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Wang X, Liu S, Chen Y, Gong J, Wu N, Yao Y. Extended depth of focus IOL in eyes with different axial myopia and targeted refraction. BMC Ophthalmol 2024; 24:183. [PMID: 38649861 PMCID: PMC11036644 DOI: 10.1186/s12886-024-03442-5] [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: 10/21/2023] [Accepted: 04/09/2024] [Indexed: 04/25/2024] Open
Abstract
AIM To evaluate the objective visual outcomes following implantation of extended depth of focus intraocular lens (EDOF IOL) in individuals with varying axial lengths (AL) and targeted refraction. METHODS This retrospective study comprised age-matched eyes that underwent implantation of the EDOF IOL. Eyes were categorized based on AL into groups: control group with AL < 26 mm; high myopia group with AL ≥ 26 mm. Each group was then subdivided based on postoperative spherical equivalent (SE). Follow-up at three months included assessment of uncorrected visual acuity at different distances, contrast sensitivity (CS), refractive outcomes, and spectacle independence. RESULTS Overall, this study included 100 eyes from 100 patients, comprising 50 males (50.00%) and 50 females (50.00%), with 20 eyes in each group. In the control group, the uncorrected distance visual acuity (UDVA) at 5 and 3 m (m) in the - 1.50 to -0.75 group was inferior to that of the - 0.75 to 0.00 group (P = 0.004). Conversely, the uncorrected near visual acuity (UNVA) at 33 cm in the - 1.50 to -0.75 group was superior to that of the - 0.75 to 0.00 group (P = 0.005). Within the high myopia group, the UDVA at 5 and 3 m in the - 2.25 to -1.50 group was worse than in the - 0.75 to 0.00 group (P = 0.009 and 0.008, respectively). However, the UNVA at 33 cm in the - 2.25 to -1.50 group was better than in the - 0.75 to 0.00 group (P = 0.020). No significant differences were observed among the groups for corrected distance visual acuity (CDVA) (P > 0.05). Additionally, in the high myopia group, the CS of the - 2.25 to -1.50 group was lower compared to that of the - 0.75 to 0.00 group (P = 0.017). Among high myopia patients, 90.00% with refraction ranging from - 1.50 to -0.75 reported achieving overall spectacle independence. CONCLUSIONS Implantation of extended depth of focus intraocular lenses (IOLs) yields satisfactory visual and refractive outcomes in eyes with axial myopia. Among high myopia patients, a refraction ranging from - 1.50 to -0.75 diopters achieves superior visual quality compared to other postoperative myopic diopters.
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Affiliation(s)
- Xiaohui Wang
- Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, 350005, Fujian, Fujian, China.
- Department of Ophthalmology, Binhai campus of the First Affiliated Hospital, National Regional Medical Center, Fujian Medical University, Fujian, China.
- Fujian Institute of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
- Fujian Provincial Clinical Medical Research Center of Eye Diseases and Optometry, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
| | - Sinan Liu
- Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, 350005, Fujian, Fujian, China
- Department of Ophthalmology, Binhai campus of the First Affiliated Hospital, National Regional Medical Center, Fujian Medical University, Fujian, China
- Fujian Institute of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Fujian Provincial Clinical Medical Research Center of Eye Diseases and Optometry, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Yinqi Chen
- Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, 350005, Fujian, Fujian, China
- Department of Ophthalmology, Binhai campus of the First Affiliated Hospital, National Regional Medical Center, Fujian Medical University, Fujian, China
- Fujian Institute of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Fujian Provincial Clinical Medical Research Center of Eye Diseases and Optometry, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Jinping Gong
- Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, 350005, Fujian, Fujian, China
- Department of Ophthalmology, Binhai campus of the First Affiliated Hospital, National Regional Medical Center, Fujian Medical University, Fujian, China
- Fujian Institute of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Fujian Provincial Clinical Medical Research Center of Eye Diseases and Optometry, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Nuozhou Wu
- Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, 350005, Fujian, Fujian, China
- Department of Ophthalmology, Binhai campus of the First Affiliated Hospital, National Regional Medical Center, Fujian Medical University, Fujian, China
- Fujian Institute of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Fujian Provincial Clinical Medical Research Center of Eye Diseases and Optometry, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Yihua Yao
- Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, 350005, Fujian, Fujian, China
- Department of Ophthalmology, Binhai campus of the First Affiliated Hospital, National Regional Medical Center, Fujian Medical University, Fujian, China
- Fujian Institute of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Fujian Provincial Clinical Medical Research Center of Eye Diseases and Optometry, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
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Shen J, Ma D, Cai L, Zhang L, Guo H, Yang J. Comparison of visual outcomes in adult patients with different types of developmental cataracts after toric multifocal intraocular lenses implantation. Graefes Arch Clin Exp Ophthalmol 2023; 261:3521-3530. [PMID: 37382611 PMCID: PMC10667390 DOI: 10.1007/s00417-023-06148-4] [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: 10/09/2022] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 06/30/2023] Open
Abstract
PURPOSE To analyze and compare the visual performance and patient satisfaction following the implantation of toric multifocal intraocular lenses (TMIOLs) in adult patients with different types of developmental cataracts (DC) accompanied by corneal astigmatism (CA). METHODS This is a prospective observational cohort study. Patients diagnosed with DC aged 18-30 years were divided into three groups according to the anatomic location of the lens opacity: cortical, nuclear, and posterior subcapsular (PSC) groups, and implanted with TMIOLs. Visual acuity (VA), postoperative refractive astigmatism (RA), intraocular lens (IOL) rotation, high-order aberrations (HOAs), modulation transfer function (MTF) curve, and Strehl ratio were compared. The functional vision and incidence of photic phenomena were surveyed using questionnaires. RESULTS Fifty-five eyes of 37 patients were enrolled and completed a 1-year follow-up. The mean CA was 2.06 ± 0.79 D preoperatively, and the mean RA was 0.29 ± 0.30 D 3-month postoperatively. The IOL rotation was 2.48° ± 1.89°, with no deviation > 10°. At 12 months, mean uncorrected distance VA improved from 0.93 ± 0.41 preoperatively to 0.08 ± 0.08 logarithm of the minimum angle of resolution (logMAR), mean uncorrected near VA increased from 0.45 ± 0.30 preoperatively to 0.12 ± 0.11 logMAR, and mean uncorrected intermediate VA was 0.14 ± 0.08 logMAR. The cortical and nuclear groups displayed better improvements in uncorrected near and intermediate VA than that in the PSC group. Similar results were observed in the 3-month defocus curves, HOAs, MTF curve, halo incidence, and near vision satisfaction. CONCLUSION In adult patients with DC accompanied by CA, TMIOLs implantation achieved good postoperative visual outcomes and significantly reduced glasses dependency. Patients with cortical or nuclear lens opacity showed better whole-course VA and quality of vision, while patients with PSC opacity showed unsatisfactory near vision and suffered more photic phenomena.
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Affiliation(s)
- Jiying Shen
- Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China
| | - Dongmei Ma
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
- The Key Laboratory of Myopia, Ministry of Health, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- Key National Health Committee of the Key Laboratory of Myopia, Fudan University, Shanghai, China
- The Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Lei Cai
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
- The Key Laboratory of Myopia, Ministry of Health, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- Key National Health Committee of the Key Laboratory of Myopia, Fudan University, Shanghai, China
- The Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Limei Zhang
- Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China
| | - Haike Guo
- Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China
| | - Jin Yang
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China.
- The Key Laboratory of Myopia, Ministry of Health, Shanghai, China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China.
- Key National Health Committee of the Key Laboratory of Myopia, Fudan University, Shanghai, China.
- The Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.
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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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Malyugin BE, Sobolev NP, Shkvorchenko DO, Fomina OV, Lanevskaya NI, Obraztsova MR. [Outcomes of surgical treatment of rhegmatogenous retinal detachment after phaco surgery and implantation of a trifocal intraocular lens in patients with myopia (clinical observations)]. Vestn Oftalmol 2022; 138:73-81. [PMID: 35801884 DOI: 10.17116/oftalma202213803173] [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] [Indexed: 06/15/2023]
Abstract
PURPOSE To analyze visual functions in moderate and high myopic patients with retinal detachment that developed after implantation of a trifocal intraocular lens (IOL). MATERIAL AND METHODS The study analyzed the functional outcomes achieved in 3 patients (4 eyes) with retinal detachment developed after implantation of AcrySof IQ PanOptix («Alcon», USA) and AT LISA tri 839 MP («Carl Zeiss Meditec», Germany) during the follow-up period of 24 months. Patient examination included measurements of visual acuity at far (4 and 5 m), near (40 cm) and intermediate distances (60 cm, 80 cm), spatial contrast sensitivity, spherical equivalent of refraction, and a survey of patients for subjective satisfaction of the obtained vision. RESULTS In four eyes of three patients with moderate and high myopia, rhegmatogenous retinal detachment was diagnosed during the follow-up period at 4 to 12 months after phacoemulsification of cataract with trifocal IOL implantation. The best visual indicators were found in patient N. as a result of surgical treatment of bilateral rhegmatogenous retinal detachment due to high myopia: visual acuity (VA) at far distance was 1.0 for each eye (with 100 points on the VF-14 questionnaire). In patients P. and M., after the development of unilateral rhegmatogenous retinal detachment, complete retinal reattachment was achieved after surgery with VA at far distance 0.55 (OS) in patient P. and 0.4 (OD) in patient M. (95 and 86 points on VF-14, respectively). CONCLUSION Good visual functions were achieved in three patients with trifocal IOL after surgical treatment of the rhegmatogenous retinal detachment that developed due to myopia. The implanted trifocal IOL did not affect the effectiveness of vitrectomy. After the treatment patients retained the ability to see at different distances.
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Affiliation(s)
- B E Malyugin
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - N P Sobolev
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - D O Shkvorchenko
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - O V Fomina
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - N I Lanevskaya
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - M R Obraztsova
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
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Tekce A, Gulmez M. Comparison of visual and refractive outcomes of diffractive bifocal toric and trifocal toric intraocular lenses 12 months after implantation in patients with moderate to high myopia. Int Ophthalmol 2021; 41:3029-3040. [PMID: 33860888 DOI: 10.1007/s10792-021-01865-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 04/08/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To compare the visual and refractive outcomes of bifocal toric and trifocal toric intraocular lenses (IOL) in patients with moderate to high myopia at 12 months after implantation. METHOD This is a prospective and comparative study. In 120 eyes with moderate to high myopia and astigmatism, bifocal toric IOLs (n = 60 eyes) or trifocal toric IOLs (n = 60 eyes) were implanted. Eyes with axial lengths from 24.0 to 26.5 mm were included. Postoperative examinations measured near, intermediate, and distance visual acuity (VA), along with refractive measurements, binocular defocus curves, and patient satisfaction with the National Eye Institute Visual Function Questionnaire. RESULTS For uncorrected- and corrected distance intermediate VA, the trifocal group showed significantly better VA at 1, 3, 6, and 12 months than the bifocal group. Driving subscale scores from the questionnaire were significantly better in the trifocal than the bifocal group. Concerning the binocular defocus curve, uncorrected distance VA was significantly higher in the trifocal than bifocal group at test distances of -1.5 D. CONCLUSIONS Both trifocal and bifocal toric IOLs effectively corrected the near, intermediate, and distance vision in patients with moderate to high myopia and astigmatism. However, intermediate vision was significantly better in eyes with trifocal than bifocal toric IOLs.
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Affiliation(s)
- Abdulhakim Tekce
- Department of Ophthalmology, The Lazer Eye Hospital, Kayseri, Turkey.
| | - Mehmet Gulmez
- Department of Ophthalmology, The Dunya Eye Hospital, Konya, Turkey
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Mustafa OM, Prescott C, Alsaleh F, Dzhaber D, Daoud YJ. Refractive and Visual Outcomes and Rotational Stability of Toric Intraocular Lenses in Eyes With and Without Previous Ocular Surgeries: A Longitudinal Study. J Refract Surg 2019; 35:781-788. [PMID: 31830294 DOI: 10.3928/1081597x-20191021-03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 10/21/2019] [Indexed: 12/22/2022]
Abstract
PURPOSE To evaluate visual and refractive outcomes and rotational stability of toric intraocular lens (IOL) implantation in eyes with previous ocular surgeries. METHODS This controlled, longitudinal cohort study included a total of 133 eyes (59 study cases with a history of corneal, vitreoretinal, and/or glaucoma surgery and 74 randomly selected controls without a history of ocular surgery) that had cataract and corneal astigmatism treated with toric IOL implantation. Postoperative outcomes were recorded at postoperative 1 month and 3 to 12 months. RESULTS Refractive prediction errors were within ±1.00 diopter (D) of target in 93.5% and 88.4% of the study cases at postoperative 1 month and 3 to 12 months, respectively. They were within ±0.50 D of target in 56.5% and 60.5% of the cases during the same follow-up intervals, respectively. Study cases showed statistically significantly inferior uncorrected distance visual acuity (UDVA) compared to controls at 1 month postoperatively (0.27 ± 0.24 and 0.17 ± 0.21 logMAR, respectively, P = .027) but not during the later follow-up (0.19 ± 0.19 and 0.16 ± 0.19 logMAR, respectively, P = .431). Corrected distance visual acuity (CDVA) was slightly lower in the study cases than in controls at 1 month postoperatively (0.13 ± 0.16 and 0.07 ± 0.14, respectively, P = .005) and subsequent follow-up months (0.10 ± 0.13 and 0.03 ± 0.10, respectively, P < .001). Of the examined study cases, 93.9% and 88.4% had IOL axes within 5° of intended axis at postoperative 1 month and 3 to 12 months, respectively. CONCLUSIONS Toric IOLs provided significant and sustained improvement in visual acuity and refraction in eyes with a history of prior ophthalmic surgery. Refractive outcomes achieved postoperatively were comparable to those in eyes without a prior history of ophthalmic surgery, although the rate of visual recovery may be different. [J Refract Surg. 2019;35(12):781-788.].
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Javaloy J, Rivera E, Montalbán R, Beltrán J, Muñoz G, Rohrweck S. Diffractive trifocal pseudophakic intraocular lenses in high myopic eyes: 2-year assessment after implantation. Graefes Arch Clin Exp Ophthalmol 2019; 257:1331-1339. [DOI: 10.1007/s00417-019-04302-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 02/17/2019] [Accepted: 03/20/2019] [Indexed: 02/04/2023] Open
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