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Komatsu K, Masuda Y, Tachibana S, Sano K, Iida M, Ichihara K, Oki T, Fukai K, Tatemichi M, Nakano T. Postoperative Visual Function of Extended Depth-of-Focus Intraocular Lenses Versus Monofocal Lenses. J Refract Surg 2024; 40:e499-e505. [PMID: 39007813 DOI: 10.3928/1081597x-20240522-01] [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: 07/16/2024]
Abstract
PURPOSE To assess the effects of intraocular lens (IOL) decentration and tilt, as well as age, on postoperative visual function (corrected distance visual acuity [CDVA] and contrast sensitivity) by comparing an extended depth-of-focus IOL using higher order aspheric optics against a monofocal IOL from the same platform. METHODS This retrospective observational study targeted patients without other eye diseases who underwent surgery to implant the Tecnis Eyhance OptiBlue or the monofocal IOL Tecnis OptiBlue 1-Piece (J&J Vision) during cataract surgery from November 2021 to December 2022. The effects of age, axial length, IOL decentration, tilt, and corneal higher order aberrations (HOAs) on the postoperative 5 m CDVA and area under log contrast sensitivity function (AULCSF) under photopic and scotopic conditions were evaluated within 3 months of surgery. RESULTS No significant difference was found in postoperative CDVA between the Tecnis Eyhance OptiBlue group (n = 61 eyes) and the Tecnis OptiBlue 1-Piece group (n = 35 eyes), but AULCSF was significantly better in the Tecnis Eyhance OptiBlue group for photopic (1.58 ± 0.13 vs 1.46 ± 0.18; P = .002) and scotopic (1.71 ± 0.11 vs 1.59 ± 0.19; P = .002) eyes. Multivariate analysis showed a negative correlation between AULCSF and IOL decentration and age in the Tecnis Eyhance OptiBlue group (P < .01), with no significant correlation with tilt, axial length, and corneal HOAs. CONCLUSIONS The Tecnis Eyhance OptiBlue yielded significantly better contrast sensitivity under photopic and scotopic conditions than the Tecnis OptiBlue 1-Piece. However, it is important to consider the effects of IOL decentration and age when evaluating the contrast sensitivity of the Tecnis Eyhance OptiBlue. [J Refract Surg. 2024;40(7):e499-e505.].
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Cerviño A, Esteve-Taboada JJ, Chiu YF, Yang CH, Tseng WC, Lee W. Tolerance to decentration of biaspheric intraocular lenses with refractive phase-ring extended depth of focus and diffractive trifocal designs. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06458-1. [PMID: 38526773 DOI: 10.1007/s00417-024-06458-1] [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: 09/24/2023] [Revised: 02/04/2024] [Accepted: 03/16/2024] [Indexed: 03/27/2024] Open
Abstract
PURPOSE This study aimed to investigate the in vitro tolerance to decentration of biaspheric intraocular lens (IOLs) with refractive phase-ring extended depth-of-focus (EDOF) and diffractive trifocal designs. METHODS This experimental study was carried out at the Department of Optics and Optometry and Vision Science, University of Valencia, Spain. The modulation transfer function (MTF) of the ETLIO130C EDOF and the TFLIO130C trifocal IOLs (AST Products Inc., Billerica, MA, USA) were determined at different levels of decentration for a given wavelength and pupil diameter using the PMTF optical bench (Lambda-X Ophthalmics, Nivelles, Belgium). The modulation transfer function (MTF) curves, the through-focus MTF curves, and the Strehl ratios were measured at 3-mm pupil aperture for 0.25-, 0.50- and 0.75-mm decentration. RESULTS The optical design of the trifocal TFLIO130C IOL is robust to small decentrations, with virtually no change in MTF response for 0.25 mm decentration. For greater decentration levels, the MTF response is slightly reduced with increasing decentration. The ETLIO130C EDOF design is robust to decentration, as the MTF response is only minimally affected when increasing the decentration up to 0.75 mm. CONCLUSIONS MTF responses are slightly reduced with greater levels of decentration, but the range of focus provided by both trifocal and EDOF designs are preserved. The effects for average levels of decentration reported in the literature are minimum for both IOL designs.
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Affiliation(s)
- Alejandro Cerviño
- Department of Optics & Optometry & Vision Sciences, University of Valencia, C / Dr. Moliner, 50., 46100, Burjassot, Valencia, Spain.
| | - Jose Juan Esteve-Taboada
- Department of Optics & Optometry & Vision Sciences, University of Valencia, C / Dr. Moliner, 50., 46100, Burjassot, Valencia, Spain
| | | | | | - Wen-Chu Tseng
- ICARES Medicus, Inc, Hsinchu County, Taiwan
- AST Products, Inc, Billerica, MA, USA
| | - William Lee
- ICARES Medicus, Inc, Hsinchu County, Taiwan
- AST Products, Inc, Billerica, MA, USA
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Kim DR, Yoon YC, Whang WJ, Hwang HS, Na KS. Ocular parameters associated with visual performance of enhanced monofocal intraocular lens. BMC Ophthalmol 2024; 24:74. [PMID: 38369454 PMCID: PMC10875848 DOI: 10.1186/s12886-024-03316-w] [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: 09/07/2023] [Accepted: 01/18/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND An enhanced monofocal intraocular lenses (IOLs) (Tecnis Eyhance ICB00 and Tecnis Eyhance Toric DIU) has been developed to enhance intermediate vision while avoiding the disadvantages of multifocal IOLs. Although many studies have demonstrated the improvement of intermediate visual acuity with enhanced monofocal IOLs, it is not known specifically for which patients these IOLs should be recommended or avoided. In this study, we aim to find out which ocular parameters affect vision performance and photic phenomenon of ICB00 or DIU at different distances. METHODS Patients who underwent cataract surgery with ICB00 or DIU, performed by a single surgeon, were included. Before surgery, the patients' age, gender, axial length, anterior chamber depth, spherical aberration Z (4,0), vertical coma, horizontal coma, angle kappa (κ), angle alpha (α), and other ocular parameters were investigated. One month after surgery, uncorrected near visual acuity (UNVA at 40 cm), uncorrected intermediate visual acuity (UIVA at 66 cm), uncorrected distance logMAR visual acuity (UDVA), IOL decentration, and quality of vision (QoV) questionnaires were conducted. RESULTS A total of 43 patients (58 eyes) were included. The results of the univariate linear regression analyses showed a negative correlation between spherical aberration and logMAR UNVA and UIVA (p = 0.003, β=-0.51 and p = 0.018, β=-0.23, respectively) and a positive correlation between angle α and logMAR UIVA (p = 0.036, β = 0.19). Deeper anterior chamber depth (ACD) was associated with poorer total QoV (p = 0.018, β = 14.43), particularly in glare, halo, blur, and fluctuation perception. A higher degree of IOL decentration tended to decrease UNVA and UIVA (Pearson correlation coefficient, r = 0.336 and r = 0.221, respectively); however, no significant effect was observed on UDVA (Pearson correlation coefficient, r = 0.042). CONCLUSIONS In enhanced monofocal IOLs, a higher level of spherical aberration is associated with better performance in UNVA and UIVA, whereas a larger angle α has a negative impact. A deeper ACD negatively affects the QoV.
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Affiliation(s)
- Da Ran Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young Chae Yoon
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Woong-Joo Whang
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ho Sik Hwang
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyung-Sun Na
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Stern B, Saad A, Flamant R, Joannes L, Gatinel D. Intra-Observer and Inter-Observer Variability of Intraocular Lens Measurements Using an Interferometry Metrology Device. Diagnostics (Basel) 2024; 14:216. [PMID: 38275463 PMCID: PMC10813881 DOI: 10.3390/diagnostics14020216] [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: 11/09/2023] [Revised: 12/20/2023] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
The NIMO TEMPO (Lambda-X, Nivelles, Belgium) is a novel, user-friendly and compact device designed for in vitro optical analysis of refractive and diffractive intraocular lenses (IOLs). This device analyzes the IOL wavefront and generates a synthetic eye model for numerical computation. The objective of this study was to evaluate the precision of this innovative device. Intra- and inter-observer variability were calculated using a two-way analysis of variance (ANOVA) after conducting ten measurements of eight different IOL models, with each measurement being repeated by three distinct operators (resulting in a total of 30 measurements for each IOL). The device demonstrated satisfactory intra- and inter-observer variability in evaluating IOL power and modulation transfer function (MTF) profiles, with values of 0.066 and 0.078 diopters for IOL power and 0.018 and 0.019 for MTF measurements, respectively. Furthermore, this hybrid optical and numerical in vitro IOL wavefront analyzer appears to have several advantages over conventional optical bench devices. It reduces the need for operator manipulation, and allows for numerical modeling of various optical environments, including cornea models and apertures. In conclusion, this novel metrology device designed for refractive and diffractive IOLs appears to provide a satisfactory precision, making it a promising tool in the field of IOL metrology.
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Affiliation(s)
- Benjamin Stern
- Department of Ophthalmology, Rothschild Foundation Hospital, 75019 Paris, France
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel
| | - Alain Saad
- Department of Ophthalmology, Rothschild Foundation Hospital, 75019 Paris, France
| | - Roxane Flamant
- Department of Ophthalmology, Rothschild Foundation Hospital, 75019 Paris, France
| | - Luc Joannes
- Lambda-X SA, Avenue Robert Schuman, 102, B-1400 Nivelles, Belgium
| | - Damien Gatinel
- Department of Ophthalmology, Rothschild Foundation Hospital, 75019 Paris, France
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Fernández J, Rocha-de-Lossada C, Zamorano-Martín F, Rodríguez-Calvo-de-Mora M, Rodríguez-Vallejo M. Positioning of enhanced monofocal intraocular lenses between conventional monofocal and extended depth of focus lenses: a scoping review. BMC Ophthalmol 2023; 23:101. [PMID: 36918799 PMCID: PMC10015679 DOI: 10.1186/s12886-023-02844-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/06/2023] [Indexed: 03/15/2023] Open
Abstract
BACKGROUND New intraocular lenses (IOLs) have emerged since the originally coined monofocal and multifocal IOLs. The extended depth of focus (EDoF) and enhanced monofocal IOLs (mono-EDoF) that have appeared in the last decade have caused some confusion in their classification. The aim of this review was to summarize the outcomes provided by mono-EDOF IOLs and to determine which of the endpoints, described by the American National Standard (ANSI) for EDoF IOLs, are fulfilled. METHODS The MEDLINE, EMBASE, and WEB OF SCIENCE databases were searched. Two independent reviewers screened the studies for inclusion and data extraction. The search strategy was limited to studies published between 2020 and 2022, but not by language. The results are presented as a narrative summary accompanied by tables, in alignment with the objectives of this scoping review. Compliance with the endpoints for clinical outcomes described in the American National Standard Z80.35-2018 (ANSI) for EDoF lenses was checked and additional endpoints were defined. RESULTS Two systematic reviews, 13 laboratory, 21 clinical, and two mixed studies were included. Tecnis Eyhance was the mono-EDOF with the highest volume of evidence to date. Although laboratory studies included other IOLs, clinical evidence for them is still scarce, with only one study of IsoPure compared to a standard monofocal IOL. Evidence in comparison to EDoF lenses is also scarce, even for Tecnis Eyhance, with only three studies including this lens in comparison to an EDoF lens. After evaluation of the ANSI criteria, agreement was found in the failure for the increase in depth of field equal to or greater than 0.5 D for a visual acuity (VA) level of 0.2 logMAR and none of the studies supported that the median monocular VA at intermediate distance was at least 0.2 logMAR. CONCLUSIONS Additional clinical evidence is required for other mono-EDOF IOLs beyond Tecnis Eyhance. Until the arrival of a standard classification, mono-EDOF should be better still classified as monofocal because the ANSI standards were not fully met.
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Affiliation(s)
- Joaquín Fernández
- Qvision. Ophthalmology Department, VITHAS Almería Hospital, 04120, Almería, Spain
| | - Carlos Rocha-de-Lossada
- Qvision. Ophthalmology Department, VITHAS Almería Hospital, 04120, Almería, Spain
- Ophthalmology Department, VITHAS Málaga. 29016, Málaga, Spain
- Hospital Regional Universitario de Málaga. Plaza del Hospital Civil, 29009, Málaga, S/N, Spain
- Departamento de Cirugía, Área de Oftalmología. Doctor Fedriani, Universidad de Sevilla, 41009, Sevilla, S/N, Spain
| | | | - Marina Rodríguez-Calvo-de-Mora
- Qvision. Ophthalmology Department, VITHAS Almería Hospital, 04120, Almería, Spain
- Ophthalmology Department, VITHAS Málaga. 29016, Málaga, Spain
- Hospital Regional Universitario de Málaga. Plaza del Hospital Civil, 29009, Málaga, S/N, Spain
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