First Results after Implantation of Hydrophilic and Hydrophobic Trifocal Intraocular Lenses: Visual and Optical Performance

Comparison of short-term clinical outcomes of a diffractive trifocal intraocular lens with phacoemulsification and femtosecond laser assisted cataract surgery

PURPOSE

To evaluate short-term visual and refractive outcomes after implantation of a diffractive trifocal intraocular lens (IOL) in cataract patients with phacoemulsification (PHACO) and femtosecond laser assisted cataract surgery (FLACS).

SETTING

Department of Ophthalmology, Shanghai Aier Eye Hospital, China.

DESIGN

A retrospective, observational study.

METHODS

Patients who underwent cataract surgery combined with Acrysoft IQ PanOptix trifocal IOL implantation were enrolled and divided into three groups: PHACO group, LAstig-FLACS group (astigmatism less then 1D) and HAstig-FLACS group (astigmatism more than 1D). Logarithm of the minimum angle of resolution (logMAR) visual acuity of uncorrected distance (UDVA), intermediate (UIVA), near visual (UNVA), defocus curve, surgically induced astigmatism (SIA) were evaluated in 1 months postoperatively and wavefront aberrations were evaluated in 6 months.

RESULTS

101 eyes of 60 patients were included with 31 eyes in PHACO group, 45 eyes in LAstig-FLACS group and 25 eyes in HAstig-FLACS group. Significant difference was found of internal Strehl Ratio (SR) between PHACO and LAstig-FLACS group (P = 0.026). In PHACO group, 79.31%, 86.21%, 72.41% of eyes gain visual acuity LogMAR 0.1 or more in UDVA, UIVA and UNVA, while 83.72%, 93.02%, 93.02% of those in LAstig-FLACS group and 92.00%, 84.00%, 76.00% in HAstig-FLACS group.

CONCLUSIONS

Panoptix diffractive trifocal IOL provides satisfied visual outcome in no matter FLACS or PHACO. Besides, trifocal IOL implantation via FLACS can provide a better accumulative visual acuity outcome at all distance than PHACO in 1 month. Femtosecond laser assisted limbal relaxing incisions (FLLRIs) is an excellent way to reduce a patient's corneal astigmatism.

Refractive Outcome and 5-Year Capsulotomy Rate of Hydrophobic and Hydrophilic IOLs with Similar Optical Design: A Contralateral Study

INTRODUCTION

To compare the short-term visual and aberrometric outcomes and the long-term capsulotomy incidence in a cohort of patients receiving IOLs with similar structural profile but with a hydrophobic matrix in one eye (PHOB group) and a hydrophilic matrix in the other one (PHIL group).

METHODS

In this retrospective, contralateral study, 26 patients sequentially undergoing phacoemulsification were implanted as mentioned above. Refraction and aberrometry were evaluated 6 months after surgery. For the quality of vision, the Hartmann-Shack optical aberration, Double-Pass Modulation Transfer Function (MTF), contrast sensitivity, and dysphotopsia results were compared. Capsulotomy was ascertained and dated by medical chart revision or phone call.

RESULTS

All the considered quantitative and qualitative visual parameters tested statistically comparable between PHIL and PHOB group. After 5 years, four patients (16.7%) in the PHOB group and five patients (20.8%) in the PHIL group underwent a Nd:YAG posterior capsulotomy (P > 0.5).

CONCLUSION

In this contralateral comparative study, the hydrophobic and hydrophilic matrix of the IOL similarly influenced the visual and aberrometric outcomes. Also the long-term laser capsulotomy incidence did not statistically differ between groups. The posterior IOL profile, rather than matrix hydrophilia, could consistently influence the posterior capsule opacification.

Early patient-reported outcomes of cataract surgery with implantation of the trifocal liberty 677MY intraocular lens: A pilot study

PURPOSE

To report our first clinical and patient-reported outcomes in the early postoperative period with a new model of trifocal diffractive intraocular lens (IOL).

METHODS

Pilot prospective analysis of the results of 26 eyes of 13 patients (age, 44-79 years) undergoing cataract surgery with implantation of the trifocal diffractive IOL Liberty 677MY (Medicontur Medical Engineering Ltd., Zsámbék, Hungary). The following clinical outcomes were evaluated during the first postoperative month: measurement of distance, intermediate and near visual acuity, binocular defocus curve, and level of spectacle independence, patient satisfaction, perception of photic phenomena, and difficulty in performing several vision-related daily tasks by means of a questionnaire.

RESULTS

Mean binocular LogMAR uncorrected distance, intermediate and near visual acuities were -0.03 ± 0.13, 0.21 ± 0.16, and 0.16 ± 0.09, respectively. Furthermore, 100.0%, 84.6% and 92.3% of patients achieved a binocular corrected distance, distance-corrected intermediate and distance-corrected near visual acuity of 20/32 or better, respectively. In the defocus curve, visual acuities were better than 0.2 logMAR for defocus levels between +1.00 and -3.00 D. Spectacle independence was referred by all patients, with any of them reporting dissatisfaction with the outcome of the surgery. The postoperative vision did not lead to difficulties in the daily life in 92.3% of patients. Bothersome halos, glare or starbursts were only reported by only 7.7% of patients.

CONCLUSIONS

The trifocal IOL evaluated provides a successful visual rehabilitation with minimal photic phenomena associated, leading to high levels of spectacle independence and patient satisfaction.

Observation of Visual Quality after Femtosecond Laser-Assisted Cataract Surgery Combined with Trifocal Intraocular Lens Implantation

Objective

This study is the first observation of Alcon's PanOptix trifocal intraocular lens (IOL) implanted in 55 cataract patients with femtosecond laser-assisted cataract surgery.

Methods

Fifty-five patients (63 eyes) with cataract were treated with femtosecond laser-assisted cataract surgery combined with trifocal IOL implantation. Visual acuity, defocus curve, higher order aberration (HOA), refractive stability, eyeglass removal rate, and satisfaction were evaluated and analyzed.

Results

We found that the visual acuity of patients with near, intermediate, and distance vision was better than 0.1 LogMAR at 1, 3, and 6 months after the completion of surgery. The uncorrected near visual acuity (UCNVA), uncorrected intermediate visual acuity (UCIVA), and uncorrected distance visual acuity (UCDVA) of patients at 1, 3, and 6 months after surgery were compared with those before operation, showing statistical significance. Six months after the operation, all patients' surgical eyes had a smooth transition in the defocus range from +0D to -2.5D, and the visual acuity of the surgical eyes reached a level better than 0.1 LogMAR. The statistical results of 6-month follow-up showed that the eyeglass removal rate at near, intermediate, and far distances was 100%. At 6 months postoperatively, only 1 case had nocturnal glare, which affected life; 3 cases developed glare and halo but did not affect life. The patient satisfaction rate was 98.18%.

Conclusions

Femtosecond laser-assisted cataract surgery with trifocal IOL implantation can remove the lens from the patient with satisfactory visual quality and significantly improve the postoperative satisfaction of the patient.