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Baur ID, Mueller A, Labuz G, Naujokaitis T, Auffarth GU, Khoramnia R. Refractive Lens Exchange: A Review. Klin Monbl Augenheilkd 2024; 241:893-904. [PMID: 39146574 DOI: 10.1055/a-2346-4428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
In recent decades, technical advancements in lens surgery have considerably improved safety and refractive outcomes. This has led to a much broader range of indications for refractive lens exchange (RLE). Effective restoration of uncorrected distance and near visual acuity is possible with modern presbyopia correcting intraocular lenses (IOLs). Hyperopic patients who are fully presbyopic were identified as ideal candidates for RLE. For myopic patients, an increased risk of retinal detachment has been reported, which leads to a higher threshold to perform RLE in this patient group. The most frequent postoperative complications include posterior capsular opacification, deviation from the target refraction and cystoid macular edema. Thus, adequate planning of surgery, careful patient selection, as well as comprehensive counseling are crucial for successful RLE.
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Affiliation(s)
| | - Arthur Mueller
- Department of Ophthalmology, University Hospital Augsburg, Germany
| | - Grzegorz Labuz
- International Vision Correction Research Centre (IVCRC) and David J Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University Hospital Heidelberg, Germany
| | - Tadas Naujokaitis
- International Vision Correction Research Centre (IVCRC) and David J Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University Hospital Heidelberg, Germany
| | - Gerd U Auffarth
- International Vision Correction Research Centre (IVCRC) and David J Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University Hospital Heidelberg, Germany
| | - Ramin Khoramnia
- International Vision Correction Research Centre (IVCRC) and David J Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University Hospital Heidelberg, Germany
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2
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Petelczyc K, Bolek J, Kakarenko K, Krix-Jachym K, Kołodziejczyk A, Rękas M. Use of the perceptual point-spread function to assess dysphotopsias. PLoS One 2024; 19:e0306331. [PMID: 39028737 PMCID: PMC11259305 DOI: 10.1371/journal.pone.0306331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 06/14/2024] [Indexed: 07/21/2024] Open
Abstract
Nowadays many patients are choosing EDOF or multifocal lenses for replacement of natural lens in cataract surgery. This can result in issues such as presence of dysphotopsias, namely halo and glare. In this work, we propose a new perimetry method to describe dysphotopsias in far-field region in a presence of bright, point-like light source. We constructed a custom device and designed measurement procedure for quantitative measurement of dysphotopias in the center of visual field and used it to examine patients with mild cataracts or implanted IOLs. Our approach may help in establishing an objective method to study and compare dysphotopsias.
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Affiliation(s)
| | - Jan Bolek
- Faculty of Physics, Warsaw University of Technology, Warsaw, Poland
| | - Karol Kakarenko
- Faculty of Physics, Warsaw University of Technology, Warsaw, Poland
| | | | | | - Marek Rękas
- Ophthalmology Department, Military Institute of Medicine, Warsaw, Poland
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3
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Yang YP, Tan Y, Liao Q. Analysis of visual quality improvement after implantation of PanOptix trifocal intraocular lens in cataract patients with different axial lengths. Am J Transl Res 2024; 16:2995-3004. [PMID: 39114707 PMCID: PMC11301498 DOI: 10.62347/frjz4885] [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: 03/20/2024] [Accepted: 05/28/2024] [Indexed: 08/10/2024]
Abstract
OBJECTIVE To assess the visual quality, both subjective and objective, of cataract patients with varying axial lengths (AL) after PanOptix trifocal intraocular lens (IOL) implantation and investigated the lens tilt and its correlation with visual outcomes. METHODS From July 2020 to June 2022, 70 patients (140 eyes) diagnosed with age-related cataracts and undergoing PanOptix implantation at Chongqing Eye and Vision Care Hospital, Aier Eye Hospital Group, were included. Patients were assigned to either the observation group (35 cases, 70 eyes with PanOptix trifocal IOL) or the control group (35 cases, 70 eyes with bifocal IOL). Patients were further subdivided based on AL into AL < 24 mm (observation group: 23 eyes; control group: 26 eyes) and AL ≥ 24 mm (observation group: 47 eyes; control group: 44 eyes). Postoperative follow-up lasted three months. Visual acuity (distant, intermediate, near), objective visual quality (Strehl ratio: SR, total eye modulation transfer function (MTF)), and visual aberrations were measured preoperatively and at 3 months post-operation. RESULTS Postoperatively, all groups saw significant improvements in uncorrected distance visual acuity (UCDVA), uncorrected intermediate visual acuity (UCIVA), and uncorrected near visual acuity (UCNVA) compared to preoperative values (T0) (all P < 0.05). Notably, UCIVA was significantly better in the observation group than in the control group (P < 0.05). At three months (T1), reductions in total high-order aberration (tHOA), internal high-order aberration (iHOA), coma, and trefoil aberrations were observed in both groups compared to baseline, with more significant decreases in the observation group (all P < 0.05). Both SR and MTF cutoff showed marked improvement from T0 to T1, with the observation group experiencing greater enhancements (both P < 0.05). The defocus curve of the observation group showed a gentle slope between +0.5 D and -3.0 D, maintaining superior visual acuity compared to the control group (P < 0.05). Subjective visual quality scores at T1 were significantly higher than at T0 for both groups (P < 0.05), with patients in the observation group scoring higher than those in the control group across all AL categories (P < 0.05). Spearman correlation analysis indicated that the tilt after PanOptix trifocal IOL implantation was associated with tHOA (r = 0.273, P = 0.022), iHOA (r = 0.433, P < 0.001), Trefoil (r = 0.360, P = 0.002) and coma (r = 0.688, P < 0.001). CONCLUSION PanOptix trifocal IOL implantation in cataract patients across different AL significantly enhances visual quality compared to bifocal IOLs, suggesting a strong case for its clinical adoption.
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Affiliation(s)
- Yin-Ping Yang
- Department of Cataract, Chongqing Eye and Vision Care Hospital·Aier Eye Hospital GroupChongqing 400000, China
| | - Ya Tan
- Department of Fundus Disease, Chongqing Eye and Vision Care Hospital·Aier Eye Hospital GroupChongqing 400000, China
| | - Qiong Liao
- Department of Cataract, Chongqing Eye and Vision Care Hospital·Aier Eye Hospital GroupChongqing 400000, China
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Tavassoli S, Ziaei H, Yadegarfar ME, Gokul A, Kernohan A, Evans JR, Ziaei M. Trifocal versus extended depth of focus (EDOF) intraocular lenses after cataract extraction. Cochrane Database Syst Rev 2024; 7:CD014891. [PMID: 38984608 PMCID: PMC11234495 DOI: 10.1002/14651858.cd014891.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
BACKGROUND Cataract, defined as an opacity of the lens in one or both eyes, is the leading cause of blindness worldwide. Cataract may initially be treated with new spectacles, but often surgery is required, which involves removing the cataract and placing a new artificial lens, usually made from hydrophobic acrylic. Recent advancements in intraocular lens (IOL) technology have led to the emergence of a diverse array of implantable lenses that aim to minimise spectacle dependence at all distances (near, intermediate, and distance). To assess the relative merits of these lenses, measurements of visual acuity are needed. Visual acuity is a measurement of the sharpness of vision at a distance of 6 metres (or 20 feet). Normal vision is 6/6 (or 20/20). The Jaegar eye card is used to measure near visual acuity. J1 is the smallest text and J2 is considered equivalent to 6/6 (or 20/20) for near vision. OBJECTIVES To compare visual outcomes after implantation of trifocal intraocular lenses (IOLs) to those of extended depth of focus (EDOF) IOLs. To produce a brief economic commentary summarising recent economic evaluations that compare trifocal IOLs with EDOF IOLs. SEARCH METHODS We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register), MEDLINE, Embase, and three trial registries on 15 June 2022. For our economic evaluation, we also searched MEDLINE and Embase using economic search filters to 15 June 2022, and the NHS Economic Evaluation Database (EED) from 1968 up to and including 31 December 2014. We did not use any date or language restrictions in the electronic searches. SELECTION CRITERIA We included studies comparing trifocal and EDOF IOLs in adults undergoing cataract surgery. We did not include studies involving people receiving IOLs for correction of refractive error alone (or refractive lens exchange in the absence of cataract). DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Two review authors working independently selected studies for inclusion and extracted data from the reports. We assessed the risk of bias in the studies, and we assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS We included five studies that compared trifocal and EDOF lenses in people undergoing cataract surgery. Three trifocal lenses (AcrySof IQ PanOptix, ATLISA Tri 839MP, FineVision Micro F) and one EDOF lens (TECNIS Symfony ZXR00) were evaluated. The studies took place in Europe and North America. Follow-up ranged from three to six months. Of the 239 enroled participants, 233 (466 eyes) completed follow-up and were included in the analyses. The mean age of participants was 68.2 years, and 64% of participants were female. In general, the risk of bias in the studies was unclear as methods for random sequence generation and allocation concealment were poorly reported, and we judged one study to be at high risk of performance and detection bias. We assessed the certainty of the evidence for all outcomes as low, downgrading for the risk of bias and for imprecision. In two studies involving a total of 254 people, there was little or no difference between trifocal and EDOF lenses for uncorrected and corrected distance visual acuity worse than 6/6. Sixty per cent of participants in both groups had uncorrected distance visual acuity worse than 6/6 (risk ratio (RR) 1.06, 95% confidence intervals (CI) 0.88 to 1.27). Thirty-one per cent of the trifocal group and 38% of the EDOF group had corrected distance visual acuity worse than 6/6 (RR 1.04, 95% CI 0.78 to 1.39). In one study of 60 people, there were fewer cases of uncorrected near visual acuity worse than J2 in the trifocal group (3%) compared with the EDOF group (30%) (RR 0.08, 95% CI 0.01 to 0.65). In two studies, participants were asked about spectacle independence using subjective questionnaires. There was no evidence of either lens type being superior. One further study of 60 participants reported, "overall, 90% of patients achieved spectacle independence", but did not categorise this by lens type. All studies included postoperative patient-reported visual function, which was measured using different questionnaires. Irrespective of the questionnaire used, both types of lenses scored well, and there was little evidence of any important differences between them. Two studies included patient-reported ocular aberrations (glare and halos). The outcomes were reported in different ways and could not be pooled; individually, these studies were too small to detect meaningful differences in glare and halos between groups. One study reported no surgical complications. Three studies did not mention surgical complications. One study reported YAG capsulotomy for posterior capsular opacification (PCO) in one participant (one eye) in each group. One study reported no PCO. Two studies did not report PCO. One study reported that three participants (one trifocal and two EDOF) underwent laser-assisted subepithelial keratectomy (LASEK) to correct residual myopic refractive error or astigmatism. One study reported a subset of participants who were considering laser enhancement at the end of the study period (nine trifocal and two EDOF). Two studies did not report laser enhancement rates. No economic evaluation studies were identified for inclusion in this review. AUTHORS' CONCLUSIONS Distance visual acuity after cataract surgery may be similar whether the lenses implanted are trifocal IOLs or EDOF (TECNIS Symfony) IOLs. People receiving trifocal IOLs may achieve better near vision and may be less dependent on spectacles for near vision. Both lenses were reported to have adverse subjective visual phenomena, such as glare and halos, with no meaningful difference detected between lenses.
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Affiliation(s)
| | - Hadi Ziaei
- Manchester Royal Eye Hospital, Manchester, UK
| | | | - Akilesh Gokul
- Department of Ophthalmology, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand
| | - Ashleigh Kernohan
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Jennifer R Evans
- ICEH (International Centre for Eye Health), London School of Hygiene & Tropical Medicine, London, UK
| | - Mohammed Ziaei
- Department of Ophthalmology, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand
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Radner W. Toward an internationally accepted standard for reading charts. Prog Retin Eye Res 2024; 101:101262. [PMID: 38574851 DOI: 10.1016/j.preteyeres.2024.101262] [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: 01/12/2024] [Revised: 03/28/2024] [Accepted: 04/01/2024] [Indexed: 04/06/2024]
Abstract
Patients who suffer from sight-threatening eye diseases share a desire to regain a comfortable reading ability. In light of the modern advances achieved in ophthalmic diagnosis and therapy, and because a significant lack of comparability between reading charts still exists, there is an increasing need for a worldwide standard in the form of a norm for diagnostic reading charts. Already, applied advancements such as digital print, which allow a calibration of the print sizes of reading charts in correctly progressing geometric proportions by using the actual height of a lower case "x" in millimeters (x-height), and psychophysically standardizing reading charts and their test items by applying modern statistical methods have significantly contributed to establishing a norm for reading charts. In 2020, a proposal of the British delegation was accepted by the International Organization for Standardization (ISO) group "Visual Optics and Optical Instruments," and a working group was established. Bearing in mind the efforts of the ISO with regard to an international norm, this review article is intended to (a) give an overview of the historical background and related normative approaches for diagnostic reading tests used in ophthalmology and optometry, (b) explain psychophysical and technical concerns, and (c) discuss the possibilities and limits of concepts that seem relevant to developing a modern standard for reading charts.
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Affiliation(s)
- Wolfgang Radner
- Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Austria; Department of Ophthalmology, University Hospital St. Pölten, Dunant-Platz 1, 3100, St. Pölten, Austria; Austrian Academy of Ophthalmology, Mollgasse 11, 1180, Vienna, Austria.
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Guo S, Huang H, Li B, Huang M, Gao L, Chen J, Zeng Y, Yang Y, Liu L, Cheng L, Yao S, Cheng H. Comparatively analysing the postoperative optical performance of different intraocular lenses: a prospective observational study. BMC Ophthalmol 2024; 24:198. [PMID: 38671381 PMCID: PMC11046961 DOI: 10.1186/s12886-024-03439-0] [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: 01/24/2023] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Postoperative performance, including best corrected distance visual acuity (BCDVA) and optical metrics (from the OQAS and iTrace devices), was compared among 4 different intraocular lenses (IOLs). METHODS This prospective observational study included 104 eyes from 104 subjects who underwent cataract surgery combined with implantation of 4 different IOLs: monofocal (Mon) IOLs, segmental refractive (SegRef) IOLs, diffractive (Dif) IOLs and extended depth of focus (EDoF) IOLs. Postoperative BCDVA and optical metrics were collected at the 6th month. The OQAS optical metrics included the objective scattering index (OSI), Strehl ratio (SR), modulation transfer function (MTF) cut-off frequency, and predicted visual acuity (PVA); the iTrace optical metrics included blur/double vision, glare/halo, starburst, mixed focus, night myopia, and night hyperopia. RESULTS There was no significant difference in BCDVA among the 4 groups (P = 0.059; power = 70.3%). Differences were observed in all OQAS optical metrics among the groups (all P < 0.001). Overall, Mon IOLs and EDoF IOLs exhibited better performance than Dif IOLs and SegRef IOLs. Starburst was the only iTrace optical metric that differed among the groups (P < 0.001): SegRef IOLs caused more starbursts than Mon IOLs (P = 0.001), Dif IOLs (P = 0.006) and EDoF IOLs (P < 0.001). Spearman rank correlation analysis was used to determine the relationships among the iTrace optical metrics, OQAS optical metrics and BCDVA: starburst was negatively correlated with BCDVA, PVA at contrasts of 100% and 20%, OSI, and MTF cut-off frequency (all P ≤ 0.001); mixed focus was positively correlated with BCDVA, PVA at contrasts of 100% and 20%, OSI, and MTF cut-off frequency (all P ≤ 0.001). CONCLUSIONS Postoperative BCDVA and optical metrics varied among the different IOLs, which should be taken into account in the selection and management of IOLs for cataract patients. TRIAL REGISTRATION This study was approved by the First Affiliated Hospital of Guangzhou Medical University Ethical Review Board (No. 50 2022).
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Affiliation(s)
- Shuanglin Guo
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China
| | - Hao Huang
- Department of Ophthalmology, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, #116, Changjiang South Road, Zhuzhou, Hunan, 412000, China.
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
| | - Bowen Li
- Eye Center of Xiangya Hospital, Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, 410008, China
| | - Mansha Huang
- Department of Ophthalmology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, 510240, China
| | - Lu Gao
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China
| | - Jingyi Chen
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China
| | - Yuying Zeng
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China
| | - Ye Yang
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China
| | - Lin Liu
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China
| | - Lu Cheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China
| | - Siyang Yao
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China
| | - Hao Cheng
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China.
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Li J, Sun B, Zhang Y, Hao Y, Wang Z, Liu C, Jiang S. Comparative efficacy and safety of all kinds of intraocular lenses in presbyopia-correcting cataract surgery: a systematic review and meta-analysis. BMC Ophthalmol 2024; 24:172. [PMID: 38627651 PMCID: PMC11020619 DOI: 10.1186/s12886-024-03446-1] [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: 10/13/2023] [Accepted: 04/10/2024] [Indexed: 04/19/2024] Open
Abstract
PURPOSE To assess the efficacy and safety of various intraocular lenses (IOLs), including standard monofocal, bifocal, trifocal, extended depth of focus (EDOF), and enhanced monofocal IOLs, post-cataract surgery through a network meta-analysis. METHODS A systematic search of PubMed, Cochrane Library, and Web of Science was conducted to identify relevant studies from the past 5 years. Parameters such as binocular visual acuities, spectacle independence, contrast sensitivity (CS), and optical quality were used to evaluate efficacy and safety. Data from the selected studies were analyzed using Review Manager 5.4 and STATA 17.0 software. RESULTS Twenty-eight Randomized Controlled Trials (RCTs) comprising 2465 subjects were included. Trifocal IOLs exhibited superior uncorrected near visual acuity (UNVA) compared to monofocal IOLs (MD: -0.35; 95% CI: -0.48, -0.22). Both trifocal (AcrySof IQ PanOptix IOLs group MD: -0.13; 95% CI: -0.21, -0.06) and EDOF IOLs (MD: -0.13; 95% CI: -0.17, -0.09) showed better uncorrected intermediate visual acuity (UIVA) than monofocal IOLs. Trifocal IOLs ranked highest in spectacle independence at various distances (AT LISAtri 839MP group: SUCRA 97.5% for distance, 80.7% for intermediate; AcrySof IQ PanOptix group: SUCRA 83.0% for near). CONCLUSIONS For cataract patients who want to treat presbyopia, trifocal IOLs demonstrated better visual acuity and spectacle independence at near distances. Different types of trifocal IOL characteristics differ. EDOF and enhanced monofocal IOLs have improved visual quality at intermediate distances.Therefore, It is very important to select the appropriate IOLs based on the lens characteristics and patient needs.
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Affiliation(s)
- Jinyu Li
- Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Binzhou Medical University, Jinbu Street, Muping area, Yantai, Shandong Province, 264000, China
| | - Bin Sun
- Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Binzhou Medical University, Jinbu Street, Muping area, Yantai, Shandong Province, 264000, China
| | - Yuexin Zhang
- Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Binzhou Medical University, Jinbu Street, Muping area, Yantai, Shandong Province, 264000, China
| | - Yansong Hao
- Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Binzhou Medical University, Jinbu Street, Muping area, Yantai, Shandong Province, 264000, China
| | - Ze Wang
- Department of Ophthalmology, Shijiazhuang People's Hospital, Shi Jiazhuang, 050200, China
| | - Chengjiang Liu
- Department of General Medicine, Affiliated Anqing First People's Hospital of Anhui Medical University, Anhui, 246000, China
| | - Shanhao Jiang
- Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Binzhou Medical University, Jinbu Street, Muping area, Yantai, Shandong Province, 264000, China.
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8
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Lyu J, Bang SP, Yoon G. Refractive extended depth-of-focus lens design based on periodic power profile for presbyopia correction. Ophthalmic Physiol Opt 2024; 44:301-310. [PMID: 37984831 PMCID: PMC10925839 DOI: 10.1111/opo.13253] [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: 12/19/2022] [Revised: 10/26/2023] [Accepted: 11/01/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE Limitations of existing diffractive multifocal designs for presbyopia correction include discrete foci and photic phenomena such as halos and glare. This study aimed to explore a methodology for developing refractive extended depth-of-focus (EDoF) lenses based on a periodic power profile. METHODS The proposed design technique employed an optical power profile that periodically alternated between far, intermediate and near distances across the pupil radius. To evaluate the lens designs, optical bench testing was conducted. The impact on visual performance was assessed using a spatial light modulator-based adaptive optics vision simulator in human subjects. Additionally, the effects of pupil size change and lens decentration on retinal image quality were examined. A comparative performance analysis was carried out against a typical diffractive trifocal design and a monofocal lens. RESULTS The proposed design method was found to be effective in uniformly distributing light energy across all object distances within the desired depth of focus (DoF). While trade-offs between overall image quality and DoF still exist, the EDoF lens design, when tested in human subjects, provided a continuous DoF spanning over 2.25 D. The results also revealed that the EDoF design had a slightly higher dependence on changes in pupil size and lens decentration than the diffractive trifocal design. CONCLUSION The proposed design method showed significant potential as an approach for developing refractive EDoF ophthalmic lenses. These lenses offer a continuous DoF but are slightly more susceptible to variations in pupil size and decentration compared with the diffractive trifocal design.
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Affiliation(s)
- Jiakai Lyu
- Institute of Optics, University of Rochester, Rochester, New York, USA
| | - Seung Pil Bang
- Department of Biomedical Engineering, University of Rochester, Rochester, New York, USA
| | - Geunyoung Yoon
- College of Optometry, University of Houston, Houston, Texas, USA
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9
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Venkataraman AP, Al-Soboh L, Hedström J, Domínguez-Vicent A. Individual vs simultaneous macular and optic disc measurements with spectral domain optical coherence tomography in glaucoma and healthy eyes. Sci Rep 2024; 14:2734. [PMID: 38302555 PMCID: PMC10834498 DOI: 10.1038/s41598-024-53293-9] [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: 04/26/2023] [Accepted: 01/30/2024] [Indexed: 02/03/2024] Open
Abstract
We assessed the repeatability and agreement of ganglion cell complex (GCC) in the macular area and the peripapillary retinal nerve fiber layer (ppRNFL) with individual and combined macula and disc scans. The macular GCC and ppRNFL thicknesses from 34 control eyes and 43 eyes with glaucoma were measured with the Canon Optical Coherence Tomography (OCT) HS-100. Two repeated measurements were performed with both scan modes. The repeatability limit (Rlim) and agreement analysis were performed. The individual scan showed better repeatability than the combined scan in both groups. However, the differences in the Rlim for the GCC in most sectors were lower than 3 μm (axial resolution of the OCT), and this was larger than 3 μm for most of the ppRNFL sectors. The mean differences in the thickness between both scan modes for the GCC and ppRNFL measurements were less than 3 and 6 μm, respectively. The interval of the limits of agreement was about 10 μm in some sectors for the GCC, and about 40 and 60 μm in some sectors in controls and glaucoma eyes, respectively. Both scan modes showed good repeatability in both groups. The agreement results suggest that the scan modes cannot be used interchangeably.
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Affiliation(s)
- Abinaya Priya Venkataraman
- Division of Eye and Vision, Department of Clinical Neuroscience, Karolinska Institute, 171 77, Stockholm, Sweden
| | - Loujain Al-Soboh
- Division of Eye and Vision, Department of Clinical Neuroscience, Karolinska Institute, 171 77, Stockholm, Sweden
| | - Johan Hedström
- Division of Eye and Vision, Department of Clinical Neuroscience, Karolinska Institute, 171 77, Stockholm, Sweden
| | - Alberto Domínguez-Vicent
- Division of Eye and Vision, Department of Clinical Neuroscience, Karolinska Institute, 171 77, Stockholm, Sweden.
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10
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Singh G, Sidhharthan KS, Reddy JK, Sundaram V, Thulasidas M. Comparison of visual outcomes in patients implanted with Tecnis Eyhance ICB00 and 1-Piece ZCB00 monofocal intraocular lenses. Indian J Ophthalmol 2024; 72:181-184. [PMID: 38273683 PMCID: PMC10941920 DOI: 10.4103/ijo.ijo_681_23] [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: 03/10/2023] [Revised: 07/19/2023] [Accepted: 08/11/2023] [Indexed: 01/27/2024] Open
Abstract
PURPOSE To compare the visual outcomes and monocular defocus curve of a new monofocal Tecnis Eyhance IOL (Tecnis ICB00) with Tecnis 1 single piece (ZCB00). METHODS Eighty patients diagnosed with cataract were divided into two groups: Tecnis ICB00 (n = 40) and ZCB00 (n = 40). The visual outcome was evaluated using the following parameters: uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), corrected distance visual acuity (CDVA), distance corrected intermediate visual acuity (DCIVA), corrected near visual acuity (CNVA), uncorrected visual acuity contrast sensitivity (UVACS), best-corrected visual acuity contrast sensitivity (BCVACS), manifest refraction, and defocus curve and was compared at the 6th week and 3 months after surgery. RESULTS The UIVA and UNVA were significantly (P < 0.05) better in ICB00 as compared with ZCB00 at 6 weeks and 3 months postoperative. The DCIVA was significantly better in ICB00 as compared with ZCB00 at 3 months postoperative (-0.015 ± 0.04 vs. 0.01 ± 0.020; P = 0.01). Regarding contrast sensitivity, UVACS and BCVACS were significantly better in ICB00 as compared with ZCB00 at 6 weeks and 3 months postoperative (P < 0.05). The defocus curves showed that the mean visual acuity of the ICB00 group was significantly better than that of the ZCB00 group at between - 0.5 D and - 2.50 D of defocus. CONCLUSION In patients undergoing cataract surgery, Eyhance ICB00 provided better intermediate vision as compared with ZCB00.
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Affiliation(s)
- Gagandeep Singh
- DNB Resident, Sankara Eye Hospital, Coimbatore, Tamil Nadu, India
| | | | - Jagadeesh K Reddy
- Cornea Department, Sankara Eye Hospital, Coimbatore, Tamil Nadu, India
| | - Vandana Sundaram
- Cornea Department, Sankara Eye Hospital, Coimbatore, Tamil Nadu, India
| | - Mithun Thulasidas
- Glaucoma Department, Sankara Eye Hospital, Coimbatore, Tamil Nadu, India
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11
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Pershin KB, Pashinova NF, Tsygankov AY, Antonov EA, Kosova IV, Korneeva EA. [Outcomes of extended depth of focus intraocular lenses implantation]. Vestn Oftalmol 2024; 140:40-46. [PMID: 38742497 DOI: 10.17116/oftalma202414002140] [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] [Indexed: 05/16/2024]
Abstract
Extended depth of focus (EDOF) intraocular lenses (IOLs) are the latest IOL designs. In recent years, several models of EDOF IOLs have become available in Russia, two of which (Tecnis Symfony and Acrysof IQ Vivity) are implanted in our clinic. Comparative studies devoted to the results of implantation of the new EDOF IOLs are rare in the available literature. PURPOSE This article compares the outcomes of implantation of two EDOF IOLs in patients with presbyopia and/or cataract. MATERIAL AND METHODS The prospective study included 60 patients (81 eyes) after implantation of EDOF IOL Tecnis Symfony (32 patients, 45 eyes; group 1) or EDOF IOL AcrySof IQ Vivity (28 patients, 36 eyes; group 2). The mean follow-up period was 3.9±1.3 months. RESULTS All groups showed a significant (p<0.05) increase in uncorrected near visual acuity (UCNVA), intermediate visual acuity (UCIVA), and distance visual acuity (UCDVA) at the maximum follow-up time compared to preoperative values. In group 1, the best corrected near visual acuity (BCNVA) increased from 0.61±0.10 to 0.82±0.16 at the maximum follow-up time, and in group 2 - from 0.58±0.08 to 0.67±0.12 (p>0.05). Both groups showed a significant increase in best corrected intermediate and distance visual acuity (BCIVA and BCDVA) at the maximum follow-up time. The increase in the indicator compared to the preoperative period was not significant in both groups (p>0.05). The frequency of side optical phenomena was low in both groups. No significant differences were found between the groups (p>0.05). CONCLUSION This study presents a comparative analysis of the results of implantation of two different EDOF IOLs. Both lenses were comparable in most of the studied parameters, including providing good distance and intermediate vision, functional near vision, as well as a low frequency of side optical phenomena. In all cases the patients were satisfied with the results of the surgical intervention.
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Affiliation(s)
- K B Pershin
- Excimer Eye Centre, Moscow, Russia
- Academy of Postgraduate Education of the Federal Scientific and Practical Center for Specialized Types of Medical Care and Medical Technologies of the Federal Medical-Biological Agency, Moscow, Russia
| | - N F Pashinova
- Excimer Eye Centre, Moscow, Russia
- Academy of Postgraduate Education of the Federal Scientific and Practical Center for Specialized Types of Medical Care and Medical Technologies of the Federal Medical-Biological Agency, Moscow, Russia
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12
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Khoramnia R, Baur ID, Łabuz G, Köppe MK, Hallak MK, Auffarth GU. Functional outcomes after bilateral refractive lens exchange with a continuous-range-of-vision intraocular lens. J Cataract Refract Surg 2023; 49:1011-1017. [PMID: 37464558 DOI: 10.1097/j.jcrs.0000000000001265] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 07/12/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE To clinically evaluate a diffractive continuous-range-of-vision intraocular lens (IOL) that combines bifocal and extended depth-of-focus technologies in refractive lens exchange (RLE) patients. SETTING University eye clinic. DESIGN Prospective interventional clinical study. METHODS Bilateral implantation of the TECNIS Synergy IOL was performed during a RLE procedure in 28 patients. At 3 months postoperatively, uncorrected (UDVA) and corrected (CDVA) distance visual acuities, uncorrected (UIVA) and distance-corrected (DCIVA) intermediate visual acuities at 80 cm, and uncorrected (UNVA) and distance-corrected (DCNVA) near visual acuities at 40 cm were assessed. Defocus curve testing and contrast sensitivity testing were also performed. RESULTS Binocular UDVA and CDVA of 56 eyes (28 patients) were -0.06 ± 0.07 logMAR and -0.13 ± 0.05 logMAR, respectively. UIVA and DCIVA were -0.06 ± 0.05 logMAR and -0.08 ± 0.06 logMAR, and UNVA and DCNVA were -0.01 ± 0.07 logMAR and -0.04 ± 0.07 logMAR. The defocus curve revealed a visual acuity of 0.10 logMAR or better from +0.50 to -3.00 diopters (D). Photopic contrast sensitivity at spatial frequencies 3.0, 6.0, 12.0, and 18.0 was 1.68 ± 0.20, 1.77 ± 0.19, 1.45 ± 0.18, and 1.02 ± 0.19 log units, respectively. Mesopic contrast sensitivity at the same frequencies was 1.56 ± 0.20, 1.44 ± 0.25, 0.92 ± 0.38, and 0.44 ± 0.37, respectively. CONCLUSIONS The Synergy IOL provided very good distance, intermediate, and near visual outcomes. A visual acuity of 0.10 logMAR or better was achieved from +0.50 to -3.0 D. Contrast sensitivity was within the normal range.
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Affiliation(s)
- Ramin Khoramnia
- From the International Vision Correction Research Center, University Eye Clinic of Heidelberg, Heidelberg, Germany
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Shemesh R, Reitblat O, Rodov L, Levy A, Assia EI, Kleinmann G. Results of an Extended Depth-of-Focus Intraocular Lens Implantation in the Second Eye of Monofocal Pseudophakic Patients: A Pilot Study. Asia Pac J Ophthalmol (Phila) 2023; 12:349-354. [PMID: 37523425 DOI: 10.1097/apo.0000000000000622] [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: 03/05/2023] [Accepted: 05/14/2023] [Indexed: 08/02/2023] Open
Abstract
PURPOSE The purpose of this study was to investigate the visual results and patient satisfaction after implantation of an extended depth-of-focus (EDOF) intraocular lens (IOL) in the second eye of patients implanted previously with a monofocal IOL in the first eye. METHODS The medical records and self-reported questionnaires from patients who were implanted with monofocal IOLs in the first eye and EDOF IOLs in the second eye (group A) and from patients implanted bilaterally with EDOF IOLs (group B) were compared for visual acuity (VA), spectacle independence, patient satisfaction, and photic phenomena. RESULTS Group A (23 eyes of 23 patients) had similar distance uncorrected VA and intermediate uncorrected VA compared with group B (72 eyes of 36 patients) (0.03±0.05 vs. 0.04±0.16; P =0.136 and 0.660, respectively). There was a tendency toward a better near uncorrected VA in group A compared with group B (0.15±0.14 vs. 0.23±0.17; P =0.074). Patients' perception of their VA was similar between groups. Spectacle independence for distance vision was reported by 16/17 (94.1%) and 35/36 (97.2%) patients ( P =0.543), 13/17 (76.5%) and 32/36 (88.9%) patients ( P =0.252) for intermediate vision, and 4/17 (23.6%) and 22/36 (61.1%) patients for near vision ( P =0.011), in groups A and B, respectively. There was no difference in complaints of photic phenomena between groups. CONCLUSIONS Patients previously implanted with a monofocal IOL in 1 eye who are interested in improving their spectacle independence can be considered for an EDOF IOL implantation in the second eye and may have similar results to those implanted bilaterally with EDOF IOLs.
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Affiliation(s)
- Rachel Shemesh
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Ein-Tal Eye Center, Tel Aviv, Israel
- Sheba Medical center, Tel-Hashomer, Israel
| | - Olga Reitblat
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Ein-Tal Eye Center, Tel Aviv, Israel
- Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
| | | | - Adi Levy
- Ein-Tal Eye Center, Tel Aviv, Israel
| | - Ehud I Assia
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Ein-Tal Eye Center, Tel Aviv, Israel
- Department of Ophthalmology, Meir Medical Center, Kfar Sava, Israel
| | - Guy Kleinmann
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Ein-Tal Eye Center, Tel Aviv, Israel
- Department of Ophthalmology, E. Wolfson Medical Center, Holon, Israel
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Fernández J, Burguera N, Rocha-de-Lossada C, Rodríguez-Calvo-de-Mora M, Rodríguez-Vallejo M. Agreement between Two Devices for Measuring Pupil Diameter in Patients Implanted with Multifocal Intraocular Lenses. Vision (Basel) 2023; 7:vision7020040. [PMID: 37218958 DOI: 10.3390/vision7020040] [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: 03/07/2023] [Revised: 04/12/2023] [Accepted: 05/03/2023] [Indexed: 05/24/2023] Open
Abstract
The purpose of this study was to evaluate the agreement between three methods for measuring pupil size in patients implanted with multifocal intraocular lenses (MIOLs): Keratograph 5M (K5M), Pentacam AXL Wave (PW), and a simple hand ruler. Sixty-nine subjects implanted with MIOLs and measured at the three-month follow-up visit were included in this retrospective analysis. K5M and PW were used to measure the photopic (PP) and mesopic (MP) pupil sizes, and a hand ruler was used to measure the pupil under environmental light conditions (135 lux). The Bland-Altman method with its limits (LoAs) was used to assess the agreement. The median PP was 2.8, 2.95, and 3 mm for K5M, PW, and the ruler, respectively (p < 0.05). Differences in PP were statistically significant for all paired comparisons (p < 0.0005) except between PW and the ruler (p = 0.44). The LoAs for the difference in PP between K5M and PW was 0.63 mm. The mean difference for MP between K5M and PW was 0.04 mm (p = 0.34) with LoAs of 0.72 mm. MP measured with K5M and PW could be considered interchangeable, although a correction of -0.3 mm (IC95%: -0.23 to -0.39) should be applied to PP measured with PW to attain the K5M mean.
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Affiliation(s)
- Joaquín Fernández
- Department of Ophthalmology (Qvision), VITHAS Almería Hospital, 04120 Almería, Spain
| | - Noemí Burguera
- Department of Ophthalmology (Qvision), VITHAS Almería Hospital, 04120 Almería, Spain
| | - Carlos Rocha-de-Lossada
- Department of Ophthalmology (Qvision), VITHAS Almería Hospital, 04120 Almería, Spain
- Department of Ophthalmology, VITHAS Málaga, 29016 Málaga, Spain
- Department of Ophthalmology, Hospital Regional Universitario de Málaga, Plaza del Hospital Civil, S/N, 29009 Málaga, Spain
- Departamento de Cirugía, Universidad de Sevilla, Área de Oftalmología, Doctor Fedriani, S/N, 41009 Sevilla, Spain
| | - Marina Rodríguez-Calvo-de-Mora
- Department of Ophthalmology (Qvision), VITHAS Almería Hospital, 04120 Almería, Spain
- Department of Ophthalmology, VITHAS Málaga, 29016 Málaga, Spain
- Department of Ophthalmology, Hospital Regional Universitario de Málaga, Plaza del Hospital Civil, S/N, 29009 Málaga, Spain
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Clinical Evaluation of Reading Performance in Refractive Lens Exchange With a Diffractive Continuous-Range-of-Vision Intraocular Lens. Am J Ophthalmol 2023; 250:25-37. [PMID: 36669611 DOI: 10.1016/j.ajo.2023.01.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/19/2023]
Abstract
PURPOSE Evaluation of reading performance with a novel presbyopia correcting intraocular lens (IOL) in refractive lens exchange using an electronic reading desk. DESIGN Prospective interventional before-and-after clinical study. METHODS In total, 56 eyes of 28 patients were included. Bilateral implantation of the TECNIS Synergy IOL (Johnson & Johnson Surgical Vision) during a bilateral delayed sequential refractive lens exchange procedure. Uncorrected and distance corrected reading acuity, reading distance, reading speed, and the smallest print size that could be read effectively at a set (40 cm/80 cm) and subjectively chosen near and intermediate distance were assessed using the Salzburg Reading Desk preoperatively and 6 months after surgery. RESULTS Uncorrected near reading acuity increased from 0.61 ± 0.16 logarithm of the minimum angle of resolution (logMAR) preoperatively to 0.05 ± 0.09 logMAR postoperatively at the set near distance (40 cm) and from 0.60 ± 0.11 logMAR to 0.07 ± 0.08 logMAR at the subjectively preferred distance (39.6 ± 5.3 cm and 37.7 ± 4.3 cm). Uncorrected intermediate reading acuity was 0.39 ± 0.19 logMAR preoperatively and 0.08 ± 0.07 logMAR postoperatively at the set intermediate distance (80 cm) and 0.43 ± 0.21 logMAR preoperatively and 0.07 ± 0.08 logMAR postoperatively at the preferred intermediate distance (73.5 ± 9.5 cm and 73.3 ± 5.9 cm). CONCLUSIONS Uncorrected intermediate and near reading function considerably improved after bilateral implantation of the TECNIS Synergy IOL. Patients preferred a closer near and intermediate distance to the set distances. However, reading function was comparable for the set and subjectively preferred distances.
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Megiddo-Barnir E, Alió JL. Latest Development in Extended Depth-of-Focus Intraocular Lenses: An Update. Asia Pac J Ophthalmol (Phila) 2023; 12:58-79. [PMID: 36706334 DOI: 10.1097/apo.0000000000000590] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/06/2022] [Indexed: 01/28/2023] Open
Abstract
In recent years, there has been an overwhelming influx of different types of intraocular lenses (IOLs) as treatment for presbyopia. The extended depth-of-focus (EDOF) technology creates a single elongated focal point to enhance depth of focus, in contrast to the multiple foci of multifocal (MF) lenses. In this way, the EDOF lenses aim to reduce photic phenomena, glare, and halos, which have been reported in MF IOLs. A potential disadvantage of this is a blur due to decreased retinal image quality when the amount of the aberrations is increased excessively. Multifocality and EDOF characteristics are not exclusive of each other. Frequently, EDOF IOLs are combined with MF optical designs, a bifocal IOL may exhibit EDOF characteristics, likewise an aspheric monofocal IOL or a diffractive or refractive trifocal IOL. Thus, EDOF lenses are commonly subjected to confusion. A wide range of different types of EDOF lenses are available on the market to surgeons. In this practical update, we aim to clarify what is a true EDOF lens, classify the different types of the EDOF lenses based on their optical principle and review their recently reported outcomes. Comprehensive patient examination and selection, combined with knowledge of the most updated options and adequate patient counseling, can avoid dissatisfaction and yield the desired outcomes.
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Affiliation(s)
| | - Jorge L Alió
- Cornea, Cataract & Refractive Surgery Unit, VISSUM (Miranza Group), Alicante, Spain
- Department of Ophthalmology, Miguel Hernandez University, Alicante, Spain
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Clinical Outcomes after Bilateral Implantation of Trifocal Diffractive Intraocular Lenses and Extended Depth of Focus Intraocular Lenses. J Clin Med 2022; 11:jcm11195729. [PMID: 36233597 PMCID: PMC9571716 DOI: 10.3390/jcm11195729] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 11/24/2022] Open
Abstract
The purpose of this retrospective study is to investigate clinical outcomes of bilateral implantation of diffractive trifocal intraocular lenses (IOLs) and extended depth of focus IOLs in Koreans. The clinical outcomes of cataract surgery with bilateral implantation of PanOptix, FineVision, Symfony, and MiniWell were evaluated. Uncorrected distant, intermediate (80 cm, 60 cm), near (40 cm) visual acuity, defocus curve, manifest refraction, contrast sensitivity, and higher-order aberrations, quality of vision, spectacle independence, and subjective satisfaction at postoperative 3 months were assessed. A total of 136 eyes in 68 patients were included in the analyses. PanOptix and FineVision performed better visual acuity compared to Symfony and MiniWell at 40 cm distance. Defocus curve showed broad range of vision in PanOptix and FineVision with visual acuity of more than 0.1 logarithm of the minimum angle of resolution at −2.5 diopter (D) of defocus power, while Symfony and MiniWell presented excellent intermediate vision without a dip at defocus power of −0.5 D to −1.0 D. Glare, halo, and starburst were significantly less in MiniWell compared to others. In conclusion, all four IOLs presented satisfactory clinical outcomes. PanOptix and FineVision provided good near and intermediate vision, while Symfony and MiniWell provided good intermediate vision. MiniWell induced little dysphotopsia.
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Evaluation of Visual and Patient-Reported Outcomes, Spectacle Dependence after Bilateral Implantation with a Non-Diffractive Extended Depth of Focus Intraocular Lens Compared to Other Intraocular Lenses. J Clin Med 2022; 11:jcm11175246. [PMID: 36079174 PMCID: PMC9456700 DOI: 10.3390/jcm11175246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/29/2022] [Accepted: 09/03/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose: To evaluate postoperative outcomes, spectacle dependance and the occurrence of the photic phenomena in patients after cataract surgery following the implantation of a non-diffractive extended depth of focus (EDOF) intraocular lens was compared to monofocal and multifocal lenses. Methods: We enrolled patients with bilateral cataracts who wanted to reduce their dependence on glasses in the study. They were followed for 6 months. The study group in which the EDOF lens was implanted consisted of 70 eyes in 35 patients. The control groups consisted of: 52 eyes in 26 patients in whom a multifocal was implanted and 52 eyes in 26 patients with implanted monofocal lens. After a total of 2 weeks, 2 months and 6 months post-surgery the following were evaluated: uncorrected and corrected visual acuity at 4 m, 80 cm, 40 cm, manifest refraction expressed as mean refractive spherical equivalent (MRSE), contrast sensitivity, intraocular pressure. A questionnaire on independence from ocular correction, the occurrence of photic phenomena, and patient satisfaction was also completed. Results: Monocular and binocular visual acuity and MRSE 6 months after the procedure were compared between three groups. All of the main analyses, except for comparisons of uncorrected distance visual acuity (both monocular and binocular) level, were significant. Contrast sensitivity was lower among patients with multifocal lens than among patients with EDOF lens. Halo and glare after 6 months were seen more often among patients with multifocal lens than among patients with the other lens (65% of eyes with multifocal lens vs. 6% of eyes with EDOF lens and 0% of eyes with monofocal lens). Glasses were needed by 35% of patients with EDOF lens, and by 96% of patients with monofocal lens and in none of the patients with multifocal lens. Conclusions: Most patients qualify for the implantation of a non-diffractive EDOF lens. Post-operative visual acuity improves at any distance. The best monocular visual acuity for intermediate distances is provided by an EDOF lens, and for near distance by a multifocal lens. The EDOF lens definitely increases independence from spectacle correction compared to monofocal lenses; however, the greatest degree of independence from spectacles is provided by multifocal lenses. The incidence of photic phenomena is slightly higher than that of a monofocal lens, and much lower for a multifocal lens.
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Borkenstein AF, Borkenstein EM, Schmid R. Evaluating Optical Quality of a New Hydrophilic Enhanced Monofocal Intraocular Lens and Comparison to the Monofocal Counterpart: An Optical Bench Analysis. Ophthalmol Ther 2022; 11:2045-2056. [PMID: 36040648 DOI: 10.1007/s40123-022-00561-4] [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: 07/14/2022] [Accepted: 08/12/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The aim of the study was to analyze the optical properties of a new hydrophilic enhanced monofocal intraocular lens (IOL) using optical bench analysis and compare it with its monofocal counterpart. METHODS This laboratory study investigates the enhanced monofocal intraocular lens (L-333) and the monofocal counterpart (L-313) IOL by Teleon Surgical, Spankeren, Netherlands on the optical bench, using OptiSpheric IOL PRO2 (Trioptics, Germany) in order to assess the optical quality according to ISO 11979 with ISO-2 Cornea. IOLs (power 22.0 D) were evaluated regarding through frequency modulation transfer function (MTF), Strehl ratio (SR), and through focus MTF at 50 lp/mm using a 3.0-mm and a 4.5-mm aperture. Tilt and decentration were applied. In addition, wavefront measurements were obtained using WaveMaster® IOL 2 device (Trioptics, Germany) and analyzed. RESULTS Centered: The MTF (mean) at 50 lp/mm (L-333/L-313) with 3.0 mm aperture was 0.606/0.724 and with 4.5 mm aperture 0.330/0.409. The SR (mean) with 3.0 mm aperture was 0.586/0.809 and with 4.5 mm aperture 0.330/0.348. Decentered by 1 mm: The MTF (mean) at 50 lp/mm (L-333/L-313) with 3.0 mm aperture was 0.485/0.705 and with 4.5 mm aperture 0.255/0.374. The SR (mean) with 3.0 mm aperture was 0.457/0.739 and with 4.5 mm aperture 0.185/0.268. Tilted by 5 degrees: The MTF (mean) at 50 lp/mm (L-333/L-313) with 3.0 mm aperture was 0.577/0.657 and with 4.5 mm aperture 0.345/0.336. The SR (mean) with 3.0 mm aperture was 0.583/0.702 and with 4.5 mm aperture 0.269/0.237. In through focus MTF and aperture of 3.0 mm, the L-333 showed a peak of 0.41 with some enlarged depth of power of about 2 D. For the aperture of 4.5 mm, the MTF values of L-313 and L-333 were slightly reduced; L-333 showed an MTF peak of 0.23 and some reduced depth of power of about 1.5 D. Wavefront measurements showed no major aberrations for the L-313, while a combination of moderate increase in Z 4-0 and Z 6-0 with opposite sign was revealed for the L-333. CONCLUSION The enhanced monofocal Lentis Quantum (L-333) produces some enlarged depth of focus by combining spherical aberration of different order and opposite sign. The Lentis Quantum performs very well in comparison to the aspherical monofocal counterpart owing to its optical design. Results with large apertures were sufficient too, suggesting that the lens is a good option in eyes with a wide pupil and thus in refractive surgeries of young patients.
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Affiliation(s)
- Andreas F Borkenstein
- Borkenstein and Borkenstein Private Practice, Privatklinik der Kreuzschwestern Graz, Kreuzgasse 35, 8010, Graz, Austria.
| | - Eva-Maria Borkenstein
- Borkenstein and Borkenstein Private Practice, Privatklinik der Kreuzschwestern Graz, Kreuzgasse 35, 8010, Graz, Austria
| | - Ruediger Schmid
- Accuratis, Practice for Refractive Eye Surgery, Hirschstrasse 1, 89073, Ulm, Germany
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Far and Near Contrast Sensitivity and Quality of Vision with Six Presbyopia Correcting Intraocular Lenses. J Clin Med 2022; 11:jcm11144150. [PMID: 35887913 PMCID: PMC9316344 DOI: 10.3390/jcm11144150] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/12/2022] [Accepted: 07/15/2022] [Indexed: 11/16/2022] Open
Abstract
The objective of this prospective, randomized, double-masked study was to compare the contrast sensitivity and quality of vision of patients bilaterally implanted with the following six different presbyopia correcting intraocular lenses (IOLs): SV25T0 (n = 19), ATLISA 809M (n = 18), ATLISA TRI 839MP (n = 19), ZKB00 (n = 20), ZLB00 (n = 20) and Symfony ZXR00 (n = 20). For comparison purposes, 36 patients were implanted with a monofocal lens (ZA9003). Contrast sensitivity was assessed binocularly at distance under photopic, mesopic and mesopic plus glare conditions, and at near under photopic conditions. Quality of vision was explored in terms of photic phenomena and spectacle independence. Overall, the monofocal lens offered better contrast sensitivity, under all illumination conditions, and less occurrence and intensity of photic phenomena. Amongst the multifocal IOL (MIOL) designs, the extended depth of focus Symfony ZXR00 provided better contrast sensitivity than the other MIOLs, particularly at intermediate and high spatial frequencies. Up to 40% and 50% of patients implanted with MIOLs reported glare and halos, respectively. The SV25T0 resulted in less occurrence and intensity of halos. The evaluation of photic phenomena and contrast sensitivity under different illumination conditions may reflect real-life, visually challenging situations, and thus provide insightful information to assist ophthalmic surgeons when selecting the best intraocular lens for their patients.
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Tahmaz V, Siebelmann S, Koch KR, Cursiefen C, Langenbucher A, Hoerster R. Evaluation of a Novel Non-Diffractive Extended Depth of Focus Intraocular Lens - First Results from a Prospective Study. Curr Eye Res 2022; 47:1149-1155. [PMID: 35642558 DOI: 10.1080/02713683.2022.2074046] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To evaluate a novel hydrophobic, non-diffractive, extended depth of focus (EDOF) intraocular lens (IOL) design in comparison to two monofocal aspheric lenses. METHODS Inclusion criteria for this prospective, monocentric cohort study were opacification of the crystalline lens and patients' wishes for surgery. In the case of the EDOF IOL, patients asked for a presbyopia correction. All patients received surgery on both eyes. Corrected and uncorrected distance visual acuity (CDVA, UCDVA), uncorrected and distance corrected intermediate visual acuity (UIVA, DCIVA) and defocus curves (all monocular and binocular) were compared three months postoperatively. RESULTS Fifty-six eyes were implanted with an EDOF IOL (LuxSmartTM, Bausch & Lomb GmbH, Berlin, Germany), 50 eyes with a monofocal aspheric IOL: 32 eyes with a clear IOL (Polylens® AS 61, Polytech Domilens, Roßdorf, Germany), 16 eyes with a yellow IOL (iSert® 251, Hoya Surgical Optics GmbH, Frankfurt, Germany). Three months postoperatively, UCDVA was comparable with the EDOF IOL, versus the monofocal IOL (P > 0.9). Binocular DCIVA in the EDOF IOL was significantly higher than in the monofocal IOL (P = 0.001). Monocular DCIVA better than 20/23 Snellen was achieved in 10% with the monofocal IOL and in 68% (P < 0.0001) with the EDOF IOL. Defocus curves showed a depth of focus at 20/23 Snellen of 1.6 vs. 0.83 diopters (D) in the EDOF IOL, vs. the monofocal IOL. No patient reported halos or starbursts in non-standardized questioning. CONCLUSION This non-diffractive EDOF IOL provided comparably high UCDVA and significantly higher DCIVA than the mono-focal lenses, causing only mild optical phenomena.
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Affiliation(s)
- Volkan Tahmaz
- Center of Ophthalmology, University of Cologne, Cologne, Germany
| | - Sebastian Siebelmann
- Center of Ophthalmology, University of Cologne, Cologne, Germany.,MVZ ADTC Moenchengladbach-Erkelenz, Erkelenz, Germany
| | - Konrad R Koch
- MVZ ADTC Moenchengladbach-Erkelenz, Erkelenz, Germany
| | - Claus Cursiefen
- Center of Ophthalmology, University of Cologne, Cologne, Germany
| | - Achim Langenbucher
- Department of Experimental Ophthalmology, Saarland University, Homburg, Germany
| | - Robert Hoerster
- Center of Ophthalmology, University of Cologne, Cologne, Germany.,MVZ ADTC Moenchengladbach-Erkelenz, Erkelenz, Germany
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Kim S, Yi R, Chung SH. Comparative Analysis of the Clinical Outcomes of Mix-and-Match Implantation of an Extended Depth-of-Focus and a Diffractive Bifocal Intraocular Lens. Eye Contact Lens 2022; 48:261-266. [PMID: 35333819 DOI: 10.1097/icl.0000000000000887] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate and compare the clinical outcomes of the extended depth-of-focus intraocular lens (EDOF-IOL) and the diffractive bifocal IOL. METHODS Fifty-six eyes of 28 patients underwent cataract surgery with implantation of an EDOF-IOL (TECNIS Symfony, ZXR00) in their dominant eye and a diffractive bifocal IOL (+3.25 D add TECNIS ZLB00) in their nondominant eye. Monocular and binocular uncorrected distance, intermediate and near visual acuity, defocus curves, contrast sensitivity, patient satisfaction score (0-5), and spectacle dependence at near vision were evaluated at 3 months after the surgery. RESULTS Postoperative binocular uncorrected distant visual acuity was 0.009±0.031 logMAR, uncorrected intermediate visual acuity was 0.090±0.158 logMAR, and uncorrected near visual acuity was 0.099±0.068 logMAR. The monocular defocus curve demonstrated better performance at intermediate distance in eyes with an EDOF-IOL and better performance at near distance in eyes with a diffractive bifocal IOL. An EDOF-IOL exhibited better outcomes in contrast sensitivity compared with a diffractive bifocal IOL. Three patients (10.7%) required glasses for near vision. CONCLUSION Mix-and-match implantation of a diffractive bifocal IOL with an EDOF-IOL provides an excellent range of vision, and high levels of contrast sensitivity and patient satisfaction.
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Affiliation(s)
- Seonjoo Kim
- Department of Ophthalmology (S.K., S.-H.C.), Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; and Department of Ophthalmology, Gimpo Hangil Eye Hospital (R.Y.), Gimpo, Gyeonggi do, Republic of Korea
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Visual Outcomes after Implantation of Lucidis EDOF IOL. J Ophthalmol 2022; 2022:5100861. [PMID: 35669466 PMCID: PMC9167139 DOI: 10.1155/2022/5100861] [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: 04/07/2022] [Accepted: 05/07/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose. To evaluate the visual performance and clinical outcomes after implantation of Lucidis EDOF IOL following cataract surgery. Design. In this retrospective study, medical records from all enrolled patients were analyzed, and the following information was extracted retrospectively over 3 months following surgery. Materials and Methods. We reviewed retrospectively 181 eyes of 98 patients, who underwent cataract surgery with Lucidis extended depth of focus IOL. Results. 44 patients were males (45%) and 54 were females (55%). The average age of the study population was 68 ± 11 years. The mean preoperative BCVA (logMAR) was 0.19 ± 0.18. The mean root mean square (RMS) high order aberration (HOA) was 0.18 ± 0.1. Monocular BCVA results were 0.02 ± 0.04 (logMAR) and 0.028 ± 0.04 (logMAR) 1 month and 3 months postoperatively, respectively. Between the baseline and 1-month measures, monocular distance BCVA improved by an average of 0.17 ± 0.14 logMAR (
= 0.0001). Between the baseline and 3-month postoperative measures, monocular distance BCVA improved by an average of 0.16 ± 0.13 logMAR (
= 0.0001). Monocular UDVA 1 and 3 months postoperatively was 0.08 ± 0.1 logMAR and 0.067 ± 0.08 logMAR, respectively. 1-Month postoperative binocular UDVA was 0.036 ± 0.05 logMAR, binocular UIVA was 0.1 ± 0.08 logMAR, and binocular UNVA was 0.12 ± 0.14 logMAR. 3-Month postoperative binocular UDVA was 0.038 ± 0.05 logMAR, binocular UIVA was 0.09 ± 0.1 logMAR, and binocular UNVA was 0.16 ± 0.14 logMAR. Conclusions. Lucidis EDOF IOL achieves good visual performances in all distances.
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Visual and optical quality of enhanced intermediate monofocal versus standard monofocal intraocular lens. Graefes Arch Clin Exp Ophthalmol 2022; 260:3617-3625. [PMID: 35622140 PMCID: PMC9581853 DOI: 10.1007/s00417-022-05700-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 04/24/2022] [Accepted: 05/17/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose Intraocular lens designs are constantly evolving, trying to obtain more spectacle independence after cataract surgery. This advantage can be linked to some disadvantages, such as optical quality decrease. For that reason, it is important to assess, not only the amount of vision provided but also the quality of vision once they are implanted. The purpose of the present work was to compare the visual performance between two monofocal intraocular models: a standard model and a monofocal with enhanced intermediate vision lens. Methods Prospective, randomized, comparative study. Sixty adult subjects scheduled to undergo bilateral cataract surgery and IOL implantation were randomized to receive one of the two IOLs in both eyes at Miranza IOA, Madrid, Spain (group A: monofocal with enhanced intermediate vision lens and group B: standard monofocal lens). Monocular outcomes (right eyes) determined 1 and 3 months postoperatively were photopic corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), perceived halo, corrected intermediate-distance contrast sensitivity, and higher-order aberrations. The impact of the new IOL in the postoperative management with autorefraction devices was also evaluated. Results No differences were found in CDVA between the two groups. Significant differences were detected between the two lenses evaluated in both total HOA (p = 0.028) and internal HOA (p = 0.037). Contrast sensitivity and halometry results obtained at 1 month were similar across the two IOL groups. Conclusion In patients undergoing cataract surgery, monofocal with enhanced intermediate vision IOL offered similar distance performance and contrast sensitivity along with perceived HOA and halos compared with the standard monofocal IOLs tested.
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Baur ID, Auffarth GU, Łabuz G, Khoramnia R. [Implantation of a Toric IOL with Enhanced Depth of Focus for Unilateral Traumatic Cataract]. Klin Monbl Augenheilkd 2022. [PMID: 35580622 DOI: 10.1055/a-1809-5187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Isabella Diana Baur
- Universitäts-Augenklinik Heidelberg, Universitätsklinikum Heidelberg, Deutschland
| | - Gerd U Auffarth
- Universitäts-Augenklinik Heidelberg, Universitätsklinikum Heidelberg, Deutschland
| | - Grzegorz Łabuz
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg, Deutschland
| | - Ramin Khoramnia
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg, Deutschland
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Nowik KE, Nowik K, Kanclerz P, Szaflik JP. Clinical Performance of Extended Depth of Focus (EDOF) Intraocular Lenses – A Retrospective Comparative Study of Mini Well Ready and Symfony. Clin Ophthalmol 2022; 16:1613-1621. [PMID: 35651536 PMCID: PMC9150758 DOI: 10.2147/opth.s341698] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/14/2022] [Indexed: 11/27/2022] Open
Abstract
Purpose Extended depth of focus intraocular (EDOF) IOLs form a bridge between single- and multifocal IOL design. This study aimed to compare clinical outcomes obtained after implanting two different optical designs of EDOF IOLs: the Mini Well Ready (SIFI Medtech, Catania, Italy) and Tecnis Symfony (Abbott Laboratories, Illinois, USA). Methods The retrospective observational study included 61 patients (122 eyes) who underwent bilateral implantation of the Mini Well Ready IOL (32 patients) or the Tecnis Symfony IOL (29 patients). The following preoperative and postoperative parameters were evaluated: spherical equivalent, anterior astigmatism, pupil size, monocular and binocular uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), monocular and binocular uncorrected intermediate visual acuity (UIVA) and distance-corrected intermediate visual acuity (DCIVA), monocular and binocular uncorrected near visual acuity (UNVA) and distance-corrected near visual acuity (DCNVA). In the 6 months postoperative period, defocus curve, contrast sensitivity, photopic phenomena, and posterior capsule opacification were assessed. Results The patients receiving the Tecnis Symfony had slightly better monocular and binocular UDVA and CDVA than with the Mini Well Ready IOL, the differences were not statistically significant. Whereas the UIVA, DCIVA, UNVA, DCNVA, UNVA and DCNVA values were higher in the Mini Well Ready group, the differences were not significant. There were no significant between-group differences regarding the defocus curve for the vast majority of tested vergences. Dysphotopsias postoperatively were assessed at 6 months. Conclusion Patients receiving both the Mini Well Ready and Symfony IOLs had excellent visual acuity outcomes and spectacle independence.
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Affiliation(s)
- Katarzyna Ewa Nowik
- Department of Ophthalmology, Public Ophthalmic Clinical Hospital (SPKSO), Medical University of Warsaw, Warsaw, Poland
- Correspondence: Katarzyna Ewa Nowik, Tel +48 509 873 680, Email
| | - Kamil Nowik
- Department of Ophthalmology, Public Ophthalmic Clinical Hospital (SPKSO), Medical University of Warsaw, Warsaw, Poland
| | - Piotr Kanclerz
- Department of Ophthalmology, Hygeia Clinic, Gdańsk, Poland
- Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland
| | - Jacek Paweł Szaflik
- Department of Ophthalmology, Public Ophthalmic Clinical Hospital (SPKSO), Medical University of Warsaw, Warsaw, Poland
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Ungewiss J, Röck T, Wörner M, Wetzel D, Bartz-Schmidt KU, Schiefer U. Vergleich der Sehleistung mit monofokalen Intraokularlinsen mit und ohne verbesserte optische Eigenschaften in einem Nachtfahrsimulator: eine
Proof-of-Concept-Studie. Klin Monbl Augenheilkd 2022; 239:996-1004. [DOI: 10.1055/a-1773-1197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Zusammenfassung
Hintergrund Ziel dieser Studie war die Einführung einer Methode zum „Benchmarking“ von Intraokularlinsen beim Autofahren, insbesondere im Hinblick auf die Sehschärfe (visual acuity,
VA) und die Kontrastempfindlichkeit (contrast sensitivity, CS). Dazu wurden Patienten mit IOL-Implantaten: ICB00 (Tecnis Eyhance, Johnson & Johnson, Santa Ana, CA, USA) vs. CNA0T0
(Clareon, Alcon Laboratories Inc., Fort Worth, TX, USA) klinisch und in einem Nachtfahrsimulator untersucht.
Patienten und Methoden Klinische Tests zum Fernvisus bei hohem (high contrast visual acuity, HCVA) und niedrigem Kontrast (low contrast visual acuity, LCVA) sowie zur mesopischen CS
wurden bei Probanden mindestens 2 Monate nach einer binokularen IOL-Operation durchgeführt (Einschlusskriterien: Visus > 20/25, ophthalmologisch normal, außer Kataraktoperation). Alle
Patienten fuhren im Simulator eine gerade Strecke ab. Die VA, CS und Halogröße wurden binokular während des nächtlichen Autofahrens mit Landolt-Ringen in 4 verschiedenen (Fern- und
Intermediärbereichs-)Positionen und Entfernungen gemessen.
Ergebnisse Die Ergebnisse werden als Median/Interquartilsbereich angegeben: ICB00-Daten (CNA0T0-Daten): 5 (6) Probanden im Alter von 69,6/8,3 (71,1/13,0) Jahren wurden
eingeschlossen. Klinische Tests: logMAR HCVA 0,11/0,39 (0,00/0,51), logMAR LCVA 0,78/0,52 (0,80/0,54); logCS ohne 0,50/0,31 (0,30/0,65), mit Blendung 0,20/0,15 (0,20/0,5). Fahrsimulator bei
Nacht: Die logMAR-VA-Schwellenwerte für die rechte Straßenseite, das Armaturenbrett, den Navigationsbildschirm und den Innenrückspiegel betrugen 0,50/0,06 (0,57/0,22), 0,81/0,07 (0,91/0,14),
0,80/0,17 (0,92/0,27), 0,50/0,11 (0,63/0,26), logCS-Schwellenwerte 1,53/0,67 (1,00/0,81), 0,82/0,11 (0,61/0,19), 0,71/0,14 (0,50/0,15), 0,87/0,07 (0,81/0,11). Größe des Halos: 5,40°/0,89°
(5,88°/2,00°).
Schlussfolgerungen In einem Nachtfahrsimulator übertraf die ICB00-IOL die CNA0T0-IOL in Bezug auf logMAR (VA) und logCS um 0,1 log-Einheiten im Intermediärbereich. Klinische Tests
für Ferne und Nähe ergaben keinen Unterschied. Dies könnte darauf hindeuten, dass Fahrsimulatorexperimente im Hinblick auf die Leistungsprüfung von IOLs – insbesondere auch im
Intermediärbereich – sinnvolle Zusatzinformationen liefern können.
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Affiliation(s)
- Judith Ungewiss
- Kompetenzzentrum Vision Research, Studiengang Augenoptik, Hochschule Aalen, Deutschland
- Zeiss Vision Care, Carl Zeiss Vision International GmbH, Aalen, Deutschland
| | - Tobias Röck
- Department für Augenheilkunde, Universitäts-Augenklinik, Eberhard-Karls-Universität Tübingen, Deutschland
| | - Michael Wörner
- Kompetenzzentrum Vision Research, Studiengang Augenoptik, Hochschule Aalen, Deutschland
- Blickshift GmbH, Stuttgart, Deutschland
| | - Denise Wetzel
- Kompetenzzentrum Vision Research, Studiengang Augenoptik, Hochschule Aalen, Deutschland
| | - Karl Ulrich Bartz-Schmidt
- Department für Augenheilkunde, Universitäts-Augenklinik, Eberhard-Karls-Universität Tübingen, Deutschland
| | - Ulrich Schiefer
- Kompetenzzentrum Vision Research, Studiengang Augenoptik, Hochschule Aalen, Deutschland
- Department für Augenheilkunde, Universitäts-Augenklinik, Eberhard-Karls-Universität Tübingen, Deutschland
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Na KS, Kim SJ, Nam G, Ha M, Whang WJ, Kim EC, Kim HS, Hwang HS. A Novel Intraocular Lens Simulator that Allows Patients to Experience the World Through Multifocal Intraocular Lenses Before Surgeries. Transl Vis Sci Technol 2022; 11:14. [PMID: 35275206 PMCID: PMC8934550 DOI: 10.1167/tvst.11.3.14] [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] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to investigate whether the intraocular lens (IOL) simulator can simulate how the world appears to patients with multifocal IOLs by allowing the patients to see far and near objects through the IOL simulator. Methods Twenty eyes from 20 patients (age = 50-70 years old) were included in the study. The IOL simulator we developed consists of a trial lens frame adapter, a lens tube, a concave lens, a spacer, a wet cell, and an IOL. We used two IOLs: Tecnis monofocal and Tecnis bifocal IOL (add +3.25 diopter [D]). Patients wore a trial lens frame with an IOL simulator on distant corrected trial lenses and underwent the following tests: defocus curve, satisfaction with distance and near vision, halo around the light, and near point accommodation (NPA). To check how the world appears to the patients through this simulator, a machine vision lens and a scientific camera were attached to the simulator, and far and near objects were photographed. Results In the defocus curve of multifocal IOL, the visual acuity showed the second peak at -4 D. Compared to monofocal IOL, satisfaction with distant vision was slightly worse, more halos were felt, satisfaction with near vision was higher, and the NPA was shorter in multifocal IOL. In the scientific camera test, through the multifocal IOL, the waiting room was blurry, the halo around the ceiling light was prominent, and the characteristics on the near visual acuity chart were clear. Conclusion Subjects could experience the functions of multifocal IOLs with our newly developed IOL simulator. Translational Relevance This IOL simulator using geometric optics allows patients to experience the function of multifocal IOLs before cataract surgery.
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Affiliation(s)
- Kyung-Sun Na
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seong-Jae Kim
- Department of Ophthalmology, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Gahee Nam
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Minji Ha
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Woong-Joo Whang
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Eun Chul Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun-Seung Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ho Sik Hwang
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Baur ID, Auffarth GU, Łabuz G, Mayer CS, Khoramnia R. Presbyopia correction after previous Intracor treatment: Combined implantation of a small-aperture and a non-diffractive extended-depth-of-focus lens. Am J Ophthalmol Case Rep 2022; 25:101398. [PMID: 35198820 PMCID: PMC8844772 DOI: 10.1016/j.ajoc.2022.101398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 02/01/2022] [Accepted: 02/01/2022] [Indexed: 01/19/2023] Open
Abstract
PURPOSE We present the case of implantation of two different Extended depth of focus intraocular lenses (EDoF IOLs) in a patient with a history of unilateral intrastromal femtosecond laser treatment for presbyopia correction (Intracor). OBSERVATIONS The patient reported decreasing visual acuity at near distance and increasing spectacle dependence. Ten years earlier, he had Intracor treatment for presbyopia correction in his left eye. Corrected distance visual acuity (CDVA) was 0.08 logMAR for the right eye and 0.16 logMAR for the left eye. Apart from dysfunctional lens syndrome, the examination results were unremarkable. Phacoemulsification and subsequent IOL implantation was performed in both eyes. The left eye was implanted with an IC-8 (AcuFocus, Irvine, CA, USA), whereas the fellow eye was implanted with an AcrySof IQ Vivity IOL (Alcon, Fort Worth, TX, USA). Postoperatively, CDVA improved to 0.02 and 0.04 logMAR for the right and left eye. Uncorrected intermediate visual acuity (UIVA) was 0.24 logMAR for the right eye and -0.04 logMAR for the left eye, binocular UIVA was -0.04 logMAR. The patient reported a low level of photic phenomena and spectacle independence for far and intermediate distance. CONCLUSIONS AND IMPORTANCE Combined implantation of a non-diffractive and a small-aperture EDoF lens after previous unilateral Intracor treatment could successfully improve visual acuity at far and intermediate distance.
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Affiliation(s)
- Isabella D. Baur
- Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Gerd U. Auffarth
- Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Grzegorz Łabuz
- Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Christian S. Mayer
- Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Ramin Khoramnia
- Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
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30
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Traumatic cataract in a young patient with myopia. J Cataract Refract Surg 2022; 48:378-382. [PMID: 35191867 DOI: 10.1097/j.jcrs.0000000000000892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A 36-year-old man was referred to our clinic because of traumatic cataract in his right eye, which had developed after being hit in the eye with a badminton shuttle as a child. He noticed that his vision in his right eye was gradually becoming worse. His refraction, corrected with spectacles, was -4.25 -2.00 × 115 in his right eye and -5.50 -1.50 × 57 in his left eye, with a corrected distance visual acuity of 20/32 and 20/20, respectively. Because of allergies, the patient never tolerated contact lens wear for more than 2 hours. On a slitlamp examination, we confirmed anterior subcapsular star-like cataract without any signs of zonulolysis. Optical biometry showed an axial length of 25.73 mm and 26.66 mm and an anterior chamber depth of 3.70 mm and 3.78 mm in the right and left eyes. Keratometric astigmatism measured by optical biometry was 1.56 diopters (D) at 30 degrees and 1.12 D at 138 degrees for the right and left eyes, and Scheimpflug tomography showed 1.1 D of regular astigmatism at 33 degrees in the right eye, and 0.9 D of regular astigmatism at 130 degrees in the left eye. The patient is a professional photographer and asked for a treatment that would still allow him to be able to perform his job: he wants to read all the buttons on the camera up close and focus on the scenery in the distance. What is your advice on this challenging case?
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Comparison of Patient Outcomes following Implantation of Trifocal and Extended Depth of Focus Intraocular Lenses: A Systematic Review and Meta-Analysis. J Ophthalmol 2022; 2021:1115076. [PMID: 35003788 PMCID: PMC8731298 DOI: 10.1155/2021/1115076] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/17/2021] [Indexed: 01/19/2023] Open
Abstract
Purpose The purpose is to compare the outcomes of implantation of trifocal intraocular lenses (TIOLs) and extended depth of focus (EDOF) intraocular lenses (IOLs). Methods A comprehensive search of PubMed, Cochrane Library, EMBASE, and ClinicalTrial.gov was conducted in March 2020 to identify relevant studies. A meta-analysis of the results was performed. Patients implanted with EDOF IOLs or TIOLs in previous studies were included. The primary outcomes of the study were uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), and defocus curve. Results TIOLs and EDOF IOLs provided comparable binocular UDVA (MD = -0.01, 95% CI: -0.04, 0.03, logMAR). However, EDOF IOLs provided better UIVA (MD: -0.08, 95% CI: -0.14, -0.01, logMAR) and worse UNVA (MD: 0.10, 95% CI: 0.06, 0.14, logMAR) than TIOLs. Fewer patients achieved spectacle independence after implantation of EDOF IOLs (RR: 0.74, 95% CI: 0.63, 0.87) than after implantation of TIOLs, especially for near vision (RR = 0.82, 95% CI: 0.68, 0.99). There was no statistically significant difference in contrast sensitivity (CS) under photopic or mesopic conditions with both IOLs. Patient satisfaction after implantation of both IOLs was high. Conclusion EDOF IOLs and TIOLs provide comparable distance vision. However, EDOF IOLs provide better intermediate vision and worse near vision than TIOLs. The advantages of EDOF IOLs over TIOLs in terms of CS, aberrations, and visual disturbance are not significant. Patients are satisfied with both types of IOLs.
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Anisimova NS, Anisimov SI, Danilchenko MI. [Pseudo-accommodative intraocular lenses]. Vestn Oftalmol 2022; 138:111-117. [PMID: 36288425 DOI: 10.17116/oftalma2022138051111] [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] [Indexed: 06/16/2023]
Abstract
This article reviews pseudo-accommodative intraocular lenses (IOLs), providing an analysis of the terminology used in this field of ophthalmology and describing the design of modern IOLs, the technological features used to achieve pseudo-accommodation that meets the needs of patients, particularly the new extended depth of focus (EDOF) IOL technology. The article presents the main types of extended depth of focus IOLs, their description, advantages and disadvantages, as well as comparison with multifocal and monofocal IOLs based on clinical studies conducted in different countries.
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Affiliation(s)
- N S Anisimova
- Eye Center «Vostok-Prozrenie», Moscow, Russia
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - S I Anisimov
- Eye Center «Vostok-Prozrenie», Moscow, Russia
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
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Coassin M, Mori T, Di Zazzo A, Poddi M, Sgrulletta R, Napolitano P, Bonini S, Orfeo V, Kohnen T. Effect of minimonovision in bilateral implantation of a novel non-diffractive extended depth-of-focus intraocular lens: Defocus curves, visual outcomes, and quality of life. Eur J Ophthalmol 2021; 32:2942-2948. [PMID: 34825597 DOI: 10.1177/11206721211064018] [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] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate overall patient satisfaction, spectacle independence, visual acuity, and prevalence of optical phenomena following bilateral implantation of a new non-diffractive extended depth-of-focus intraocular lens targeted for minimonovision. METHODS Multicenter prospective case series. Postoperative far and near visual acuity at 3 months and patient quality of life by NEI-VFQ-25 questionnaire were assessed. Postoperative evaluation included defocus curves analysis, spectacle independence assessment, and recording of photic phenomena. RESULTS The study enrolled 97 eyes of 59 patients that underwent femtosecond-assisted cataract surgery with AcrySof IQ Vivity intraocular lens implantation. Thirty subjects (60 eyes) were eligible for analysis. After 3 months, postoperative achieved binocular uncorrected visual acuity was -0.03 ± 0.06 logarithm of the minimum angle of resolution for distance, 0.06 ± 0.06 logarithm of the minimum angle of resolution for intermediate, and 0.19 ± 0.03 logarithm of the minimum angle of resolution for near. Defocus curve showed a smooth profile with no abrupt decrease of visual acuity. Minimonovision significantly improved visual acuity compared to when minimonovision was neutralized, for values of defocus curves from -1 to -3 D (p < 0.05). Twenty-six (87%) patients reported complete spectacle independence. High levels of satisfaction for distance and near vision resulted at VFQ-25 questionnaire. Only two patients complained of halos (6.7%) and one of them also of glare (3.3%). CONCLUSIONS Implantation of this new non-diffractive extended depth-of-focus intraocular lens with minimonovision resulted in satisfying far, intermediate, and near visual acuity with a consistent reduction of spectacle dependence and improvement in patient's quality of life.
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Affiliation(s)
- Marco Coassin
- Ophthalmology, 9317University Campus Bio-Medico, Roma, Italy
| | - Tommaso Mori
- Ophthalmology, 9317University Campus Bio-Medico, Roma, Italy
| | | | - Maria Poddi
- Ophthalmology, 9317University Campus Bio-Medico, Roma, Italy
| | | | | | - Stefano Bonini
- Ophthalmology, 9317University Campus Bio-Medico, Roma, Italy
| | - Vincenzo Orfeo
- 47235Clinica Mediterranea, Ophthalmology Unit, Napoli, Italy
| | - Thomas Kohnen
- Department of Ophthalmology, 144867Goethe University, Frankfurt, Germany
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Citation network analysis of the various types of multifocal intraocular lenses. ARCHIVOS DE LA SOCIEDAD ESPAÑOLA DE OFTALMOLOGÍA 2021; 96:527-544. [PMID: 34620483 DOI: 10.1016/j.oftale.2020.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/21/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE The implantation of multifocal intraocular lens (IOL) has increased in recent years, allowing patients to achieve good quality vision at all distances, independence from use of glasses, and consequently, an increase in quality of life. The main purpose of this study was to analyse the links between publications and authors via citation networks, as well to as identify the different research areas and determine the most cited publications. MATERIAL AND METHODS The publication search was performed through the Web of Science database, using the terms «Multifocal intraocular lens», «Bifocal intraocular lens», «Trifocal intraocular lens», «Diffractive intraocular lens», «Refractive intraocular lens», «Accommodative intraocular lens» and «Extended depth of focus intraocular lens», for a time interval from 1989 to August 2020. The software used to analyse the publications was the Citation Network Explorer. RESULTS A total of 1293 publications were found, with 11,730 citations generated in the network, and 2019 had the highest number of publications of any year. The most cited publication was «European multicenter study of the AcrySof ReSTOR apodized diffractive intraocular lens» by Kohnen et al., published in 2006. Four groups about different research areas in this field were found using the Clustering functionality: visual quality, IOL designs, ocular aberrations, or defocus curves. CONCLUSIONS The citation network offers an objective and comprehensive analysis of the main articles on the different designs and classes of multifocal IOL.
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Non-diffractive wavefront shaping extended depth of focus (EDoF) intraocular lens: visual performance and patient-reported outcome. J Cataract Refract Surg 2021; 48:144-150. [PMID: 34653094 DOI: 10.1097/j.jcrs.0000000000000826] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 09/21/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate visual performance and patient-reported outcomes after bilateral implantation of new non-diffractive wavefront shaping extended depth of focus (EDOF) intraocular lens (IOL). SETTING Department of Ophthalmology, Goethe University, Frankfurt, Germany. DESIGN Prospective, single-arm, single-center study. METHODS Patient population: We included 16 patients (32 eyes) who received bilateral implantation of a non-diffractive wavefront shaping EDOF IOL (AcrySof® IQ Vivity®, Alcon Research, TX, USA). Target refraction in both eyes was emmetropia. Observation procedure: Monocular and binocular uncorrected (UCVA) and distance-corrected (DCVA) visual acuity (VA), refractive outcome, defocus curve, contrast sensitivity (CS) were evaluated 3 months after surgery with a questionnaire on optical phenomena and spectacle independence. Main Outcome measure: Three months postoperative monocular and binocular UCVA and DCVA (logMAR); defocus curve; CS; and quality of vision (QoV) questionnaire results. RESULTS Mean spherical equivalent was -0.16 ± 0.37 D 3 month postoperatively. Binocular UDVA at distance, intermediate, and near was 0.01 ± 0.05 logMAR at 4m, 0.05 ± 0.05 logMAR at 80cm, 0.07 ± 0.06 logMAR at 66cm, and 0.25 ± 0.11 logMAR at 40cm, respectively. Despite some minor optical phenomena, 88% of patients would choose the same lens. 63% of patients reported no optical phenomena at all. Contrast sensitivity was 1.25 ± 0.41 logCS (photopic), 0.96 ± 0.24 logCS (mesopic) and 0.93 ± 0.24 (mesopic + glare). CONCLUSIONS This non-diffractive wavefront shaping EDOF IOL provides good VA at far and intermediate distance and functional near VA. It showed good QoV and CS, and high spectacle independence for distance and intermediate vision with significantly less optical phenomena than with other EDOF or MIOLs.
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Baur ID, Khoramnia R, Weindler J, Naujokaitis T, Poompokawat P, Auffarth GU. Clinical Outcomes of a New Hybrid Monofocal IOL With Extended Depth of Focus. J Refract Surg 2021; 37:601-608. [PMID: 34506236 DOI: 10.3928/1081597x-20210610-03] [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: 01/19/2023]
Abstract
PURPOSE To evaluate a new extended depth of focus intraocular lens (IOL), the xact Mono-EDOF ME4 (Santen Pharmaceuticals), Conformitè Europëenne-marked as a monofocal IOL, which has four diffractive rings intended to enhance intermediate vision. METHODS Results are reported for 47 IOLs implanted in 28 patients who underwent cataract surgery and implantation of the xact Mono-EDOF ME4 IOL in one (9 patients) or both (19 patients) eyes. Postoperative follow-up examinations included visual acuity testing (monocular and binocular; uncorrected distance visual acuity [UDVA], corrected distance visual acuity [CDVA], uncorrected intermediate visual acuity [UIVA], distance-corrected intermediate visual acuity [DCIVA]), defocus curve and contrast sensitivity testing, and dysphotopsia evaluation. RESULTS Follow-up at 6 months postoperatively revealed a monocular UDVA of 0.08 ± 0.15 logMAR, binocular UDVA of -0.02 ± 0.09 logMAR, monocular CDVA of -0.07 ± 0.08 logMAR, binocular CDVA of -0.09 ± 0.09 logMAR, monocular UIVA (70 cm) of 0.18 ± 0.16 logMAR, binocular UIVA (70 cm) of 0.09 ± 0.12 logMAR, monocular DCIVA (70 cm) of 0.25 ± 0.14 logMAR, and binocular DCIVA (70 cm) of 0.13 ± 0.11 logMAR. Defocus curve testing demonstrated a functional defocus of 1.25 diopters at 0.20 logMAR for monocular and 1.50 diopters at 0.20 logMAR for binocular testing. The contrast sensitivity corresponded to the age-appropriate normal values. Patients reported low levels of halo and glare. CONCLUSIONS The xact Mono-EDOF ME4 IOL showed good functional results for far and intermediate distance visual acuity while inducing a low level of photic phenomena. [J Refract Surg. 2021;37(9):601-608.].
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Abstract
The extended depth-of-focus intraocular lenses (EDOF IOLs) represent one of the most exciting advancements in the field of lens surgery. EDOF IOLs promise an excellent visual experience, minimizing visual disturbances (ie, halos and glare) commonly associated with multifocal IOLs. The pros and cons of EDOF IOLs should be evaluated in comparison with other more traditional multifocal or monofocal IOLs. The aim of this review is to provide the most current information regarding EDOF IOLs for power calculating formulas, refractive outcomes, incidence of photic phenomena, and patient satisfaction.
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Spadea L, Giannico MI, Formisano M, Alisi L. Visual Performances of a New Extended Depth-of-Focus Intraocular Lens with a Refractive Design: A Prospective Study After Bilateral Implantation. Ther Clin Risk Manag 2021; 17:727-738. [PMID: 34295162 PMCID: PMC8291859 DOI: 10.2147/tcrm.s320422] [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: 05/23/2021] [Accepted: 07/05/2021] [Indexed: 01/19/2023] Open
Abstract
Purpose The aim of the present study was to evaluate the visual outcome of a new extended depth-of-focus (EDOF) intraocular lens (IOL) after bilateral implantation. A qualitative and quantitative analysis was performed and data were compared with those given by other studies regarding multifocal IOLs, which have the same purpose of giving spectacle independence to the patients. Methods The study enrolled 40 eyes of 20 patients who underwent cataract surgery with bilateral implantation of an EDOF IOL (Evolve Soleko, Rome, Italy). The mean age was 74.5±9 years (range 59-83ys). Refractive outcomes and contrast sensitivity were evaluated preoperatively and at 6-month follow-up. We also examined reading speed, glare, halos, difficulties in the night driving, the requirement for spectacles, and overall satisfaction with vision. Two questionnaires were administered for this purpose. Results At 6 months, the percentage of eyes within ±0.50 diopters (D) from emmetropia was 82.5%. Of all patients, 90% were satisfied with their vision. The percentage of spectacle-free for near and distance vision patients was 70% and 95%, respectively. A postoperative binocular uncorrected 60cm intermediate visual acuity (UI60VA) of 0.2 logMAR or better was achieved in 92% of patients. Contrast sensitivity significantly improved postoperatively (p<0.001) and mean reading speed was good. Conclusion This new EDOF IOL seems to provide an effective alternative to patients who desire a spectacle-free lifestyle postoperatively. These lenses can supply a satisfactory distance, intermediate and near vision, and retain good contrast sensitivity, with most patients reporting excellent satisfaction.
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Affiliation(s)
- Leopoldo Spadea
- Eye Clinic, Policlinico Umberto 1, "Sapienza" University of Rome, Rome, Italy
| | | | - Martina Formisano
- Eye Clinic, Policlinico Umberto 1, "Sapienza" University of Rome, Rome, Italy
| | - Ludovico Alisi
- Eye Clinic, Policlinico Umberto 1, "Sapienza" University of Rome, Rome, Italy
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Venkataraman AP, Rosén R, Heredia AA, Piers P, Vidal CC, Lundström L. Peripheral vision and hazard detection with average phakic and pseudophakic optical errors. BIOMEDICAL OPTICS EXPRESS 2021; 12:3082-3090. [PMID: 34221646 PMCID: PMC8221950 DOI: 10.1364/boe.419120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 05/06/2023]
Abstract
The impact of peripheral optical errors induced by intraocular lenses was evaluated by simulating the average phakic and pseudophakic image qualities. An adaptive optics system was used to simulate the optical errors in 20° nasal and inferior visual field in phakic subjects. Peripheral resolution acuity, contrast sensitivity and hazard detection were evaluated. Pseudophakic errors typical for monofocal designs had a negative effect on resolution acuity and contrast sensitivity and the hazard detection task also showed increased false positive and misses and a longer reaction time compared to phakic optical errors. The induced peripheral pseudophakic optical errors affect the peripheral visual performance and thereby impact functional vision.
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Affiliation(s)
- Abinaya Priya Venkataraman
- Department of Applied Physics, Biomedical and X-ray Physics, KTH Royal Institute of Technology, Stockholm, Sweden
- Division of Eye and Vision, Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
| | - Robert Rosén
- Johnson & Johnson Surgical Vision, R&D, Groningen, Netherlands
| | | | - Patricia Piers
- Johnson & Johnson Surgical Vision, R&D, Groningen, Netherlands
| | | | - Linda Lundström
- Department of Applied Physics, Biomedical and X-ray Physics, KTH Royal Institute of Technology, Stockholm, Sweden
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Baur I, Auffarth GU, Łabuz G, Khoramnia R. Unilateral implantation of a new non-diffractive extended range-of-vision IOL in a young patient with Curschmann-Steinert myotonic dystrophy. Am J Ophthalmol Case Rep 2021; 22:101109. [PMID: 33997472 PMCID: PMC8094889 DOI: 10.1016/j.ajoc.2021.101109] [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: 10/29/2020] [Revised: 02/01/2021] [Accepted: 04/04/2021] [Indexed: 12/14/2022] Open
Abstract
PURPOSE We present the case of a 36-year old Curschmann-Steinert myotonic dystrophy patient with posterior subcapsular cataract that we treated with unilateral implantation of an extended depth of focus intraocular lens to address his wish for spectacle independence at far and intermediate distance. OBSERVATIONS The patient underwent phacoemulsification with subsequent implantation of the AcrySof IQ Vivity IOL (Alcon, Fort Worth, TX, USA) in his left eye. Uncorrected distance visual acuity (UDVA) on the left eye increased from +0.40 logMAR preoperatively to -0.12 logMAR at 3 months postoperatively. At the three months follow-up distance corrected intermediate visual acuity (DCIVA) at 80 cm distance was -0.08 logMAR and DCIVA at 66 cm distance was 0.14 logMAR for the left eye. The defocus curve showed a functional defocus of 2.0 diopters at 0.2 logMAR or better, corresponding to the extended depth of focus. Dysphotopsia evaluation with a Halo & Glare simulator (Eyeland-Design Network GmbH, Vreden, Germany) revealed a very low level of photic phenomena. CONCLUSIONS AND IMPORTANCE Unilateral implantation of a new generation, non-diffractive extended depth of focus IOL was well tolerated and provided good functional results for far and intermediate distances. The patient reported a very low level of photic phenomena.
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Affiliation(s)
- Isabella Baur
- David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Gerd U. Auffarth
- David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Grzegorz Łabuz
- David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Ramin Khoramnia
- David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
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41
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Fernández J, Rodríguez-Vallejo M, Martínez J, Burguera N, Piñero DP. What we have learnt from 30 years living with positive dysphotopsia after intraocular lens implantation?: a review. EXPERT REVIEW OF OPHTHALMOLOGY 2021. [DOI: 10.1080/17469899.2021.1917997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Joaquín Fernández
- Department of Ophthalmology (Qvision, VITHAS Hospital, Almería, Spain
| | | | - Javier Martínez
- Department of Ophthalmology (Qvision, VITHAS Hospital, Almería, Spain
| | - Noemi Burguera
- Department of Ophthalmology (Qvision, VITHAS Hospital, Almería, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- Department of Ophthalmology (Imqo-oftalmar), Vithas Medimar International Hospital, Alicante, Spain
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Gabrić N, Gabrić I, Gabrić K, Biščević A, Piñero DP, Bohač M. Clinical Outcomes With a New Continuous Range of Vision Presbyopia-Correcting Intraocular Lens. J Refract Surg 2021; 37:256-262. [PMID: 34038663 DOI: 10.3928/1081597x-20210209-01] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE To evaluate the clinical outcomes including patient-reported outcome measures in a sample of eyes undergoing bilateral cataract surgery with implantation of a new model of presbyopia-correcting intraocular lens (IOL). METHODS This non-randomized prospective case series enrolled 206 eyes of 103 patients undergoing phacoemulsification cataract surgery with bilateral implantation of the TECNIS Synergy IOL (Johnson & Johnson Vision). High and low contrast visual acuity, refractive, defocus curve, and patient-reported visual performance (Catquest-9SF questionnaire) outcomes were evaluated during a 3-month follow-up. RESULTS A total of 96.1% (99 of 103) and 91.3% (94 of 103) of patients achieved binocular postoperative uncorrected distance (UDVA) and near visual acuity (UNVA) of 0.00 logMAR (20/20), respectively. Mean postoperative mesopic UNVA for both eyes was 0.14 ± 0.03 logMAR. Likewise, mean binocular UDVA and UNVA were 0.00 ± 0.03 and 0.04 ± 0.02 logMAR. An almost flat mean defocus curve was obtained, with visual acuities between 0.00 and 0.10 logMAR for most defocus levels in both eyes. A reduction of contrast led to a limited but statistically significant change in UNVA in both eyes (P < .001). The Rasch calibrated scoring of item 2 and the Rasch calibrated mean score of the Catquest-9SF questionnaire increased significantly with surgery (P < .001). CONCLUSIONS This new presbyopia-correcting IOL provides a continuous range of functional focus, with a limited deterioration under mesopic conditions, which is perceived as a satisfactory outcome by the patient if proper patient selection is performed. [J Refract Surg. 2021;37(4):256-262.].
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Tavassoli S, Ziaei H, Yadegarfar ME, Gokul A, Kernohan A, Evans JR, Ziaei M. Trifocal versus extended depth of focus (EDOF) intraocular lenses for cataract extraction. Hippokratia 2021. [DOI: 10.1002/14651858.cd014891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Hadi Ziaei
- Manchester Royal Eye Hospital; Manchester UK
| | | | - Akilesh Gokul
- Department of Ophthalmology, New Zealand National Eye Centre; University of Auckland; Auckland New Zealand
| | - Ashleigh Kernohan
- Population Health Sciences Institute; Newcastle University; Newcastle upon Tyne UK
| | - Jennifer R Evans
- Cochrane Eyes and Vision, ICEH; London School of Hygiene & Tropical Medicine; London UK
| | - Mohammed Ziaei
- Department of Ophthalmology, New Zealand National Eye Centre; University of Auckland; Auckland New Zealand
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Luo J, Liu Y, Wang F, Su Y, Xiao X, Du H, Guo Q. Effect of the kappa angle on depth of focus after implantation of the TECNIS Symfony intraocular lens. Int Ophthalmol 2021; 41:2513-2520. [PMID: 33751306 DOI: 10.1007/s10792-021-01809-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/10/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate the clinical effect of TECNIS Symfony intraocular lens (IOL) implantation and identify the effect of kappa angle on the depth of focus (DOF) after implantation. METHODS This prospective clinical study included consecutive patients who underwent cataract surgery and TECNIS Symfony IOL implantation at the Daqing Oilfield General Hospital from January 2019 to September 2019. Patients were divided into three groups according to the preoperative kappa angle (r): A (0 < r ≤ 0.2), B (0.2 < r ≤ 0.4), and C (r > 0.4). Uncorrected visual acuity was performed preoperatively and at 7 days, 1 month, and 3 months postoperatively. Synthetical optometry, higher-order aberrations, and defocus examinations were performed at 3 months postoperatively. Single-factor analysis of variance and Spearman correlation coefficient were used for data analysis. RESULTS The uncorrected visual acuity values of the three groups were significantly improved postoperatively, compared with preoperative values (p < 0.001). Three months postoperatively, the best-corrected visual acuity values of the three groups were 0.11 ± 0.02 logarithm of the minimum angle of resolution (logMAR), 0.09 ± 0.03 logMAR, and 0.11 ± 0.03 logMAR, respectively. Spherical equivalent (SE) values were 0.37 ± 0.08 D, 0.41 ± 0.06 D, and 0.42 ± 0.06 D, respectively. Best-corrected visual acuity and SE did not significantly differ among the three groups (F = 1.254, p = 0.135; F = 0.849, p = 0.228). There was no significant difference in SE between the three groups (F = 1.658, p = 0.312). Moreover, higher-order aberrations did not significantly differ among the three groups (p > 0.05). The kappa angle was negatively correlated with the postoperative DOF (r = -4.341, p = 0.026). Three months postoperatively, 54.55% of patients exhibited DOF ≥ 3 D, while 92.42% of patients exhibited DOF ≥ 2 D. The ranges of DOF in the three groups were 3.18 ± 0.27 D, 2.83 ± 0.80 D, and 2.57 ± 0.89 D, respectively; the difference among the three groups was statistically significant (F = 5.689, p = 0.037). CONCLUSION Most patients achieved full-range vision after TECNIS Symfony IOL implantation, but the DOF narrowed for those with an excessively large kappa angle, which indicates a need for careful selection.
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Affiliation(s)
- Jie Luo
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, 23 Bundesgasse, Harbin, Heilongjiang Province, China.,Department of Ophthalmology, The Daqing Oilfields General Hospital, 19 ZhongKang Roud, Daqing, Heilongjiang Province, China
| | - Yang Liu
- Department of Ophthalmology, The Daqing Oilfields General Hospital, 19 ZhongKang Roud, Daqing, Heilongjiang Province, China
| | - Feng Wang
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, 23 Bundesgasse, Harbin, Heilongjiang Province, China.
| | - Ying Su
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, 23 Bundesgasse, Harbin, Heilongjiang Province, China.
| | - Xuebing Xiao
- Department of Ophthalmology, The Daqing Oilfields General Hospital, 19 ZhongKang Roud, Daqing, Heilongjiang Province, China
| | - Haitao Du
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, 23 Bundesgasse, Harbin, Heilongjiang Province, China
| | - Qiang Guo
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, 23 Bundesgasse, Harbin, Heilongjiang Province, China
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Iradier MT, Cruz V, Gentile N, Cedano P, Piñero DP. Clinical Outcomes with a Novel Extended Depth of Focus Presbyopia-Correcting Intraocular Lens: Pilot Study. Clin Ophthalmol 2021; 15:1215-1221. [PMID: 33776418 PMCID: PMC7989957 DOI: 10.2147/opth.s297985] [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: 12/18/2020] [Accepted: 03/02/2021] [Indexed: 01/19/2023] Open
Abstract
Purpose To evaluate the clinical outcomes of cataract surgery with implantation of a novel model of extended depth of focus (EDOF) intraocular lens (IOL). Methods Pilot case series enrolling a total of 27 eyes of 16 patients (49 to 84 years) undergoing uncomplicated phacoemulsification cataract surgery with implantation of the EDOF IOL Synthesis PLUS (Cutting Edge, Montpellier, France). Near (UNVA, uncorrected near visual acuity; DCNVA, distance-corrected near visual acuity) and distance visual acuity (uncorrected and corrected distance visual acuity, UDVA and CDVA), monocular defocus curve and refractive outcomes were evaluated during a 3-month follow-up. Results Mean postoperative UDVA, UNVA and DCNVA were 0.11±0.17, 0.14±0.22 and 0.37±0.36 logMAR, respectively. A total of 84.6%, 91.7%, and 96.3% of eyes achieved postoperative UDVA, UNVA and CDVA of 0.20 logMAR or better. A total of 78.6% of eyes achieved postoperative DCNVA of 0.30 logMAR or better. Mean postoperative spherical equivalent was −0.76±0.53 D. The distance-corrected visual acuity was maintained on average over a value of 0.30 logMAR for the range of defocus levels between +1.00 and −1.50 D. Conclusion The implantation of the Synthesis plus EDOF IOL after cataract surgery seems to provide functional levels of distance, intermediate and near visual acuity. The near visual performance with this new IOL might be significantly enhanced using a micro-monovision approach. The results of this pilot study should be confirmed in future clinical trials.
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Affiliation(s)
| | | | | | | | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
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Abstract
The extended depth-of-focus (EDOF) intraocular lens (IOL) is an emerging technology that is designed to improve range of vision, especially at intermediate distances. In this review, we describe the clinical performance of 4 emerging EDOF IOL technologies; that is, small aperture, bioanalogic, diffractive optics, and nondiffractive optical manipulations. The American Academy of Ophthalmology generated a consensus statement for EDOF IOLs that provided benchmarks and recommendations for classifying an implant as an EDOF IOL as well as standardized testing criteria for evaluating performance. Although many types of EDOF technologies are being developed, there are important differences in their performance that require further testing and evaluation.
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Assessment of the image quality of extended depth-of-focus intraocular lens models in polychromatic light. J Cataract Refract Surg 2021; 46:108-115. [PMID: 32050240 DOI: 10.1097/j.jcrs.0000000000000037] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The use of monochromatic light in the assessment of intraocular lenses (IOLs) has been criticized for not representing the real-world situation. This study aimed to measure and compare the image quality of 3 extended depth-of-focus (EDOF) IOL models in monochromatic and polychromatic light. SETTING David J Apple Laboratory, Heidelberg, Germany. DESIGN In vitro study. METHODS An optical metrology instrument was used to study image quality metrics of diffractive IOLs with chromatic aberration correction (Symfony and AT Lara) and a refractive lens (Mini Well). The modulation transfer function (MTF) was measured in green and polychromatic light at a 2.0 mm, 3.0 mm, and 4.0 mm aperture. The EDOF IOL's tolerance to defocus was tested against a monofocal lens. RESULTS The mean MTF of the EDOF IOL at far distance was decreased in polychromatic compared with monochromatic light. The largest effect was found in the refractive lens; however, at intermediate distance, only small differences occurred. In their tolerance to defocus, the EDOF IOLs were superior to the monofocal IOL. The diffractive IOL had higher MTFs than that of the refractive IOL at 2 primary foci, the refractive IOL's optical quality varied less with defocus at 3.0 mm. The refractive lens was the most susceptible to changes in aperture size. CONCLUSION The diffractive EDOF IOL was more resistant to chromatic effects than the refractive IOL. The EDOF IOLs provided an extended through-focus performance compared with the monofocal IOL, but differences in optical design, particularly pupil dependency, should be considered when refining IOL selection for patients.
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Pedrotti E, Chierego C, Talli PM, Selvi F, Galzignato A, Neri E, Barosco G, Montresor A, Rodella A, Marchini G. Extended Depth of Focus Versus Monofocal IOLs: Objective and Subjective Visual Outcomes. J Refract Surg 2021; 36:214-222. [PMID: 32267951 DOI: 10.3928/1081597x-20200212-01] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 02/10/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE To evaluate and compare the objective and subjective outcomes between bilateral implantation of the extended depth of focus (EDOF) Mini Well intraocular lens (IOL) and the aspheric monofocal Mini-4-Ready IOL (both SIFI S.p.A., Catania, Italy). METHODS This prospective comparative study included 25 patients (50 eyes) bilaterally implanted with an EDOF Mini Well IOL (EDOF group) and 25 patients (50 eyes) bilaterally implanted with a Mini-4-Ready IOL (monofocal group). Three-month follow-up data included corrected and uncorrected distance visual acuity at 4 m and 80, 67, and 40 cm. Defocus curves, subjective and objective contrast sensitivity, and objective optical quality (modulation transfer function cutoff and Strehl ratio calculated with Optical Quality Analysis System [OQAS]; Visiometrics SL, Terrassa, Spain), halometry, and reading performance were measured. Subjective visual quality was evaluated based on National Eye Institute Refractive Error Quality of Life Instrument 42 (NEI RQL-42) scores. RESULTS Postoperative uncorrected and corrected monocular and binocular intermediate and near visual acuity was significantly better in the EDOF group (P < .001). No differences were observed for distance visual acuity (P ⩾ .312). Defocus curve outcomes for myopic values were better in the EDOF group (P < .001). No significant differences were found in hyperopic (obtained in steps of +0.50 diopters [D] from emmetropia to 1.50 D) values (P ⩾ .095), contrast sensitivity curves (P ⩾ .087), or OQAS outcomes (P ⩾ .138). Halometric values were significantly better in the monofocal group (P < .05). There was a correlation between mean keratometry values and intermediate/near visual acuity. Significantly better NEI RQL-42 subscale scores for near vision, far vision, activity limitations, glare, dependence on correction, and suboptimal correction were noted in the EDOF group (P < .05). CONCLUSIONS Intermediate and near visual acuity was better after EDOF IOL than after aspheric monofocal IOL implantation while maintaining similar levels of visual quality, except for halo perception. [J Refract Surg. 2020;36(4):214-222.].
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Kohnen T, Suryakumar R. Measures of visual disturbance in patients receiving extended depth-of-focus or trifocal intraocular lenses. J Cataract Refract Surg 2021; 47:245-255. [PMID: 32818348 DOI: 10.1097/j.jcrs.0000000000000364] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 07/14/2020] [Indexed: 02/07/2023]
Abstract
The degree of visual disturbance associated with a particular model of intraocular lens (IOL) depends on several factors, including IOL optic, material, and mechanics. Characterization of visual disturbance profiles is paramount for informing clinical IOL selection. Although many studies evaluating presbyopia-correcting IOLs include subjective assessment of visual symptoms, the types of patient-reported outcome measures (PROMs) used to capture these outcomes are inconsistent across studies, complicating data contextualization. Furthermore, some tools produce more meaningful results than others. This review presents a discussion on the scientific literature published on the subjective and semiobjective (halo and glare simulator, light-distortion analyzer, vision monitor, and halometers) methods used to assess visual disturbances in patients implanted with trifocal or extended depth-of-focus IOLs, highlighting their advantages and limitations. It underscores the importance of between-study comparisons and the need for standardized PROMs in clinical IOL research to provide more accurate information for IOL selection.
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Affiliation(s)
- Thomas Kohnen
- From the Department of Ophthalmology (Kohnen), Goethe University Frankfurt, Frankfurt, Germany; and Alcon Vision LLC (Suryakumar), Fort Worth, Texas, USA
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Martinez-Perez C, Alvarez-Peregrina C, Villa-Collar C, Arance-Gil A, Sánchez-Tena MA. Citation network analysis of the various types of multifocal intraocular lenses. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2021; 96:S0365-6691(20)30492-5. [PMID: 33495051 DOI: 10.1016/j.oftal.2020.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/16/2020] [Accepted: 11/21/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND OBJECTIVE The implantation of multifocal intraocular lens (IOL) has increased in recent years, allowing patients to achieve good quality vision at all distances, independence from use of glasses, and consequently, an increase in quality of life. The main purpose of this study was to analyse the links between publications and authors via citation networks, as well to as identify the different research areas and determine the most cited publications. MATERIAL AND METHODS The publication search was performed through the Web of Science database, using the terms «Multifocal intraocular lens», «Bifocal intraocular lens», «Trifocal intraocular lens», «Diffractive intraocular lens», «Refractive intraocular lens», «Accommodative intraocular lens» and «Extended depth of focus intraocular lens», for a time interval from 1989 to August 2020. The software used to analyse the publications was the Citation Network Explorer. RESULTS A total of 1293 publications were found, with 11730 citations generated in the network, and 2019 had the highest number of publications of any year. The most cited publication was «European multicenter study of the AcrySof ReSTOR apodized diffractive intraocular lens» by Kohnen et al., published in 2006. Four groups about different research areas in this field were found using the Clustering functionality: visual quality, IOL designs, ocular aberrations, or defocus curves. CONCLUSIONS The citation network offers an objective and comprehensive analysis of the main articles on the different designs and classes of multifocal IOL.
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Affiliation(s)
- C Martinez-Perez
- Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, España.
| | - C Alvarez-Peregrina
- Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, España
| | - C Villa-Collar
- Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, España
| | - A Arance-Gil
- Hospital Universitario HM Montepríncipe, Madrid, España
| | - M A Sánchez-Tena
- Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, España
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