1
|
Fernández-Núñez S, Pérez-Sanz L, Gómez-Pedrero JA, García-Montero M, Albarrán-Diego C, Garzón N. Optical quality in vitro and in vivo of an extended depth-of-focus intraocular lens with isofocal design. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06590-y. [PMID: 39046519 DOI: 10.1007/s00417-024-06590-y] [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: 04/21/2024] [Revised: 07/01/2024] [Accepted: 07/05/2024] [Indexed: 07/25/2024] Open
Abstract
PURPOSE The aim of this study is to compare optical quality results obtained in laboratory analysis (in vitro) versus clinical data (in vivo). METHODS The optical quality of ISOPure intraocular lens was assessed both in vitro and in vivo using the modulation transfer function (MTF) for 3.0 and 4.5 mm pupil diameters. In vitro measurements were obtained using deflectometer NIMO TRF1504, while in vivo measurements were taken with OPD-Scan III in a set of patients implanted with this lens. Ray tracing techniques were used to determine the MTF and area under MTF curve (MTFa) from the measured wavefront for the isolated lens and for the whole eye. RESULTS The MTF of the isolated lens obtained under both in vitro and in vivo conditions showed comparable results for both pupil sizes. However, differences were found when comparing the MTF of the whole eye with the lens implanted versus the MTF measured in vitro for 4.5 mm pupil size. Also, the MTFa defocus curve was compared with the defocus curve measured in vivo. CONCLUSION The defocus curve from the in vivo study aligns closely with the MTFa of the in vitro model, with a useful defocus range of 0.40D. Thus, it is possible to anticipate the visual results of the implanted isofocal lens by using measurements on an optical bench and conducting optical simulations.
Collapse
Affiliation(s)
- Sara Fernández-Núñez
- Dpto. de Óptica, Universidad Complutense de Madrid, Av. Arcos del Jalón 118, Madrid, E-28037, Spain
| | - Lidia Pérez-Sanz
- Dpto.de Optometría y Visión, Universidad Complutense de Madrid, Av. Arcos del Jalón 118, Madrid, E-28037, Spain
- Miranza IOA, Calle Galileo, 104, Madrid, 28003, Spain
| | | | - María García-Montero
- Dpto.de Optometría y Visión, Universidad Complutense de Madrid, Av. Arcos del Jalón 118, Madrid, E-28037, Spain.
| | - César Albarrán-Diego
- Dpto. de Óptica y Optometría y Ciencias de la Visión, Universitat de València, Doctor Moliner 50, Burjassot, 46100, Spain
| | - Nuria Garzón
- Dpto.de Optometría y Visión, Universidad Complutense de Madrid, Av. Arcos del Jalón 118, Madrid, E-28037, Spain
| |
Collapse
|
2
|
Akahoshi T. Hydrophobic Trifocal Toric Intraocular Lens Outcomes in Japanese Eyes After Cataract Surgery. Clin Ophthalmol 2024; 18:2021-2031. [PMID: 39010936 PMCID: PMC11249101 DOI: 10.2147/opth.s471846] [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: 04/02/2024] [Accepted: 07/02/2024] [Indexed: 07/17/2024] Open
Abstract
Purpose To analyze the refractive and visual outcomes following cataract surgery and implantation of a new hydrophobic trifocal toric intraocular lens (IOL) in Japanese eyes with different degrees of corneal astigmatism. Methods A total of 66 eyes from 39 patients implanted with a FineVision HP Toric IOL (Beaver-Visitec International Inc) were analyzed retrospectively. The main outcome measures considered were refraction, monocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), and distance-corrected intermediate visual acuity (DCIVA) at 80 and 66 cm, uncorrected near visual acuity (UNVA) and distance-corrected near visual acuity (DCNVA) at 40 cm. Eyes were evaluated at three months post-surgery. Results Sixty-five eyes (98.48%) were within ±0.50D of spherical equivalent, and all were within ±1.00D (mean: 0.00±0.21D). Moreover, 63 eyes (95.45%) had ≤0.50D of residual astigmatism, and all had ≤1.00D (mean: -0.08±0.23D). Similarly, 58 (87.88%) and 60 eyes (90.91%) had ≥20/20 UDVA and CDVA, respectively, with 65 (98.48%) and 66 eyes (100%) achieving ≥20/25 UDVA and CDVA, respectively. In addition, 28 (42.42%) and 23 eyes (34.85%) had ≥20/25 DCIVA at 80 and 66 cm, respectively, with 49 (74.24%) and 52 eyes (78.79%) achieving ≥20/32 DCIVA at 80 and 66 cm, respectively. Finally, 39 (59.09%) and 40 eyes (60.61%) had ≥20/20 UNVA and DCNVA, respectively, with 58 (87.88%) and 59 eyes (89.39%) achieving ≥20/25 UNVA and DCNVA, respectively. Conclusion Our study shows that implantation of the new hydrophobic FineVision HP Toric IOL results in accurate refractive outcomes, with good visual acuity at different distances, in Japanese eyes.
Collapse
Affiliation(s)
- Takayuki Akahoshi
- Cataract and Refractive Surgery Department, Nihonbashi Cataract Clinic, Tokyo, Japan
| |
Collapse
|
3
|
Daya S, Espinosa Lagana M. Visual and Refractive Outcomes of a New Hydrophobic Trifocal Toric Intraocular Lens. Clin Ophthalmol 2024; 18:997-1007. [PMID: 38584722 PMCID: PMC10999220 DOI: 10.2147/opth.s453565] [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: 01/12/2024] [Accepted: 03/28/2024] [Indexed: 04/09/2024] Open
Abstract
Purpose To evaluate the visual outcomes and efficacy of astigmatism correction using a new hydrophobic trifocal toric intraocular lens (IOL). Methods This study involved 62 eyes implanted with the FineVision HP Toric IOL. The visual and refractive outcomes were assessed preoperatively and 6 weeks after the surgery. Specifically, monocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA) at 80 and 60 cm and uncorrected near visual acuity at (UNVA) at 40 cm were evaluated. The rotational stability of the lens was also assessed. Results Sixty-one eyes (98.39%) were within ±1.00D and 55 eyes (88.71%) were within ±0.50 D of spherical equivalent, with a mean value of 0.09±0.39 D. 51 (82.26%) and 61 (98.39%) eyes had a UDVA of ≥20/20 and ≥20/25, respectively, and for CDVA these values were as follows: 59 (95.16%) and 62 eyes (100%), respectively. The mean UDVA and CDVA were 0.01±0.06 and -0.01±0.04logMAR, respectively. Greater than or equal to unaided 20/20 vision was achieved at 40 cm in 42 (67.74%), UIVA at 60 cm in 42 (67.74%) and 50 eyes (80.65%) at 80 cm. Those achieving ≥20/25 were 56 (90.32%, 40 cm), 59 (95.16%, 60 cm), and 62 eyes (100%, 80 cm). Postoperative mean values were 0.04±0.07, 0.03±0.07, and 0.00±0.07logMAR for UCNVA, UIVA at 60 cm, and UIVA at 80 cm, respectively. The mean rotation of the IOL was 5.8 degrees. Conclusion This hydrophobic trifocal toric IOL provides good refractive outcomes with excellent visual acuity across multiple distances, providing a full range of focus.
Collapse
Affiliation(s)
- Sheraz Daya
- Centre for Sight, East Grinstead, West Sussex, UK
| | | |
Collapse
|
4
|
Thulasidas M, Kadam A. Toric intraocular lens: A literature review. Taiwan J Ophthalmol 2024; 14:197-208. [PMID: 39027059 PMCID: PMC11254006 DOI: 10.4103/tjo.tjo_43_21] [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: 05/08/2021] [Accepted: 10/07/2021] [Indexed: 11/04/2022] Open
Abstract
Toric intraocular lenses (IOLs) are universally recommended in cataract cases with preoperative corneal astigmatism ≥1.5 D. An optimal surgical outcome depends on careful patient selection, complete preoperative evaluation, accurate IOL power calculation, precise marking of the axis, meticulous intraoperative approach, and methodical postoperative care. Understanding the importance of posterior corneal astigmatism, surgically induced astigmatism, and effective lens position in IOL power calculation and newer techniques to measure them directly have resulted in better postoperative refractive outcomes. We present a brief overview of toric IOLs along with the preoperative evaluation, IOL power calculation, different marking methods, intraoperative approach, and postoperative outcomes. Functional and anatomical outcomes, including uncorrected visual acuity, residual refractive astigmatism, and postoperative IOL misalignment, which have been reported for both toric IOLs and multifocal toric IOLs, are reviewed.
Collapse
Affiliation(s)
- Mithun Thulasidas
- Cataract and Glaucoma Services, Sankara Eye Hospital, Coimbatore, Tamil Nadu, India
| | | |
Collapse
|
5
|
Ang RET. Long-term trifocal toric intraocular lens outcomes in Asian eyes after cataract surgery. J Cataract Refract Surg 2023; 49:832-839. [PMID: 37482666 DOI: 10.1097/j.jcrs.0000000000001195] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/05/2023] [Indexed: 07/25/2023]
Abstract
PURPOSE To determine the visual and refractive outcomes of trifocal toric intraocular lens (IOL) implantation in Asian eyes with cataract and astigmatism. SETTING Asian Eye Institute, Makati City, Philippines. DESIGN Prospective study. METHODS 187 eyes were implanted with the FineVision POD FT IOL and followed for 2 years. The measurements included subjective refraction, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), distance-corrected intermediate visual acuity (DCIVA), uncorrected near visual acuity (UNVA), distance-corrected near visual acuity (DCNVA), defocus curve, photopic and mesopic contrast sensitivity, and rotational stability. RESULTS The mean spherical equivalent and cylinder values were, respectively, -0.07 ± 0.34 diopters (D) and -0.48 ± 0.31 D at the 2-year follow-up. At this same follow-up, 69.4% of patients had monocular CDVA and 79.3% had binocular UDVA ≤0.0 logMAR. For intermediate vision, monocular DCIVA reached 74.1%, while binocular UIVA was 86.2% ≤ 0.1 logMAR. Near vision showed 63% for monocular DCNVA and 70.7% for binocular UNVA ≤0.1 logMAR. The mean values at this follow-up were 0.02 ± 0.08, 0.08 ± 0.10, and 0.10 ± 0.12 logMAR for CDVA, DCIVA, and DCNVA, respectively. At the visual acuity threshold of ≤0.20 logMAR, the binocular defocus curve extended up to -3.75 D. Stable contrast sensitivity values were obtained at the different follow-ups. The mean IOL rotation was ≤2 degrees. CONCLUSIONS The FineVision POD FT IOL yielded good visual outcomes at far, near, and intermediate distances with accurate refractive outcomes and good rotational stability in Asian eyes.
Collapse
|
6
|
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.
Collapse
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.
| |
Collapse
|
7
|
Zhu Y, Zhong Y, Fu Y. The effects of premium intraocular lenses on presbyopia treatments. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2022; 2:100042. [PMID: 37846220 PMCID: PMC10577869 DOI: 10.1016/j.aopr.2022.100042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/28/2022] [Accepted: 02/20/2022] [Indexed: 10/18/2023]
Abstract
Background Presbyopia has become a global disease affecting the world's aging population. Among various treatments, cataract extraction and intraocular lens (IOL) implantation have become the most popular and common methods of presbyopia correction. During the twentieth century, IOLs have underwent significant innovation and advancements to meet the patients' high demands for functional vision at all distances. Main Text To meet the increasing needs for excellent near and intermediate vision for daily activities, some premium IOLs with more than one focus have been developed, for example, the refractive MfIOLs, diffractive MfIOLs, extended depth of field (EDOF) IOLs, and accommodating IOLs (AIOLs) were introduced to meet this need. In addition, the add-on MfIOLs have been explored as promising supplementary IOLs for pseudophakic presbyopia. When selecting the MfIOLs, the IOLs' features, patients' characteristics, preoperative eye conditions, and treatment expectations should be considered. Conclusions In this review, we focus on the multifocal IOLs (MfIOLs) commonly used for presbyopia correction and systematically summarized their optical designs and clinical outcomes. More evidence-based studies are required to provide guidelines for MfIOL selection, provide maximum visual benefits, and develop personalized visual solutions in the future.
Collapse
Affiliation(s)
- Yanan Zhu
- Corresponding author. Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jiefang Road, Hangzhou, 310009, Zhejiang Province, China.
| | | | - Yanyan Fu
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang Province, China
| |
Collapse
|
8
|
First Results after Implantation of Hydrophilic and Hydrophobic Trifocal Intraocular Lenses: Visual and Optical Performance. J Ophthalmol 2021; 2021:3514577. [PMID: 34961831 PMCID: PMC8710168 DOI: 10.1155/2021/3514577] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 11/22/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose To compare postcataract surgery visual and optical performance between two trifocal intraocular lenses (IOLs) with the same optical design: a hydrophobic acrylic glistening-free IOL and a hydrophilic acrylic IOL. Methods Patients were bilaterally implanted with either the hydrophobic or the hydrophilic IOL. The data of the patients' right eyes were evaluated. Visual quality assessments included refractive outcomes, monocular visual acuity (VA) at far, intermediate, and near distances, defocus curve, aberrations (spherical aberration (SA)), root mean square (RMS) of corneal, internal, and total higher-order aberrations (HOAs)), and tilt of IOL. Results Fifty-one patients were included in the analysis: 26 patients implanted with the hydrophobic IOL and 25 patients implanted with the hydrophilic IOL. At 1 month, no statistically significant differences were found for monocular uncorrected and corrected VA at distance, distance-corrected VA at intermediate and near, defocus curve, manifest spherical equivalent, total SA, and RMS of the total, internal, and corneal HOA. The defocus curve of both groups showed a visual acuity of 0.3 logMAR or better in the intermediate range from 0.5 to −2.5 D of vergence level with no significant differences between the groups. Compared to the hydrophilic group, y-direction tilt was significantly higher in the hydrophobic group (p=0.027). The total tilt and x-axis tilt did not differ between the groups. Conclusion Both IOLs demonstrated an excellent quality of vision and provided the patient with a wide range of vision.
Collapse
|
9
|
Donmez O, Asena BS, Aydin Akova Y. Subjective and objective clinical outcomes of a new trifocal toric intraocular lens and effect of femtosecond laser cataract surgery. Eur J Ophthalmol 2021; 32:2225-2233. [PMID: 34528478 DOI: 10.1177/11206721211046496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate the clinical outcomes and quality of life following implantation of PanOptix toric intraocular lens (IOL) and to compare the outcomes following femtosecond laser assisted cataract surgery (FLACS) and standard cataract surgery (SCS). METHODS This comparative retrospective study included 79 eyes of 55 patients underwent cataract or refractive lens exchange surgery between April 2017 and January 2020 in Bayindir Hospital and Kaskaloglu Eye Hospital. Corneal (CA) and refractive astigmatism (RA), uncorrected visual acuities for distant, intermediate, and near (UDVA, UIVA, and UNVA), low contrast distance visual acuity, rotational stability, defocus curves, photopic and mesopic contrast sensitivity (CS), visual function-14 (VF-14) test, presence of dysphotopsia, and need for spectacles were evaluated at postoperative third month. Outcomes were compared between FLACS and SCS group. RESULTS The mean UDVA, UIVA, and UNVA were 0.05 ± 0.07, 0.08 ± 0.08, and 0.06 ± 0.07 logMAR, respectively. All patients achieved ⩾0.3 logMAR uncorrected visual acuity for all distances. UDVA was found significantly better in FLACS group (p = 0.03). All eyes had ⩽1 D of subjective postoperative RA. Defocus curve had two peaks at 0 and -1.50 D. Spectacle independence was achieved in 88.7% of patients. Photopic and mesopic CS was within normal range in all patients. The mean VF-14 score was 98 ± 2. The mean IOL axis rotation was 2.1° ± 2.3°. Only one patient reported seeing disturbing halos. CONCLUSIONS This trifocal toric IOL effectively reduced refractive astigmatism and provided excellent visual outcomes with high spectacle independence, patients' satisfaction, and good rotational stability. FLACS might have an impact on optimal postoperative results.
Collapse
Affiliation(s)
- Oya Donmez
- Tinaztepe University Galen Hospital, Izmir, Turkey
| | | | | |
Collapse
|
10
|
Kohnen T, Lwowski C, Hinzelmann L, Ahmad W, Petermann K, Hemkeppler E, Pawlowicz K, Böhm M. Presbyopia Correction in Astigmatic Eyes Using a Toric Trifocal Intraocular Lens With Quadrifocal Technology. J Refract Surg 2021; 36:638-644. [PMID: 33034355 DOI: 10.3928/1081597x-20200729-04] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/21/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the visual performance after bilateral implantation of a toric diffractive aspheric multifocal intraocular lens (IOL) with a +2.17 diopters (D) (60 cm) intermediate and a +3.25 D (40 cm) addition (add) power. METHODS This prospective single-arm study was conducted at the Department of Ophthalmology, Goethe University, Frankfurt, Germany. Twenty-five patients (50 eyes) received bilateral implantation of the toric PanOptix IOL (AcrySof IQ PanOptix; Alcon Research LLC) before enrollment. Exclusion criteria were previous ocular surgeries excluding lens surgery and ocular pathologies or corneal abnormalities. Examination at 3 months postoperatively included manifest refraction; monocular and binocular uncorrected distance (UDVA) and distance-corrected (DCVA) visual acuity at 4 m and 80, 60, and 40 cm; and slit-lamp examination. At 3 months postoperatively, monocular and binocular defocus, binocular contrast sensitivity under photopic and mesopic conditions, and optical phenomena, and spectacle independence were evaluated. RESULTS Mean refractive spherical equivalent was 0.12 ± 0.380 D and mean refractive cylinder was -0.21 ± 0.237 D at 3 months postoperatively. A significant decrease in refractive cylinder was observed postoperatively (P < .05), with 98% showing a postoperative astigmatism below 0.75 D. Monocular UDVA was better than 0.14 logMAR in all distances. Binocular defocus curve showed peaks at 0.00 D (-0.09 logMAR) and -1.50 and -2.00 D (-0.02 and 0.00 logMAR). The worst values between far (4 m) and near (40 cm) distance were 0.04 logMAR at -1.00 D. Despite some optical phenomena, 92% of patients would choose the same IOL again and recommend it to others. CONCLUSIONS The visual performance of the toric PanOptix IOL showed good visual acuity at all distances; more than 90% achieved a decrease of refractive cylinder below 0.75 D, high patient satisfaction despite some optical phenomena, and high spectacle independence 3 months postoperatively. [J Refract Surg. 2020;36(10):638-644.].
Collapse
|
11
|
Orts-Vila P, Aguilar-Córcoles S, Tello-Elordi C, Ramos-Alzamora M, Montés-Micó R, Tañá-Rivero P. Trifocal toric intraocular lenses in eyes with low amount of corneal astigmatism. Int J Ophthalmol 2020; 13:1567-1573. [PMID: 33078106 DOI: 10.18240/ijo.2020.10.09] [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: 04/10/2020] [Accepted: 06/24/2020] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate the refractive and visual outcomes following cataract surgery and implantation of a trifocal toric intraocular lens (IOL) in eyes with low degrees of corneal astigmatism. METHODS Twenty-six eyes of 22 patients who underwent implantation a trifocal toric IOL (FineVision PODFT, PhysIOL s.a., Liege, Belgium) were enrolled. Phacoemulsification with femtosecond laser, capsular tension ring insertion and intraoperative aberrometry were performed in all cases. All IOLs used showed a cylinder power of 1.00 D. Main outcome measures were refractive error and corrected-distance visual acuity (CDVA) and uncorrected-distance visual acuity (UDVA) values. Eyes were evaluated at 4mo post-surgery. RESULTS Totally 50% of eyes showed a spherical equivalent (SE) within ±0.13 D and all of them within ±0.50 D. The mean SE and refractive cylinder were -0.02±0.23 and -0.16±0.22 D, respectively. Vector analysis revealed that 100% of eyes were within ±0.50 D for the SE and cylindrical components (J0 and J45). Refractive changes were not correlated with keratometric changes (P>0.05) showing that the reduction in astigmatism comes from the trifocal toric IOL. Of 81% and 96% of eyes showed UDVA and CDVA of 20/20, respectively. The postoperative mean values of monocular distance Snellen decimal UDVA and CDVA were 0.97±0.05 and 0.99±0.02 (about 20/20), respectively. CONCLUSION Our study suggests that the use of this trifocal toric IOL in patients with low amount of astigmatism provides accurate refractive outcomes and enables them to achieve excellent visual acuity.
Collapse
Affiliation(s)
| | | | | | | | - Robert Montés-Micó
- Oftalvist Clinic, Alicante 03001, Spain.,Optics and Optometry & Vision Sciences Department, University of Valencia, Burjassot, Valencia 46100, Spain
| | | |
Collapse
|
12
|
Poyales F, Pérez R, López-Brea I, Zhou Y, Rico L, Garzón N. Comparison of Visual Performance and Patient Satisfaction Outcomes with Two Trifocal IOLs with Similar Optical Design but Different Materials. Clin Ophthalmol 2020; 14:3237-3247. [PMID: 33116374 PMCID: PMC7569070 DOI: 10.2147/opth.s273641] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 09/25/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare clinical outcomes in a prospective trial of cataract surgery patients bilaterally implanted with two different trifocal intraocular lenses (IOLs) with very similar optical designs but consisting of different IOL materials (hydrophobic and hydrophilic). Patients and Methods Fifty-one patients (102 eyes) were randomized to receive trifocal IOLs bilaterally – FineVision POD F (hydrophilic) or FineVision POD F GF (hydrophobic) (both PhysIOL, Liége, Belgium). The follow-up period was 3 months. Outcome measurements included uncorrected distance (UDVA), corrected distance (CDVA), distance-corrected intermediate (DCIVA), and distance-corrected near visual acuity (DCNVA), refraction, negative dysphotopsia, optical quality of vision, contrast sensitivity under photopic and mesopic conditions, halometry (discrimination index), and patient-reported outcomes. Results At the final study visit, mean (SD) values for binocular UDVA, CDVA, DCIVA (80 cm), and DCNVA (40 cm) were −0.01 (0.06), −0.04 (0.04), 0.09 (0.10), and 0.10 (0.09) logMAR, respectively, for POD F, and 0.01 (0.08), −0.03 (0.03), 0.08 (0.1), and 0.13 (0.11) respectively, for POD F GF. Defocus assessments showed a continuous curve with a functional range of visual acuity (≤0.15 logMAR) from ~30 cm to infinity in both groups. The discrimination index was >0.85 for all patients, and both groups showed similar contrast sensitivity under photopic and mesopic conditions. At 3 months, no patient reported negative dysphotopsia, and high satisfaction rates were observed. Conclusion Clinical outcomes showed no significant difference between each lens when measured at 1 month and 3 months after implantation. This equally good clinical performance of hydrophilic and hydrophobic trifocal lenses allows the surgeon to choose the IOL material based on personal preferences or patients’ needs.
Collapse
Affiliation(s)
| | | | | | | | | | - Nuria Garzón
- Miranza IOA, Madrid, Spain.,Optometry and Vision Department, Universidad Complutense, Madrid, Spain
| |
Collapse
|
13
|
Remón L, Cabeza-Gil I, Calvo B, Poyales F, Garzón N. Biomechanical Stability of Three Intraocular Lenses With Different Haptic Designs: In Silico and In Vivo Evaluation. J Refract Surg 2020; 36:617-624. [PMID: 32901830 DOI: 10.3928/1081597x-20200713-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 06/16/2020] [Indexed: 01/10/2023]
Abstract
PURPOSE To assess the biomechanical stability of three different marketed intraocular lenses (IOLs) with different haptic designs (four-loop IOL [Micro F FineVision model] and double C-loop IOL [POD F and POD FT models], all manufactured by PhysIOL), in silico (computer simulation) and in vivo (in the context of lens surgery). METHODS An in silico simulation investigation was performed using finite element modeling (FEM) software to reproduce the compression test defined by the International Organization for Standardization and in vivo implantation in patients in the context of lens surgery was evaluated 1 day and 3 months postoperatively. IOL decentration and rotation were tested. In addition, the stress and strains were analyzed with the finite element method. RESULTS In the in silico evaluation, the compression force for the POD F IOL was slightly lower than for the POD FT IOL and Micro F IOL for all compression diameters. The axial displacement was maximum for the POD FT IOL and the tilt, rotation, and lateral decentration were substantially lower than the acceptable tolerance limits established in ISO 11979-2. In the in vivo evaluation, a total of 45 eyes from 45 patients were selected, 15 eyes for each IOL model under assessment. Statistically significant differences were found between the Micro F and POD F IOLs for lateral decentration in x-direction (in absolute value) at 3 months postoperatively (P = .03). CONCLUSIONS Although statistically significant differences have been found when comparing the displacement, tilt, and rotation between the different lenses, these differences cannot be considered clinically relevant, which would suggest that all three IOL models yield excellent stability in those terms. FEM appears to be a powerful tool for numerical studies of the biomechanical properties of IOLs. [J Refract Surg. 2020;36(9):617-624.].
Collapse
|
14
|
Systematic Study on the Biomechanical Stability of C-Loop Intraocular Lenses: Approach to an Optimal Design of the Haptics. Ann Biomed Eng 2019; 48:1127-1136. [PMID: 31828454 DOI: 10.1007/s10439-019-02432-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 12/03/2019] [Indexed: 12/14/2022]
Abstract
To study the main design parameters that affect the mechanical stability of C-loop intraocular lenses, leading to an optimal design that minimizes the axial displacement, tilt and rotation. A total of 144 geometrical variations were studied on a 1-piece, non-angulated, C-loop hydrophobic acrylate intraocular lens. The study was performed in a finite element modeling simulation. The suitable set of variations was determined using a mixed-factorial analysis, allowing to analyse the impact of the different designs on the mechanical stability of the lens (compression force, axial displacement, tilt and rotation). The design parameters under study were: the length, width, thickness and opening angle of the haptic, the haptic-optic junction and the start of the haptic curvature. The compression (or reaction) force is affected by the haptic width, the haptic-optic junction, and the interaction between both. The axial displacement is mainly affected by the width and thickness of the haptic, and the size of the haptic-optic junction as well. The tilt is affected by the haptic thickness and the interaction between the haptic curvature and the haptic-optic junction. The rotation is affected by the start of the haptic curvature, the haptic-optic junction and the haptic width. The haptic-optic juntion is one of the most influential parameters affecting the four responses studied of the C-Loop IOL. The smaller the haptic-optic juntion, the better biomechanical stability.
Collapse
|