of the Vivinex Toric IOL with textured haptics in all eyes, irrespective of the preoperative AL measurements.
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Affiliation(s)
- Sheetal Brar
- From the Department of Phaco and Refractive Services, Nethradhama Super Speciality Eye Hospital, Bangalore, India
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Wang Y, Lou X, Qian S, Li Y, Wu X, Li S, Wang Y, Zhao Y, Chang P. Comparison of the effect of capsular bend on the rotational stability between 2 toric intraocular lenses. J Cataract Refract Surg 2024; 50:283-288. [PMID: 38085243 PMCID: PMC10878446 DOI: 10.1097/j.jcrs.0000000000001373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 02/22/2024]
Abstract
PURPOSE To compare the effect of capsular bend on the rotational stability between 2 toric intraocular lenses (IOLs). SETTING Eye Hospital of Wenzhou Medical University, Hangzhou, Zhejiang Province, China. DESIGN Prospective study. METHODS Patients with preexisting astigmatism received AcrySof IQ (SN6AT) or TECNIS (ZCT/ZMT) toric IOL during cataract surgery. CASIA2 was used to record the toric IOL axial orientation and capsular bend index (CBI) at the 1-day, 1-week, 1-month, and 3-month interval postoperatively. The postoperative rotational stability and CBI of both models were compared. RESULTS A total of 58 eyes from 58 patients were enrolled in this study. The total misalignment of the TECNIS (ZCT/ZMT) group (6.96 ± 5.10 degrees, 7.41 ± 5.19 degrees, 6.93 ± 5.29 degrees, and 6.86 ± 5. 27 degrees) was significantly higher than that of the AcrySof IQ (SN6AT) group (3.55 ± 2.21 degrees, 4.00 ± 2.74 degrees, 3.72 ± 2.72 degrees, and 3.52 ± 2.50 degrees) at all follow-up intervals ( P < .05). The mean rotation of the TECNIS (ZCT/ZMT) group (2.66 ± 2.18 degrees) was significantly greater than that of the AcrySof IQ (SN6AT) group (1.65 ± 1.47 degrees) from 1 day to 1 week postoperatively ( P < .05). The capsular bend formation in the TECNIS (ZCT/ZMT) group was delayed compared with the AcrySof IQ (SN6AT) group ( P < .05, at the 1-week, 1-month, and 3-month interval). The TECNIS (ZCT/ZMT) group showed fibrosis in the peripheral anterior capsule, leading to its stretching away from the IOL surface, while the AcrySof IQ (SN6AT) group exhibited gentle adherence of the anterior capsule to the IOL surface. CONCLUSIONS The AcrySof IQ toric IOL (SN6AT) exhibited greater rotational stability than the TECNIS toric IOL (ZCT/ZMT), which may partially result from the delay in capsular bend formation of TECNIS at the 1-day to 1-week follow-up postoperatively.
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Affiliation(s)
- Yiyi Wang
- From the Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); The First Affiliated Hospital of Ningbo University, Ningbo, China (Qian)
| | - Xicong Lou
- From the Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); The First Affiliated Hospital of Ningbo University, Ningbo, China (Qian)
| | - Shuyi Qian
- From the Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); The First Affiliated Hospital of Ningbo University, Ningbo, China (Qian)
| | - Yuanyuan Li
- From the Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); The First Affiliated Hospital of Ningbo University, Ningbo, China (Qian)
| | - Xueer Wu
- From the Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); The First Affiliated Hospital of Ningbo University, Ningbo, China (Qian)
| | - Siyan Li
- From the Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); The First Affiliated Hospital of Ningbo University, Ningbo, China (Qian)
| | - Yalan Wang
- From the Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); The First Affiliated Hospital of Ningbo University, Ningbo, China (Qian)
| | - Yune Zhao
- From the Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); The First Affiliated Hospital of Ningbo University, Ningbo, China (Qian)
| | - Pingjun Chang
- From the Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China (Yiyi Wang, Lou, Y. Li, Wu, S. Li, Yalan Wang, Zhao, Chang); The First Affiliated Hospital of Ningbo University, Ningbo, China (Qian)
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Werner L, Hawn VS, Bundogji N, Eid K, Kelkar N, Renschler A, Mamalis N. Rotational stability of a new hydrophobic acrylic intraocular lens platform. J Cataract Refract Surg 2024; 50:289-294. [PMID: 37991418 PMCID: PMC10878450 DOI: 10.1097/j.jcrs.0000000000001361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/03/2023] [Accepted: 11/02/2023] [Indexed: 11/23/2023]
Abstract
PURPOSE To evaluate rotational stability for ease of rotation of a new intraocular lens (IOL) platform with 4 haptics in an ex vivo model and compare it with a control single-piece lens with 2 open loops. SETTING Intermountain Ocular Research Center, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah. DESIGN Experimental study. METHODS 10 human cadaver eyes were prepared as per the Miyake-Apple technique. After injection of the test or control lens, clockwise and counterclockwise rotations were attempted with a hook, with and without an ophthalmic viscosurgical device in place. Ease of rotation was scored as (1) very easy, (2) easy, (3) difficult, and (4) very difficult. Rotation of the entire eye containing test or control IOL was also performed with a multipurpose rotator (2 minutes; 220 revolutions per minute) to evaluate its effect on IOL alignment. RESULTS There were statistically significant differences regarding ease of rotation between test and control lenses in all 4 scenarios, with rotation being more difficult with the test lens ( P < .05, Wilcoxon signed-rank test). No change in the alignment of test or control lenses was observed after eye rotation with the multipurpose rotator. CONCLUSIONS The new IOL platform showed greater rotational stability than the control lens in this model, owing to design features such as 4 small arcs of contact between the haptics and the bag equator, a bulge at the distal end of each haptic, and arcuate haptics with curvatures oriented toward each other.
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Affiliation(s)
- Liliana Werner
- From the Intermountain Ocular Research Center, Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
| | - Vivian S. Hawn
- From the Intermountain Ocular Research Center, Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
| | - Nour Bundogji
- From the Intermountain Ocular Research Center, Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
| | - Kevin Eid
- From the Intermountain Ocular Research Center, Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
| | - Neil Kelkar
- From the Intermountain Ocular Research Center, Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
| | - Andy Renschler
- From the Intermountain Ocular Research Center, Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
| | - Nick Mamalis
- From the Intermountain Ocular Research Center, Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
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Chen X, Lin IC, Miao H, Cheng M, Li B, Jiang Y, Lei Y, Wang X, Zhou X. Effects of Decentration of Implantable Collamer Lens V4c on Visual Quality With the OPD-Scan III Aberrometer. Am J Ophthalmol 2024; 259:88-95. [PMID: 37952651 DOI: 10.1016/j.ajo.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 11/04/2023] [Accepted: 11/05/2023] [Indexed: 11/14/2023]
Abstract
PURPOSE This study aimed to analyze the relationship between visual quality and implantable collamer lenses (ICL) decentration. DESIGN Prospective treatment evaluation clinical study METHODS: This prospective study included 119 eyes with ICL implantation. Refractive parameters and ocular aberrations were examined pre- and postoperatively. ICL decentration and higher-order aberrations (HOAs) were evaluated using the OPD-Scan III aberrometer. RESULTS At the 1-month follow-up, the mean values for decentration were 0.38 ± 0.19 mm (0.02-0.78). Regarding the position of decentration in right and left eyes, 22.8% and 17.7% were located in the superior nasal section, 0% and 6.5% in the inferior nasal section, 50.9% and 53.2% in the superior temporal section, and 26.3% and 22.6% in the inferior temporal section, respectively. The root mean square values of whole-eye total HOAs, coma, and trefoil had significantly increased. Decentration had a significant negative correlation with variation in the pre- and postoperative trefoils of the whole eye. CONCLUSIONS ICL decentration had a slightly negative correlation with trefoil and slightly affected visual quality.
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Affiliation(s)
- Xun Chen
- From the Fudan University Eye Ear Nose and Throat Hospital (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; National Health Commission Key Lab of Myopia (Fudan University) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China
| | - I-Chun Lin
- From the Fudan University Eye Ear Nose and Throat Hospital (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; National Health Commission Key Lab of Myopia (Fudan University) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China
| | - Huamao Miao
- From the Fudan University Eye Ear Nose and Throat Hospital (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; National Health Commission Key Lab of Myopia (Fudan University) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China
| | - Mingrui Cheng
- From the Fudan University Eye Ear Nose and Throat Hospital (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; National Health Commission Key Lab of Myopia (Fudan University) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China
| | - Boliang Li
- From the Fudan University Eye Ear Nose and Throat Hospital (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; National Health Commission Key Lab of Myopia (Fudan University) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China
| | - Yinjie Jiang
- From the Fudan University Eye Ear Nose and Throat Hospital (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; National Health Commission Key Lab of Myopia (Fudan University) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China
| | - Yadi Lei
- From the Fudan University Eye Ear Nose and Throat Hospital (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; National Health Commission Key Lab of Myopia (Fudan University) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China
| | - Xiaoying Wang
- From the Fudan University Eye Ear Nose and Throat Hospital (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; National Health Commission Key Lab of Myopia (Fudan University) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China.
| | - Xingtao Zhou
- From the Fudan University Eye Ear Nose and Throat Hospital (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; National Health Commission Key Lab of Myopia (Fudan University) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China
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Ullrich M, Fisus AD, Palkovits S, Hienert J, Hirnschall N, Findl O. Rotational stability and capsular bag performance of a hydrophobic acrylic open-loop single-piece intraocular lens. Eur J Ophthalmol 2024:11206721241234393. [PMID: 38389411 DOI: 10.1177/11206721241234393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
PURPOSE To evaluate the rotational stability and capsular bag performance of a blue light-absorbing hydrophobic acrylic open-loop single-piece intraocular lens (IOL) with a blast-finished anchor wing haptic design during the first 6 postoperative months. METHODS In this prospective clinical study, patients with age-related cataract and potential postoperative corrected distance visual acuity (CDVA) of 0.2 logMAR or better were included. The patients received a non-toric hydrophobic acrylic single-piece IOL with an axis mark (YST0.00; Nidek Co. Ltd, Japan). Surgeries were video-taped. Retroillumination images were acquired 1 h, 1 week and 6 months postoperatively. Rotational stability was assessed by precise image overlay. At 6 months, Purkinje meter measurements were performed to evaluate tilt and decentration. RESULTS In total, 100 eyes of 77 patients were included in the analysis. Mean absolute rotation was 2.1 ± 1.7° (median 1.7, range: 0-7.9) at 6 months (1 h - 6 months postoperatively). IOL rotation was ≤3° and ≤6° in 74 (74%) and 98 (98%) eyes, respectively. Mean absolute IOL rotation from the end of surgery to 6 months was 2.5 ± 2.2° (median 2.3, range: 0-15.6; n = 78). Mean tilt (pupillary axis) and decentration were 4.1 ± 1.9° (median 4.0, range: 0.5-8.2) and 0.35 ± 0.17 mm (median 0.32, range: 0.06-0.91) respectively (n = 84). Postoperatively, 98 (98%) eyes achieved a CDVA of 0.2 logMAR or better, 95 (95%) of ≤0.1 and 81 (81%) of ≤0.0. CONCLUSIONS This hydrophobic acrylic single-piece IOL showed an excellent rotational stability and capsular bag position with low tilt and decentration values.
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Affiliation(s)
- Marlies Ullrich
- VIROS - Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
| | - Andreea D Fisus
- VIROS - Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
| | - Stefan Palkovits
- VIROS - Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
| | - Julius Hienert
- VIROS - Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
| | - Nino Hirnschall
- VIROS - Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
- Department of Ophthalmology and Optometry, Kepler University Hospital GmbH, Johannes Kepler University Linz, Linz, Austria
| | - Oliver Findl
- VIROS - Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
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Shi R, Ma D, Zeng Q, Hua Z, Shen W, Cai L, Yang J. Rotational stability of monofocal and diffractive multifocal toric intraocular lens with identical design and material: a propensity score based prospective comparative study. BMC Ophthalmol 2024; 24:72. [PMID: 38365667 PMCID: PMC10870427 DOI: 10.1186/s12886-024-03281-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 01/03/2024] [Indexed: 02/18/2024] Open
Abstract
PURPOSE To compare the rotational stability of a monofocal and a diffractive multifocal toric intraocular lens(IOLs) with identical design and material. METHODS This prospective study enrolled patients who underwent plate-haptic toric IOL (AT TORBI 709 M and AT LISA 909 M) implantation. Propensity score matching (PSM) was performed to balance baseline factors. Follow-up examinations were conducted at 1 h, 1 day, 3 days, 1 week, 2 weeks, 1 month, and 3 months postoperatively. A linear mixed model of repeated measures was used to investigate the changes in IOL rotation over time. A 2-week timeframe was utilized to assess differences in IOL rotation between the two groups. RESULT After PSM, a total of 126 eyes were selected from each group for further analysis. Postoperatively, the time course of IOL rotation change in the two groups remained consistent, with the greatest rotation occurring between 1 h and 1 day postoperatively. At the 2-week postoperative mark, the monofocal toric IOL exhibited a higher degree of rotation compared to the multifocal toric IOL (5.40 ± 7.77° vs. 3.53 ± 3.54°, P = 0.015). In lens thickness(LT) ≥ 4.5 mm and white-to-white distance(WTW) ≥ 11.6 mm subgroups, the monofocal toric IOL rotated greater than the multifocal toric IOL (P = 0.026 and P = 0.011, respectively). CONCLUSION The diffractive multifocal toric IOL exhibits superior rotational stability compared to the monofocal toric IOL, especially in subgroups LT ≥ 4.5 mm and WTW ≥ 11.6 mm. Moreover, the time course of IOL rotation change is consistent for both, with the maximum rotation occurring between 1 h and 1 day postoperatively.
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Affiliation(s)
- Runhan Shi
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Rd, Shanghai, 200031, China
- Key NHC Laboratory of Myopia, Laboratory of Myopia, Fudan University, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Dongmei Ma
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Rd, Shanghai, 200031, China
- Key NHC Laboratory of Myopia, Laboratory of Myopia, Fudan University, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Qiulin Zeng
- Department of Ophthalmology, Shanghai Xinshijie Dongqu Eye Hospital, Shanghai, China
| | - Zhixiang Hua
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Rd, Shanghai, 200031, China
- Key NHC Laboratory of Myopia, Laboratory of Myopia, Fudan University, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Wenqian Shen
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Rd, Shanghai, 200031, China
- Key NHC Laboratory of Myopia, Laboratory of Myopia, Fudan University, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Lei Cai
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Rd, Shanghai, 200031, China
- Key NHC Laboratory of Myopia, Laboratory of Myopia, Fudan University, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Jin Yang
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Rd, Shanghai, 200031, China.
- Key NHC Laboratory of Myopia, Laboratory of Myopia, Fudan University, Chinese Academy of Medical Sciences, Shanghai, China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China.
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Lin X, Ma D, Yang J. Insights into the rotational stability of toric intraocular lens implantation: diagnostic approaches, influencing factors and intervention strategies. Front Med (Lausanne) 2024; 11:1349496. [PMID: 38414624 PMCID: PMC10896894 DOI: 10.3389/fmed.2024.1349496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 01/30/2024] [Indexed: 02/29/2024] Open
Abstract
Toric intraocular lenses (IOLs) have been developed to enhance visual acuity impaired by cataracts and correct corneal astigmatism. However, residual astigmatism caused by postoperative rotation of the toric IOL is an important factor affecting visual quality after implantation. To decrease the rotation of the toric IOL, significant advancements have been made in understanding the characteristics of toric IOL rotation, the factors influencing its postoperative rotation, as well as the development of various measurement techniques and interventions to address this issue. It has been established that factors such as the patient's preoperative refractive status, biological parameters, surgical techniques, postoperative care, and long-term management significantly impact the rotational stability of the toric IOL. Clinicians should adopt a personalized approach that considers these factors to minimize the risk of toric IOL rotation and ensure optimal outcomes for each patient. This article reviews the influence of various factors on toric IOL rotational stability. It discusses new challenges that may be encountered to reduce and intervene with rotation after toric IOL implantation in the foreseeable future.
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Affiliation(s)
- Xuanqiao Lin
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- Key NHC Laboratory of Myopia, Fudan University, and Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Dongmei Ma
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- Key NHC Laboratory of Myopia, Fudan University, and Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Jin Yang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- Key NHC Laboratory of Myopia, Fudan University, and Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
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Hong Y, Sun Y, Liu H, Ji Y. Effect of Decentration, Rotation, and Tilt on Objective Optical Quality of Plate Haptic Toric Intraocular Lenses in the Early Postoperative Period. Transl Vis Sci Technol 2024; 13:19. [PMID: 38407885 PMCID: PMC10902868 DOI: 10.1167/tvst.13.2.19] [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: 04/12/2023] [Accepted: 01/19/2024] [Indexed: 02/27/2024] Open
Abstract
Purpose This study aimed to determine the influence of decentration, rotation, and tilt on objective optical quality of plate haptic toric intraocular lenses (tIOLs). Methods The area ratio of modulation transfer function (MTF), strehl ratio of point spread function (PSF), and higher order aberrations (HOAs) for 3 mm and 5 mm pupil diameter (PD) were evaluated at postoperative 1 month. The retroillumination images pictured by OPD-scan III were used to quantify the degree of decentration and rotation, whereas the tIOL tilt was directly obtained by the tilt aberration. Patients were separated into two subgroups based on tIOL misalignment cutoff values. Results There were 29 eyes (24 patients) in the study. The decentration of more than 0.25 mm did not substantially differ from those less than or equal to 0.25 mm. PSF of 3 mm PD and MTF, intraocular HOAs, and trefoil aberration for 3 mm and 5 mm PD significantly deteriorated with a rotation of more than 3 degrees, whereas only intraocular HOAs for 5 mm PD and coma for 3 mm and 5 mm PD were significantly severe with a tilt of more than 0.1 µm and 0.25 µm in corresponding PD. Furthermore, tIOL rotation and tilt were highly correlated with intraocular trefoil aberration and coma, respectively. Conclusions The decentration of the monofocal bitoric IOLs is more tolerant to optical quality degradation after 1 month of surgery but more sensitive to intraocular trefoil aberration caused by rotation and coma aberration induced by tilt. Translational Relevance As far as we know, this is the first study to investigate the relationship between the plate haptic bitoric IOL misalignment and objective optical quality measured by OPD-scan III in the real world, which may provide reference information for IOL selection to improve surgical outcomes.
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Affiliation(s)
- Yingying Hong
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yang Sun
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Houyi Liu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Yinghong Ji
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
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Cinar E, Yuce B, Aslan F, Erbakan G. Influence of Nd:YAG laser capsulotomy on toric intraocular lens rotation and change in cylinder power. J Cataract Refract Surg 2024; 50:43-50. [PMID: 37702513 DOI: 10.1097/j.jcrs.0000000000001306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 08/31/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE To investigate toric monofocal intraocular lens (TIOL) rotation and associated changes in cylinder power caused by Nd:YAG laser capsulotomy performed due to posterior capsule opacification (PCO). SETTING Ekol Eye Hospital, Izmir, Turkey. DESIGN Prospective case series. METHODS 41 eyes of 20 women and 21 men were included in the study. Before and 1 month after Nd:YAG laser capsulotomy, TIOL tilt and decentration were determined with Scheimpflug camera, and TIOL axial rotation and the change in cylinder power induced by this rotation were measured by ray tracing aberrometry. The time interval between cataract surgery and Nd:YAG laser capsulotomy was noted. RESULTS Rotational misalignment of the TIOL was measured as 4.65 ± 2.75 degrees (range 0 to 11 degrees) before vs 6.97 ± 2.92 degrees (range 0 to 13 degrees) after capsulotomy, and absolute rotation was 2.75 ± 1.94 degrees (range 0 to 7 degrees, P = .028). Before and after Nd:YAG laser capsulotomy, cylinder power was 0.24 ± 0.70 diopter (D) (range 0.00 to 0.63 D) vs 0.56 ± 0.77 D (range 0.02 to 0.91 D), respectively, with an absolute change in cylinder power of 0.34 ± 0.22 D (range 0.01 to 0.90 D, P = .001). After capsulotomy, there was a significant decrease in IOL tilt in the horizontal and vertical planes and an increase in decentration ( P < .05). Time interval (33.02 ± 12.9 months) and IOL horizontal decentration were independent factors affecting IOL rotation after capsulotomy ( P < .05). CONCLUSIONS Nd:YAG laser capsulotomy may cause TIOL rotation as well as tilt and decentration, resulting in a change in the TIOL's corrective effect on corneal astigmatism. Although this change was clinically insignificant, it may be beneficial to consider that TIOL rotational misalignment may occur in patients undergoing early capsulotomy.
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Affiliation(s)
- Esat Cinar
- From the Ekol Eye Hospital, Izmir, Turkey (Cinar, Erbakan); İzmir Tepecik Training and Research Hospital Ophthalmology Clinic, University of Health Sciences, Izmir, Turkey (Yuce); Department of Ophthalmology, Alaattin Keykubat University, Antalya, Turkey (Aslan)
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D'Oria F, Bagaglia SA, Alio Del Barrio JL, Alessio G, Alio JL, Mazzotta C. Refractive surgical correction and treatment of keratoconus. Surv Ophthalmol 2024; 69:122-139. [PMID: 37774800 DOI: 10.1016/j.survophthal.2023.09.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 10/01/2023]
Abstract
Keratoconus is an ectatic corneal disorder that causes severe vision loss. Surgical options allow us to correct, partially or totally, the induced refractive error. Intracorneal ring segments (ICRS) implantation represents a minimally invasive surgical option that improves visual acuity, with a high success rate and a low overall complication rate. Corneal allogenic ICRS consists of ring segments derived from allogenic eye bank-processed donor corneas. Selective topography-guided transepithelial photorefractive or phototherapeutic keratectomy combined with CXL is another way in selected cases to improve spectacles corrected distance visual acuity. The microphotoablative remodeling of the central corneal profile is generally planned by optimizing the optical zones and minimizing tissue consumption. Phakic intraocular lens (PIOL) implant is considered in patients with stable disease and acceptable anatomical requirements. The two types of pIOLs, depending on their implantation inside the eye, are anterior chamber-pIOLs, which fixate to the anterior surface of the iris by using a polymethomethacrolate claw at the two haptics, and posterior chamber-pIOLs. In patients with both cataracts and keratoconus, the correct IOL power is difficult to obtain due to the irregular corneal shape and K values. Toric IOL is recommended, but carefully judging the topography and the possible need of subsequent keratoplasties.
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Affiliation(s)
- Francesco D'Oria
- Section of Ophthalmology, Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari, Bari, Italy.
| | - Simone A Bagaglia
- Departmental Ophthalmology Unit, Sant' Andrea Hospital, USL Toscana Sud-Est, Massa Marittima, Italy
| | - Jorge L Alio Del Barrio
- Vissum Miranza, Alicante, Spain; Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain
| | - Giovanni Alessio
- Section of Ophthalmology, Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - Jorge L Alio
- Vissum Miranza, Alicante, Spain; Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain.
| | - Cosimo Mazzotta
- Departmental Ophthalmology Unit, AUSL Toscana Sud Est, Campostaggia, Siena, Italy; Department of Medicine, Surgery and Neurosciences, Postgraduate Ophthalmology School, Siena University, Siena, Italy; Siena Crosslinking Center, Siena, Italy
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Hu EH. Repositioning Rates of Toric IOLs Implanted in Cataract Surgery Patients: A Retrospective Chart Review. Clin Ophthalmol 2023; 17:4001-4007. [PMID: 38152615 PMCID: PMC10752012 DOI: 10.2147/opth.s441524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/14/2023] [Indexed: 12/29/2023] Open
Abstract
Purpose To determine the incidence of postoperative repositioning of toric intraocular lenses (IOLs) due to clinically significant rotation. Patients and Methods This study included consecutive cataract patients with pre-existing astigmatism who had undergone cataract surgery with toric IOL implantation by a single experienced surgeon. Case records of patients who were recommended to undergo toric IOL repositioning surgery due to clinically significant postoperative IOL rotation from the implanted axis were identified. The need for a secondary intervention to manage residual astigmatism was based upon postoperative residual astigmatic error ≥0.75 D, the patient's qualitative dissatisfaction with the level of postoperative distance vision, dilated post-op examination, and confirmation of the significant potential for astigmatism reduction. Results Case records of 993 eyes implanted with AcrySof toric (N = 362), Tecnis Toric I (N = 53), Tecnis Toric II (N = 308), or enVista Toric IOLs (N = 270) were included. Postoperative toric IOL repositioning was recommended in 16 eyes (1.6%). The repositioning rate was highest in the eyes implanted with Tecnis Toric I (5.7%), followed by AcrySof Toric (2.2%), enVista Toric IOLs (1.1%), and Tecnis Toric II (0.6%). Conclusion This real-world analysis of eyes implanted with toric IOLs revealed that the rate of surgical IOL repositioning due to clinically significant IOL rotation was lower than 2% for enVista and Tecnis Toric II IOLs. When needed and with appropriate planning, toric IOL repositioning can be very successful.
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Ang RET, Tañá-Rivero P, Pastor-Pascual F, Stodulka P, Tetz M, Fischinger I. Visual and Refractive Outcomes After Bilateral Implantation of a Biconvex Aspheric Toric Monofocal Intraocular with a Double C-Loop Haptic Design. Clin Ophthalmol 2023; 17:2765-2776. [PMID: 37750099 PMCID: PMC10518175 DOI: 10.2147/opth.s432598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 09/13/2023] [Indexed: 09/27/2023] Open
Abstract
Purpose To show the visual and refractive outcomes in cataract patients with corneal astigmatism when bilaterally implanted with a biconvex aspheric toric monofocal intraocular lens (IOL) with a double C-loop haptic-design. Methods Forty-seven cataract patients (94 eyes) with corneal astigmatism (≥0.75D) were implanted with the monofocal PODEYE toric IOL and assessed for 4-6 months post-surgery. Measurements included monocular and binocular uncorrected-distance visual acuity (UDVA) and corrected-distance visual acuity (CDVA), under both photopic and mesopic lighting conditions. Refraction, photopic and mesopic contrast sensitivity (with and without glare), and rotational stability were also recorded at the last postoperative visit. Results At 4-6 months, 78.2% and 98.9% of eyes were within ±0.50D and ±1.00D of the target refraction, respectively. The mean spherical equivalent and refractive cylinder values were 0.09±0.35D and -0.36±0.35D, respectively. 76.5% and 98.8% of eyes presented a postoperative refractive cylinder of ≤0.50D and ≤1.00D, respectively. 91.5% and 100% of patients had a binocular UDVA and CDVA of ≥20/25, respectively. The mean binocular UDVA and CDVA were 0.02±0.08 and -0.02±0.07 logMAR, respectively. Under mesopic conditions, 78.7% and 83.0% of patients presented a binocular UDVA and CDVA ≥20/32, respectively. The mean binocular UDVA and CDVA were 0.15±0.11 and 0.12±0.11 logMAR, respectively. The patients showed good contrast sensitivity under photopic and mesopic conditions. The mean absolute IOL rotation was 1.22±2.21 degrees with 97.87% of eyes having a rotation of <10 degrees. Conclusion This study shows good visual and refractive outcomes for the PODEYE toric IOL when implanted bilaterally in cataract patients with corneal astigmatism.
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Affiliation(s)
- Robert Edward T Ang
- Cataract and Refractive Surgery Department, Asian Eye Institute, Makati City, Philippines
| | - Pedro Tañá-Rivero
- Cataract and Refractive Surgery Department, Oftalvist, Alicante, Spain
| | | | - Pavel Stodulka
- Cataract and Refractive Surgery Department, Gemini Eye Clinic, Zlin, Czech Republic
| | - Manfred Tetz
- Cataract and Refractive Surgery Department, Augentagesklinik Spreebogen, Berlin, Germany
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Nagata M, Hanemoto T, Matsushima H, Senoo T. Relationship between anterior capsule opening and direction of intraocular lens decentration. J Cataract Refract Surg 2023; 49:917-920. [PMID: 37306397 DOI: 10.1097/j.jcrs.0000000000001235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/01/2023] [Indexed: 06/13/2023]
Abstract
PURPOSE To compare intraocular lens (IOL) decentration between patients in whom the continuous curvilinear capsulorhexis (CCC) completely covers the IOL optic and those in whom it incompletely covers the IOL optic and determine how an incompletely covered CCC affects the IOL position. SETTING Tertiary hospital in Japan. DESIGN Single-center retrospective study. METHODS 57 eyes of 57 patients (mean age 70.8 ± 6.2 years) that underwent phacoemulsification and IOL (SN60WF) implantation in the bag between April 2010 and April 2015 were included in this study. The patients were classified based on whether the CCC completely (CC group) or incompletely (NCC group) covered the IOL optic using an anterior eye segment analysis system (EAS-1000). The IOL decentration of the groups was analyzed using EAS-1000 at 1 week, 1 month, 3 months, and 6 months postoperatively and compared. The relationship between the NCC location and the IOL direction at 3 months postoperatively was analyzed. RESULTS The NCC group (25 eyes) had a significantly higher amount of IOL decentration than the CC group (32 eyes) at 1 week, 1 month, 3 months, and 6 months postoperatively ( P < .05). There was a correlation between the direction of IOL decentration and the NCC location, and IOL decentration in the NCC group occurred in the opposite direction to the NCC area. CONCLUSIONS An anterior capsule opening that completely covers the IOL optic is important to control IOL decentration.
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Affiliation(s)
- Mayumi Nagata
- From the Department of Ophthalmology, Dokkyo Medical University, Tochigi, Japan (Nagata, Hanemoto, Matsushima, Senoo); Hanemoto Eye Clinic, Ibaraki, Japan (Hanemoto)
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15
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Bai H, Sun J, Shi X, Li H, Wu X. Visual performance and rotational stability of a multifocal toric intraocular lens in myopic eyes. Graefes Arch Clin Exp Ophthalmol 2023; 261:2557-2565. [PMID: 37004517 DOI: 10.1007/s00417-023-06046-9] [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: 08/20/2022] [Revised: 03/03/2023] [Accepted: 03/24/2023] [Indexed: 04/04/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate the visual performance and rotational stability of the multifocal toric intraocular lens in myopes. METHODS This prospective, observational study included patients with an axial length of ≥24.5 mm and regular corneal astigmatism of >1 diopter who underwent phacoemulsification cataract surgery and implantation of a multifocal toric intraocular lens (AT LISA toric 909M). The visual acuity, defocus curves, residual astigmatism, rotational stability, higher-order aberrations (HOAs), modulation transfer function (MTF), spectacle dependence and patient satisfaction were evaluated 3 months after surgery. RESULTS Forty-three eyes from 30 patients were enrolled in this study. Postoperatively, uncorrected distance and near visual acuities (logMAR) were 0.09 ± 0.08 (standard deviation, SD) and 0.14 ± 0.08, respectively. The defocus curve analysis provided a bimodal curve showing two peaks of maximum vision at 0.0 D and at -3.0 D defocus level. The multifocal toric intraocular lens showed excellent rotational stability; the mean rotation was 4.02 ± 2.49 (SD) degrees at 3 months postoperatively. Refractive predictability was excellent with a mean spherical equivalent of 0.19 ± 0.37 (SD) diopters (D) and a mean refractive cylinder of -0.34 ± 0.39 (SD) D. CONCLUSIONS The diffractive multifocal toric intraocular lens, AT LISA toric 909M, provided effective distance and near visual acuities in myopic eyes. It was a predictable and effective device with good rotational stability for the correction of preexisting astigmatism during cataract surgery. In this study, more than 80% of patients achieved spectacle independence.
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Affiliation(s)
- Huiran Bai
- Department of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, 266071, Shandong Province, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, People's Republic of China
| | - Jiajun Sun
- Department of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, 266071, Shandong Province, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, People's Republic of China
| | - Xiujing Shi
- Department of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, 266071, Shandong Province, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, People's Republic of China
| | - Honglei Li
- Department of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, 266071, Shandong Province, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, People's Republic of China
| | - Xiaoming Wu
- Department of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, 266071, Shandong Province, China.
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, People's Republic of China.
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Oshika T, Nakano S, Inamura M, Ikai N, Kato Y, Izumi I, Shimokawabe K. Extensive misalignment of plate-haptic rotationally asymmetric multifocal toric intraocular lens. Jpn J Ophthalmol 2023; 67:560-564. [PMID: 37289297 DOI: 10.1007/s10384-023-01001-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: 01/24/2023] [Accepted: 04/26/2023] [Indexed: 06/09/2023]
Abstract
PURPOSE Plate-haptic rotationally asymmetric multifocal toric intraocular lenses (IOL) (Lentis Comfort Toric) occasionally rotate extensively after surgery. We conducted the current study to investigate the incidence of extensive misalignment of this IOL and its association with clinical parameters. STUDY DESIGN Retrospective case series. SUBJECTS AND METHODS Data were collected from patients who had undergone phacoemulsification and implantation of a plate-haptic multifocal toric IOL. RESULTS Among 332 eyes, extensive misalignment of toric IOLs ≥ 45º occurred in 3.3% (11 eyes). The amount of misalignment in eyes with extensive misalignment was 81.6 ± 22.9º, while in those without extensive misalignment, it was 3.0 ± 2.7º. The eyes with extensive misalignment showed significantly greater axial length (p < 0.001), larger corneal diameter (p = 0.034), and flatter corneas (p = 0.044) than those without extensive misalignment. Repositioning surgery to correct toric IOL misorientation was conducted in 9 eyes between 7 and 28 days after cataract surgery. In 2 eyes, repositioning surgery was carried out twice. CONCLUSIONS In majority of cases plate-haptic multifocal toric IOLs showed satisfactory rotational stability, but extensive misalignment ≥ 45º occurred in 3.3% of cases.
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Affiliation(s)
- Tetsuro Oshika
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Shinichiro Nakano
- Division of Ophthalmology, Ryugaski Saiseikai Hospital, Ryugasaki, Ibaraki, Japan
| | | | - Nakako Ikai
- Inamura Eye Clinic, Yokoham, Kanagawa, Japan
| | - Yuji Kato
- Sapporo Kato Eye Clinic, Sapporo, Hokkaido, Japan
| | - Iori Izumi
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
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17
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Ucar F, Turgut Ozturk B. Effectiveness of toric IOL and capsular tension ring suturing technique for rotational stability in eyes with long axial length. Int Ophthalmol 2023; 43:2917-2924. [PMID: 36930361 DOI: 10.1007/s10792-023-02694-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 03/11/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVE To evaluate the efficacy of the toric intraocular lens (IOL) and capsular tension ring (CTR) suturing technique in eyes with long axial length (AL) with a high risk of toric IOL rotation. METHODS This is a retrospective observational case series. The data files of patients who underwent a one-piece acrylic toric IOL (Tecnis Toric IOL and Acrysof IQ Toric IOL) implantation with the toric IOL and CTR suturing technique for cataract and astigmatism or toric IOL repositioning were analyzed. Inclusion criteria were a regular total corneal astigmatism of ≥ 1.5 D and an AL of ≥ 26.0 mm. Preoperative and postoperative astigmatism, uncorrected distance visual acuity (UDVA), IOL rotation, intraoperative, and postoperative complications were evaluated. RESULTS A total of 30 eyes of 29 patients were included in this study. The mean AL was 27.82 ± 1.53 mm (range, 26.08-31.07). UDVA revealed a statistically significant improvement from 0.84 ± 0.20 logMAR preoperatively to 0.04 ± 0.06 logMAR postoperatively (p < 0.001). The mean preoperative corneal astigmatism was 3.08 ± 1.01 D reduced to the postoperative residual astigmatism of 0.59 ± 0.32 D which was found also statistically significant (p < 0.001). Only 2 eyes (6.2%) had postoperative toric IOL rotation of 5° and 10°, respectively. The mean degree of postoperative rotation was 0.50 ± 2.01. CONCLUSION This technique provided excellent rotational stability even in eyes with longer AL and did not require additional intervention.
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Affiliation(s)
- Fikret Ucar
- Department of Ophthalmology, Konyagoz Eye Hospital, Sancak Mah. Unluer Sok. No: 13, Selcuklu, 42100, Konya, Turkey.
| | - Banu Turgut Ozturk
- Department of Ophthalmology, Faculty of Medicine, Selcuk University, Konya, Turkey
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18
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Fan W, Zhang G. Stereopsis after bilateral implantation of Toric intraocular lenses in high myopic cataract patients with astigmatism. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2023; 3:147-152. [PMID: 37846364 PMCID: PMC10577849 DOI: 10.1016/j.aopr.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/05/2023] [Accepted: 07/09/2023] [Indexed: 10/18/2023]
Abstract
Purpose To evaluate near, intermediate, distance visual acuity and stereopsis after bilateral implantation of Toric intraocular lenses (IOLs) in high myopic patients with astigmatism. Methods Bilateral Toric or non-Toric IOL implantation (n = 40 eyes each) was performed on high myopic cataract eyes with astigmatism. Best-corrected distance visual acuity (BCDVA), uncorrected intermediate visual acuity (UCIVA), uncorrected near visual acuity (UCNVA), residual refractive astigmatism (RRA), and near, intermediate, and distance stereoacuity were measured postoperatively at 7 days, 1 month, and 3 months. Results The three-month postoperative BCDVA, UCIVA, and UCNVA of the Toric group were 0.08 ± 0.07, 0.30 ± 0.11, and 0.23 ± 0.14 LogMAR. All improved over the preoperative assessments (P < 0.05). The RRA, UCIVA, and UCNVA were significantly better in the Toric group than the non-Toric group at all follow-up examinations (all P < 0.05). At 3 months, the median near and intermediate stereoacuity of the Toric group were 100 (range 40 - 400) and 120 (range 50 - 400) arcsec, which were better than the non-Toric group (both P < 0.05). Fine near stereopsis ≥100 arcsec was present in 65% of the Toric patients, and 50% had good intermediate stereopsis of ≥100 arcsec. However among non-Toric patients, only 15% and 5% achieved fine near and intermediate stereopsis. The postoperative BCDVA and best-corrected distance stereoacuity were similar in the two groups (P > 0.05). Conclusions In bilateral high myopic cataract patients with astigmatism, Toric IOLs not only improved UCIVA, UCNVA, and RRA, but also enhanced near and intermediate stereopsis acuity.
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Affiliation(s)
- Wei Fan
- Eye Institute and Affiliated Xiamen Eye Center of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China
| | - Guangbin Zhang
- Eye Institute and Affiliated Xiamen Eye Center of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China
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19
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Chassain C, Hallak MK, Lesaffre M. Rotational stability and clinical outcomes after implantation of a new monofocal toric intraocular lens with double C-loop design. J Fr Ophtalmol 2023:S0181-5512(22)00420-X. [PMID: 37179129 DOI: 10.1016/j.jfo.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/28/2022] [Accepted: 07/01/2022] [Indexed: 05/15/2023]
Abstract
PURPOSE To investigate rotational stability and visual outcomes of patients unilaterally or bilaterally implanted with a new monofocal toric intraocular lens (IOL). SETTING Ophthalmology service, clinique Beausoleil, avenue de Lodève, Montpellier. DESIGN Single-center retrospective study. METHODS This study included patients who underwent routine cataract surgery with the PODEYE toric (BVI/PhysIOL SA, Liège, Belgium) IOL using the ZEISS CALLISTO eye®. Biometry and keratometry data, refractive outcomes, rotational stability, and astigmatism correction were recorded. IOL rotation was evaluated using an image analysis technique. Postoperative assessments were performed at 1 week, 1 month, and 4 to 6 months after surgery. RESULTS Clinical outcomes of 102 patients (136 eyes) were analyzed. Patients had a mean age of 74 years. Of the included eyes, 25% had an axial length greater than 24.5mm. Median postoperative IOL rotation from baseline (surgery) was 2̊. With the exception of one outlier (15̊ rotation), IOL rotation was ≤ 6̊ (1 month) and ≤ 10̊ (4-6 months) in 100% of the eyes. No surgical IOL re-positioning was required. Median postoperative corrected distance visual acuity was -0.08 logMAR, and median postoperative subjective cylinder was between 0.25 and 0.50 D. CONCLUSION The PODEYE toric IOL showed high rotational stability, allowing for correction of corneal astigmatism during cataract surgery.
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Affiliation(s)
- C Chassain
- Clinique Beau Soleil, 119, avenue de Lodève, 34070 Montpellier, France.
| | - M Kamal Hallak
- Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - M Lesaffre
- Clinique Beau Soleil, 119, avenue de Lodève, 34070 Montpellier, France
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20
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Gu X, Zhang M, Liu Z, Ruan X, Tan X, Zhang E, Chen X, Luo L, Liu Y. Building prediction models of clinically significant intraocular lens tilt and decentration for age-related cataract. J Cataract Refract Surg 2023; 49:385-391. [PMID: 36574752 DOI: 10.1097/j.jcrs.0000000000001115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 12/02/2022] [Indexed: 12/29/2022]
Abstract
PURPOSE To explore the risk factors and construct nomogram models to predict the risks of clinically significant intraocular lens (IOL) tilt and decentration after cataract surgery in patients with age-related cataract. SETTING Zhongshan Ophthalmic Center, Guangzhou, China. DESIGN Prospective cohort study. METHODS 207 patients (207 eyes) who underwent phacoemulsification combined with IOL implantation were enrolled in the study. Casia2 was used to measure the tilt and decentration of crystalline lenses and IOLs before and 3 months after surgery. Univariate and multivariate logistic regression analyses were used to determine the risk factors of clinically significant IOL tilt and decentration, and nomogram prediction models were constructed according to the results of the multivariate logistic regression analysis. RESULTS Two hundred and seven patients were included in analysis. 24 eyes (11.59%) and 16 eyes (7.73%) had clinically significant IOL tilt and decentration at 3 months after cataract surgery. Multivariate logistic regression analysis revealed that preoperative crystalline lens tilt and decentration were the risk factors for clinically significant IOL tilt (odds ratio [OR], 3.519, P < .001) and decentration (OR, 410.22, P = .001), respectively. Axial length was another association factor for clinically significant IOL decentration (OR, 2.155, P = .019). The risk models demonstrated good calibrations and discriminations for the predictions of clinically significant IOL tilt (receiver operating characteristic [ROC] area = 0.833, cutoff value = 6.5) and decentration (ROC area = 0.757, cutoff value = 0.08). CONCLUSIONS The good performances of our models suggested that they may be useful risk prediction tools for postoperative IOL tilt and decentration. The measurement of preoperative crystalline lens tilt and decentration should be one of the routine examinations before cataract surgery, especially for toric and multifocal IOLs.
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Affiliation(s)
- Xiaoxun Gu
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China (Gu, M. Zhang, Z. Liu, Ruan, Tan, E. Zhang, Chen, Luo, Y. Liu); Xi'an People's Hospital (Xi'an Fourth Hospital), Shaanxi Eye Hospital, Xi'an, China (Gu)
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21
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Rotational stability of plate-haptic toric intraocular lenses in Asian eyes: risk period for intraocular lens rotation and its influencing factors. J Cataract Refract Surg 2023; 49:253-258. [PMID: 36867471 DOI: 10.1097/j.jcrs.0000000000001107] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/20/2022] [Indexed: 03/04/2023]
Abstract
PURPOSE To investigate the rotational stability of plate-haptic toric intraocular lenses (IOLs) during 3-month follow-up. SETTING Eye and ENT Hospital of Fudan University, Shanghai, China. DESIGN Prospective observational study. METHODS Patients with cataracts implanted with AT TORBI 709M toric IOLs were enrolled and followed at 1 hour, 1 day, 3 days, 1 week, 2 weeks, 1 month, and 3 months postoperatively. A linear mixed model of repeated measures was applied to investigate the time course of absolute IOL rotation change. The 2-week overall IOL rotation was analyzed in the age, sex, axial length (AL), lens thickness (LT), preexisting astigmatism, and white-to-white subgroups. RESULTS A total of 328 eyes of 258 patients were included. The rotation from the end of surgery to 1 hour and 1 day to 3 days was significantly smaller compared with the rotation from 1 hour to 1 day but more than that at other time intervals in the overall group. 2 weeks postoperatively, the mean uncorrected distance visual acuity and remaining positive cylinder were 0.19 ± 0.22 logMAR and 0.60 ± 0.44 diopters, respectively. Significant between-group differences in 2-week overall rotation were found in the age, AL, and LT subgroups. CONCLUSIONS Maximum rotation occurred within 1 hour to 1 day postoperatively, and the first 3 days postoperatively was a high-risk period for the plate-haptic toric IOL rotation. Surgeons should make the patients aware of this.
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22
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Ma D, Yu W, Cai L, Shen J, Guo T, Chen X, Dong J, Zeng Q, Wang A, Hua Z, Zhu X, Zheng T, Lu Y, Yang J. Optimal Timing of Repositioning Surgery for a Plate-Haptic Toric Intraocular Lens: A Multicenter Retrospective Study. J Refract Surg 2023; 39:120-126. [PMID: 36779462 DOI: 10.3928/1081597x-20221221-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
PURPOSE To evaluate risk factors for significant rotation and determine optimal timing for repositioning surgery following a plate-haptic toric intraocular lens (IOL) implantation. METHODS This retrospective study enrolled patients who underwent the plate-haptic toric IOL implantation at seven hospitals in Shanghai. IOL rotation and residual astigmatism were compared before and after repositioning surgery. Risk factors for significant IOL rotation after cataract surgery were identified by stepwise multiple linear regression analysis. Spearman's and linear regression analyses were performed to identify factors associated with IOL rotation after repositioning. The receiver operator characteristic (ROC) curve was used to analyze the optimal timing for repositioning surgery. RESULTS Among 2,745 eyes implanted with the toric IOL, 46 eyes (1.68%) of 45 patients underwent repositioning surgery. Axial length and lens thickness were significantly associated with IOL rotation before repositioning. After repositioning surgery, IOL rotation and residual astigmatism were significantly reduced (all P < .001). IOL rotation after repositioning was negatively associated with the timing of repositioning surgery (all P < .001). The ROC curve showed that the optimal cut-off for the timing of repositioning surgery was 15 days or greater. CONCLUSIONS The prevalence of repositioning surgery after the plate-haptic toric IOL implantation was 1.68%, and the optimal timing for repositioning surgery was recommended to be 2 to 3 weeks after cataract surgery. [J Refract Surg. 2023;39(2):120-126.].
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Chang P, Chen D, Hu B, Wang Y, Qian S, Ding X, Zhao Y. Effect of capsular bend on the rotational stability of toric intraocular lens. Eye (Lond) 2023; 37:480-485. [PMID: 35165380 PMCID: PMC9905548 DOI: 10.1038/s41433-022-01964-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 01/12/2022] [Accepted: 02/02/2022] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To assess the effect of capsular bend and axial length on the rotational stability of toric IOL. METHODS The prospective study included patients with preexisting astigmatism that were implanted with Acrysof IQ Toric IOL. According to the pre‑operative axial length, all patients were divided into 2 groups: high myopia (AL ≥ 26 mm) group, and emmetropia or low to moderate myopia group (AL <26 mm). High-speed Swept-source Optical Coherence Tomography (SS-OCT) radial scanning was performed after pupil dilation to obtain the toric IOL axial orientation and capsular bending index (CBI) at 1-day, 1-week, 1-month and 3-month intervals postoperatively. The correlation between the rotation of toric intraocular lens and the axial length or CBI was subsequently analyzed. RESULTS 68 eyes of 57 patients were included in the research. The rotation of toric IOL within the high myopia group was greater than the control group (P = 0.001, 1month postoperative). Capsular contact with the IOL was delayed in highly myopic eyes, although the results were not statistically significant (P = 0.094, 1-month postoperatively). There was a positive correlation between the degree of rotation and axial length at the interval found between 1-week and 1-month after the operation (r = 0.333, P = 0.005). There was a significant negative correlation between the IOL rotational speed and CBI (P < 0.001). The regression equation was Y = -0.441*X + 1.712 (R2 = 0.323, P < 0.001). CONCLUSION There was a significant negative correlation between the IOL rotation speed and the CBI, while the influence of the axial length and capsular bending mainly occurred between one week and one month after the operation.
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Affiliation(s)
- Pingjun Chang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Dongjie Chen
- Hwa Mei Hospital, University of Chinese Academy of Science (Ningbo No.2 Hospital), Ningbo, Zhejiang, China
| | - Bin Hu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Yalan Wang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Shuyi Qian
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Xixia Ding
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Yune Zhao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China.
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24
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Yao Y, Wei L, Chen Z, Li H, Qi J, Wu Q, Zhou X, Lu Y, Zhu X. Single-cell RNA sequencing: Inhibited Notch2 signalling underlying the increased lens fibre cells differentiation in high myopia. Cell Prolif 2023:e13412. [PMID: 36717696 PMCID: PMC10392066 DOI: 10.1111/cpr.13412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/26/2022] [Accepted: 01/18/2023] [Indexed: 02/01/2023] Open
Abstract
High myopia is the leading cause of blindness worldwide. It promotes the overgrowth of lens, which is an important component of ocular refractive system, and increases the risks of lens surgery. While postnatal growth of lens is based on the addition of lens fibre cells (LFCs) supplemented by proliferation and differentiation of lens epithelial cells (LECs), it remains unknown how these cellular processes change in highly myopic eyes and what signalling pathways may be involved. Single-cell RNA sequencing was performed and a total of 50,375 single cells isolated from the lens epithelium of mouse highly myopic and control eyes were analysed to uncover their underlying transcriptome atlas. The proportion of LFCs was significantly higher in highly myopic eyes. Meanwhile, Notch2 signalling was inhibited during lineage differentiation trajectory towards LFCs, while Notch2 predominant LEC cluster was significantly reduced in highly myopic eyes. In consistence, Notch2 was the top down-regulated gene identified in highly myopic lens epithelium. Further validation experiments confirmed NOTCH2 downregulation in the lens epithelium of human and mouse highly myopic eyes. In addition, NOTCH2 knockdown in primary human and mouse LECs resulted in enhanced differentiation towards LFCs accompanied by up-regulation of MAF and CDKN1C. These findings indicated an essential role of NOTCH2 inhibition in lens overgrowth of highly myopic eyes, suggesting a therapeutic target for future interventions.
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Affiliation(s)
- Yunqian Yao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,National Health Center Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Ling Wei
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,National Health Center Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Zhenhua Chen
- State Key Laboratory of Molecular Development Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Hao Li
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,National Health Center Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Jiao Qi
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,National Health Center Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Qingfeng Wu
- State Key Laboratory of Molecular Development Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China.,Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Beijing, China.,Chinese Institute for Brain Research, Beijing, China.,Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,National Health Center Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yi Lu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,National Health Center Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China.,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Xiangjia Zhu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,National Health Center Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China.,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
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25
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Singh C, Joshi VP. Cataract surgery in Keratoconus revisited - An update on preoperative and intraoperative considerations and postoperative outcomes. Semin Ophthalmol 2023; 38:57-64. [PMID: 35996343 DOI: 10.1080/08820538.2022.2112702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
PURPOSE This review aims to evaluate and simplify the recent literature on preoperative surgical planning, intraoperative considerations, postoperative surprises, and their management in patients with keratoconus undergoing cataract surgery. METHODS A review of the literature was done to analyze all the pertinent articles on Keratoconus and cataract surgery. RESULTS The surgical planning of cataracts in eyes with keratoconus needs a multifaceted approach. Preoperatively, techniques such as cross-linking or the use of intra-corneal rings help stabilize the progression. Unreliable biometric measurements are a significant problem in keratoconus patients, especially in an advanced stage of the disease. It is better to consider actual K readings if the K value is less than 55D but for a K value, more than 55D using standard K values will prevent postoperative refractive surprises. For calculation of K values, an elevation-based device like pentacam gives better repeatability in mild to moderate cases whereas for advanced keratoconus none of the keratometers is reliable. Recently, the Kane keratoconus formula performed better in all stages of disease whereas previous studies showed good results with SRK/T formula is a mild and moderate disease. Monofocal intraocular lenses are a better choice in these patients. Toric lenses can be used in mild and stable keratoconus. Intraoperatively, the use of a customized RGP lens can overcome the challenge of image distortion and loss of visual perspective. Despite taking necessary measures, postoperative refractive surprise can occur and can be managed with IOL exchange or Secondary IOLs. CONCLUSION There is a spectrum of challenges in managing cataracts in keratoconus which makes thorough preoperative planning important for good surgical outcomes. Despite the measures, there might be post-operative surprises and the patients need to be informed regarding the same.
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Affiliation(s)
- Charul Singh
- Academy of Eye Care Education, L V Prasad Eye Institute, Hyderabad, India.,The Cornea Institute, L V Prasad Eye Institute, Hyderabad, India
| | - Vineet P Joshi
- The Cornea Institute, L V Prasad Eye Institute, Hyderabad, India.,Centre for Innovation, L V Prasad Eye Institute, Hyderabad, India
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26
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Cataract surgery considerations in patients with prior history of keratoconus and ectasia. Curr Opin Ophthalmol 2023; 34:41-47. [PMID: 36165405 DOI: 10.1097/icu.0000000000000908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW Preoperative workup for cataract surgery in patients with keratoconus poses certain challenges, particularly in patients with moderate-to-severe disease. This review aims to outline the appropriate preoperative, intraoperative, and postoperative considerations and provides an algorithm to help guide the workup prior to surgery. RECENT FINDINGS A new system for keratoconus progression and staging has been proposed and additional studies comparing intraocular lens (IOL) formulas calculations and biometry devices have been conducted. SUMMARY Patients with severe keratoconus have unpredictable results and have an increased risk of a hyperopic refraction postoperatively. Although studies have compared IOL calculation formulas, there is no consensus on management. Clinical considerations and an approach to the workup are presented; however, additional studies are required to determine the most appropriate management of cataracts in severe keratoconus.
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Gonzalez-Salinas R, Franco JJ, Reyes-Luis JL, Sánchez-Huerta V, de Wit-Carter G, Hernández-Quintela E, Pineda R. Cataract surgery in patients with underlying keratoconus: focused review. J Cataract Refract Surg 2023; 49:97-102. [PMID: 36194107 DOI: 10.1097/j.jcrs.0000000000001069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 09/24/2022] [Indexed: 11/07/2022]
Abstract
An underlying diagnosis of keratoconus (KC) can complicate cataract surgery. In this study, the results of a focused review of the literature pertaining to cataract surgery in patients with KC are detailed. Topics essential for the appropriate management of this patient population are discussed. First, the individual and shared epidemiology and pathophysiology of cataract and KC are reviewed. Then, the theory and approach to intraocular lens power calculation are discussed, highlighting particularities and pitfalls of this exercise when performed in patients with KC. Finally, several special-although not uncommon-management scenarios and questions are addressed, such as surgical planning in cases where corneal stabilization or tissue replacement interventions are also necessitated.
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Affiliation(s)
- Roberto Gonzalez-Salinas
- From the Anterior Segment Surgery Department, Asociación para Evitar la Ceguera I.A.P., Mexico City, Mexico (Gonzalez-Salinas); Harvard Medical School, Boston, Massachusetts (Franco, Pineda); Cornea and Refractive Surgery Service, Massachusetts Eye and Ear, Boston, Massachusetts (Reyes-Luis, Pineda); Cornea Department, Asociación para Evitar la Ceguera I.A.P., Mexico City, Mexico (Sánchez-Huerta, de Wit-Carter); Division of Comprehensive Ophthalmology, Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, Maryland (Hernández-Quintela)
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28
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Kim HW, Lee SH, Lee CE, Lee KW, Seo S. A Case Exhibiting Late, Postoperative, Toric Intraocular Lens Rotation. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2022. [DOI: 10.3341/jkos.2022.63.12.1028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Purpose: We present a case of spontaneous toric intraocular lens (IOL) rotation in the late postoperative period (after 10 months).Case summary: A 44-year-old male underwent phacoemulsification and placement of an IOL (AcrySof IQ Toric, Alcon Laboratories Inc., Fort Worth, FL, USA) in the right eye. The preoperative best corrected visual acuities (BCVAs) were 0.2 in the right eye and 0.3 in the left eye, and the corneal astigmatisms -2.25 × 175° and -2.25 × 178°. Ten months later, the astigmatic IOL axis was 85° (the initial [correct] value). The BCVA after surgery was 1.0. At 11 months postoperatively, the patient presented with a sudden decrease in visual acuity in the right eye. The IOL had rotated 50° clockwise; we decided to reposition it. A capsular tension ring had been placed during surgery. The IOL was re-aligned but rotated again 1 week later. We replaced the IOL with a monofocal non-toric IOL (enVista MX60, Bausch & Lomb, Rochester, NY, USA).Conclusions: Severe toric IOL rotation is a late postoperative complication.
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Sun T, Liu Y, Gao Y, Tang C, Lan Q, Yang T, Zhao X, Qi H. Comparison of visual outcomes of a diffractive trifocal intraocular lens and a refractive bifocal intraocular lens in eyes with axial myopia: a prospective cohort study. BMC Ophthalmol 2022; 22:407. [PMID: 36266642 PMCID: PMC9585875 DOI: 10.1186/s12886-022-02626-1] [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: 05/13/2022] [Accepted: 09/30/2022] [Indexed: 11/18/2022] Open
Abstract
Background To assess and compare the efficacy, safety, accuracy, predictability and visual quality of a diffractive trifocal intraocular lens (IOL) and a refractive rotationally asymmetric bifocal IOL in eyes with axial myopia. Methods This prospective cohort study enrolled patients with implantation of the diffractive trifocal IOL or the refractive bifocal IOL. Eyes were divided into four groups according to the IOL implanted and axial length. Manifest refraction, uncorrected and corrected visual acuity at far, intermediate and near distances, prediction error of spherical equivalent (SE), contrast sensitivity and aberrations were evaluated three months after surgery. Results In total, 80 eyes of 80 patients were included: 20 eyes in each group. Three months postoperatively, the corrected distance visual acuity of two trifocal groups were significantly better than the axial myopia bifocal group (P = 0.007 and 0.043). There was no significant difference of postoperative SE (P = 0.478), but the SE predictability of the trifocal IOL was better, whether in axial myopia groups (P = 0.015) or in control groups (P = 0.027). The contrast sensitivity was similar among four groups. The total aberration, higher order aberration and trefoil aberration of bifocal groups were significantly higher (all P < 0.001). Conclusions The diffractive trifocal IOL and the refractive bifocal IOL both provided good efficacy, accuracy, predictability and safety for eyes with axial myopia. By contrast, the trifocal IOL had a better performance in corrected distance visual acuity and visual quality. Trial registration The study was retrospectively registered and posted on clinicaltrials.gov at 12/02/2020 (NCT04265846).
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Affiliation(s)
- Tong Sun
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Yiyun Liu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Yufei Gao
- Department of Ophthalmology, Affiliated Hospital of Yunnan University, Kunming, China
| | - Chuhao Tang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Qianqian Lan
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China.,Department of Ophthalmology, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Tingting Yang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Xiaorui Zhao
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Hong Qi
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China. .,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China. .,, Present Address: Beijing, P R China.
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Zhang L, Schickhardt S, Auffarth GU. An Experimental Laboratory Study Using the Miyake-Apple Posterior View Technique to Investigate the Dynamics Between Capsular Bags and Different IOL Models. J Refract Surg 2022; 38:654-660. [PMID: 36214352 DOI: 10.3928/1081597x-20220825-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE To evaluate the dynamics between capsular bags and different intraocular lens (IOL) models in human cadaver eyes using the Miyake-Apple posterior view technique. METHODS In an in vitro laboratory study, human cadaver eyes were prepared according to the Miyake-Apple posterior view technique. Five IOLs from each of the six groups (Avansee 1P [Simonvision], Avansee 3P [Simonvision], CT Lucia [Carl Zeiss Meditec], Acrysof [Alcon Laboratories, Inc], RayOne [Rayner], and CT Asphina [Carl Zeiss Meditec]) were implanted into capsular bags with different diameters. The empty capsular bag diameter and capsular bag diameter with an IOL in it were evaluated based on the Miyake-Apple view pictures. Posterior capsule striae were observed and compared between groups. The arc of contact between IOLs and the capsular equator was noted. Correlations between the empty capsular bag diameter and the capsular bag diameter with IOL, as well as between the empty capsular bag diameter and the arc of contact, were examined. With the Avansee 3P as a reference, the area deviation of the haptics of IOL models with looped haptics was compared. RESULTS The capsular bag diameter with IOL inside and the arc of contact were proportional to the empty capsular bag diameter. The RayOne, Avansee 3P, and CT Lucia showed a longer arc of contact. Posterior capsule striae were observed in the Avansee 1P (1, 20%), Avansee 3P (5, 100%), Acrysof (1, 20%), and RayOne (2, 40%). Areas of deviation were 0.38 mm2 (Avansee 1P), 0.24 mm2 (CT Lucia), 0.34 mm2 (Acrysof), and 0.31 mm2 (RayOne), respectively. CONCLUSIONS Different IOL models showed varied characteristics in terms of capsular bag fitting and arc of contact. Understanding these dynamics is critical to optimizing postoperative outcomes. [J Refract Surg. 2022;38(10):654-660.].
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Sheen-Ophir S, Reitblat O, Levy A, Assia EI, Kleinmann G. Deviation from the planned axis of three toric intraocular lenses. Sci Rep 2022; 12:13760. [PMID: 35962050 PMCID: PMC9374735 DOI: 10.1038/s41598-022-17811-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 08/01/2022] [Indexed: 12/02/2022] Open
Abstract
In this study, we retrospectively evaluated the deviation from the planned axis of 3 Toric intraocular lenses (TIOL). Included in the study 190 eyes, operated by two surgeons using two different manual marking techniques. The patients were implanted with either AcrySof IQ Toric SN6AT (Alcon) (n = 90), POD FT (PhysIOL) (n = 50), or TECNIS Symfony Toric (J&J) (n = 50). At least 1 month postoperatively, the IOL was photographed, and the axis was measured using a designed software. The difference between the planned and actual axis was defined as axis deviation. The effect of IOL type, astigmatism direction, and marking techniques on the average degree and direction of the IOL deviation were evaluated and compared. There was no significant difference in the average deviation between the IOLs (TECNIS Symfony: 4.03° ± 4.34, POD FT: 3.52° ± 3.38, and SN6AT: 4.24° ± 4.10), and its direction (55.8%, 39.0%, and 56.6% clockwise (CW) deviation, respectively). With the rule, astigmatism had significantly more CW deviation compared with against the rule and oblique astigmatism (64.3%, 43.8%, and 41.7%, respectively, P = 0.027), but the average deviation was similar. The marking techniques did not influence the degree or direction of the deviation.
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Affiliation(s)
- Shira Sheen-Ophir
- Ein-Tal Eye Center, 15 Habrzel St, 6971021, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Ophthalmology, Hawke's Bay Fallen Soldiers' Memorial Hospital, Hastings, New Zealand
| | - Olga Reitblat
- Ein-Tal Eye Center, 15 Habrzel St, 6971021, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
| | - Adi Levy
- Ein-Tal Eye Center, 15 Habrzel St, 6971021, Tel Aviv, Israel
| | - Ehud I Assia
- Ein-Tal Eye Center, 15 Habrzel St, 6971021, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Ophthalmology, Meir Medical Center, Kfar Sava, Israel
| | - Guy Kleinmann
- Ein-Tal Eye Center, 15 Habrzel St, 6971021, Tel Aviv, Israel. .,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. .,Department of Ophthalmology, E. Wolfson Medical Center, Holon, Israel.
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Goggin M. Toric intraocular lenses: Evidence‐based use. Clin Exp Ophthalmol 2022; 50:481-489. [PMID: 35584257 PMCID: PMC9543206 DOI: 10.1111/ceo.14106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/10/2022] [Accepted: 05/14/2022] [Indexed: 11/30/2022]
Abstract
Uncorrected refractive astigmatism degrades visual acuity. Spherical intraocular lenses (IOLs) leave astigmatic errors resident in the cornea manifest in refractive astigmatism. Toric IOLs, correcting for this corneal astigmatism, contribute to spectacle‐free vision in the pseudophakic eye. This review provides information to assist surgeons in a rational choice of eyes suitable for toric IOL implantation, methods of IOL cylinder power calculation, surgical techniques for toric IOLs and management of complications. With appropriate application of this information, correction of visually detrimental astigmatism can be achieved routinely.
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Affiliation(s)
- Michael Goggin
- The Queen Elizabeth Hospital University of Adelaide Woodville South South Australia Australia
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Oshika T, Nakano S, Fujita Y, Nomura Y, Inoue Y, Takehara H, Miyata K, Honbou M, Sugita T, Kaneko T. Long-term outcomes of cataract surgery with toric intraocular lens implantation by the type of preoperative astigmatism. Sci Rep 2022; 12:8457. [PMID: 35589932 PMCID: PMC9120159 DOI: 10.1038/s41598-022-12426-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 05/10/2022] [Indexed: 12/02/2022] Open
Abstract
Surgical outcomes of toric intraocular lens (IOL) implantation for 8 years after surgery were analyzed. Data were retrospectively collected in 176 eyes of 176 patients before and 1 month, 1, 3, 5, and 8 years after phacoemulsification and implantation of a toric IOL. Preoperative corneal and postoperative manifest astigmatism was analyzed by converting to power vector notations; horizontal/vertical (J0) and oblique (J45) astigmatism components. Toric IOL implantation significantly reduced pre-existing astigmatism by decreasing J0 in eyes with preoperative with-the-rule (WTR) astigmatism, increasing J0 in eyes with against-the-rule (ATR) astigmatism, and correcting J45 in eyes with oblique astigmatism. After surgery, the eyes with preoperative ATR astigmatism showed a significant ATR astigmatic shift, and J0 at 5 and 8 years was significantly smaller than that at 1 month postoperatively. Uncorrected distance visual acuity was also significantly worse at 5 and 8 years than at 1 month postoperatively. In eyes with WTR and oblique astigmatism, the effects of toric IOLs on astigmatism and visual acuity were sustained for 8 years. The long-term astigmatism-correcting effects did not differ among the models of toric IOL used in this study, SN6AT3–8 (Alcon Laboratories). In eyes with preoperative ATR astigmatism, astigmatism-correcting effects of toric IOLs decreased at 5 years and later postoperatively, indicating that overcorrection may be considered at the time of cataract surgery. In eyes with WTR and oblique astigmatism, the effects of toric IOLs were maintained throughout the 8-year follow-up period.
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Affiliation(s)
- Tetsuro Oshika
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Shinichiro Nakano
- Division of Ophthalmology, Ryugasaki Saiseikai Hospital, Ryugasaki, Ibaraki, Japan
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Evaluation of Intraocular Lens Tilt and Decentration in Congenital Ectopia Lentis by the Pentacam Scheimpflug System. J Ophthalmol 2022; 2022:7246730. [PMID: 35309109 PMCID: PMC8933096 DOI: 10.1155/2022/7246730] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/18/2022] [Accepted: 02/12/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose The purpose of this study was to quantify the characteristics of the tilt and decentration of the IOL after trans-scleral suture fixation surgery in congenital ectopia lentis (CEL) patients. Methods The clinical characteristics of 70 CEL patients at Zhongshan Ophthalmic Center in China were retrospectively analyzed. The tilt and decentration of intraocular lens (IOL) were measured by using a Pentacam and compared between different axial length (AL) subgroups. The correlation between IOL tilt, decentration, and ocular characteristics was investigated using Spearman's correlation analysis. Results The postoperative IOL position of CEL patients was mainly located nasally inferiorly. The average tilt of the IOL in CEL patients was less than 7° (for temporal: 2.21 ± 1.53°, for nasal: −1.84 ± 2.04°, for superior: 2.22 ± 2.18°, and for inferior: −1.70 ± 1.62°), and the average decentration of the IOL in CEL patients was larger than 0.4 mm (for temporal: 0.49 ± 0.38 mm, for nasal: −0.69 ± 0.46 mm, for superior: 0.72 ± 0.58 mm, and for inferior: −0.68 ± 0.54 mm). The decentration of CEL patients in the AL ≥ 26 subgroup was greater than those with AL < 24 mm and AL 24 to 26 mm subgroups (for superior: 0.72 ± 0.28 mm vs. 0.46 ± 0.25 mm and 0.48 ± 0.22 mm, all P < 0.05; for inferior: -0.94 ± 0.56 mm vs. −0.44 ± 0.26 mm and -0.44 ± 0.46 mm, all P < 0.05). IOL decentration was positively correlated with AL (for superior: r = 0.44, P=0.019; for inferior: r = 0.54, P=0.006). IOL tilt was positively correlated with AL on the superior side (r = 0.38, P=0.041). Conclusions The extent of IOL decentration after trans-scleral suture fixation was great in CEL patients, and the IOL decentration in CEL patients was significantly associated with AL.
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Leng L, Bai H, Li H, Liu D, Han Y, Wu X. Comparison of Anterior Capsule Polishing on the Rate of Neodymium: YAG Laser Capsulotomy After Two Multifocal Intraocular Lens Implantation. Front Med (Lausanne) 2022; 9:815966. [PMID: 35372397 PMCID: PMC8965588 DOI: 10.3389/fmed.2022.815966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/10/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeTo compare the impact of anterior capsule polishing (ACP) during cataract surgery on the rate of neodymium: YAG (Nd: YAG) laser capsulotomy in pseudophakic eyes with two multifocal intraocular lenses (MIOLs).MethodsData were collected on patients who underwent cataract surgery and implanted segmental refractive MIOLs (SBL-3, Lenstec) or diffracted MIOLs (AT LISA tri 839MP, Carl Zeiss Meditec). The participants were divided into ACP and non-ACP groups based on whether the anterior capsule was polished. The primary outcome measure was whether Nd: YAG capsulotomy was performed during the 3 years follow-up. We used Kaplan–Meier survival curves to determine the time from IOL implantation to Nd: YAG laser capsulotomy.ResultsACP and non-ACP groups comprised 70 and 60 eyes, respectively. One year postoperatively, 7.14% of ACP group eyes and 8.33% of non-ACP group required Nd: YAG laser capsulotomy (P > 0.99). After 2 years, it was 24.29 and 18.33%, respectively (P = 0.52), while after 3 years, it reached 30.0 and 28.33% (P = 0.85). No distinct difference existed in the probability of using Nd: YAG laser in both groups evaluated using Kaplan-Meier survival curves (P = 0.81). Patients with diffractive MIOLs (AT LISA tri 839MP) implantation were more likely to require Nd: YAG laser capsulotomy (P < 0.01).ConclusionPolishing the anterior capsule had no remarkable effect on reducing the rate of Nd: YAG laser capsulotomy following phacoemulsification in MIOLs. Patients with diffractive MIOLs implantation had a high probability of requiring Nd: YAG laser capsulotomy.
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Affiliation(s)
- Lin Leng
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Huiran Bai
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Honglei Li
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Dongle Liu
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Yanfeng Han
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Xiaoming Wu
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
- *Correspondence: Xiaoming Wu,
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Walters TR, Lehmann R, Moyes A, French JW, Sreenivasan V, Modi SS. Rotational Stability of the Clareon Monofocal Aspheric Hydrophobic Acrylic Intraocular Lens 6 Months After Implantation. Clin Ophthalmol 2022; 16:401-409. [PMID: 35210745 PMCID: PMC8858001 DOI: 10.2147/opth.s348551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/12/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Thomas R Walters
- Texan Eye, Austin, TX, USA
- Correspondence: Thomas R Walters, Texan Eye, 1700 S MoPac Expy, Austin, TX, 78746, USA, Tel +1 512-327-7000, Email
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Impact of Material and Lens Design on Repositioning Surgery of Toric Intraocular Lenses: A Single-Arm Meta-Analysis. J Ophthalmol 2022; 2022:6699596. [PMID: 35223091 PMCID: PMC8881179 DOI: 10.1155/2022/6699596] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/22/2021] [Indexed: 11/29/2022] Open
Abstract
Aim To analyze the pooled incidence rate in repositioning surgery by considering different materials and designs. Methods All published studies investigating the repositioning surgery of toric intraocular lenses (IOLs) before September 1, 2020, were searched and evaluated. The R3.5.2 software was used to extract the data, and a single arm meta-analysis was performed. Results 19 cases from 18 published studies articles were included in the meta-analysis. The pooled incidence rate in repositioning surgery was 2% (I2 = 53%, Pheterogeneity<0.01). Plate and silicone IOLs had significantly higher incidence rates (6% for each) than loop (2%) and hydrophobic acrylate (2%). Incidence rates of Acrysof, Staar, TECNIS, PhysIOL SA, T-flex 623T, and Microsil 6116TU groups were 1% (95% CI [1%–2%]), 6% (95% CI [4%–9%]), 3% (95% CI [2%–4%]), 1.40% (1/71), 3.03% (1/33), and 4.76% (1/21), respectively. Conclusions The pooled incidence rate of repositioning surgery in IOLs was 2%. Materials and designs would be risk factors for the rotational stability of the toric IOLs. Pooled incidence rates of the hydrophobic acrylate and loop group were lower than those of the silicone and plate group. Product identity is the main driver of heterogeneity.
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He W, Yao Y, Zhang K, Du Y, Qi J, Zhang Y, Zhang S, Zhao Z, Cai L, Fan Q, Jiang Y, Yang J, Zhu X, Lu Y. Clinical Characteristics and Early Visual Outcomes of Highly Myopic Cataract Eyes: The Shanghai High Myopia Study. Front Med (Lausanne) 2022; 8:671521. [PMID: 35059406 PMCID: PMC8764297 DOI: 10.3389/fmed.2021.671521] [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: 02/24/2021] [Accepted: 11/29/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: To report ocular characteristics and early visual outcomes of highly myopic cataract eyes, and to analyze the risk factors of low vision. Methods: A total of 2,027 eyes of 1,400 cataract patients with axial length (AL) ≥ 26 mm undergoing cataract surgery in Eye & ENT Hospital of Fudan University, who were registered in the Shanghai High Myopia Study, were analyzed. Routine pre-operative ophthalmic examinations were performed and macular scan of optical coherence tomography (OCT) were obtained. Macular complications, central foveal thickness (CFT) and subfoveal choroidal thickness (SFCT) were evaluated from OCT images. Ocular and surgical history and perioperative complications were also recorded. Uncorrected and best-corrected visual acuity (UCVA/BCVA) 1 month post-operatively and its influencing factors were evaluated. Results: The average AL of all involved eyes was 29.52 ± 2.26 mm, and 39.7% of which were with an AL > 30 mm and 26.4% of which were with a corneal astigmatism more than 1.5 D. Nuclear cataract accounted for the largest proportion (70.6%). The rate of overall macular complications was 27.6%. Postoperative UCVA and BCVA were 0.70 ± 0.46 and 0.25 ± 0.32 logMAR, respectively. BCVA improved significantly after surgery (vs. P < 0.001) and affected by the elongation of AL (P < 0.001) and thinning of CFT and SFCT (both P < 0.001). The risk factors of post-operative low vision (BCVA < 20/66) were macular atrophy, lamellar macular hole, high corneal astigmatism, long AL, thin SFCT and junior surgeons, odds ratios ranging from 1.54 to 54.87 (all P < 0.05). Conclusion: Cataract surgery could improve the VA of highly myopic eyes. Eye with macular complications, higher corneal astigmatism, longer AL, thinner SFCT, and who was treated by a junior surgeon, may have a high risk of low vision after surgery.
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Affiliation(s)
- Wenwen He
- Department of Ophthalmology, Eye Institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yunqian Yao
- Department of Ophthalmology, Eye Institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Keke Zhang
- Department of Ophthalmology, Eye Institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yu Du
- Department of Ophthalmology, Eye Institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Jiao Qi
- Department of Ophthalmology, Eye Institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yinglei Zhang
- Department of Ophthalmology, Eye Institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Shaohua Zhang
- Department of Ophthalmology, Eye Institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Zhennan Zhao
- Department of Ophthalmology, Eye Institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Lei Cai
- Department of Ophthalmology, Eye Institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Qi Fan
- Department of Ophthalmology, Eye Institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yongxiang Jiang
- Department of Ophthalmology, Eye Institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Jin Yang
- Department of Ophthalmology, Eye Institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Xiangjia Zhu
- Department of Ophthalmology, Eye Institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yi Lu
- Department of Ophthalmology, Eye Institute, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
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Fus M, Pitrova S. Evaluation of Decentration, Tilt and Angular Orientation of Toric Intraocular Lens. Clin Ophthalmol 2022; 15:4755-4761. [PMID: 34983999 PMCID: PMC8699775 DOI: 10.2147/opth.s346968] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 11/30/2021] [Indexed: 01/19/2023] Open
Abstract
Purpose The aim of this study was to develop software for the universal objective evaluation of factors influencing intraocular correction of astigmatism, such as decentration, tilt, axial position and angular orientation the toric intraocular lens (IOL). Patients and Methods Software was developed using the MS Visual Studio environment. The analysis was presented using images of 67 eyes with an implanted IOLs of the SN6ATx model series. Decentration and angular position of the lens were obtained from images of the anterior segment of the eye, using a Visucam unit. Tilt was measured on tomographic images from OCT Avanti (in meridian of highest tilt and perpendicular meridian) and preoperative biometry parameters of eye (axial length, anterior chamber depth – ACD, ocular lens thickness – LT, limbus diameter and mean keratometry value) including postoperative anterior chamber depth (pACD) were measured using Lenstar LS900. Results Applying the software methodology to the evaluation of individual toric IOL parameters, the following results were obtained: mean decentration 0.25 ± 0.17 mm which was observed in 61.19% of eyes, mean misalignment to the planned axis equal to 3.8 ± 3.6 degrees, mean highest inclination equal to 3.7 ± 1.2 degrees and mean difference of pACD and ACD was equal to 1.46 ± 0.31 mm. There was only a weak nonsignificant correlation between preoperative ACD versus decentration and tilt of IOL or a weak significant correlation between preoperative LT and both decentration and misalignment of IOL. Conclusion The use of the presented methodology for determining the positional parameters of the toric IOL provided comparable results with the results of recent studies. Software design can be considered as a suitable alternative to previously published techniques, with the significant advantage of the possibility of using universal input images, their graphical editing and especially the possibility of comprehensive analysis of all parameters.
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Affiliation(s)
- Martin Fus
- Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic
| | - Sarka Pitrova
- Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic
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Avetisov SE, Voronin GV, Yevdokimova AN, Avetisov KS, Shkolyarenko NY, Yusef SN. [The impact of the position of toric intraocular lenses on the functional outcomes of phaco surgery]. Vestn Oftalmol 2022; 138:273-278. [PMID: 36287167 DOI: 10.17116/oftalma2022138052273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The article reviews data on the impact of the position (orientation) of toric intraocular lenses on the functional outcomes of cataract phacoemulsification surgery, discusses the algorithm of astigmatism correction with intraocular lenses including preoperative determination of the size and position of main meridians, calculation of lens parameters, marking of corneal meridians, intraoperative positioning, as well as rotation and/or repositioning of the lens when necessary.
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Affiliation(s)
- S E Avetisov
- Research Institute of Eye Diseases, Moscow, Russia.,I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - G V Voronin
- Research Institute of Eye Diseases, Moscow, Russia.,I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - A N Yevdokimova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - K S Avetisov
- Research Institute of Eye Diseases, Moscow, Russia
| | | | - S N Yusef
- Research Institute of Eye Diseases, Moscow, Russia
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Singh A, Kapoor G, Baranwal VK, Kalra N. Rotational stability of Toric intraocular lenses. Med J Armed Forces India 2022; 78:68-73. [PMID: 35035046 PMCID: PMC8737107 DOI: 10.1016/j.mjafi.2020.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 03/24/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND A prospective study to evaluate the rotational stability of toric intraocular lenses (IOLs). METHODS A prospective study of 30 eyes in 29 patients. All patients with regular astigmatism of range 0.75-4 D were included in the study. Exclusion criteria included irregular corneal astigmatism, post-refractive surgery and corneal dystrophies. All patients underwent uncomplicated phacoemulsification cataract surgery by the same surgeon. Three eyes with corneal astigmatism of 0.75-1.5 D were implanted with the AcrySof SA60T3 IOL, eight eyes with astigmatism between 1.5 and 2.0 D received the SA60T4 IOL and eight eyes with astigmatism between 2.0 and 2.50 D received the SA60T5 and rest with astigmatism of 2.5 D and higher received SA60T6 and above models. Main outcome measure was the post-operative position of the lens, assessed at day 1, 1 week, 1 month and 6 months, using toric marker and the slit lamp. RESULTS There was no significant rotation of IOL observed during a follow-up period of 6 months. Overall, the post-operative rotation was within 5° in 95% of cases. There was no trend for either clockwise or anti-clockwise rotation. However, IOL rotation happens mostly within the first month of surgery, and if it is significant, it requires early repositioning. CONCLUSION Toric IOLs are very effective and consistent in correcting astigmatism during the cataract surgery. Once placed to its position, toric IOLs demonstrate rotational stability in the capsular bag.
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Affiliation(s)
- Abhinav Singh
- Graded Specialist (Ophthalmology), Military Hospital, Agra, India
| | - Gaurav Kapoor
- Senior Adviser (Ophthalmology), Base Hospital, Delhi Cantt, India,Corresponding author.
| | | | - Nidhi Kalra
- Classified Specialist (Ophthalmology), Base Hospital, Delhi Cantt, India
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The Effect of Toric Intraocular Lens Implantation in Irregular Corneal Steep and Flat Meridian. J Ophthalmol 2021; 2021:3630668. [PMID: 34777858 PMCID: PMC8589528 DOI: 10.1155/2021/3630668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 10/26/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose To evaluate the effect of toric intraocular lens implantation in cataract patients with irregular corneal steep and flat meridian. Methods Data of 112 eyes of 78 patients who underwent toric intraocular lens implantation were analyzed retrospectively. Steep meridian deviations (not 180°) and steep and flat meridian deviations (not 90°) were classified as 0, 1–9, 10–19, 20–29, 30–39, and over 30°. Meridian deviation was measured with a sagittal map of a rotating Scheimpflug camera (Pentacam®: Oculus, Wetzlar, Germany) using PicPickTools (NGWIN, Seoul, Korea). Results Residual astigmatism (D) of 0 (0.51 ± 0.13, 0.55 ± 0.15) and 1–9 (0.61 ± 0.16, 0.66 ± 0.19) groups were significantly lower than that of 10–19 (0.92 ± 0.24, 0.90 ± 0.28), 20–29 (0.10 ± 0.32, 1.01 ± 0.35), and over 30° groups (1.12 ± 0.37, 1.14 ± 0.40) both in steep meridian deviations and horizontal and vertical meridian deviations at 6 months (P < 0.05). Postoperative mean UCVA (logMAR) of 0 (0.09 ± 0.04, 0.09 ± 0.05) (logMAR) and 1–9 (0.10 ± 0.04, 0.11 ± 0.08) groups was significantly improved compared to that of 10–19 (0.14 ± 0.05, 0.17 ± 0.10), 20–29 (0.18 ± 0.08, 0.21 ± 0.10), and over 30° groups (0.20 ± 0.09, 0.22 ± 0.11) both in steep meridian deviations and horizontal and vertical meridian deviations at 6 months (P < 0.05). Conclusions Correction of astigmatism with toric intraocular lens implantation is not accurate in corneas with steep meridian deviations and steep and flat meridian deviations of more than 10°. Therefore, care should be taken when we perform toric intraocular lens implantation in patients with irregular corneal meridian.
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Schartmüller D, Röggla V, Schwarzenbacher L, Leydolt C, Menapace R. Rotational Stability of a New Hydrophobic Acrylic IOL With Modified C-loop Haptics. J Refract Surg 2021; 37:112-118. [PMID: 33577697 DOI: 10.3928/1081597x-20201216-01] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 11/23/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE To assess rotational stability, axial stability, decentration, and tilt of the Rayner RAO800C single-piece hydrophobic acrylic intraocular lens (IOL) (Rayner Intraocular Lenses Ltd) from end of surgery to 4 to 7 months postoperatively. METHODS Surgeries were performed at the Department of Ophthalmology at the Medical University of Vienna. A total of 130 eyes of 68 patients received an aspheric hydrophobic Rayner RAO0800C IOL. IOLs were randomly implanted to the 0 ± 10, 45 ± 10, 90 ± 10, or 135 ± 10 degree axis. Baseline measurement was performed with the patient still supine on the operating table. Axis alignment after 1 hour, 1 week, 1 month, and 4 months was evaluated by retroillumination pictures. Postoperative IOL decentration, tilt, and aqueous depth at 4 months were assessed using an anterior segment swept-source optical coherence tomography. RESULTS Absolute median IOL rotation from end of surgery to 4 months was 2.4 degrees (range: 0.0 to 85.0 degrees). Median IOL rotation from end of surgery to 1 hour, 1 hour to 1 week, 1 week to 1 month, and 1 month to 4 months was 1.6 (range: 0.0 to 86.2), 1.1 (range: 0.0 to 28.8), 0.6 (range: 0.0 to 5.2), and 0.7 (range: 0.0 to 2.6) degrees. Respective proportions of IOLs rotating more than 5, 10, and 20 degrees from end of surgery to 4 months were 23.9%, 11.0%, and 6.4%. Horizontal and vertical decentration at 4 months was -0.09 ± 0.14 and 0.09 ± 0.14 mm, respectively. Horizontal and vertical tilt at 4 months was -4.78 ± 1.36 and -1.58 ± 1.10 degrees, respectively. A posterior axial shift of 0.052 ± 0.055 mm was observed from 1 week to 4 months. CONCLUSIONS Although median IOL rotation appeared to be low, a significant proportion of IOLs rotated postoperatively. Decentration and tilt values were generally low. A minimal posterior optic shift was observed after 1 week. [J Refract Surg. 2021;37(2):112-118.].
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Lazăr AS, Tăbăcaru B, Stanca S, Stanca TH. Toric intraocular lens implantation - atypical cases. Rom J Ophthalmol 2021; 64:432-443. [PMID: 33367183 PMCID: PMC7739021 DOI: 10.22336/rjo.2020.67] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objective: To describe the results of toric intraocular lens (IOL) implantation in three atypical cases (four eyes) with cataract and corneal astigmatism: one with bilateral keratoconus, one with pellucid marginal degeneration and one with buphthalmos due to congenital glaucoma. Methods: Three patients (four eyes) with corneal astigmatism (one with bilateral keratoconus, one with pellucid marginal degeneration and one with buphthalmos due to congenital glaucoma) underwent cataract surgery by standard phacoemulsification and the implantation of toric IOLs in the capsular bag. The presence of corneal astigmatism was identified by automated keratometry and confirmed by Scheimpflug-based corneal tomography. The toric IOL implanted in all cases was a single-piece AcrySof Toric IOL (Alcon Laboratories, Inc.). Postoperative visual acuity, the reduction in the refractive astigmatism, the spherical equivalent (SE) and the rotational stability of the toric IOL were recorded for all the patients. Results: Visual acuity increased and the refractive astigmatism decreased in all cases. In Case 1, the right eye achieved a postoperative uncorrected visual acuity (UCVA) of 20/ 20, a decrease in the refractive astigmatism from -3 DCyl to -0.75 DCyl and a spherical equivalent (SE) of -0.25. The left eye presented with a best-corrected visual acuity (BCVA) of 20/ 20, a decrease in the refractive astigmatism from -1.50 DCyl to -1.25 DCyl and a SE of -0.25. In Case 2, the postoperative UCVA was 20/ 20, with a decrease in the refractive astigmatism from -5.5 DCyl to -1 DCyl and a SE for the right eye of 0.00 D. In Case 3, the postoperative BCVA was 20/ 20, with a decrease in the refractive astigmatism from -4.75 DCyl to -1.50 DCyl and a SE of +1.25. No misalignment of the axis of the toric IOL was observed in any patient at subsequent follow-ups. The postoperative visual acuity was satisfactory for all the patients. Conclusions: Toric intraocular lenses can be an effective option for implantation in patients with cataract and corneal astigmatism in atypical situations such as mild to moderate keratoconus, pellucid marginal degeneration and buphthalmos due to congenital glaucoma. Predicting the refractive outcome is difficult in atypical cases and the surgeon should have accuracy and consistency in the preoperative measurements, for achieving satisfactory postoperative results.
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Affiliation(s)
- Alina Simona Lazăr
- "Prof. Dr. Agrippa Ionescu" Clinical Emergency Hospital, Bucharest, Romania
| | - Bogdana Tăbăcaru
- "Prof. Dr. Agrippa Ionescu" Clinical Emergency Hospital, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Simona Stanca
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Tudor Horia Stanca
- "Prof. Dr. Agrippa Ionescu" Clinical Emergency Hospital, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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Rotational stability of toric intraocular lenses with a newly modified capsular tension ring. J Cataract Refract Surg 2021; 47:516-521. [PMID: 33196571 DOI: 10.1097/j.jcrs.0000000000000478] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 10/06/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine whether a newly modified capsular tension ring (CTR) is effective at preventing toric intraocular lens (TIOL) rotation and misalignment. SETTING John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. DESIGN Experimental study. METHODS Ten human cadaver eyes were used to test the ease or difficulty of TIOL rotation in the capsular bag under 3 experimental conditions: a TIOL alone, a TIOL with a standard CTR, or a TIOL with a newly modified CTR with indentations in a sinusoidal pattern. Scores for the ease of IOL rotation were compared by using the nonparametric Friedman analysis of variance test. In addition, both anterior and posterior Miyake-Apple views were filmed to observe the rotational stability of TIOLs in the capsular bag under the 3 test conditions. RESULTS In the ten eyes of five patients, the rotational stability improved with a standard CTR, but further improvement was statistically observed (P < .05) with the newly modified CTR under all test conditions. This was true for both IOLs used (AcrySof and TECNIS toric IOLs), with or without ophthalmic viscosurgical device, and for either clockwise or counterclockwise rotations. CONCLUSIONS A newly designed CTR prototype represents a new technology for improving the rotational stability of a TIOL in the capsular bag. Under all test conditions, the prototype performed significantly better than a standard CTR. The results support the use of this new CTR design to improve the accuracy and refractive success of TIOLs.
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Chen X, Gu X, Wang W, Xiao W, Jin G, Wang L, Dai Y, Zhang E, Ruan X, Liu Z, Luo L, Liu Y. Characteristics and factors associated with intraocular lens tilt and decentration after cataract surgery. J Cataract Refract Surg 2021; 46:1126-1131. [PMID: 32352251 DOI: 10.1097/j.jcrs.0000000000000219] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE To analyze the characteristics and factors associated with intraocular lens (IOL) tilt and decentration after uneventful phacoemulsification with IOL implantation. SETTING Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. DESIGN Cross-sectional study. METHODS All patients underwent a general ophthalmologic examination and anterior segment photography. IOL tilt and decentration were measured with a second-generation anterior segment optical coherence tomography (Casia2). Univariate and multivariate regression analyses were performed to assess the association between IOL tilt and decentration with ocular biometric and systemic parameters, and the visual acuity. RESULTS A total of 196 eyes of 196 patients were enrolled in this study. IOLs showed a mean tilt of 4.8 degrees toward the inferotemporal direction, and the mean decentration was 0.21 mm. Both eyes presented a mirror symmetry relationship. Twenty-two eyes (11.22%) had a tilt greater than 7 degrees, and 21 eyes (10.72%) had a decentration more than 0.4 mm. Multivariate regression analysis showed previous pars plana vitrectomy (PPV) and short axial length (AL) were associated with greater IOL tilt (P = .014 and P < .001). In addition, long AL, thicker lens, and less capsulorhexis-IOL overlap were positively correlated with decentration (P < .001, P = .029, and P = .026). Corrected distance visual acuity did not directly correlate with IOL tilt and decentration (P = .417 and P = .550). CONCLUSIONS PPV history and short AL were associated with greater IOL tilt, whereas longer AL, thicker lens, and overlarge capsulorhexis contribute to greater decentration. Implantation of toric and multifocal IOLs in these patients should be cautious.
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Affiliation(s)
- Xiaoyun Chen
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
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Anterior capsule coverage and rotational stability of an acrylic toric intraocular lens. J Cataract Refract Surg 2021; 47:618-621. [PMID: 33252567 DOI: 10.1097/j.jcrs.0000000000000489] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 10/14/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To investigate factors related to the rotational stability of an acrylic toric intraocular lens (IOL). SETTING Four ophthalmic surgical sites in Japan. DESIGN Prospective case series. METHODS The study included 120 eyes of 120 patients undergoing phacoemulsification and implantation of a toric IOL (AcrySof IQ, Alcon Laboratories, Inc.). At 1 hour postoperatively, the area of continuous curvilinear capsulorhexis (CCC) was measured, and the state of anterior capsule coverage on the IOL optic (total on or partial on) was recorded. The toric IOL axis orientation was assessed at the end of surgery and at 1 hour, 1 week, 1 month, and 6 months postoperatively. Multiple regression analysis was performed to explore any clinical factors relevant to IOL rotation from the end of surgery to 6 months postoperatively. The explanatory variables included age, anterior chamber depth preoperatively, axial length, type of corneal astigmatism (with-the-rule, against-the-rule, or oblique astigmatism), area of CCC, state of anterior capsule overlap on IOL optic (total coverage vs partial coverage), and surgical sites (surgeons). RESULTS The multiple regression analysis in 110 eyes of 110 patients indicated that anterior capsule overlap on the IOL optic was the only variable associated with IOL rotation at 6 months postoperatively (P = .0482). The mean absolute rotation at 6 months was 1.96 ± 1.81 degrees in the total on group and 3.79 ± 3.12 degrees in the partial on group (P = .0004). CONCLUSIONS Rotational stability of a single-piece, acrylic toric IOL was better in eyes with total anterior capsule coverage than that in those with partial anterior capsule coverage on the IOL optic.
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Comparison of the rotational stability between plate-haptic toric and C-loop haptic toric IOLs in myopic eyes. J Cataract Refract Surg 2021; 46:1353-1359. [PMID: 33060472 DOI: 10.1097/j.jcrs.0000000000000259] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE To compare the rotational stability of a plate-haptic toric intraocular lens (IOL) vs a C-loop haptic toric IOL in myopic cataract eyes. SETTING Eye and Ear, Nose, and Throat Hospital of Fudan University, China. DESIGN Prospective, randomized, controlled study. METHODS Cataract eyes with axial length (AL) more than 24.5 mm were randomly assigned to receive implantation of a C-loop haptic toric IOL (AcrySof Toric IOL) (Group A) or a plate-haptic toric IOL (AT TORBI 709M IOL) (Group B). IOL rotation, residual astigmatism, visual acuity, and higher-order aberrations (HOAs) evaluated with OPD-Scan III aberrometer were compared at 3 months postoperatively. RESULTS In total, 62 eyes of 62 patients were eligible for analysis: 31 in Group A and 31 in Group B. The mean rotation of toric IOLs was greater in Group A than that in Group B (8.00 ± 3.60 degrees vs 4.42 ± 3.24 degrees, respectively, P < .001), especially when IOLs were vertically placed. IOL rotation was positively correlated with AL in Group A, whereas no such correlations were found in Group B. Residual astigmatism in Group A was greater than that in Group B (-0.76 ± 0.30 diopter [D] vs -0.51 ± 0.29 D, respectively, P = .001). Fewer eyes achieved residual astigmatism of 0.50 D or less in Group A than in Group B (38.71% vs 64.52%). Group A had worse postoperative uncorrected visual acuity and higher total HOAs and coma for a 6.0 mm pupil than Group B, whereas postoperative corrected visual acuity was not different between the 2 groups. CONCLUSIONS The plate-haptic toric IOL might be a better choice for myopic cataract eyes with corneal astigmatism because of reduced postoperative rotation.
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Tan X, Liu Z, Chen X, Zhu Y, Xu J, Qiu X, Yang G, Peng L, Gu X, Zhang J, Luo L, Liu Y. Characteristics and Risk Factors of Intraocular Lens Tilt and Decentration of Phacoemulsification After Pars Plana Vitrectomy. Transl Vis Sci Technol 2021; 10:26. [PMID: 34003961 PMCID: PMC7995916 DOI: 10.1167/tvst.10.3.26] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose The purpose of this study was to investigate the characteristics and risk factors of intraocular lens (IOL) tilt and decentration of phacoemulsification after pars plana vitrectomy (PPV) using swept-source optical coherence tomography (SS-OCT). Methods One hundred four eyes with prior PPV and 104 eyes without PPV undergoing uneventful cataract surgery were enrolled in this study. IOL tilt and decentration were measured by SS-OCT (CASIA2) 3 months postoperatively. Results The mean IOL tilt and decentration were greater in the PPV group (5.36 ± 2.50 degrees and 0.27 ± 0.17 mm, respectively) than in the non-PPV group (4.54 ± 1.46 degrees, P = 0.005; 0.19 ± 0.12 mm, P < 0.001, respectively). Multiple logistic regression showed that silicone oil (SO) tamponade (odds ratio [OR] = 5.659, P = 0.021) and hydrophilic IOL (OR = 5.309, P = 0.022) were associated with IOL tilt over 7 degrees, and diabetes mellitus (DM; OR = 5.544, P = 0.033) was associated with IOL decentration over 0.4 mm. Duration of SO tamponade was positively correlated with IOL tilt (P = 0.014) and decentration (P < 0.001). The internal total higher-order aberration, coma, trefoil, and secondary astigmatism in the PPV group were higher than in the non-PPV group, and positively correlated with IOL tilt (P < 0.05). Conclusions Patients with prior vitrectomy had greater IOL tilt and decentration than the non-PPV group. Longer duration of SO tamponade, hydrophilic IOL, as well as DM were the risk factors of greater IOL tilt and decentration in patients with prior PPV. Translational Relevance Optically sophisticated designed IOLs should be used cautiously in vitrectomized eyes.
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Affiliation(s)
- Xuhua Tan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaoyun Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yi Zhu
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jingmin Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaozhang Qiu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Guangyao Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Lulu Peng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaoxun Gu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jiaqing Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Lixia Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yizhi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
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Wei L, He W, Meng J, Qian D, Lu Y, Zhu X. Evaluation of the White-to-White Distance in 39,986 Chinese Cataractous Eyes. Invest Ophthalmol Vis Sci 2021; 62:7. [PMID: 33393973 PMCID: PMC7794278 DOI: 10.1167/iovs.62.1.7] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose To investigate the distribution of white-to-white (WTW) distance and its associations with other biometric parameters in Chinese cataractous eyes. Methods Data on 39,986 eyes from 23,627 Chinese cataract patients were analyzed. Ocular biometric parameters, including WTW distance, corneal curvature, anterior chamber depth (ACD), lens thickness (LT), central corneal thickness (CCT), and axial length (AL), were obtained using the ZEISS IOLMaster 700. Results The mean age of patients was 63.7 ± 12.4 years, and 57.61% were female. The mean WTW distance was 11.69 ± 0.46 mm. The WTW distance was larger in male patients than in female patients for all age groups (all P < 0.001). The WTW distance was positively correlated with corneal curvature and ACD and negatively correlated with age, LT, and CCT (all P < 0.001). Multivariable analysis revealed that a larger WTW distance was associated with younger age; male gender; larger corneal curvature, ACD, and LT; and thinner CCT (all P < 0.001). Notably, the association between WTW distance and AL was not linear. As the AL increased, the WTW distance initially increased, reached a peak in the group with ALs of 24.5 to 26 mm, and then slowly decreased. However, all of the myopic eyes (AL > 24.5 mm) still had larger WTWs than the normal and short eyes (AL ≤ 24.5 mm). Conclusions In Chinese cataractous eyes, the WTW distance was larger in younger male patients with flatter corneas, deeper anterior chambers, thicker lenses, and thinner central corneas. The association between WTW distance and AL was not linear, and WTW distance was the largest in eyes with ALs of 24.5 to 26 mm.
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Affiliation(s)
- Ling Wei
- Department of Ophthalmology, Shanghai Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University; Key Laboratory of Myopia, Chinese Academy of Medical Science; and Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Wenwen He
- Department of Ophthalmology, Shanghai Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University; Key Laboratory of Myopia, Chinese Academy of Medical Science; and Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Jiaqi Meng
- Department of Ophthalmology, Shanghai Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University; Key Laboratory of Myopia, Chinese Academy of Medical Science; and Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Dongjin Qian
- Department of Ophthalmology, Shanghai Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University; Key Laboratory of Myopia, Chinese Academy of Medical Science; and Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yi Lu
- Department of Ophthalmology, Shanghai Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University; Key Laboratory of Myopia, Chinese Academy of Medical Science; and Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Xiangjia Zhu
- Department of Ophthalmology, Shanghai Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University; Key Laboratory of Myopia, Chinese Academy of Medical Science; and Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
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