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Niazi S, Gatzioufas Z, Dhubhghaill SN, Moshirfar M, Faramarzi A, Mohammadi F, Kheiri B, Peyman A, Heidari M, Doroodgar F. Association of Patient Satisfaction with Cataract Grading in Five Types of Multifocal IOLs. Adv Ther 2024; 41:231-245. [PMID: 37884810 DOI: 10.1007/s12325-023-02698-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/26/2023] [Indexed: 10/28/2023]
Abstract
INTRODUCTION This study investigated patient satisfaction levels in five premium intraocular lenses (IOLs). A secondary aim was to determine whether patient satisfaction was associated with the cataract grade before lens surgery. METHODS In this multicenter prospective comparative study, 164 patients from diverse backgrounds underwent cataract surgery and were assigned for identical bilateral implantation of multifocal IOLs. In addition to visual performance, quality of life was measured using the National Eye Institute Refractive Error Quality Of Life Instrument (NEI-RQL 42) scoring questionnaire. The Sirius Scheimpflug Analyzer was used to evaluate the posterior cornea and aberrations. Finally, the association of patient satisfaction reports with the Pentacam Cataract Grading Scale (PCGS) and Lens Opacities Classification System (LOCS III) was evaluated. RESULTS A considerable subjective improvement was observed in uncorrected far, near (40 cm), and intermediate (60 cm) visual acuity in the five groups (P values < 0.001). A significant difference was observed in mesopic and photopic contrast sensitivity between Symfony, Trinova, and AT LISA at the spatial frequency of 12 cycles per degree, favoring Symfony (P < 0.001). PanOptix users had considerably lower mean coma values (P < 0.001), while AT LISA users had lower mean spherical aberrations (P = 0.009) compared to the other groups. No additional safety concerns relating to IOLs were recorded. Mean satisfaction had a high correlation with LOCS and Pentacam Nuclear Staging (PNS) in each lens group, e.g., correlation coefficient and P value for AT LISA were respectively r = 0.99, P < 0.001 and r = 0.97, P = 0.004. CONCLUSION Despite discrepancies between groups of lenses, most patients who received multifocal IOLs reported satisfaction at more than 3 years after the initial operation. A growing number of patients with cataracts are seeking spectacle-free vision with presbyopia-correcting IOLs. Hence, the high satisfaction rate among patients with cataract could indicate the value of offering a wider range of available lenses.
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Affiliation(s)
- Sana Niazi
- Translational Ophthalmology Research Center, Tehran University of Medical Science, Tehran, Iran
| | | | - Sorcha N Dhubhghaill
- Antwerp University Hospital, Edegem, Belgium
- Faculty of Health Sciences, Antwerp University, Edegem, Belgium
| | - Majid Moshirfar
- Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT, USA
| | - Amir Faramarzi
- Department of Ophthalmology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Farzad Mohammadi
- Translational Ophthalmology Research Center, Tehran University of Medical Science, Tehran, Iran
| | - Bahar Kheiri
- University Eye Hospital Basel, Basel, Switzerland
| | - Alireza Peyman
- Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Heidari
- Department of Epidemiology and Biostatistics, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Farideh Doroodgar
- Translational Ophthalmology Research Center, Tehran University of Medical Science, Tehran, Iran.
- Negah Aref Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Skrzypecki J, Izdebska J, Ordon AJ, Przybek-Skrzypecka J, Szaflik JP. Spherical aberrations and their role in modern ophthalmology. Clin Exp Optom 2023; 106:703-710. [PMID: 36822601 DOI: 10.1080/08164622.2022.2160235] [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: 07/20/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 02/25/2023] Open
Abstract
Spherical aberration is an imperfection of the optical system of the human eye. The role of spherical aberration of the human eye in the quality of vision and pseudoaccommodation is reviewed. Spherical aberration is an imperfection of the optical system of the human eye. In most cases, due to well-developed neuroadaptation, it is insignificant for the perception of the image. Nevertheless, its role in modern ophthalmology is far from straightforward. On the one hand, there are clinical scenarios in which an excess of spherical aberration degrades the retinal image and leads to a high dissatisfaction rate among patients.©Recently, there is a growing interest in the modulation of spherical aberration in the clinical setting. Modern intraocular lenses as well as laser refractive procedures are aimed at interfering with spherical aberrations of the optical system in order to increase range of pseudoaccommodation. Here, we review the role of spherical aberration of the human eye in the quality of vision and pseudoaccommodation.
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Affiliation(s)
- Janusz Skrzypecki
- Departament of Ophthalmology, Independent Public University Eye Hospital, Warsaw, Poland
- Department of Experimental Physiology and Pathophysiology, Medical University of Warsaw, Warsaw, Poland
| | - Justyna Izdebska
- Departament of Ophthalmology, Independent Public University Eye Hospital, Warsaw, Poland
- Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland
| | - Agata Joanna Ordon
- Departament of Ophthalmology, Independent Public University Eye Hospital, Warsaw, Poland
- Department of Binocular Vision Pathophysiology and Strabismus, Medical University of Lodz, Lodz, Poland
| | - Joana Przybek-Skrzypecka
- Departament of Ophthalmology, Independent Public University Eye Hospital, Warsaw, Poland
- Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland
| | - Jacek Pawel Szaflik
- Departament of Ophthalmology, Independent Public University Eye Hospital, Warsaw, Poland
- Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland
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Clinical outcomes of presbyopia-correcting intraocular lenses in patients with Fuchs endothelial corneal dystrophy. Sci Rep 2023; 13:786. [PMID: 36646806 PMCID: PMC9842705 DOI: 10.1038/s41598-023-27830-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 01/09/2023] [Indexed: 01/18/2023] Open
Abstract
Fuchs endothelial corneal dystrophy (FECD) is considered a contraindication for the implantation of presbyopia-correcting IOLs, without sufficient corroborating evidence. A Retrospective, case-control study. Nineteen eyes of ten patients with grade 2-5 FECD (study group) and 57 healthy eyes of 57 patients (control group) who underwent cataract surgery with implantation of presbyopia-correcting IOLs, at the Ein-Tal Eye Center, Tel Aviv, Israel, were included. The target refraction was emmetropia for both groups. Two subgroups of IOLs were analyzed separately: extended depth of focus (EDOF), (9 eyes of FECD patients and 27 eyes of control patients) and multifocal IOLs (10 eyes of FECD patients and 30 eyes of control patients). Main outcome measures were visual acuity and refraction 6 weeks after the surgery. Secondary outcomes were patient perceptions of visual acuity, spectacle independence, photic phenomena and satisfaction scores, reported in a self-assessment questionnaire. FECD patients in the EDOF IOL subgroup had inferior uncorrected distance visual acuity (P = 0.007) and better uncorrected near visual acuity (P = 0.001) compared to the controls. They had less spectacle independence for the intermediate range (P = 0.01) and overall (P = 0.006). However, they did not have more photic phenomena. In the multifocal IOL subgroup, no significant differences were found between the FECD and the control group in visual acuity for all ranges and in spectacle independence. FECD patients had more photic phenomena than the controls (P = 0.006), but it did not interfere with daily life activities. There was no difference in post-operative mean spherical equivalent, patient reported visual perception, and general satisfaction between FECD and control patients in both groups. Our results suggest that presbyopia-correcting IOLs can be carefully considered in patients with grade 2-5 FECD, with slightly inferior results compared with healthy eyes.
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Yang LWY, Ong HS, Chiam N, Mehta JS. Centration and Stability of Small-Aperture Intraocular Lens in Aberrated Eyes. J Refract Surg 2022; 38:98-105. [DOI: 10.3928/1081597x-20211116-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Hovanesian JA, Jones M, Allen Q. The Vivity Extended Range of Vision IOL vs the PanOptix Trifocal, ReStor 2.5 Active Focus and ReStor 3.0 Multifocal Lenses: A Comparison of Patient Satisfaction, Visual Disturbances, and Spectacle Independence. Clin Ophthalmol 2022; 16:145-152. [PMID: 35082481 PMCID: PMC8785133 DOI: 10.2147/opth.s347382] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/29/2021] [Indexed: 12/21/2022] Open
Affiliation(s)
- John A Hovanesian
- Harvard Eye Associates, Laguna Hills, CA, USA
- Correspondence: John A Hovanesian Harvard Eye Associates, 23961 Calle De La Magdalena, #300, Laguna Hills, CA, 92653, USATel +1 949 951 2020Fax +1 949 951 9244 Email
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Hovanesian JA, Jones M, Allen Q. The PanOptix Trifocal IOL vs the ReSTOR 2.5 Active Focus and ReSTOR 3.0-Add Multifocal Lenses: A Study of Patient Satisfaction, Visual Disturbances, and Uncorrected Visual Performance. Clin Ophthalmol 2021; 15:983-990. [PMID: 33692612 PMCID: PMC7939508 DOI: 10.2147/opth.s285628] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 02/12/2021] [Indexed: 11/26/2022] Open
Abstract
Purpose To compare spectacle independence, patient-reported outcomes (PROs), and dysphotopsia after multifocal intraocular lens (IOL) implantation with the AcrySof PanOptix trifocal or the ReSTOR +2.5/3.0 D or ReSTOR +2.5 D mini-monovision multifocal IOL. Patients and Methods Prospective, open-label, multicenter analysis of PROs, spectacle independence, and satisfaction among patients undergoing cataract surgery who had been implanted at least 1 month previously with AcrySof IQ PanOptix or PanOptix Toric trifocal (n = 59) IOLs bilaterally. Results were compared to outcomes from a similar study with the AcrySof ReSTOR 2.5/3.0 or the ReSTOR ActiveFocus 2.5 mini-monovision lens [n = 191]). Results Spectacle independence was significantly higher in the PanOptix cohort, with 83% of patients “never” needing glasses for any activity versus 36% in the ReSTOR 2.5 mini-monovision and 34% in the ReSTOR 2.5/3.0 cohorts. No significant differences in patient satisfaction rates were reported between the three cohorts. Glare and halo were rated “extremely” noticeable more with the PanOptix (10%) than with the ReSTOR 2.5 mini-monovision (1%) or ReSTOR 2.5/3.0 (3%). BCVA differences were not statistically significant, and no new safety concerns were reported. Conclusion The AcrySof PanOptix trifocal provides significantly greater spectacle independence across all measured activities than the AcrySof ReSTOR multifocal IOLs.
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Evaluation of Safety Following Optic Exchange of a Modular Intraocular Lens. J Cataract Refract Surg 2021; 47:1273-1278. [PMID: 33769763 DOI: 10.1097/j.jcrs.0000000000000628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 02/16/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To characterize safety of optic exchange using a modular lens. SETTING 3 study sites (New Zealand, Philippines). DESIGN Prospective clinical study. METHODS Harmoni modular intraocular lens (HMIOL) with separate base and optic components was implanted in the study eye (monovision target -1.5 D). Contralateral eyes received standard monofocal lenses. Subjects could elect optic exchange 3 months after primary implantation. Adverse events (AEs) and endothelial cell loss (ECL) were assessed through 12-months follow-up. RESULTS 114 subjects successfully received HMIOL and 114 received control lens in contralateral eye. At month 3, 65 HMIOL eyes had optic exchange due to unsatisfactory visual outcome from high monovision (Exchange cohort); 49 eyes received no exchange (No Exchange cohort). Exchange, No Exchange, and Control cohorts reported ocular AEs in 10 (15%), 6 (12%), and 14 (12%) eyes. No posterior capsular rupture occurred during optic exchange procedures. Short-term (12-month) posterior capsule opacification (PCO) evaluation showed all eyes had PCO grade ≤1 at month 12; no YAG capsulotomy was performed in the Exchange cohort. No Exchange and Exchange cohorts had similar ECL at 3 months versus preoperative baseline (-4.5%, n=48 and -4.0%, n=65). In the Exchange cohort, additional 2.7% ECL occurred 3 months after optic exchange compared with pre-exchange baseline; ECL was significantly below the 14% threshold (P<0.001) and was 5.8% at 12 months. CONCLUSIONS HMIOL safety outcomes were comparable with standard monofocal lenses; HMIOL may provide an effective method for correcting postoperative refractive errors.
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Auffarth GU, Gerl M, Tsai L, Janakiraman DP, Jackson B, Alarcon A, Dick HB. Clinical evaluation of a new monofocal IOL with enhanced intermediate function in patients with cataract. J Cataract Refract Surg 2021; 47:184-191. [PMID: 32932369 DOI: 10.1097/j.jcrs.0000000000000399] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 08/04/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE To evaluate the effectiveness and safety of 2 enhanced monofocal intraocular lenses (IOLs). The TECNIS Eyhance IOL (Model ICB00) was compared with a standard monofocal IOL (TECNIS Monofocal, Model ZCB00). SETTING European multicenter study. DESIGN Prospective, bilateral, randomized, comparative/evaluator-masked, controlled study. METHODS Adult subjects scheduled to undergo bilateral, primary phacoemulsification cataract extraction and posterior IOL implantation were randomized to receive the enhanced monofocal ICB00 IOL or the monofocal ZCB00 IOL in both eyes. Monocular endpoints at 6 months included distance-corrected intermediate visual acuity (DCIVA), photopic corrected distance visual acuity, and uncorrected intermediate visual acuity (UIVA). Binocular visual acuities, monocular corrected distance contrast sensitivity (first eyes), patient-reported outcomes, and safety were assessed at 6 months. RESULTS Overall, 139 patients were bilaterally implanted with the enhanced monofocal IOL (n = 67) or standard monofocal IOL (n = 72) and available for the 6-month visit. The enhanced monofocal IOL significantly improved mean monocular and binocular DCIVA and UIVA by at least 1-line logarithm of the minimum angle of resolution vs the standard monofocal IOL (all P ≤ .0001). Distance vision for the enhanced monofocal IOL was 20/20 or better and comparable with that of the standard monofocal lens at 6 months. Contrast sensitivity, photic phenomena outcomes, and rates of adverse events were similar between the 2 groups. CONCLUSIONS In patients undergoing cataract surgery, TECNIS Eyhance IOL Model ICB00 provided enhanced intermediate vision and similar distance performance and photic phenomena compared with a standard monofocal IOL, along with improved functional performance in daily life.
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Affiliation(s)
- Gerd U Auffarth
- From the International Vision Correction Research Centre (IVCRC), University-Eye-Clinic (Auffarth), Heidelberg, Augenklinik Ahaus (Gerl), Ahaus, Germany; Johnson & Johnson Vision (Tsai, Janakiraman, Jackson), Santa Ana, California, USA; AMO (Alarcon), Groningen, the Netherlands; University Eye Hospital (Dick), Bochum, Germany
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Shafer BM, Greenwood M. Presbyopia Correction at the Time of Cataract Surgery. CURRENT OPHTHALMOLOGY REPORTS 2020. [DOI: 10.1007/s40135-020-00236-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Hovanesian JA, Lane SS, Allen QB, Jones M. Patient-Reported Outcomes/Satisfaction and Spectacle Independence with Blended or Bilateral Multifocal Intraocular Lenses in Cataract Surgery. Clin Ophthalmol 2019; 13:2591-2598. [PMID: 31920282 PMCID: PMC6938179 DOI: 10.2147/opth.s227629] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 12/13/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare patient-reported outcomes (PROs) and satisfaction results after multifocal intraocular lens (IOL) implantation in three groups: two receiving bilateral implantation of the same IOL and another undergoing blended vision with two different multifocal IOLs. Patients and methods A questionnaire was administered to patients who had undergone uncomplicated cataract surgery and 2 months of follow-up: the first group underwent bilateral implantation with Alcon’s AcrySof ReSTOR 3.0 lens (“3.0/3.0,” n=78); the second group underwent implantation with the ReSTOR ActiveFocus 2.5 or the ReSTOR ActiveFocus 2.5 toric lens (“2.5 mini-monovision,” n=102); and the third group underwent implantation with the ReSTOR 2.5 lens in the dominant eye and the ReSTOR 3.0 lens in the non-dominant eye (“2.5/3.0,” n=89). Results Overall PROs and satisfaction was similar among the groups. Refractive outcomes and accuracy were similar among the groups, but the 2.5 mini-monovision group reported better intermediate vision. Refractive outcome differences were not meaningful among the groups and were not a differentiating factor in PROs. Substantially fewer patients in the 2.5 mini-monovision group noticed glare and halo compared with the 3.0/3.0 group (P<0.0001, chi-square test). No new safety concerns were reported. Conclusion The 2.5 mini-monovision results in a higher percentage of patients being satisfied with intermediate vision than bilateral ReSTOR 3.0 or blended vision with ReSTOR 2.5/3.0 implants, but overall PRO differences were not statistically significant.
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Hamdi IM. Subjective Perception Of Trifocal IOL Performance, Including Toric Models. Clin Ophthalmol 2019; 13:1955-1961. [PMID: 31631963 PMCID: PMC6778730 DOI: 10.2147/opth.s223062] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 09/13/2019] [Indexed: 11/25/2022] Open
Abstract
Purpose To study the patients’ perception of trifocal IOL (Panoptix™) performance. Patients and methods 60 eyes of 35 were implanted with trifocal IOL. Refractive (sphere – S, cylinder – Cyl and spherical equivalent – SE, all in D) and visual (distance uncorrected – VAsc, distance corrected – VAcc, intermediate – IntVA, near uncorrected – NVAsc and distance corrected near – NVAcc, all in LogMAR) results were recorded. Patients were asked about satisfaction (per eye), spectacle independence, near and intermediate activities, distance activities in quantity and quality, finally about personal facial care (per patient). Comparison was made between non-toric (48) and toric models, genders (18 males) and between bilateral (25 patients) and unilateral implantations. Results were correlated to age and IOL power. Results With a SE of mean −0.3 ± 0.5 D, cases achieved mean VAsc 0.09 ± 0.1 (~20/25), VAcc 0.05 ± 0.1 (~20/22), IntVA 0.05 ± 0.9 (~20/22), NVAsc 0.05 ± 0.09 (~~20/22) and NVAcc 0.04 ± 0.8 (~~20/22). Mean level of satisfaction was 85.7 ± 16.5, spectacle independence 96.0 ± 10.6, near activities 95.4 ± 9.8, intermediate activities 97.7 ± 6.4, quantity of distance activities 90.2 ± 10.1, quality of distance activities 88.0 ± 12.1 and facial care 92.6 ± 11.9. All comparisons (non-toric and toric, male and female and bilateral and unilateral implantation) were statistically insignificant (P>0.05). Correlation with age and IOL power was also statistically insignificant (P>0.05). Conclusion As perceived by patients, trifocal IOL resulted in very high level of satisfaction. This satisfaction is reflected on diverse visual activities. This level is achieved regardless of gender, IOL model or even unilateral implantation. It is also achieved regardless the age of patients or preoperative eye status.
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Affiliation(s)
- Islam Mahmoud Hamdi
- Ophthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.,Ophthalmology Consultant, The Eye Consultants Center, Jeddah, Saudi Arabia
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