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Tabuchi H, Yamauchi T, Shojo T, Takase K, Tanabe M. Training data size and predication errors in the use of machine-learning assisted intraocular lens power calculation. Sci Rep 2023; 13:11348. [PMID: 37443278 PMCID: PMC10344910 DOI: 10.1038/s41598-023-38616-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 07/11/2023] [Indexed: 07/15/2023] Open
Abstract
This retrospective study examined the effect of the size of training data on the accuracy of machine learning-assisted SRK/T power calculation. Clinical records of 4800 eyes of 4800 Japanese patients with intraocular lenses (IOLs) were reviewed. A support vector regressor (SVR) was used for refining the SRK/T formula, and dataset sizes for training and evaluation were reduced from full to 1/64. The prediction errors from the postoperative refractions were calculated, and the proportion within ± 0.25 D, ± 0.50 D, and ± 1.00 D of errors were compared with those using full data. The influence of the difference in A-constant was also evaluated. Prediction errors within ± 0.50 D in the use of full data were obtained with the dataset of ≥ 150 eyes (P = 0.016), whereas the datasets of ≥ 300 eyes were required for the error within ± 0.25 D (P < 0.030). The prediction errors did not alter with the A-constant values among IOLs with open-loop haptics, except for IOLs with plated haptics. In conclusion, the accuracy of SVR-assisted SRK/T could be achieved with the training dataset of ≥ 150 eyes for the Japanese population, and the calculation was versatile for any open-looped IOLs.
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Affiliation(s)
- Hitoshi Tabuchi
- Department of Technology and Design Thinking for Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
- Department of Ophthalmology, Tsukazaki Hospital, 68-1 Waku, Aboshi-ku, Himeji, Hyogo, 671-1227, Japan
| | - Tomofusa Yamauchi
- Department of Ophthalmology, Tsukazaki Hospital, 68-1 Waku, Aboshi-ku, Himeji, Hyogo, 671-1227, Japan.
| | - Tomohiro Shojo
- Department of Ophthalmology, Tsukazaki Hospital, 68-1 Waku, Aboshi-ku, Himeji, Hyogo, 671-1227, Japan
| | - Kosuke Takase
- Department of Ophthalmology, Tsukazaki Hospital, 68-1 Waku, Aboshi-ku, Himeji, Hyogo, 671-1227, Japan
| | - Mao Tanabe
- Department of Ophthalmology, Tsukazaki Hospital, 68-1 Waku, Aboshi-ku, Himeji, Hyogo, 671-1227, Japan
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Martínez-Plaza E, López-de la Rosa A, Papadatou E, Habib NE, Del Águila-Carrasco AJ, López-Miguel A, Maldonado MJ, Buckhurst PJ. Influence of decentration and tilt of Tecnis ZCB00 on visual acuity and higher order aberrations. Eye (Lond) 2023; 37:1640-1645. [PMID: 36002509 PMCID: PMC10219962 DOI: 10.1038/s41433-022-02211-2] [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: 12/17/2021] [Revised: 06/23/2022] [Accepted: 08/10/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND/OBJECTIVES To determine the influence of decentration and tilt of a pseudophakic aspheric intraocular lens (IOL) on visual acuity (VA) and higher-order aberrations (HOAs), and to analyze the agreement between pupil center/axis and iridocorneal angles center/axis when assessing IOL decentration and tilt. SUBJECTS/METHODS A prospective interventional case series study including thirty-three patients undergoing Tecnis ZCB00 (Abbott Medical Optics) implantation. IOL decentration and tilt with respect to two reference systems (pupil and iridocorneal angles centers/axes), in cartesian (X,Y) and polar (radius/tilt, polar angle/azimuth) coordinates, were assessed with optical coherence tomography. VA and internal and ocular HOAs were evaluated. Multiple linear regression models and intraclass correlation coefficient (ICC) were computed. RESULTS IOL decentration only showed a significant effect on internal HOAs for [Formula: see text] (R2 = 0.20, P = 0.04). IOL decentration with respect to the pupil center showed a significant effect on ocular [Formula: see text] (R2 = 0.18, P = 0.05), [Formula: see text] (R2 = 0.36, P = 0.001) and [Formula: see text] (R2 = 0.24, P = 0.02); and with respect to the center of iridocorneal angles, on ocular [Formula: see text] (R2 = 0.21, P = 0.03), [Formula: see text] (R2 = 0.32, P = 0.003), primary coma (R2 = 0.41, P < 0.001), and coma-like (R2 = 0.40, P = 0.001). Poor agreement between both reference systems was found for IOL decentration measurements (ICC ≤ 0.41), except for the polar angle coordinate (ICC = 0.83). Tilt measurements showed good agreement (ICC ≥ 0.75). CONCLUSIONS Tecnis ZCB00 decentration and tilt values after uneventful implantation appear not to have influence on VA, and their effect on HOAs are not high enough to clinically affect quality of vision. Pupil and iridocorneal angles used as reference systems may be interchangeable for IOL tilt measurements, but not for decentration.
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Affiliation(s)
- Elena Martínez-Plaza
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
- Red Temática de Investigación Colaborativa en Oftalmología (OftaRed), Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Nabil E Habib
- Royal Eye Infirmary, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | | | - Alberto López-Miguel
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain.
- Red Temática de Investigación Colaborativa en Oftalmología (OftaRed), Instituto de Salud Carlos III, Madrid, Spain.
| | - Miguel J Maldonado
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
- Red Temática de Investigación Colaborativa en Oftalmología (OftaRed), Instituto de Salud Carlos III, Madrid, Spain
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Goto S, Maeda N, Ohnuma K, Noda T. Comparison of two one-piece acrylic foldable intraocular lenses: Short-term change in axial movement after cataract surgery and its effect on refraction. PLoS One 2022; 17:e0273431. [PMID: 36040874 PMCID: PMC9426912 DOI: 10.1371/journal.pone.0273431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 08/08/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose
To compare the change in intraocular lens (IOL) axial movement, corneal power, and postoperative refraction of eyes implanted with two different single-piece, open loop, acrylic foldable IOLs with planar-haptic design: one IOL with hinges vs. one IOL without hinges. The role of IOL axial movement on short-term refractive shift after cataract surgery was also evaluated.
Methods
This retrospective comparative study enrolled consecutive patients who had phacoemulsification with aspheric IOL implantation. The IOL depth (the distance from corneal endothelium to IOL surface) and corneal power were measured via anterior-segment optical coherence tomography at 4 days and 1 month postoperatively. The changes in axial movement of the IOL, corneal power, and manifest refractive spherical equivalent (MRSE) were compared among groups, and the correlations between each lens were evaluated.
Results
IOL with hinges was implanted in 42 eyes of 42 patients and IOL without hinges was implanted in 42 eyes of 42 patients. The change in axial movement between 4 days and 1 month was significantly smaller in the IOL with hinges group than in the IOL without hinges group (p < 0.001). The axial movement of IOL with hinges did not correlate with the MRSE change; however, the forward shift of IOL without hinges correlated with the myopic refractive change (Pearson r = 0.62, p < 0.001).
Conclusion
The postoperative axial movement of IOL was more stable in the IOL with hinges group than the IOL without hinges group between 4 days and 1 month after cataract surgery. Even though the two study IOLs with planar-haptic design are made of similar acrylic materials, other characteristics such as hinge structure may affect IOL stability in the bag.
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Affiliation(s)
- So Goto
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
- National Hospital Organization, Tokyo Medical Center, Tokyo, Japan
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, California, United States of America
| | - Naoyuki Maeda
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
- * E-mail:
| | | | - Toru Noda
- National Hospital Organization, Tokyo Medical Center, Tokyo, Japan
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Refractive Changes Following Premature Posterior Capsulotomy Using Neodymium:Yttrium–Aluminum–Garnet Laser. J Pers Med 2022; 12:jpm12020272. [PMID: 35207760 PMCID: PMC8874370 DOI: 10.3390/jpm12020272] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/31/2022] [Accepted: 02/10/2022] [Indexed: 12/03/2022] Open
Abstract
We aimed to determine the timing of neodymium:yttrium–aluminum–garnet (Nd:YAG) laser capsulotomy on corrected-distance visual acuity (CDVA), intraocular pressure (IOP), and spherical equivalent (SE) in patients with posterior capsular opacification (PCO). There were 59 patients with unilateral PCO and a history of Nd:YAG laser capsulotomy enrolled and further divided into the early Nd:YAG group (timing < 12 months, n = 25) and late Nd:YAG group (timing > 12 months, n = 34) depending on the elapsed months from phacoemulsification to Nd:YAG laser capsulotomy. The primary outcomes were CDVA, IOP, and SE before (immediately before Nd:YAG laser capsulotomy) and after (weeks one and four after the laser treatment). The independent t test was applied to analyze the difference in CDVA, IOP, and SE between the two groups, while the generalized estimating equation with Bonferroni adjustment was conducted to evaluate the effect of all the parameters on the change in SE with adjusted odds ratio (aOR) and 95% confidence interval (CI). The CDVA showed significant improvement in both the early Nd:YAG group (p = 0.005) and the late Nd:YAG group (p = 0.001), and hyperopic change occurred in both the early Nd:YAG group (p = 0.003) and the late Nd:YAG group (p = 0.017). The early Nd:YAG group revealed more significant hyperopic change compared with the late Nd:YAG group four weeks after Nd:YAG treatment (p < 0.001), which was still significant after multivariable analysis (aOR: 0.899, 95% CI: 0.868–0.930, p = 0.011). In addition, a deeper ACD (aOR: 0.764, 95% CI: 0.671–0.869, p = 0.019) was significantly correlated with hyperopic change. In conclusion, Nd:YAG laser capsulotomy performed within one year after cataract surgery may lead to significant hyperopic change, in which the ACD alteration affects the hyperopic shift significantly.
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Xiao Z, Wang G, Zhen M, Zhao Z. Stability of Intraocular Lens With Different Haptic Design: A Swept-Source Optical Coherence Tomography Study. Front Med (Lausanne) 2021; 8:705873. [PMID: 34568368 PMCID: PMC8455909 DOI: 10.3389/fmed.2021.705873] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/18/2021] [Indexed: 12/14/2022] Open
Abstract
Purpose: To investigate the stability of intraocular lens (IOLs) with different haptics by swept-source anterior-segment optical coherence tomography (AS-OCT). Methods: Sixty-eight eyes from 55 patients received the implantation of Rayner 920H (Closed C-loop Group), Zeiss 509M (Plate Group) or Lenstec SOFTEC HD (C-loop Group) IOLs. The tilt and decentration of IOLs were evaluated using AS-OCT at least 1 month postoperatively. Results: Mean decentration and tilt of IOLs were 0.18 ± 0.12 mm (range 0.02 to 0.59 mm) and 5.63 ± 1.65° (range 2.2 to 9.6°) respectively. Decentration was significantly smaller in the plate haptic group (0.12 ± 0.06 mm) as compared to the C-loop group (0.22 ± 0.13 mm, P = 0.02). The tilt of IOL was also significantly smaller in the plate haptic group (4.96 ± 0.89°) as compared to the C-loop group (6.28 ± 1.83°, P = 0.01). There was marginal difference between the Closed C-loop group (5.52 ± 1.74°) and C-loop group (6.28 ± 1.83°, P = 0.07). Conclusions: The Plate-haptic IOLs should have better stability for the decentration and tilt than the C-loop design IOLs.
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Affiliation(s)
- Zixuan Xiao
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China
| | - Geng Wang
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China
| | - Miaoru Zhen
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China
| | - Zifeng Zhao
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China
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Onur IU, Kırık F, Yiğit FU, Vural AD, Cavusoglu E, Evcimen Y. Refractive precision in uncomplicated eyes with pseudoexfoliation: three-piece versus one-piece intraocular lens implantation. Acta Ophthalmol 2021; 99:616-620. [PMID: 33415833 DOI: 10.1111/aos.14703] [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: 06/14/2020] [Revised: 11/05/2020] [Accepted: 11/09/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate the refractive precision of three-piece versus one-piece intraocular lenses (IOLs) in eyes with pseudoexfoliation (PXF) and changes in anterior chamber depth (ACD) following cataract surgery. METHODS This prospective, nonrandomized, interventional, comparative case series included PXF eyes, which were implanted with one-piece acrylic IOL or three-piece acrylic IOLs (Group A; n = 31, Group B; n = 30). Non-PXF control eyes were implanted with one-piece acrylic IOL (Group C; n = 30). Postoperative refractive error (RE) and absolute RE, as well as pre- to postoperative ACD changes, were statistically analysed. A p value < 0.05 was considered statistically significant. RESULTS Changes in ACD (mean ± standard deviation) in Groups A, B and C were 0.9 ± 0.4, 1.0 ± 0.3 and 0.7 ± 0.4 mm, respectively. Significant differences were found between Groups A and C (p = 0.043) and between Groups B and C (p = 0.008). In Groups A, B and C, the median and interquartile (Q1 to Q3) values were 0.3 (-0.8 to 1.0), -0.5 (-0.8 to -0.3) and 0.1 (-0.4 to 0.3) for RE and 1.0 (0.4 to 1.3), 0.5 (0.3 to 0.8) and 0.3 (0.3 to 0.5) for absolute RE, respectively. The RE differences between Group A and B (p = 0.009) and Group B and C (p < 0.001) were statistically significant. For absolute RE, the differences were significant for all comparisons (p < 0.05). CONCLUSION Refractive precision in PXF eyes may be better with three-piece than with one-piece IOL implantation, but worse than with one-piece IOL implantation in non-PXF eyes. Significant changes in ACD in PXF eyes may be related to RE.
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Affiliation(s)
- Ismail Umut Onur
- Department of Ophthalmology Bakirkoy Dr. Sadi Konuk Training and Research Hospital Istanbul Turkey
| | - Furkan Kırık
- Department of Ophthalmology Bakirkoy Dr. Sadi Konuk Training and Research Hospital Istanbul Turkey
| | - Fadime Ulviye Yiğit
- Department of Ophthalmology Bakirkoy Dr. Sadi Konuk Training and Research Hospital Istanbul Turkey
| | - Asli Deger Vural
- Department of Ophthalmology Bakirkoy Dr. Sadi Konuk Training and Research Hospital Istanbul Turkey
| | - Ercan Cavusoglu
- Department of Ophthalmology Bakirkoy Dr. Sadi Konuk Training and Research Hospital Istanbul Turkey
| | - Yusuf Evcimen
- Department of Ophthalmology Bakirkoy Dr. Sadi Konuk Training and Research Hospital Istanbul Turkey
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Chen X, Gu X, Wang W, Xiao W, Jin G, Wang L, Dai Y, Zhang E, Ruan X, Liu Z, Luo L, Liu Y. Characteristics and factors associated with intraocular lens tilt and decentration after cataract surgery. J Cataract Refract Surg 2021; 46:1126-1131. [PMID: 32352251 DOI: 10.1097/j.jcrs.0000000000000219] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE To analyze the characteristics and factors associated with intraocular lens (IOL) tilt and decentration after uneventful phacoemulsification with IOL implantation. SETTING Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. DESIGN Cross-sectional study. METHODS All patients underwent a general ophthalmologic examination and anterior segment photography. IOL tilt and decentration were measured with a second-generation anterior segment optical coherence tomography (Casia2). Univariate and multivariate regression analyses were performed to assess the association between IOL tilt and decentration with ocular biometric and systemic parameters, and the visual acuity. RESULTS A total of 196 eyes of 196 patients were enrolled in this study. IOLs showed a mean tilt of 4.8 degrees toward the inferotemporal direction, and the mean decentration was 0.21 mm. Both eyes presented a mirror symmetry relationship. Twenty-two eyes (11.22%) had a tilt greater than 7 degrees, and 21 eyes (10.72%) had a decentration more than 0.4 mm. Multivariate regression analysis showed previous pars plana vitrectomy (PPV) and short axial length (AL) were associated with greater IOL tilt (P = .014 and P < .001). In addition, long AL, thicker lens, and less capsulorhexis-IOL overlap were positively correlated with decentration (P < .001, P = .029, and P = .026). Corrected distance visual acuity did not directly correlate with IOL tilt and decentration (P = .417 and P = .550). CONCLUSIONS PPV history and short AL were associated with greater IOL tilt, whereas longer AL, thicker lens, and overlarge capsulorhexis contribute to greater decentration. Implantation of toric and multifocal IOLs in these patients should be cautious.
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Affiliation(s)
- Xiaoyun Chen
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
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Nováček LV, Němcová M, Tyx K, Lahodová K, Rejmont L, Rozsíval P, Studený P. Comparison of Clinical Outcomes, Visual Quality and Visual Function of Two Presbyopia-Correcting Intraocular Lenses Made from the Same Material, but with Different Design and Optics. J Clin Med 2021; 10:3268. [PMID: 34362052 PMCID: PMC8347739 DOI: 10.3390/jcm10153268] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/16/2021] [Accepted: 07/22/2021] [Indexed: 02/06/2023] Open
Abstract
This semi-prospective, parallel, comparative investigation evaluated the clinical outcomes and quality of vision (contrast sensitivity, visual function, dysphotopsia, spectacle use, overall satisfaction) after mono- or bilateral implantation of two presbyopia-correcting intraocular lenses (IOL)-the Liberty® 677MY or the AT LISA® tri 839M-in 50 eyes of 25 cataract patients. Clinical outcomes were assessed 3 and 12 months postoperatively. Eighty-nine percent of eyes implanted with the Liberty IOL and 59% of eyes implanted with the AT LISA IOL achieved a refractive outcome ±0.5 diopters of the target (emmetropia). Refractive outcomes were stable with both lenses. The proportions of eyes with 20/20 uncorrected distance visual acuity (UDVA) and 20/20 uncorrected near visual acuity (UNVA) were higher in the Liberty group than in the AT LISA group (UDVA: 56% vs. 41%; UNVA: 83% vs. 66%). Optical quality assessment results were comparable for the two IOLs. Superior photopic contrast sensitivity was found with the Liberty lens. The rate of Nd:YAG capsulotomy at the 12-month follow-up was 16.7% in the Liberty group and 40.6% for the AT LISA IOL. Considering that both lenses are made from the same material, we propose that the noted differences in clinical outcomes may derive from differences in design and optical surface between the two IOLs.
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Affiliation(s)
- Ladislav Viktor Nováček
- Department of Ophthalmology, Institute of Aviation Medicine Prague, 160 00 Prague, Czech Republic; (M.N.); (K.T.); (K.L.); (P.R.)
- Department of Ophthalmology, 1st Faculty of Medicine, Charles University and the Military University Hospital Prague, 121 08 Prague, Czech Republic; (L.R.); (P.S.)
| | - Marie Němcová
- Department of Ophthalmology, Institute of Aviation Medicine Prague, 160 00 Prague, Czech Republic; (M.N.); (K.T.); (K.L.); (P.R.)
| | - Kateřina Tyx
- Department of Ophthalmology, Institute of Aviation Medicine Prague, 160 00 Prague, Czech Republic; (M.N.); (K.T.); (K.L.); (P.R.)
| | - Kristýna Lahodová
- Department of Ophthalmology, Institute of Aviation Medicine Prague, 160 00 Prague, Czech Republic; (M.N.); (K.T.); (K.L.); (P.R.)
| | - Leoš Rejmont
- Department of Ophthalmology, 1st Faculty of Medicine, Charles University and the Military University Hospital Prague, 121 08 Prague, Czech Republic; (L.R.); (P.S.)
| | - Pavel Rozsíval
- Department of Ophthalmology, Institute of Aviation Medicine Prague, 160 00 Prague, Czech Republic; (M.N.); (K.T.); (K.L.); (P.R.)
- Department of Ophthalmology Charles University Prague, School of Medicine Hradec Králové, 500 03 Hradec Králové, Czech Republic
| | - Pavel Studený
- Department of Ophthalmology, 1st Faculty of Medicine, Charles University and the Military University Hospital Prague, 121 08 Prague, Czech Republic; (L.R.); (P.S.)
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Negishi K, Masui S, Torii H, Nishi Y, Tsubota K. Refractive stability of a new single-piece hydrophobic acrylic intraocular lens and corneal wound repair after implantation using a new automated intraocular lens delivery system. PLoS One 2020; 15:e0238366. [PMID: 32877454 PMCID: PMC7467255 DOI: 10.1371/journal.pone.0238366] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/15/2020] [Indexed: 01/11/2023] Open
Abstract
PURPOSE To investigate refractive stability and characterize corneal incision repair up to 3 months after implantation of a new hydrophobic acrylic intraocular lens (IOL) with hydroxyethylmethacrylate using a new automated IOL delivery system. METHODS This prospective case series included 50 eyes of 50 patients undergoing phacoemulsification and implantation of the Clareon® CNA0T0 IOL using the AutonoMe® automated delivery system in the Department of Ophthalmology, Keio University School of Medicine. The clinical data were collected from 46 eyes of 46 patients preoperatively and 1 day, 1 week, and 1 and 3 months postoperatively. Endothelial-side incision gaping, posterior incision retraction, and Descemet's membrane detachment were recorded as present or absent using anterior-segment optical coherence tomography postoperatively. RESULTS The uncorrected distance and corrected distance visual acuities improved and stabilized 1 week postoperatively. The anterior chamber depth was stable from 1 week postoperatively. The subjective refraction was stable from 1 day postoperatively. Descemet's membrane detachments and endothelial-side wound gaping were seen in 19 (41.3%) eyes and 34 (73.9%) eyes 1 day postoperatively and decreased gradually. Posterior incision retraction was seen in eight eyes (17.4%) on day 1 and increased to 19 eyes (41.3%) 3 months postoperatively. CONCLUSIONS The Clareon IOL had excellent refractive stability from day 1 postoperatively. The AutonoMe automated delivery system enables safe IOL implantation through a 2.4-mm corneal incision, although the wound required longer than 1 month to heal postoperatively.
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Affiliation(s)
- Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- * E-mail:
| | - Sachiko Masui
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Hidemasa Torii
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Yasuyo Nishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
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Lawu T, Mukai K, Matsushima H, Senoo T. Effects of decentration and tilt on the optical performance of 6 aspheric intraocular lens designs in a model eye. J Cataract Refract Surg 2019; 45:662-668. [PMID: 30876781 DOI: 10.1016/j.jcrs.2018.10.049] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 10/23/2018] [Accepted: 10/24/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE To compare the effect of decentration and tilt on the optical performance of 6 aspheric intraocular lens (IOL) designs in a model eye. SETTING Department of Ophthalmology, Graduate School of Medicine, Dokkyo Medical University, Tochigi, Japan. DESIGN Experimental study. METHODS In theoretical simulations, the amount of spherical aberration in the IOL was varied to produce residual ocular spherical aberration (range -0.15 to 0.30 μm) at a 6.0 mm entrance pupil. Wavefront aberration analyses were performed with the ZEMAX optical design program (version August 20, 2014) to obtain the ocular root-mean-square values of astigmatism, coma, trefoil, and higher-order aberrations (HOAs) when the IOL was centered on the insertion position and misaligned at a 4.0 mm entrance pupil. The retinal visual images were calculated using the same conditions. Six 20.0 diopter (D) aspheric IOLs and one 20.0 D spherical IOL were used for the experimental studies. Each IOL was inserted in the model eye. The actual alignments were measured using a Scheimpflug camera (EAS-1000). The wavefront aberrations and visual images were gauged using a wavefront analyzer (KR-1W) at several IOL alignments. RESULTS Intraocular lens decentration and tilt increased wavefront aberrations and degraded optical performance. Astigmatism, coma, and HOAs generated by misaligned IOLs were related to the amount of spherical aberration correction of the IOLs. The extent of spherical aberration remained unchanged by the amount of misalignment. Experimental model eye results showed trends similar to theoretical results. CONCLUSIONS The spherical aberration correction amount in the aspheric IOL design was critical for the astigmatism, coma, and HOAs generated by the IOL misalignment. Additional spherical aberration corrections led to a more sensitive optical performance degradation resulting from IOL misalignment.
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Affiliation(s)
- Tjundewo Lawu
- Graduate School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan.
| | - Koichiro Mukai
- Graduate School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan
| | - Hiroyuki Matsushima
- Graduate School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan
| | - Tadashi Senoo
- Graduate School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan
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11
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Zhang Z, Miao Y, Fang X, Luo Q, Wang Y. Accuracy of the Haigis and SRK/T Formulas in Eyes Longer than 29.0 mm and the Influence of Central Corneal Keratometry Reading. Curr Eye Res 2018; 43:1316-1321. [PMID: 29958004 DOI: 10.1080/02713683.2018.1488265] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Zhihua Zhang
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yuyu Miao
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoling Fang
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai, China
| | - Qin Luo
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai, China
| | - Yulan Wang
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai, China
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Dick HB, Schultz T, Lesieur G, Morselli S, Toso A, Alio JL, Buckhurst PJ, Johansson B. Evaluation of clinical outcomes following implantation of a sub-2-mm hydrophilic acrylic MICS intraocular lens. Int Ophthalmol 2018; 39:1043-1054. [PMID: 29654574 DOI: 10.1007/s10792-018-0905-3] [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: 07/17/2017] [Accepted: 03/22/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate clinical outcomes following sub-2-mm microincision cataract surgery (MICS) and intraocular lens (IOL) implantation. SETTING Five EU clinical sites. DESIGN Prospective, multicenter, open-label, single-arm, non-randomized. METHODS Preoperative assessment involved visual acuity (VA), intraocular pressure and biometry measurements. 1.4-mm wound-assisted or 1.8-mm MICS was performed. Follow-up visits were made 1 day, 1-2 weeks, 1-2 and 4-6 months after surgery. The incision size, corrected distance VA (CDVA), uncorrected distance VA, manifest refraction spherical equivalent (MRSE), refraction predictability/stability and IOL decentration were assessed. At 12-, 18-, and 24-month, long-term centration, posterior capsular opacification (PCO) and Nd:YAG capsulotomy rates were investigated. RESULTS A total of 103 eyes were implanted with the study IOL (INCISE, Bausch & Lomb), 96 of which were included in visual outcome analysis. A mean 6-month CDVA of - 0.02 logMAR (20/20 + 1) was observed and 75 eyes (79.8%) and 93 eyes (98.3%) achieved a visual acuity of at least 20/20 or 20/40. Mean MRSE was - 0.20 ± 0.60 D. Mean absolute predictive error was 0.44 ± 0.36 D, with 90.4% within 1.00 D of target. Mean total decentration was 0.35 ± 0.36 mm at 6 months and 0.32 ± 0.14 mm at 24 months (p > 0.05). 24-month evaluation of posterior capsular opacification score was 0.03 for the central area. A Nd:YAG rate of 3.4% was observed at 24 months. CONCLUSIONS The new MICS IOL provided excellent visual outcomes and was safe and effective for the sub-2-mm procedure. The MICS IOL demonstrated long-term centration, stability and a low rate of PCO development.
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Affiliation(s)
- H Burkhard Dick
- University Eye Hospital Bochum, In der Schornau 23-25, 44892, Bochum, Germany.
| | - Tim Schultz
- University Eye Hospital Bochum, In der Schornau 23-25, 44892, Bochum, Germany
| | | | - Simonetta Morselli
- Ospedale di Bassano del Grappa Bassano del Grappa, Bassano del Grappa, Italy
| | - Antonio Toso
- Ospedale di Bassano del Grappa Bassano del Grappa, Bassano del Grappa, Italy
| | - Jorge L Alio
- Vissum-Instituto Oftalmologico de Alicante, University Miguel Hernandez, Alicante, Spain
| | | | - Björn Johansson
- Department of Ophthalmology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.,St. Erik Eye Hospital, Stockholm, Sweden
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Comparison of Two Toric IOLs with Different Haptic Design: Optical Quality after 1 Year. J Ophthalmol 2018; 2018:4064369. [PMID: 29607216 PMCID: PMC5828049 DOI: 10.1155/2018/4064369] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 11/10/2017] [Accepted: 11/20/2017] [Indexed: 12/02/2022] Open
Abstract
Background The purpose of this prospective, randomised study was to interocularly compare the visual performance after implantation of two different toric IOLs with different haptic design. Methods 59 subjects with corneal astigmatism greater than 1.25 diopter (D) were implanted with an AT TORBI 709M IOL (Carl Zeiss Meditec AG) in one eye and with a Tecnis toric aspheric IOL (Abbot Medical Optics) in the other eye. Observation procedure was performed 12 months postoperatively. Main outcome measures included uncorrected distance visual acuity (UDVA), manifest refraction, IOL rotation, and IOL position. Results Mean UCDVA was 0.04 ± 0.14 logMAR for AT TORBI eyes and 0.06 ± 0.15 logMAR for Tecnis eyes (p = 0.3). The postoperative spherical equivalent values were significantly lower in the AT TORBI group. Mean toric IOL axis rotation was 3.0 ± 2.26 degrees for AT TORBI eyes and 3.27 ± 2.37 for Tecnis eyes (p = 0.5). The mean vertical IOL tilt and vertical decentration values measured with the Visante OCT were significantly larger in the AT TORBI group (p < 0.05). Conclusions Both the Tecnis and the AT TORBI toric IOLs successfully reduced ocular astigmatism. Emmetropia could be better achieved with the AT TORBI IOL, whereas the Tecnis showed better positional stability. This trial is registered with ICMJE NCT03371576.
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Abstract
PURPOSE To assess the decentration and angle of tilt of the intraocular lens (IOL) according to the intravitreal tamponade types used in combined phacoemulsification and vitreoretinal surgery. METHODS This prospective and randomized clinical study involved 73 eyes of 69 patients who underwent combined vitreoretinal surgery. Eyes with intravitreal tamponades formed the study group and eyes without intravitreal tamponades formed the control group. The study group was further divided into silicone oil and gas tamponade subgroups. Cross-sectional IOL images were captured using a Pentacam HR (Oculus, Germany) and tilt and decentration were calculated with Adobe Photoshop software (Adobe, San Jose, CA). RESULTS The mean angle of tilt and decentration at the vertical meridian were significantly higher in both tamponade groups than in the control group (P < 0.05 for all). No significant difference was observed among the groups regarding IOL position parameters at the horizontal meridian (P > 0.05). When comparing the silicone oil and gas tamponade subgroups, no significant differences were noted on the position of IOL at both meridians (P > 0.05 for all). CONCLUSION Intravitreal tamponades have an important effect on the position of IOL in combined vitreoretinal surgery. Silicone oil and gas tamponades may induce postoperative tilt and decentration of one-piece acrylic IOLs.
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Clinical study inpatient-reported outcomes after binocular implantation of aspheric intraocular lens of different negative spherical aberrations. ASIAN PAC J TROP MED 2017; 10:710-713. [DOI: 10.1016/j.apjtm.2017.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 06/30/2017] [Accepted: 07/05/2017] [Indexed: 11/19/2022] Open
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Ozates S, Koc M, Uzel MM, Yilmazbas P. Comparison of Intraocular Lens Position Change Following Two Different Implantation Techniques. Curr Eye Res 2017; 42:1235-1239. [PMID: 28557589 DOI: 10.1080/02713683.2017.1309053] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To assess the decentration and tilt of one-piece foldable acrylic intraocular lens following two different intraocular lens implantation techniques. METHODS This prospective, randomized clinical study conducted on 102 eyes of 91 patients who underwent cataract surgery between September 2015 and May 2016 at Ulucanlar Eye Training and Research Hospital, Ankara, Turkey. Intraocular lens implantations were performed with the help of an ophthalmic viscosurgical device or a hydroimplantation technique during surgery. The main outcomes, which were evaluated one day and one month after surgery, were corrected distant visual acuity, intraocular lens tilt, and decentration at the vertical and horizontal meridians. All outcomes were compared between and within implantation technique groups. RESULTS Angle of tilt and decentration of intraocular lens at the vertical and horizontal meridians showed no significant change within the ophthalmic viscosurgical device and hydroimplantation groups during follow-up (p > 0.05 for all). However, intraocular lens at both meridians were significantly lower in the hydroimplantation group (Vertical: p = 0.004, Horizontal: p = 0.015), and intraocular lens decentration tilt at both meridians were significantly lower in the hydroimplantation group than in the ophthalmic viscosurgical device group (Vertical: p = 0.004, Horizontal: p = 0.039). Postoperative corrected distant visual acuity outcomes showed no difference between and within the groups during follow-up (p > 0.05 for all). CONCLUSIONS The intraocular lens implantation technique had an important effect on intraocular lens position. The hydroimplantation technique induces central placement of one-piece foldable acrylic intraocular lenses postoperatively by reducing decentration and the angle of tilt.
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Affiliation(s)
- Serdar Ozates
- a Department of Opthalmology, Ulucanlar Eye Training and Research Hospital , Ankara , Turkey
| | - Mustafa Koc
- a Department of Opthalmology, Ulucanlar Eye Training and Research Hospital , Ankara , Turkey
| | - Mehmet Murat Uzel
- a Department of Opthalmology, Ulucanlar Eye Training and Research Hospital , Ankara , Turkey
| | - Pelin Yilmazbas
- a Department of Opthalmology, Ulucanlar Eye Training and Research Hospital , Ankara , Turkey
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Mednick ZD, Varma DK, Campos-Möller X, Ahmed IIK. Refractive predictability of a 3-piece intraocular lens platform versus its 1-piece counterpart. Can J Ophthalmol 2017; 52:146-149. [DOI: 10.1016/j.jcjo.2016.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 09/29/2016] [Accepted: 10/05/2016] [Indexed: 11/29/2022]
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