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Ju RH, Qu HK, Wu ZM, Chen Y, Wu LN, Long Y, Wang Z. Comparison of visual performance with iTrace analyzer following femtosecond laser-assisted cataract surgery with bilateral implantation of two different trifocal intraocular lenses. Int J Ophthalmol 2023; 16:1773-1781. [PMID: 38028512 PMCID: PMC10626356 DOI: 10.18240/ijo.2023.11.06] [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: 07/31/2023] [Accepted: 09/28/2023] [Indexed: 12/01/2023] Open
Abstract
AIM To compare the postoperative binocular visual performance with an iTrace analyzer following femtosecond laser-assisted cataract surgery (FLACS) combined with bilateral implantation of two different types of diffractive trifocal intraocular lenses (IOL). METHODS During this retrospective observational study, patients who received bilateral FLACS combined with implantation of two different types of diffractive trifocal IOLs were evaluated. According to the IOLs' different types and design, the patients were divided into AT LISA tri839MP group (tri839 group) and AcrySof PanOptix TFNT00 group (TFNT group). Study parameters included preoperative and postoperative uncorrected distance visual acuity (UDVA) at 5 m, uncorrected near visual acuity (UNVA) at 30 cm and 40 cm, uncorrected intermediate visual acuity (UIVA) at 60 cm and 80 cm, postoperative refractive status, objective visual qualities and total high order aberrations (HOAs) postoperatively. The postoperative complications were also recorded. RESULTS Totally 56 eyes of 28 patients (tri839 group, n=26; TFNT group, n=30) were included. Preoperative baseline characteristics between groups were not statistically significantly different. UDVA was not significantly different between groups except for 1wk follow-up due to the postoperative corneal edema. TFNT group showed statistically significant better UNIA at 60 cm than tri839 group at the 1wk (0.05±0.19 vs 0.15±0.10 logMAR, P=0.013), 1mo (0.05±0.12 vs 0.15±0.09 logMAR, P=0.001) and 3mo (0.04±0.12 vs 0.15±0.11 logMAR, P=0.001) follow-up, while tri839 group showed statistically significant better UNIA at 80 cm than TFNT group at the 1d (0.14±0.15 vs 0.20±0.14 logMAR, P=0.041) and 1mo (0.09±0.07 vs 0.14±0.10 logMAR, P=0.042) follow-up. Postoperative refractive status showed stable at every visit. Modulated transfer function (MTF) values and strehl ratio (SR) values were improved and HOAs were lower significantly after surgery. CONCLUSION FLACS with bilateral implantations of both tri839 and TFNT00 can achieve satisfactory natural whole-course vision, high postoperative refractive stability and good visual quality but without significantly difference. iTrace aberration instrument can accurately evaluate the visual quality under different status.
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Affiliation(s)
- Rui-Hong Ju
- Aier Eye Hospital, Jinan University, Guangzhou 510071, Guangdong Province, China
| | - Hao-Kun Qu
- Aier Eye Hospital, Jinan University, Guangzhou 510071, Guangdong Province, China
| | - Zhe-Ming Wu
- Aier Eye Hospital, Jinan University, Guangzhou 510071, Guangdong Province, China
| | - Yun Chen
- Aier Eye Hospital, Jinan University, Guangzhou 510071, Guangdong Province, China
| | - Li-Nan Wu
- Aier Eye Hospital, Jinan University, Guangzhou 510071, Guangdong Province, China
| | - Yuan Long
- Aier Eye Hospital, Jinan University, Guangzhou 510071, Guangdong Province, China
| | - Zheng Wang
- Aier Eye Hospital, Jinan University, Guangzhou 510071, Guangdong Province, China
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Ahn H, Jun I, Seo KY, Kim EK, Kim TI. Femtosecond laser-assisted cataract surgery after corneal refractive surgery. Sci Rep 2022; 12:4263. [PMID: 35277568 PMCID: PMC8917192 DOI: 10.1038/s41598-022-08297-8] [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: 09/02/2021] [Accepted: 03/04/2022] [Indexed: 11/24/2022] Open
Abstract
Cataract is the leading cause of blindness worldwide, and advanced cataract techniques such as femtosecond laser-assisted cataract surgery (FLACS) have been commercially available. Corneal refractive surgery (CRS) is one of the most popular surgeries for the correction of refractive errors. CRS changes the cornea not only anatomically but also pathophysiologically. However, there has been no clinical research analyzing the refractive and safety outcomes of FLACS after CRS. The aim of this retrospective chart review and comparative study is to evaluate the effect and safety of FLACS after CRS comparing with conventional PCS. Participants with a previous CRS history who underwent FLACS or conventional PCS were included in this study. The visual outcomes and the refractive outcomes including refractive, corneal, and ocular residual astigmatism were compared. The safety outcomes were then studied intraoperatively and postoperatively. A total of 102 patients with age-related cataract were enrolled. At 3 months postoperatively, UCVA, BCVA, and predictive error were not significantly different between the FLACS and conventional PCS groups. Reduction of refractive astigmatism was higher in FLACS. Postoperative ORA was significant lower in FLACS. Reduction of ORA was higher in FLACS. The intraoperative and postoperative complications were also not significantly different between the two groups. FLACS could effectively change refractive astigmatism and ORA; without more complications than conventional PCS. FLACS’ competitive edge in postoperative ORA may provide better visual quality than conventional PCS in patients with a previous history of CRS.
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Affiliation(s)
- Hyunmin Ahn
- Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Ikhyun Jun
- Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.,Department of Ophthalmology, Corneal Dystrophy Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemungu, Seoul, 03722, Korea
| | - Kyoung Yul Seo
- Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Eung Kweon Kim
- Department of Ophthalmology, Corneal Dystrophy Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemungu, Seoul, 03722, Korea.,Saevit Eye Hospital, Goyang, Gyunggi-do, Korea
| | - Tae-Im Kim
- Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. .,Department of Ophthalmology, Corneal Dystrophy Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemungu, Seoul, 03722, Korea.
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Cobo-Soriano R, Ortega-Usobiaga J, Rodríguez-Gutiérrez B, Tejerina V, Llovet F, Casco B, Baviera J. Trifocal intraocular lens implantation in eyes with previous corneal refractive surgery for myopia and hyperopia. J Cataract Refract Surg 2021; 47:1265-1272. [PMID: 33769921 DOI: 10.1097/j.jcrs.0000000000000637] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 03/01/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the visual and refractive outcomes of trifocal intraocular lens (IOL) implantation in eyes previously treated with myopic and hyperopic corneal refractive laser surgery. SETTING Clinica Baviera-AIER-Eye group, Spain. DESIGN Retrospective comparative case series. METHODS The series was divided into 2 groups according to the type of corneal laser refraction (myopic and hyperopic). The main visual and refractive outcome measures included corrected distance visual acuity (CDVA) and uncorrected distance and near visual acuity, safety, efficacy, and predictability. The secondary outcome measures were percentage of enhancement and Nd:YAG capsulotomy and influence of prelaser magnitude of myopia and hyperopia on the outcome of trifocal IOL implantation. RESULTS The sample comprised 868 eyes (543 patients): myopic, n = 319 eyes (36.7%); and hyperopic, n = 549 eyes (63.2%). Three months postoperatively, visual outcomes were poorer in the hyperopic group than those in the myopic group for mean CDVA (0.06 ± 0.05 vs 0.04 ± 0.04, P < .01) and safety (21% vs 12% of CDVA line loss, P < .05) outcomes. However, precision outcomes were worse in the myopic group than those in the hyperopic group, with a mean spherical equivalent of -0.38 ± 0.3 vs -0.17 ± 0.3 (P < .01). Stratification by magnitude of primary laser treatment revealed poorer visual and safety results in the high hyperopia subgroup (>+3.0 diopters [D]) and poorer precision in the high myopia subgroup (<-5.0 D). CONCLUSIONS Trifocal IOL implantation after photorefractive surgery in eyes previously treated with myopic ablation achieved good visual outcomes but less predictability in the high myopia subgroup. However, eyes with a previous hyperopic corneal ablation achieved excellent precision but worse visual and safety outcomes in the high hyperopia subgroup.
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Affiliation(s)
- Rosario Cobo-Soriano
- From the Clinica Baviera-AIER Eye Group, Madrid, Spain (Cobo-Soriano, Ortega-Usobiaga, Rodríguez-Gutiérrez, Tejerina, Llovet, Casco, Baviera); Francisco de Vitoria University, Madrid, Spain (Cobo-Soriano)
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Li QM, Wang F, Wu ZM, Liu Z, Zhan C, Chen BH, Sima J, Stieger K, Li SW. Trifocal diffractive intraocular lens implantation in patients after previous corneal refractive laser surgery for myopia. BMC Ophthalmol 2020; 20:293. [PMID: 32680481 PMCID: PMC7367255 DOI: 10.1186/s12886-020-01556-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/06/2020] [Indexed: 01/07/2023] Open
Abstract
Background With the difficulties in IOL power calculation and the potential side effects occurring postoperatively, multifocal IOL implantation after previous corneal refractive surgery are rarely reported especially for the trifocal IOL. Herein we report the clinical observation of trifocal IOL implantation in patients with previous myopia excimer laser correction. In this study, a multi-formula average method was performed for the IOLs power calculation to improve the accuracy. Visual and refractive outcomes were analyzed, and the subjective quality of patients’ life was evaluated by questionnaires survey. Methods This retrospective case series included patients with previous myopia excimer laser correction who underwent femtosecond laser assisted phacoemulsification and trifocal IOL (AT LISA tri 839 MP) implantation. Follow-up was done at 1-day, 1-month and 3-month to assess the visual outcomes. Outcome measures were uncorrected distance, intermediate and near visual acuity (UDVA, UIVA, UNVA), manifest refraction, defocus curve, and subjective quality of vision. Results Twenty-one Eyes from sixteen patients (14 eyes with previous laser in situ keratomileusis and 7 eyes with previous photorefractive keratectomy) were included. Mean postoperative spherical equivalent (SE) at 3-month was − 0.56 D ± 0.49 SD, wherein, 10 eyes (47.6%) were within ±0.50 D of the desired emmetropia and 19 eyes (90.5%) were within ±1.0 D. Mean monocular UDVA, UIVA and UNVA (logMAR) at last visit were 0.02 ± 0.07, 0.10 ± 0.10, and 0.15 ± 0.11 respectively. Three patients (19%) reported halos and glare in postoperative 3 months, two of them needed to use spectacles to improve the intermediate visual acuity. Fifteen patients (94%) reported a satisfaction score of ≥3.5 out of 4.0, without any difficulty in daily activity. Thirteen patients (81%) did not need spectacles at all distances, while the other 3 patients (19%) used spectacles for near-distance related visual activity. Mean composite score of the VF-14 questionnaire was 95.00 ± 7.29 out of 100. Conclusions Trifocal IOL implantation after myopia excimer laser correction could restore good distance, intermediate visual acuity and acceptable near visual acuity, and provide accurate refractive outcomes as well as high spectacles independence rate.
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Affiliation(s)
- Qiu-Mei Li
- Beijing Aier-Intech Eye Hospital, Beijing, 100021, China
| | - Feng Wang
- Department of Ophthalmology, Aier School of Ophthalmology, Central South University, Changsha, 410083, China.,Department of Ophthalmology, Justus-Liebig-University, 35385, Giessen, Germany
| | - Zhe-Ming Wu
- Guangzhou Aier Eye Hospital, Guangzhou, 510260, China
| | - Zhen Liu
- Chongqing Aier Eye Hospital, Chongqing, 400020, China
| | - Chuan Zhan
- Wanzhou Aier Eye Hospital, Chongqing, 404000, China
| | | | - Jing Sima
- Shenzhen Aier Eye Hospital, Shenzhen, 518005, China
| | - Knut Stieger
- Department of Ophthalmology, Justus-Liebig-University, 35385, Giessen, Germany.
| | - Shao-Wei Li
- Beijing Aier-Intech Eye Hospital, Beijing, 100021, China. .,Department of Ophthalmology, Aier School of Ophthalmology, Central South University, Changsha, 410083, China.
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Zhu Y, Chen X, Chen P, Xu W, Shentu X, Yu Y, Yao K. Lens capsule-related complications of femtosecond laser-assisted capsulotomy versus manual capsulorhexis for white cataracts. J Cataract Refract Surg 2019; 45:337-342. [PMID: 30709630 DOI: 10.1016/j.jcrs.2018.10.037] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 10/13/2018] [Accepted: 10/16/2018] [Indexed: 12/20/2022]
Abstract
PURPOSE Comparison of lens capsule-related complications resulting from femtosecond laser-assisted capsulotomy and manual capsulorhexis in patients with white cataracts. SETTING Eye Center, Second Affiliated Hospital, Zhejiang Medical School, Hangzhou, China. DESIGN Prospective consecutive nonrandomized comparative cohort study. METHODS Selected patients were divided into a femtosecond laser-assisted cataract surgery group (FLACS group) and a conventional phacoemulsification cataract surgery group (CPCS group). Each case was recorded as either a type I or type II white cataract. Here, type I was characterized by the presence of a liquefied cortex, whereas type II had a solid cortex. Five experienced phacoemulsification surgeons conducted all surgeries. Lens capsule-related events, including anterior capsule tears, posterior capsule ruptures (PCRs), incomplete capsulotomies, and irregular capsulorhexes were recorded; surgical parameters, postoperative visual acuities, and intraocular lens (IOL) decentrations were evaluated. RESULTS The study comprised 132 eyes of 132 patients (66 in each group). Anterior capsule tears were significantly more common in the CPCS group than the FLACS group (12.1% versus 0%). All 8 cases of anterior capsule tears were type I cases. Six FLACS cases developed incomplete capsulotomies, four of which were type I cases. The incidences of PCRs and vitreous loss were the same. Capsulotomy produced better circularity index and diameter stability than capsulorhexis. IOLs were better centered in the FLACS group than the CPCS group. The mean ultrasound power, absolute phaco time, effective phaco time, and postoperative visual acuities were similar in both groups. CONCLUSIONS Compared with CPCS, FLACS decreased the risk for anterior capsule tears in white cataracts, especially in type I cases. However, it did not reduce the incidence of PCR. Incomplete capsulotomy during FLACS could happen in white cataracts. Using FLACS on white cataracts enabled more precise capsulotomies and better-centered IOLs.
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Affiliation(s)
- Yanan Zhu
- Eye Center, Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xinyi Chen
- Eye Center, Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Peiqing Chen
- Eye Center, Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Wen Xu
- Eye Center, Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xingchao Shentu
- Eye Center, Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yibo Yu
- Eye Center, Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Ke Yao
- Eye Center, Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
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Abstract
PURPOSE OF REVIEW This review aims to introduce recent updates in cataract surgery and lens implantation. RECENT FINDINGS Compared to phacoemulsification, femtosecond laser-assisted cataract surgery (FLACS) may offer benefit for cataract patients with other complicated ocular diseases, such as corneal disease and vitreous abnormalities. Meanwhile, several types of novel intraocular lenses (IOLs) have been introduced to the market, and each of them has particular features in improving patients' visual acuity. In addition, based on a series of studies, multifocal IOL is superior to monofocal IOL when it comes to providing a better visual correction at different distances. Furthermore, a research group has introduced a new approach for cataract surgery - all laser surgery (FLACS band with nanolaser emulsification), which can effectively reduce iatrogenic trauma to the cornea. Also, a novel technique designed for children can lessen damage from cataract surgery. SUMMARY Based on previous studies, we summarize the new proceedings in FLACS and the indications for applying multifocal or toric IOL. In addition, we briefly introduce a new approach to cataract surgery - all laser surgery (FLACS band with nanolaser emulsification), and a less invasive surgical procedure used in pediatric cataract patients.
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