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Chung HS, Nam S, Jang JH, Lee KE, Kim JY, Tchah H, Lee H. Short-term clinical outcomes after implantation of monofocal intraocular lens with enhanced intermediate function in eyes with epiretinal membrane. Sci Rep 2023; 13:18018. [PMID: 37865699 PMCID: PMC10590442 DOI: 10.1038/s41598-023-44839-4] [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: 04/05/2023] [Accepted: 10/12/2023] [Indexed: 10/23/2023] Open
Abstract
Our study evaluated the clinical outcomes after implantation of a monofocal intraocular lens (IOL) with enhanced intermediate function in eyes with epiretinal membrane (ERM). Patients with preexisting ERM who underwent cataract surgery with implantation of monofocal IOL with enhanced intermediate function were included retrospectively. According to the ERM grade and central subfield thickness (CST) obtained from preoperative optical coherence tomography, patients were divided into non-fovea-involving and fovea-involving ERM groups. At 1 month after surgery, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), contrast sensitivity, defocus curve, and satisfaction questionnaire were evaluated. Postoperative clinical findings were compared with age-matched controls without ERM. A total of 50 patients' eyes (28 and 22 in the non-fovea-involving and fovea-involving ERM groups, respectively) were compared with 42 control eyes. One month post-surgery, significant differences in UDVA, CDVA, and CST (corrected P was < 0.001, = 0.001, and < 0.001, respectively) were observed between the fovea-involving ERM and control group; however, no significant differences in UIVA and UNVA were observed between the two groups. Contrast sensitivity showed inferior results in the fovea-involving group without significance. Photic phenomena were reported less in the fovea-involving group than in the non-fovea-involving group. More than 70% of patients in both ERM groups were satisfied. Implantation of monofocal IOL with enhanced intermediate function could be a good option for patients with ERM that need intermediate vision.
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Affiliation(s)
- Ho Seok Chung
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea
| | - Sanghyu Nam
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea
| | - Joon Hyuck Jang
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea
| | - Ko Eun Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea
| | - Jae Yong Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea
| | - Hungwon Tchah
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea
| | - Hun Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea.
- Center for Cell Therapy, Asan Medical Center, Seoul, South Korea.
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Jeon S, Choi A, Kwon H. Clinical outcomes after implantation of extended depth-of-focus AcrySof® Vivity® intraocular lens in eyes with low-grade epiretinal membrane. Graefes Arch Clin Exp Ophthalmol 2022; 260:3883-3888. [PMID: 35796821 DOI: 10.1007/s00417-022-05751-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/18/2022] [Accepted: 06/29/2022] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To evaluate the clinical outcomes of extended depth-of-focus (EDoF) AcrySof® Vivity® intraocular lens in eyes with low-grade epiretinal membrane (ERM). METHODS Forty-five eyes with low-grade ERM and history of Vivity implantation were compared with 50 age-matched controls with Vivity implantation and no ERM. Eyes with ERM showing widening of the outer nuclear layer and loss of the foveal depression, but no ectopic inner foveal layer or outer retinal defect were eligible. Corrected and uncorrected distant visual acuity (CDVA and UDVA), uncorrected intermediate and near visual acuity (UIVA and UNVA), contrast sensitivity detected by area under the log contrast sensitivity function (AULCSF), Strehl ratio, area ratio, and occurrence of dysphotopsia were compared between groups. RESULTS UDVA and CDVA were similar between groups (UDVA: 0.01 ± 0.05 vs 0.03 ± 0.06, P = 0.154; CDVA: 0.00 ± 0.00 vs 0.00 ± 0.02, P = 0.125). UIVA and mesopic AULCSF were significantly worse in eyes with ERM compared to those with no ERM (UIVA: 0.09 ± 0.09 vs 0.14 ± 0.10, P = 0.028; mesopic AULCSF: 1.26 ± 0.15 vs 1.17 ± 0.10, P = 0.013). The occurrence of dysphotopsia was similar in both groups (glare: P = 0.465; halo: P = 0.218; starburst: P = 0.457). DISCUSSION Eyes with low-grade ERM showed comparable outcomes to eyes without ERM after Vivity IOL implantation. Implantation of this newly developed EDoF IOL with low addition can be of benefit to eyes with low-grade, reversible ERM that is limited to the inner retina.
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Affiliation(s)
- Sohee Jeon
- Keye Eye Center, 326 Teheran-ro, Gangnam-gu, Seoul, Republic of Korea.
| | - Ayoung Choi
- Keye Eye Center, 326 Teheran-ro, Gangnam-gu, Seoul, Republic of Korea
| | - Hyunggoo Kwon
- Keye Eye Center, 326 Teheran-ro, Gangnam-gu, Seoul, Republic of Korea
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Arrevola-Velasco L, Beltran J, Gimeno MJ, Ortega-Usobiaga J, Druchkiv V, Llovet-Osuna F, Baviera-Sabater J. Visual outcomes after vitrectomy for epiretinal membrane in pseudophakic eyes with a diffractive trifocal intraocular lens: a retrospective cohort study. BMC Ophthalmol 2022; 22:39. [PMID: 35086499 PMCID: PMC8796395 DOI: 10.1186/s12886-022-02273-6] [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: 09/07/2021] [Accepted: 01/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diffractive intraocular lenses (IOLs) could affect visual acuity in patients with macular pathologies such as epiretinal membrane (ERM) and could influence the results of pars plana vitrectomy (PPV) for ERM removal in pseudophakic eyes with these IOLs. The aim of this study is to evaluate the effect on visual outcomes of a diffractive trifocal IOL in PPV for ERM peeling. METHODS This is a retrospective cohort study on 20 eyes with a single model of trifocal IOL that underwent PPV for removal of ERM between January 2015 and September 2018 in our clinics. Follow up was at least 1 year. Primary outcome measure was mean change in visual acuity. Secondary outcome measures were mean change in central macular thickness (CMT), recovery of the external retinal layers, and change in spherical equivalent (SE). RESULTS Mean corrected distance visual acuity (CDVA) was 0.03 ± 0.03 logMAR after phacoemulsification; this worsened to 0.23 ± 0.10 logMAR with ERM, improving to 0.10 ± 0.04 log MAR 12 months after PPV (p = 0.001). Mean uncorrected near visual acuity (UNVA) was Jaeger 2.62 ± 0.51 after lensectomy. This worsened to Jaeger 5.46 ± 1.67 with ERM and improved to the initial Jaeger 2.69 ± 0.84 after PPV (p = 0.005). CMT decreased significantly, from 380.15 ± 60.50 μm with the ERM to 313.70 ± 36.98 μm after PPV. Mean SE after lensectomy was - 0.18 ± 0.38 D, which minimally changed to - 0.18 ± 0.47 D after PPV (p = 0.99). The only complication recorded after PPV was a case of cystoid macular edema. No difficulties in visualization due to IOL design were reported during PPV. CONCLUSION PPV for ERM in eyes with this trifocal IOL seems to be safe and effective, and allows recovery of the loss of UNVA.
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Affiliation(s)
- Luis Arrevola-Velasco
- Retina-Vitreous Unit, Refractive Surgery Unit, Clinica Baviera (an AIER EYE HOSPITAL GROUP division), Paseo de la Castellana, 20 28046, Madrid, Spain.
| | - Jaime Beltran
- Research and Development Clinica Baviera (an AIER EYE HOSPITAL GROUP division), Valencia, Spain
| | - Maria Jesus Gimeno
- Refractive Surgery Unit, Research and Development, Clinica Baviera (an AIER EYE HOSPITAL GROUP division), Valencia, Spain
| | - Julio Ortega-Usobiaga
- Refractive Surgery Unit, Clinica Baviera (an AIER EYE HOSPITAL GROUP division), Bilbao, Spain
| | - Vasyl Druchkiv
- Research and Development Clinica Baviera (an AIER EYE HOSPITAL GROUP division), Valencia, Spain
| | - Fernando Llovet-Osuna
- Refractive Surgery Unit, Clinica Baviera (an AIER EYE HOSPITAL GROUP division), Madrid, Spain
| | - Julio Baviera-Sabater
- Refractive Surgery Unit, Clinica Baviera (an AIER EYE HOSPITAL GROUP division), Valencia, Spain
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Lee JY, Joo K, Park SJ, Woo SJ, Park KH. EPIRETINAL MEMBRANE SURGERY IN PATIENTS WITH MULTIFOCAL VERSUS MONOFOCAL INTRAOCULAR LENSES. Retina 2021; 41:2491-2498. [PMID: 34267117 DOI: 10.1097/iae.0000000000003255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare the visual/anatomical outcomes and feasibility of epiretinal membrane surgery between patients with multifocal or monofocal intraocular lenses (IOLs). METHODS We reviewed the medical records of 46 patients who underwent epiretinal membrane surgery under multifocal or monofocal IOL pseudophakia. The operation time, mean changes in best-corrected visual acuity, and central macular thickness, and complications were compared between the groups. RESULTS Macular surgery was performed in 22 and 24 eyes with multifocal and monofocal IOLs, respectively. The total operation time and the total membrane peeling time were similar in both groups (P = 0.125, P = 0.462, respectively). The mean time to create a membrane edge or flap with retinal microforceps was longer for multifocal than for monofocal IOLs (P = 0.013). The mean changes in best-corrected visual acuity and central macular thickness were similar in both groups (P = 0.682, P = 0.741, respectively). Complications were similar between groups. CONCLUSION With multifocal IOLs, vision outside the central surgical field was blurred, requiring more time to create the membrane flap. Retinal surgeons should anticipate the difficulty in precise focusing when creating a membrane flap in macular surgery in patients with multifocal IOLs and should pay more attention to the macular surgery.
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Affiliation(s)
- Jong Young Lee
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; and
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kwangsic Joo
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; and
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sang Jun Park
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; and
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Se Joon Woo
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; and
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyu Hyung Park
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; and
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
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Visual Function and Patient Satisfaction with Multifocal Intraocular Lenses in Patients with Glaucoma and Dry Age-Related Macular Degeneration. J Ophthalmol 2021; 2021:9935983. [PMID: 34221497 PMCID: PMC8213489 DOI: 10.1155/2021/9935983] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/11/2021] [Accepted: 05/29/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose To report visual function and self-reported satisfaction of patients with glaucoma and dry age-related macular degeneration (dAMD) implanted with multifocal intraocular lenses (MIOL). Methods Patients with glaucoma or dAMD as well as healthy individuals implanted with MIOL were invited to participate. Explorations performed were uncorrected and corrected distance visual acuity (UDVA and CDVA), low-contrast visual acuity (LCVA), binocular contrast sensitivity, and defocus curves. Patients completed the Catquest-9 questionnaire and reported on the presence of dysphotopsias and the need for spectacles. Results 38 subjects were included: 11 in the healthy/control group and 9 each in the preperimetric glaucoma, perimetric glaucoma, and dAMD groups. Controls had statistically better monocular UDVA, CDVA, and LCVA than patients with glaucoma and dAMD, as well as better binocular acuity in the defocus curves between −2.00 D and +0.50 D. Differences between controls and patients with preperimetric glaucoma were not statistically significant. Between −3.0 D and +0.5 D, all groups except dAMD achieved acuities better than 0.2 logMAR. Patients with dAMD had worse contrast sensitivity than all others for 3 cycles per degree (cpd), and patients with glaucoma had worse values than all others for 12 cpd; other differences did not reach statistical significance. Healthy subjects and patients with preperimetric glaucoma perceived halos more often than patients with glaucoma or dAMD, while suffering less from glare. Patients with glaucoma and dAMD found more difficulties when driving at night and required spectacles for near more often than the other subjects. Patients with dAMD were less satisfied with their vision. Conclusions MIOLs may be implanted in patients with preperimetric glaucoma with little fear of patient dissatisfaction. In glaucoma and dAMD, MIOLs might be considered with caution, after explaining the increased risk of glare and the higher need for spectacle correction for reading.
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Comparing the Effect of Monofocal and Multifocal Intraocular Lenses on Macular Surgery. J Ophthalmol 2020; 2020:1375298. [PMID: 32765902 PMCID: PMC7387972 DOI: 10.1155/2020/1375298] [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: 05/09/2020] [Revised: 06/09/2020] [Accepted: 06/19/2020] [Indexed: 11/22/2022] Open
Abstract
Aim To compare the effects of previously implanted monofocal and multifocal intraocular lenses (IOL) on macular surgery. Methods Seventy eyes of 70 patients with epiretinal membrane (ERM) and symptomatic vitromacular traction syndrome that previously had IOL implantation for cataract surgery were included in this prospective randomized clinical trial. Cases were divided into two groups. Group 1 and Group 2 were composed of eyes with monofocal and multifocal IOLs, respectively. The effects of refraction error and IOL decentration at the time of macular surgery performed for ERM and ILM peeling, according to the lens type, were investigated. Pars plana vitrectomy (PPV) was performed to peel ERM and ILM in all cases. Complete ophthalmological examination, fundus fluorescein angiography, and optical coherence tomography imaging were made to all cases, preoperatively and postoperatively. Results The mean BCVA in Group 1 and Group 2 improved from 0.69 ± 0.15 and 0.38 ± 0.14 logMAR to 0.40 ± 0.14 and 0.10 ± 0.04 logMAR, respectively, at the 6th month. There was no statistically significant difference between the groups in terms of the mean spherical refraction error (P > 0.05) and IOL decentration level (P > 0.05). The mean time required for macular surgery in Group 2 was statistically significantly longer than that for Group 1 (P < 0.05). There was no statistically significant relationship between IOL decentration and macular surgery time in Group 1 (P > 0.05), but there it was found in Group 2 (P < 0.05). In Group 2, there was a positive correlation between IOL decentration and macular surgery time. Conclusion In cases with multifocal IOL implants, especially with lens decentration, the time of macular surgery for ERM and ILM peeling during PPV is longer than that of eyes with monofocal IOL due to fluctuations in the clarity of the surgeon's view.
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Chow LWL, Fung NSK, Kwok KHA. Premium intraocular lens implantation in eyes with vitrectomy done. Int Ophthalmol 2020; 40:2949-2956. [PMID: 32613459 DOI: 10.1007/s10792-020-01478-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 06/20/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE Phacoemulsification with premium intraocular lens (IOL) implantation has been increasingly popular in the recent years. However, it is not commonly implanted in eyes who had underwent previous vitrectomy surgery as the contrast sensitivity is thought to be reduced and surgeons are worried about poor visualization of the posterior segment after implantation. Since cataract and vitreoretinal diseases often coexist, premium IOLs should be a considerable option for implantation in carefully selected cases. This study aims at reporting the postoperative near and distance visual acuity and subjective quality of vision in eyes with premium IOLs implantation and vitrectomy done. METHODS Twenty eyes with posterior vitrectomy and premium IOL implantation from 2006 to 2018 were included. Fourteen eyes were included in Group 1 with patients who underwent a combined phacovitrectomy surgery in the same setting, and six eyes were included in Group 2 with patients who received premium IOL implantation after previous posterior vitrectomy. RESULTS Both the postoperative corrected distance and near visual acuity at 1 month, 3 month and 1 year are improved in both groups. The subjective quality of vision as graded by the National Eye Institute Refractive Error Quality of Life Instrument-42 questionnaire also showed high patient satisfaction in both groups. CONCLUSION We conclude that the presence of a multifocal IOL does not impede visualization of the posterior segment during vitrectomy surgery and surgical complications were not raised. With careful patient selection and preoperative assessment, premium IOLs can be a considerable option in patients requiring posterior vitrectomy. TRIAL REGISTRATION Retrospectively registered with the HKSH Medical Group Research Committee (Ref No. RC-2019-31, Date of registration: December 13, 2019).
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Affiliation(s)
- Lok Wan Loraine Chow
- Department of Ophthalmology, Grantham Hospital, No. 125 Wong Chuk Hang Road, Hong Kong, Hong Kong.
| | - Nicholas Siu Kay Fung
- Department of Ophthalmology, University of Hong Kong, Room 301, Level 3, Block B, Cyberport 4, 100 Cyberport Road, Hong Kong, Hong Kong
| | - Kwan Ho Alvin Kwok
- Department of Ophthalmology, Hong Kong Sanatorium Hospital, 2-4 Village Road, Happy Valley, Hong Kong, Hong Kong
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