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Auffarth GU, Łabuz G, Khoramnia R, Yildirim TM. [Overview of intraocular lenses with optics for correcting presbyopia]. DIE OPHTHALMOLOGIE 2024:10.1007/s00347-024-02071-z. [PMID: 38980387 DOI: 10.1007/s00347-024-02071-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND In recent years intraocular lenses (IOLs) for correcting presbyopia have been significantly improved and diversified. There are currently many different IOL models based on a wide variety of optical designs. OBJECTIVE The wide variety of available IOL solutions to correct presbyopia can be challenging for surgeons and patients. In everyday practice, the question is which IOL is best for which patient. MATERIAL AND METHODS This overview describes and categorizes the currently available implants. The respective optical properties are analyzed and clinical study results are discussed, in particular those evaluating visual performance and the occurrence of photic phenomena. RESULTS Monofocal-plus IOLs provide improved intermediate visual acuity with optimal distant visual acuity and minimal photic phenomena. Extended depth of field (EDoF) IOLs extend the depth of field through different optical principles and provide good distant and intermediate visual acuity. Trifocal lenses enable the greatest independence from spectacles at the price of a higher probability of dysphotopsia. CONCLUSION The selection of the most suitable IOL for correction of presbyopia requires a balance between the patient's visual needs and possible side effects. An adequate knowledge of the currently available implants allows a patient-oriented selection of IOLs.
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Affiliation(s)
- Gerd U Auffarth
- Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.
| | - Grzegorz Łabuz
- Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - Ramin Khoramnia
- Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - Timur M Yildirim
- Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
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Łabuz G, Khoramnia R, Naujokaitis T, Auffarth GU. [Optical benchtop evaluation of special intraocular lens optics]. DIE OPHTHALMOLOGIE 2024:10.1007/s00347-024-02064-y. [PMID: 38977490 DOI: 10.1007/s00347-024-02064-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 05/06/2024] [Accepted: 06/03/2024] [Indexed: 07/10/2024]
Abstract
Intraocular lenses (IOL) featuring complex optical designs can pose a challenge in understanding their performance, which may hinder making an informed decision when selecting suitable lenses for patients. This underlines the importance of collecting optical quality data of IOLs and making them available. The deployment of benchtop systems for IOL testing offers not only insights into the design features of various IOL solutions but also provides a platform for objective comparisons of special optics designs, including information about their susceptibility to photic phenomena. Recent advances in IOL testing have improved the ability to predict functional effects on visual acuity and contrast sensitivity from objective optical quality metrics. This, for instance, can be used to study monofocal lenses and the impact of asphericity on vision and IOLs tolerance to misalignment. Monofocal-plus IOLs consistently show only a slight improvement in the depth of focus when tested on the optical bench and in clinical settings. Although the pupil dependence found in this technology may limit the advantages of monofocal-plus over standard monofocal technology to extend the range of vision, it is the key to reduce photic phenomena. Refractive and diffractive extended depth of focus (EDOF) IOLs can effectively enhance intermediate vision, with the latter offering a slightly broader depth of focus but potentially increasing the risk of dysphotopsia. However, the limitation of EDOF IOLs is that they often fail to deliver spectacle independence for reading, which can be overcome by trifocal technology. Still, the available trifocal IOLs differ in their location of intermediate and near foci and the susceptibility to produce glare effects. Therefore, the knowledge from optical benchtop testing of IOLs can support optimizing the IOL selection by aligning the patient's visual needs with the IOL's properties, setting the right expectations, and assessing the risk profile for the occurrence of photic phenomena, potentially leading to improved decision-making.
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Affiliation(s)
- Grzegorz Łabuz
- The David J. Apple Center for Vision Research, Augenklinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.
| | - Ramin Khoramnia
- The David J. Apple Center for Vision Research, Augenklinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - Tadas Naujokaitis
- The David J. Apple Center for Vision Research, Augenklinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - Gerd U Auffarth
- The David J. Apple Center for Vision Research, Augenklinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
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Pérez-Sanz L, Vega F, Azor-Morón JA, Cuellar F, Millán MS, Garzón N. Tolerance to residual astigmatism of an isofocal intraocular lens. Graefes Arch Clin Exp Ophthalmol 2024; 262:1169-1180. [PMID: 37950754 DOI: 10.1007/s00417-023-06305-9] [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: 06/08/2023] [Revised: 10/12/2023] [Accepted: 10/23/2023] [Indexed: 11/13/2023] Open
Abstract
PURPOSE To evaluate the impact of residual astigmatism on the optical and visual performance of an enhanced-monofocal isofocal intraocular lens (EM Isopure, BVI medical, Belgium) compared to a monofocal one (Micropure, BVI medical, Belgium). METHODS Laboratory investigation and prospective, comparative and randomized clinical study. Optical quality was assessed on an optical bench for 2.0, 3.0, and 4.5 mm pupils. The effect of residual astigmatism was investigated from through-focus images recorded with increasing amounts of regular positive astigmatism induced with a deformable mirror. To evaluate the impact of residual astigmatism, 28 eyes of 28 patients were randomly assigned to either group. Residual astigmatism was induced with positive and negative cylinder lenses at 90 and 180°. Visual acuity (VA) was measured at each step. RESULTS The optical performance of both IOLs was quite similar for 2.0 and 3.0 mm pupils. For 4.5-mm pupil, the EM Isopure showed a significant reduction of its optical quality in comparison with the monofocal IOL. When visual performance was evaluated, no statistically significant differences were found for any power of induced astigmatism. More differences were found when positive induced astigmatism was compared within each group, and VA was better when the astigmatism was induced at 180° vs. 90°. The greatest differences were found for and induced positive astigmatism of + 1.50D (p = 0.009 for Isopure and p = 0.023 for Micropure). CONCLUSIONS The tolerance to residual astigmatism of the EM Isopure lens is similar to that of a reference monofocal lens with pupils up to 3.5 mm.
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Affiliation(s)
- Lidia Pérez-Sanz
- Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, Avda. Arcos de Jalón 118, 28037, Madrid, Spain.
- Miranza IOA. C/Galileo 104, 28003, Madrid, Spain.
| | - Fidel Vega
- Grupo de Óptica Aplicada y Procesado de Imagen (GOAPI), Department of Optics and Optometry, Universitat Politècnica de Catalunya BarcelonaTech, Violinista Vellsolà 37, 08222, Terrassa, Spain
| | - Juan A Azor-Morón
- Grupo de Óptica Aplicada y Procesado de Imagen (GOAPI), Department of Optics and Optometry, Universitat Politècnica de Catalunya BarcelonaTech, Violinista Vellsolà 37, 08222, Terrassa, Spain
| | - Fátima Cuellar
- Grupo de Óptica Aplicada y Procesado de Imagen (GOAPI), Department of Optics and Optometry, Universitat Politècnica de Catalunya BarcelonaTech, Violinista Vellsolà 37, 08222, Terrassa, Spain
| | - María S Millán
- Grupo de Óptica Aplicada y Procesado de Imagen (GOAPI), Department of Optics and Optometry, Universitat Politècnica de Catalunya BarcelonaTech, Violinista Vellsolà 37, 08222, Terrassa, Spain
| | - Nuria Garzón
- Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, Avda. Arcos de Jalón 118, 28037, Madrid, Spain
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Bang SP, Jung H, Li KY, Yoon G. Comparison of modal and zonal wavefront measurements of refractive extended depth of focus intraocular lenses. BIOMEDICAL OPTICS EXPRESS 2024; 15:1618-1629. [PMID: 38495697 PMCID: PMC10942709 DOI: 10.1364/boe.513529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 03/19/2024]
Abstract
Extended depth-of-focus (EDoF) intraocular lenses (IOLs) are typically evaluated using commercially available aberrometers. Given the intricate optical design of these IOLs, employing an appropriate wavefront reconstruction method with a sufficient sampling resolution of the aberrometer is crucial. A high-resolution Shack-Hartmann wavefront sensor was developed by magnifying the pupil aperture by a factor of five onto a lenslet array (pitch: 133 µm) and utilizing a full-frame CMOS sensor (24 by 36 mm), resulting in a 26.6 µm sampling resolution. Zonal wavefront reconstruction was used and compared with Zernike-based modal wavefront reconstruction to retain detailed local slope irregularities. Four refractive EDoF IOLs with a power of 20D were examined, and the wavefront difference between the zonal and modal methods, expressed as the root mean squared error (RMSE), remained significant for two of the IOLs up to the 16th-order Zernike spherical aberrations (SAs). Conversely, a negligibly small RMSE was observed for the other two IOLs, as long as the Zernike SAs were higher than the 6th order. The raytracing simulation results from the zonal wavefronts exhibited a stronger correlation with the results of recent optical bench studies than those from the modal wavefronts. The study suggests that certain recent refractive EDoF IOLs possess a complex optical profile that cannot be adequately characterized by limited orders of SAs.
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Affiliation(s)
- Seung Pil Bang
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, USA
- College of Optometry, University of Houston, Houston, TX, USA
| | - HaeWon Jung
- College of Optometry, University of Houston, Houston, TX, USA
| | - Kaccie Y Li
- School of Optometry, University of California, Berkeley, CA, USA
| | - Geunyoung Yoon
- College of Optometry, University of Houston, Houston, TX, USA
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Giglio R, Vinciguerra AL, Presotto M, Jonak K, Rejdak R, Toro MD, Nanavaty MA, Tognetto D. Visual outcomes and patient satisfaction after bilateral implantation of an enhanced monofocal intraocular lens: a single-masked prospective randomized study. Int Ophthalmol 2024; 44:112. [PMID: 38407686 PMCID: PMC10896881 DOI: 10.1007/s10792-024-02946-9] [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: 02/08/2023] [Accepted: 12/04/2023] [Indexed: 02/27/2024]
Abstract
PURPOSE To evaluate and compare the visual outcomes of an enhanced monofocal intraocular lens (IOL) with two different monofocal IOLs. SETTING Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy. DESIGN Prospective, single-center, single-masked, randomized controlled clinical study. METHODS The study included patients undergoing phacoemulsification and IOL implantation. Patients were consecutively randomized by block randomization and assigned in a 1:1:1 allocation ratio to three study arms to bilaterally receive Tecnis Eyhance™ (model ICB00) or Tecnis® monofocal 1-piece (model PCB00) or Clareon® monofocal (model CNA0T0), respectively. Monocular and binocular (both corrected and uncorrected) visual acuities for far, intermediate and near were registered and compared among groups at 3 months. To track changes in patient quality of life, the Catquest-9SF questionnaire was administered to each patient before and after cataract extraction. RESULTS Ninety patients (30 for each group) were enrolled. At 3 months follow-up, statistically significant differences for intermediate visual acuities were found between the three groups. Nonstatistically significant differences were observed for distance visual acuities and the changes in Catquest-9SF scores. CONCLUSION Tecnis Eyhance™ provided better results in intermediate visual outcomes without adverse effects on patients' quality of life.
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Affiliation(s)
- Rosa Giglio
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Ospedale Maggiore, Piazza Ospedale 1, 34129, Trieste, Friuli-Venezia Giulia, Italy
| | - Alex Lucia Vinciguerra
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Ospedale Maggiore, Piazza Ospedale 1, 34129, Trieste, Friuli-Venezia Giulia, Italy.
| | - Marianna Presotto
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Ospedale Maggiore, Piazza Ospedale 1, 34129, Trieste, Friuli-Venezia Giulia, Italy
| | - Kamil Jonak
- Department of Biomedical Engineering, Lublin University of Technology, 20-618, Lublin, Poland
- Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 20-093, Lublin, Poland
| | - Robert Rejdak
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-093, Lublin, Poland
| | - Mario Damiano Toro
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-093, Lublin, Poland
- Eye Clinic, Public Health Department, University of Naples Federico II, 80138, Naples, Italy
| | | | - Daniele Tognetto
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Ospedale Maggiore, Piazza Ospedale 1, 34129, Trieste, Friuli-Venezia Giulia, Italy
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Kim DR, Yoon YC, Whang WJ, Hwang HS, Na KS. Ocular parameters associated with visual performance of enhanced monofocal intraocular lens. BMC Ophthalmol 2024; 24:74. [PMID: 38369454 PMCID: PMC10875848 DOI: 10.1186/s12886-024-03316-w] [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: 09/07/2023] [Accepted: 01/18/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND An enhanced monofocal intraocular lenses (IOLs) (Tecnis Eyhance ICB00 and Tecnis Eyhance Toric DIU) has been developed to enhance intermediate vision while avoiding the disadvantages of multifocal IOLs. Although many studies have demonstrated the improvement of intermediate visual acuity with enhanced monofocal IOLs, it is not known specifically for which patients these IOLs should be recommended or avoided. In this study, we aim to find out which ocular parameters affect vision performance and photic phenomenon of ICB00 or DIU at different distances. METHODS Patients who underwent cataract surgery with ICB00 or DIU, performed by a single surgeon, were included. Before surgery, the patients' age, gender, axial length, anterior chamber depth, spherical aberration Z (4,0), vertical coma, horizontal coma, angle kappa (κ), angle alpha (α), and other ocular parameters were investigated. One month after surgery, uncorrected near visual acuity (UNVA at 40 cm), uncorrected intermediate visual acuity (UIVA at 66 cm), uncorrected distance logMAR visual acuity (UDVA), IOL decentration, and quality of vision (QoV) questionnaires were conducted. RESULTS A total of 43 patients (58 eyes) were included. The results of the univariate linear regression analyses showed a negative correlation between spherical aberration and logMAR UNVA and UIVA (p = 0.003, β=-0.51 and p = 0.018, β=-0.23, respectively) and a positive correlation between angle α and logMAR UIVA (p = 0.036, β = 0.19). Deeper anterior chamber depth (ACD) was associated with poorer total QoV (p = 0.018, β = 14.43), particularly in glare, halo, blur, and fluctuation perception. A higher degree of IOL decentration tended to decrease UNVA and UIVA (Pearson correlation coefficient, r = 0.336 and r = 0.221, respectively); however, no significant effect was observed on UDVA (Pearson correlation coefficient, r = 0.042). CONCLUSIONS In enhanced monofocal IOLs, a higher level of spherical aberration is associated with better performance in UNVA and UIVA, whereas a larger angle α has a negative impact. A deeper ACD negatively affects the QoV.
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Affiliation(s)
- Da Ran Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young Chae Yoon
- 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
| | - Ho Sik Hwang
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyung-Sun Na
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Negishi K, Masui S, Ayaki M, Torii H, Yotsukura E, Nishi Y. Clinical Results and Factors Affecting Visual Function in Eyes Implanted with an Enhanced Monofocal Intraocular Lens. Clin Ophthalmol 2023; 17:3965-3973. [PMID: 38146453 PMCID: PMC10749537 DOI: 10.2147/opth.s438599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/13/2023] [Indexed: 12/27/2023] Open
Abstract
Purpose To compare the clinical results achieved with the enhanced monofocal intraocular lenses (IOLs) with those of the monofocal IOL and investigate factors affecting the distance, intermediate, and near vision. Patients and Methods Patients were included who underwent bilateral consecutive cataract surgeries using the same IOLs with follow-up to 1 month postoperatively. Refractions, monocular UDVA and CDVA, and binocular distance-corrected functional visual acuity at 5 meters (BDCFVA), at 66 centimeters (BDCIFVA) and at 40 centimeters (DCNVA) were assessed. Multiple regression analysis was used to assess the factors affecting binocular BDCFVA, BDCIFVA, and BDCNFVA. Subjective symptoms were assessed using the Near Activity Visual Questionnaire (NAVQ) and visual analogue scale (VAS). Results Sixty patients (120 eyes) implanted with the Tecnis Eyhance IOL (30 patients, 60 eyes) or the Tecnis monofocal IOL (30 patients, 60 eyes) were included. The Tecnis Eyhance IOL provided significantly better binocular BDCIFVA than the Tecnis monofocal IOL in patients under 70 years of age. Multiple regression analysis showed that age was the only factor affecting distance and intermediate visual function in eyes with the Tecnis Eyhance IOL; gender, pupillary diameter, axial length, and average keratometry were not significant. There were no significant differences in subjective symptoms. Conclusion The comprehensive cohort analysis did not confirm the advantage on the intermediate vision of the Tecnis Eyhance IOL. Younger age may be an important factor to benefit from the unique optical characteristics of this IOL.
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Affiliation(s)
- Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku‑Ku, Tokyo, Japan
| | - Sachiko Masui
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku‑Ku, Tokyo, Japan
| | - Masahiko Ayaki
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku‑Ku, Tokyo, Japan
- Otake Clinic Moon View Eye Center, Yamato-City, Kanagawa, Japan
| | - Hidemasa Torii
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku‑Ku, Tokyo, Japan
| | - Erisa Yotsukura
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku‑Ku, Tokyo, Japan
| | - Yasuyo Nishi
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku‑Ku, Tokyo, Japan
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Steinmüller LN, Greve D, Rua Amaro D, Bertelmann E, von Sonnleithner C. Analysis of higher-order aberrations in relation to the clinical outcome of an enhanced monofocal IOL. Eur J Ophthalmol 2023; 33:2096-2105. [PMID: 36274639 PMCID: PMC10590024 DOI: 10.1177/11206721221134171] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 09/25/2022] [Indexed: 10/22/2023]
Abstract
PURPOSE To analyse higher-order aberrations of an enhanced monofocal aspheric intraocular lens (IOL) in relation to the clinical outcome compared to a monofocal aspheric IOL. SETTING Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Germany. DESIGN Prospective, monocentric, controlled, non-randomized, two-armed study. METHODS After phacoemulsification, a total of 30 patients (60 eyes) were bilaterally implanted with either TECNIS Eyhance IOL model ICB00 (Johnson & Johnson Surgical Vision, Inc.) or TECNIS Monofocal 1-Piece IOL model ZCB00 (Johnson & Johnson Surgical Vision, Inc.) in 30 eyes each. Assessments were performed 1 and 3 months after surgery including refraction, uncorrected and best-corrected distance, intermediate and near visual acuity, defocus curves, contrast sensitivities under photopic, mesopic and mesopic conditions with glare, higher-order aberrations (HOAs) at pupil sizes of 5, 4, 3 and 2 mm and patient satisfaction. RESULTS At 3-month follow-up, measurements of HOAs revealed significant higher negative internal and ocular primary spherical aberrations in the ICB00 group at pupil sizes of 5, 4, 3 and 2 mm. The ICB00 showed significant better results in intermediate and near visual acuity, but no difference in distance visual acuity. No significant difference was found in contrast sensitivities at any condition or spatial frequency. Spectacle independence was significant better without significant higher rates of dysphotopsia in the ICB00 group. CONCLUSIONS Higher negative spherical aberrations in the ICB00 group at all measured pupil sizes appear to lead to a superior clinical outcome in intermediate and near vision compared to the ZCB00 group without compromising contrast sensitivity or distance visual acuity.
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Affiliation(s)
| | - Daria Greve
- Department of Ophthalmology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - David Rua Amaro
- Department of Ophthalmology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Eckart Bertelmann
- Department of Ophthalmology, Charité – Universitätsmedizin Berlin, Berlin, Germany
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Choi SH, Lee HS, Chang IB, Ma DJ, Cho IH, Lee SJ, Hong IH. Evaluation of a New Monofocal Intraocular Lens in Patients Undergoing Cataract and Vitrectomy Surgery for Idiopathic Macular Hole. Curr Eye Res 2023; 48:904-910. [PMID: 37382109 DOI: 10.1080/02713683.2023.2229542] [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: 05/18/2023] [Accepted: 06/16/2023] [Indexed: 06/30/2023]
Abstract
PURPOSE To evaluate the usefulness of a newly generated monofocal intraocular lens (IOL) in patients who underwent combined cataract and pars plana vitrectomy (PPV) surgery for idiopathic macular hole (MH). METHODS A prospective study was conducted on 89 eyes of 89 patients who underwent combined cataract and PPV surgery for MH. The patients were divided into two groups: Eyhance ICB00 and Tecnis ZCB00. Pre-operative characteristics, post-operative visual outcomes, contrast sensitivity, and complications were compared between the two groups. A univariate regression analysis was performed to identify the factors that may affect the postoperative visual outcomes. RESULTS Both groups showed significant improvement in mean corrected distance visual acuity (CDVA) six months post-operation (p < 0.001). There was no significant difference in pre-operative characteristics or complications between the two groups. However, the Eyhance ICB00 group showed a significantly higher uncorrected intermediate visual acuity (UCIVA) value at 6 months after surgery than the Tecnis ZCB00 group (p = 0.014). Contrast sensitivity values were not significantly different between the two groups. The univariate regression analysis revealed a significant correlation between preoperative CDVA and minimum linear diameter of MH with postoperative UCIVA in the Eyhance ICB00 group. CONCLUSIONS The newly generated Eyhance ICB00 IOL showed promising results in terms of post-operative UCIVA, with no significant difference in complications or contrast sensitivity values compared to the Tecnis ZCB00 IOL. These findings suggest that the Eyhance ICB00 IOL may be a useful option for patients who undergo combined cataract and PPV surgery for idiopathic MH, particularly for those who require intermediate visual acuity.
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Affiliation(s)
- Se Hyun Choi
- Department of Ophthalmology, Hallym University Sacred Heart Hospital, Anyang-si, South Korea
| | - Ho Seok Lee
- Department of Ophthalmology, Dongtan Sacred Heart Hospital, Hallym University Medical Center, Hwaseong-si, Gyeonggi-do, Korea
| | | | - Dae Joong Ma
- Department of Ophthalmology, Gangnam Sacred Heart Hospital, Seoul, Korea
| | - In Hwan Cho
- Department of Ophthalmology, College of Medicine, Soonchunhyang University, Cheonan-si, Chungcheongnam-do, South Korea
| | | | - In Hwan Hong
- Department of Ophthalmology, Dongtan Sacred Heart Hospital, Hallym University Medical Center, Hwaseong-si, Gyeonggi-do, Korea
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Park MJ, Lee HS, Chang IB, Hong IH. Improved Intermediate Visual Function with New Monofocal Intraocular Lens in Combined Cataract and Vitrectomy Surgery for Retinal Disease. KOREAN JOURNAL OF OPHTHALMOLOGY 2023; 37:401-408. [PMID: 37621091 PMCID: PMC10587461 DOI: 10.3341/kjo.2023.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/04/2023] [Accepted: 08/23/2023] [Indexed: 08/26/2023] Open
Abstract
PURPOSE To evaluate the usefulness of a newly generated monofocal intraocular lens (IOL) in patients with various retinal diseases who underwent combined cataract and pars plana vitrectomy surgery. METHODS This prospective observational study included 33 patients with various retinal diseases. Monocular best-corrected distance visual acuity (BCDVA), uncorrected distance visual acuity (UCDVA), uncorrected intermediate visual acuity (UCIVA), uncorrected near visual acuity (UCNVA), and contrast sensitivity were measured and compared with 40 age-matched patients in the standard monofocal IOL. RESULTS The Eyhance IOL group demonstrated significantly better UCIVA at 6 months follow-up compared to the standard monofocal IOL group. No significant differences were observed between the two groups in contrast sensitivity, BCDVA, UCDVA, or UCNVA. The regression analysis showed a significant association between preoperative corrected distance visual acuity and improved UCIVA in the Eyhance IOL group. CONCLUSIONS The Eyhance ICB00 IOL proved to be a valuable option for patients with retinal diseases undergoing combined cataract surgery and vitrectomy. It effectively improved intermediate vision without compromising contrast sensitivity or distance visual acuity.
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Affiliation(s)
- Min Ji Park
- Department of Ophthalmology, Hallym University Dongtan Sacred Heart Hospital, Hallym University Medical Center, Hwaseong,
Korea
| | - Ho Seok Lee
- Department of Ophthalmology, Hallym University Dongtan Sacred Heart Hospital, Hallym University Medical Center, Hwaseong,
Korea
| | | | - In Hwan Hong
- Department of Ophthalmology, Hallym University Dongtan Sacred Heart Hospital, Hallym University Medical Center, Hwaseong,
Korea
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Donoso R, Torres A, Klagges J, Mercado Y, Gonzalez T, Astudillo M, Norambuena H, Medina E. Enhanced vs conventional monofocal intraocular lens clinical results in patients with cataract: randomized clinical trial. J Cataract Refract Surg 2023; 49:818-825. [PMID: 37232418 DOI: 10.1097/j.jcrs.0000000000001224] [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: 07/14/2022] [Accepted: 05/17/2023] [Indexed: 05/27/2023]
Abstract
PURPOSE To compare clinical outcomes between an enhanced and a conventional monofocal intraocular lens (IOL) after cataract surgery. SETTING Ophthalmology Unit, Hospital del Salvador, University of Chile (tertiary care hospital). DESIGN Double-masked, prospective randomized controlled trial. METHODS 66 healthy adults with corneal astigmatism less than 1.50 diopters and axial length between 21 and 27 mm were randomly allocated (1:1) for bilateral phacoemulsification with either an enhanced monofocal IOL (ICB00) or a conventional aspheric monofocal IOL (ZCB00) implant. The refractive target was emmetropia in both eyes. Visual acuities, defocus curves, Catquest-9SF, and quality of vision (QoV) were measured 3 months postoperatively. RESULTS Binocular uncorrected intermediate visual acuity was improved in patients implanted with the enhanced monofocal lens (0.37 ± 0.12) compared with the conventional monofocal (0.45 ± 0.10) ( P < .01). There were no significant differences in corrected distance visual acuity (CDVA), Catquest-9SF, or QoV scores. CONCLUSIONS The enhanced monofocal IOL provided 1 additional line of intermediate visual acuity after cataract surgery. There was no significant change in either CDVA or QoV.
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Affiliation(s)
- Rodrigo Donoso
- From the Hospital del Salvador, Universidad de Chile, Santiago, Chile
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12
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Vega F, Faria-Ribeiro M, Armengol J, Millán MS. Pitfalls of Using NIR-Based Clinical Instruments to Test Eyes Implanted with Diffractive Intraocular Lenses. Diagnostics (Basel) 2023; 13:diagnostics13071259. [PMID: 37046477 PMCID: PMC10093131 DOI: 10.3390/diagnostics13071259] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/13/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
The strong wavelength dependency of diffractive elements casts reasonable doubts on the reliability of near-infrared- (NIR)-based clinical instruments, such as aberrometers and double-pass systems, for assessing, post-surgery, the visual quality of eyes implanted with diffractive multifocal intraocular lenses (DMIOLs). The results obtained for such patients when using NIR light can be misleading. Ordinary compensation for the refractive error bound to chromatic aberration is not enough because it only considers the best focus shift but does not take into account the distribution of light energy among the foci which strongly depends on the wavelength-dependent energy efficiency of the diffractive orders used in the DMIOL design. In this paper, we consider three commercial DMIOL designs with the far focus falling within the range of (−1, 0, +1)-diffractive orders. We prove theoretically the differences existing in the physical performance of the studied lenses when using either the design wavelength in the visible spectrum or a NIR wavelength (780 to 850 nm). Based on numerical simulation and on-bench experimental results, we show that such differences cannot be neglected and may affect all the foci of a DMIOL, including the far focus.
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13
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Alarcon A, Canovas C, Koopman B, Pande MV, Koch DD, Piers P. Optical bench evaluation of the effect of pupil size in new generation monofocal intraocular lenses. BMC Ophthalmol 2023; 23:112. [PMID: 36941624 PMCID: PMC10026412 DOI: 10.1186/s12886-023-02839-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/02/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND A new generation of enhanced monofocal IOLs has been introduced to slightly increase the depth of focus as compared to standard monofocal IOLs. The purpose of this study is to evaluate the effect of pupil size on the through-focus optical performance of three new enhanced monofocal IOLs, designed to improve the range of vision as compared to standard monofocal IOLs. METHODS Optical bench testing in white light was performed for different pupils, using an average cornea eye. Distance image quality was evaluated using Modulation Transfer Function (MTF) measurements. Through-focus Visual Acuity (VA) was simulated from these measurements (sVA). Three enhanced monofocal IOLs (ICB00, ISOPure, and RayOne-EMV) and three standard monofocal IOLs: two aspheric (ZCB00 and SN60WF) and one spherical (AAB00) were included. RESULTS The enhanced monofocal IOLs provided an improvement in the intermediate sVA as compared to standard monofocal IOLs. For ICB00, the improvement was independent of the pupil size, while for the ISOPure and RayOne-EMV, the intermediate sVA improved with increased pupil size. Similar to the spherical monofocal IOL, the ISOPure and RayOne-EMV showed a strong correlation between improvement in intermediate sVA and reduction of distance sVA and MTF, and increasing pupil size. ICB00 provided the same distance sVA as the aspheric monofocal IOLs and the lowest variability in MTF with pupil size. CONCLUSION Optical bench results showed that the ISOPure and RayOne-EMV provide similar performance to a spherical monofocal IOL, with a strong pupil dependency for distance and intermediate vision. The other enhanced monofocal IOL, ICB00, provided a sustained improvement in simulated intermediate VA and maintained distance image quality comparable to that of the standard aspheric monofocal IOLs, even for larger pupils.
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Affiliation(s)
- Aixa Alarcon
- Johnson and Johnson Vision, Groningen, Netherlands.
| | | | - Bram Koopman
- Johnson and Johnson Vision, Groningen, Netherlands
| | - Milind V Pande
- Vision Surgery & Research Centre, North Ferriby, East Yorkshire, UK
| | - Douglas D Koch
- Cullen Eye Institute, Baylor College of Medicine, Houston, US
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14
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Fernández J, Rocha-de-Lossada C, Zamorano-Martín F, Rodríguez-Calvo-de-Mora M, Rodríguez-Vallejo M. Positioning of enhanced monofocal intraocular lenses between conventional monofocal and extended depth of focus lenses: a scoping review. BMC Ophthalmol 2023; 23:101. [PMID: 36918799 PMCID: PMC10015679 DOI: 10.1186/s12886-023-02844-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/06/2023] [Indexed: 03/15/2023] Open
Abstract
BACKGROUND New intraocular lenses (IOLs) have emerged since the originally coined monofocal and multifocal IOLs. The extended depth of focus (EDoF) and enhanced monofocal IOLs (mono-EDoF) that have appeared in the last decade have caused some confusion in their classification. The aim of this review was to summarize the outcomes provided by mono-EDOF IOLs and to determine which of the endpoints, described by the American National Standard (ANSI) for EDoF IOLs, are fulfilled. METHODS The MEDLINE, EMBASE, and WEB OF SCIENCE databases were searched. Two independent reviewers screened the studies for inclusion and data extraction. The search strategy was limited to studies published between 2020 and 2022, but not by language. The results are presented as a narrative summary accompanied by tables, in alignment with the objectives of this scoping review. Compliance with the endpoints for clinical outcomes described in the American National Standard Z80.35-2018 (ANSI) for EDoF lenses was checked and additional endpoints were defined. RESULTS Two systematic reviews, 13 laboratory, 21 clinical, and two mixed studies were included. Tecnis Eyhance was the mono-EDOF with the highest volume of evidence to date. Although laboratory studies included other IOLs, clinical evidence for them is still scarce, with only one study of IsoPure compared to a standard monofocal IOL. Evidence in comparison to EDoF lenses is also scarce, even for Tecnis Eyhance, with only three studies including this lens in comparison to an EDoF lens. After evaluation of the ANSI criteria, agreement was found in the failure for the increase in depth of field equal to or greater than 0.5 D for a visual acuity (VA) level of 0.2 logMAR and none of the studies supported that the median monocular VA at intermediate distance was at least 0.2 logMAR. CONCLUSIONS Additional clinical evidence is required for other mono-EDOF IOLs beyond Tecnis Eyhance. Until the arrival of a standard classification, mono-EDOF should be better still classified as monofocal because the ANSI standards were not fully met.
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Affiliation(s)
- Joaquín Fernández
- Qvision. Ophthalmology Department, VITHAS Almería Hospital, 04120, Almería, Spain
| | - Carlos Rocha-de-Lossada
- Qvision. Ophthalmology Department, VITHAS Almería Hospital, 04120, Almería, Spain
- Ophthalmology Department, VITHAS Málaga. 29016, Málaga, Spain
- Hospital Regional Universitario de Málaga. Plaza del Hospital Civil, 29009, Málaga, S/N, Spain
- Departamento de Cirugía, Área de Oftalmología. Doctor Fedriani, Universidad de Sevilla, 41009, Sevilla, S/N, Spain
| | | | - Marina Rodríguez-Calvo-de-Mora
- Qvision. Ophthalmology Department, VITHAS Almería Hospital, 04120, Almería, Spain
- Ophthalmology Department, VITHAS Málaga. 29016, Málaga, Spain
- Hospital Regional Universitario de Málaga. Plaza del Hospital Civil, 29009, Málaga, S/N, Spain
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15
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Madrid-Costa D, Fernández-Vega-Cueto L, Azor-Morón JA, Vega F, Millán MS, Alfonso JF. Beam-Shaping Extended Depth of Focus Intraocular Lens: Optical Assessment With Corneas of Increasing Spherical Aberration. J Refract Surg 2023; 39:95-102. [PMID: 36779468 DOI: 10.3928/1081597x-20221215-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
PURPOSE To assess the optical quality and halo formation of a beam-shaping extended depth-of-focus (EDOF) intraocular lens (IOL) (AcrySof IQ Vivity; Alcon Laboratories, Inc) with corneas of long-range spherical aberration (SA) such as those resulting from myopic laser ablations. METHODS The optical quality of the EDOF IOL and a reference monofocal IOL was evaluated with three corneas (A, B, and C, with SA =+0.135, +0.290, +0.540 µm, respectively, for a 5.15-mm pupil at the IOL plane). The through-focus modulation transfer function area (MTFa) curves were obtained between -5.00 and +2.00 diopters (D) defocus range. The halo was also assessed with the three corneas. RESULTS Through-focus MTFa curves for a 4.5-mm IOL pupil showed a slight decrease in the maximum MTFa value provided by the EDOF IOL compared to the monofocal IOL in the three corneal situations (A: 45.9 vs 38.6 units; B: 41.1 vs 33.1 units, and C: 26.9 vs 23.8 units). For the 3.0-mm pupil, the EDOF IOL also had lower maximum MTFa than the monofocal IOL; however, the depth-of-focus increased to -2.20 D. With corneas A and B, the halo induced was of low energy with both IOLs. With cornea C, the EDOF IOL created a much larger and intense halo. CONCLUSIONS The EDOF IOL provided a good distance optical performance and an extended range of focus of approximately 2.00 D, with a halo of low intensity when evaluated with a corneal SA similar to the one induced by a low to moderate myopic ablation. With a high myopic ablation, the halo induced would be of considerable size and energy. [J Refact Surg. 2023;39(2):95-102.].
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16
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Schmid R, Fuchs C, Luedtke H, Borkenstein AF. Depth of focus of four novel extended range of vision intraocular lenses. Eur J Ophthalmol 2023; 33:257-261. [PMID: 36112834 DOI: 10.1177/11206721221125081] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE To assess the depth of focus of four latest non-diffractive extended range of vision IOLs on the optical bench. Such comparison had not been done before. METHODS We assessed and compared the through focus modulation transfer function (MTF) of the following novel IOLs with a nominal power of 22 D: Acrysof Vivity, LuxSmart Crystal, RayOne EMV and Tecnis Eyhance. An ISO-2 model eye was applied with apertures of 3 and 4.5 mm with monochromatic light of 546 nm. Measurements were done on OptiSpheric IOL PRO 2 optical bench. RESULTS For the aperture of 3 mm, Eyhance and RayOne EMV showed the most pronounced peak in MTF with only little enlarged depth of power. Vivity and LuxSmart showed two peaks of about 1.7 D respectively 1.3 D depth of focus, yet reduced MTF and with maxima differently located. For 4.5 mm, MTF values for Eyhance and particularly for RayOne EMV dropped. For Vivity and LuxSmart, only the peak for the secondary focus decreased. CONCLUSION Vivity and LuxSmart showed a larger depth of focus for our measuring conditions than Eyhance and RayOne EMV. Correspondingly, the peak MTF was best for Eyhance and RayOne ERV with small aperture. With the larger aperture, RayOne EMV considerably lost performance.
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Affiliation(s)
- Ruediger Schmid
- accuratis. Practice for Refractive Eye Surgery, Ulm, Germany
| | | | - Holger Luedtke
- accuratis. Practice for Refractive Eye Surgery, Ulm, Germany
| | - Andreas F Borkenstein
- Borkenstein & Borkenstein. Private practice at Privatklinik der Kreuzschwestern, Graz, Austria
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17
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Poyales F, Garzón N, Rico L, Zhou Y, Millán MS, Vega F. Comparison of visual performance between two aspheric monofocal intraocular lens models. Clin Exp Optom 2023; 106:29-35. [PMID: 34875207 DOI: 10.1080/08164622.2021.2009737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
CLINICAL RELEVANCE It is important to distinguish between visual acuity, optical quality and quality of vision when outcomes obtained with intraocular lenses are evaluated. These parameters, that includeobjective and subjective tests, should be assessed to obtain results that are not biased. BACKGROUND To assess the difference in visual and optical quality between two monofocal intraocular lens models. METHODS : This was a prospective, parallel and randomised clinical study conducted at Miranza IOA, a private clinic in Madrid, Spain. Sixty patients were implanted bilaterally, 30 per group, with two aspheric IOLs with induced spherical aberration of -0.27 μm for Group A and -0.20 μm for Group B. Visual outcomes obtained at 1 and 3 months after surgery included both uncorrected (UCVA) and corrected monocular distance visual acuity (DCVA), objective scattering index (OSI), modulation transfer function (MTF) cut-off, Strehl Ratio (SR), contrast sensitivity defocus curve (CSDC), intraocular lens spherical aberration (SA), and longitudinal chromatic aberration of the eye. Activity limitations in daily life were assessed using CatQuest-9SF questionnaire. RESULTS There were statistically significant differences for DCVA (0.04 LogMAR; p = .008) and SR (0.03; p = .003) between groups. Outcomes related to CSDC showed statistically significant differences for vergences between -0.50 D and +1.00 D (3 mm pupil) and for vergences of 0.00 D and +0.50 D (4.5 mm pupil) between groups. Overall, Group A showed better results regarding visual and optical quality, including a lower longitudinal chromatic aberration result in comparison to Group B. Patient satisfaction evaluated with CatQuest-9SF showed that Group A achieved better outcomes, although the differences were statistically significant only for the 'Reading text on television' item (p = 0.027). CONCLUSIONS Both intraocular lens models showed excellent quantity of vision, optical and visual quality as well as high patient satisfaction. Despite this, the the Group A model provided slightly better outcomes than the Group B model.
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Affiliation(s)
| | - Nuria Garzón
- Ophthalmology Department, Miranza IOA, Madrid, Spain.,Departamento Optometría y Visión, Universidad Complutense de Madrid, Madrid, Spain
| | - Laura Rico
- Ophthalmology Department, Miranza IOA, Madrid, Spain
| | - Ying Zhou
- Ophthalmology Department, Miranza IOA, Madrid, Spain
| | - María S Millán
- Departament d'Òptica i, Universitat Politècnica de Catalunya-BarcelonaTech, Spain
| | - Fidel Vega
- Departament d'Òptica i, Universitat Politècnica de Catalunya-BarcelonaTech, Spain
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18
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Gigon E, Bouthour W, Panos GD, Pajic B, Massa H. Real world outcomes of the new Tecnis Eyhance IOL. Eur J Ophthalmol 2022; 33:1390-1397. [PMID: 36567614 PMCID: PMC10152560 DOI: 10.1177/11206721221146675] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE To compare the performance of Tecnis Eyhance ICB00 with Tecnis PCB00 IOL for far, intermediate, and near vision, in patients after bilateral cataract surgery. SETTINGS This study was done at Geneva University Hospitals. DESIGN This is a retrospective study of 224 eyes that underwent cataract between May 2019 and June 2020. METHODS Visual acuity was assessed from month 1 to 12 after surgery for distance, intermediate and near visual acuity, by the same optometrist, which was blind regarding the type of IOL. The patients answered to a quality of life questionnaire. Patients were excluded for: monocular surgery, macular disease, other IOL type, or inability to reach 20/20 visual acuity in both eyes without correction. RESULTS One hundred and fifty-two eyes were excluded. Three groups were then analyzed: PCB00 group (38 eyes), ICB00 group (22 eyes), and mismatch group (12 eyes). Monocular visual acuities (CIVA, UNVA and CNVA, in logMAR) were higher in the ICB00 group than the PCB00 group (respectively 0.3 vs 0.4, p = 0.0033; 0.3 vs 0.4, p = 0.0408; 0.3 vs 0.4, p = 0.0039). Binocular visual acuities, CIVA and CNVA were higher in the ICB00 group than the PCB00 group (0.2 vs 0.4, p = 0.0061; 0.15 vs 0.3, p = 0.018). This mirrored the findings of the quality of life questionnaire. There was no significant difference between PCB00 and mismatch groups. CONCLUSIONS the Tecnis Eyhance was more effective for intermediate and near vision. The central defocus of the lens might help patients achieve spectacle independence and better quality of life.
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Affiliation(s)
- Edward Gigon
- Department of Clinical Neurosciences, Division of Ophthalmology, Geneva University Hospitals, Geneva, Switzerland
| | - Walid Bouthour
- Department of Clinical Neurosciences, Division of Ophthalmology, Geneva University Hospitals, Geneva, Switzerland
| | - Georgios D Panos
- Department of Ophthalmology, Queen's Medical Centre, 9820Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Bojan Pajic
- Department of Clinical Neurosciences, Division of Ophthalmology, Geneva University Hospitals, Geneva, Switzerland.,Eye Clinic Orasis, Swiss Eye Research Foundation, Reinach AG, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Faculty of Sciences, Department of Physics, University of Novi Sad, Novi Sad, Serbia.,Faculty of Medicine of the Military Medical Academy, University of Defense, Belgrade, Serbia
| | - Horace Massa
- Department of Clinical Neurosciences, Division of Ophthalmology, Geneva University Hospitals, Geneva, Switzerland
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19
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Azor JA, Vega F, Armengol J, Millan MS. Optical Assessment and Expected Visual Quality of Four Extended Range of Vision Intraocular Lenses. J Refract Surg 2022; 38:688-697. [DOI: 10.3928/1081597x-20220926-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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20
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Schmid R, Luedtke H, Borkenstein AF. Effect of decentration and tilt on four novel extended range of vision intraocular lenses regarding far distance. Eur J Ophthalmol 2022; 33:11206721221128864. [PMID: 36163687 DOI: 10.1177/11206721221128864] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To analyze the effect of decentration and tilt on four novel non diffractive extended range of vision intraocular lenses (IOLs). METHODS Acrysof Vivity, LuxSmart Crystal, RayOne EMV and Tecnis Eyhance were compared on the optical bench (power of 22 D each). Modulation transfer functions were obtained and Strehl ratio was calculated in an ISO-2 model. Apertures of 3 mm and 4.5 mm were applied. For qualitative assessment, United States Airforce (USAF) chart images were evaluated. Additional to centered IOLs, tilt of 5 degrees and decentration of 1 mm were applied. RESULTS RayOne EMV was very robust against misalignment but had considerable deterioration of modulation transfer function (MTF) for large aperture with USAF images seriously blurred. Tilt and decentration decreased the performance of Eyhance significantly but had minor impact on the performance of Vivity and LuxSmart. For 4.5 mm aperture, MTF and Strehl ratio decreased markedly for all IOLs compared to 3 mm aperture size. The best MTF and Strehl ratio was obtained for Eyhance IOL well centered for both sizes of aperture. CONCLUSION Tilt and decentration had a major impact on the performance of Eyhance only, which performed best of all IOLs tested when well centered. With large aperture, performance of all IOLs significantly decreased. Manufacturer's different approaches for these novel IOLs to increase depth of focus by increasing spherical aberration lead to a different performance in respect to contrast function and sensitivity to misalignment. Our results apply to the distance vision. Near vision performance will be evaluated in a separate investigation.
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Affiliation(s)
- Ruediger Schmid
- accuratis, Practice for Refractive Eye Surgery, Ulm, Germany
| | - Holger Luedtke
- accuratis, Practice for Refractive Eye Surgery, Ulm, Germany
| | - Andreas F Borkenstein
- Borkenstein & Borkenstein, Private practice at Privatklinik der Kreuzschwestern, Graz, Austria
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21
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Fernández-Vega-Cueto L, Vega F, Guerra-Velasco R, Millán MS, Madrid-Costa D, Alfonso JF. Optical and Clinical Outcomes of an Enhanced Monofocal Intraocular Lens for High Hyperopia. J Refract Surg 2022; 38:572-579. [PMID: 36098391 DOI: 10.3928/1081597x-20220802-01] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the optical and clinical performance of an enhanced monofocal intraocular lens (IOL) (TECNIS Eyhance ICB00; Johnson & Johnson Vision) in patients with high hyperopia and a short axial length. METHODS Power mapping, wavefront analysis, and the through-focus modulation transfer function area (TF-MTFa) were measured in vitro for three IOL powers (10.00, 20.00, and 30.00 diopters [D]). The clinical study included 22 patients with an axial length of less than 22.5 mm. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity and binocular defocus curve were evaluated 6 months postoperatively. RESULTS For the three IOL powers, the power mapping revealed an increase in positive power from the periphery to the center of the lens, providing an extra positive correction of 1.00 D for a 2-mm pupil size. The TF-MTFa curves showed only a peak of maximum MTFa at the distance focus. As the pupil size became smaller, there was a focus extension effect, providing an extended depth of focus of up to -1.50 D for a 2-mm pupil size. No significant dependency of the IOL base power on the power profile, wavefront, or optical quality was found. The clinical outcomes showed that all patients achieved a binocular CDVA of 0.1 logMAR or better. The mean visual acuity was better than 0.1 logMAR between +0.50 and -1.50 D of defocus. At a vergence of -2.00 D, the visual acuity was 0.11 ± 0.13 logMAR. CONCLUSIONS The monofocal enhanced IOL provided good distance optical and visual quality and optimal visual acuity up to an intermediate-near vision distance of 50 to 40 cm in patients with high hyperopia and a short axial length. [J Refract Surg. 2022;38(9):572-579.].
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22
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Wan KH, Au ACK, Kua WN, Ng ALK, Cheng GPM, Lam NM, Chow VWS. Enhanced Monofocal Versus Conventional Monofocal Intraocular Lens in Cataract Surgery: A Meta-analysis. J Refract Surg 2022; 38:538-546. [PMID: 35947003 DOI: 10.3928/1081597x-20220707-01] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare different outcomes of an enhanced monofocal intraocular lens (IOL) versus a conventional monofocal IOL implantation after cataract surgery. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline was used for abstracting data and assessing quality. Comparative studies between enhanced monofocal versus conventional monofocal IOL implantations reporting outcomes in monocular and binocular visual acuities at various distances, spectacle independence, contrast sensitivity, optical quality, and adverse effects were identified from three databases. Meta-analysis, sensitivity analysis, and subgroup analysis were performed. RESULTS A total of 680 eyes implanted with an enhanced monofocal IOL (Tecnis Eyhance ICB00; Johnson & Johnson) and 647 eyes with a conventional monofocal IOL from 3 randomized controlled trials and 9 comparative studies were included. The enhanced monofocal IOL showed better monocular uncorrected intermediate visual acuity (UIVA) (mean difference [MD]: -0.11 logMAR; 95% CI: -0.12 to -0.09), binocular UIVA (MD: -0.17 logMAR; 95% CI: -0.23 to -0.11), and binocular uncorrected near visual acuity performance (MD: -0.17 logMAR; 95% CI: -0.29 to -0.04) than the conventional monofocal IOL. More patients were spectacle free at intermediate distance with the enhanced monofocal IOL (odds ratio: 12.9; 95% CI: 6.2 to 27.0). Both monocular (MD: -0.002 logMAR; 95% CI: -0.01 to 0.01) and binocular (MD: 0.01 logMAR; 95% CI: -0.02 to 0.03) uncorrected distance visual acuity revealed non-significant differences between the IOL designs. Contrast sensitivity, photic phenomenon, and adverse effects were comparable. CONCLUSIONS Enhanced monofocal IOLs effectively improved unaided intermediate vision with similar distance performance relative to conventional monofocal IOLs. This was achieved without compromising the contrast sensitivity or inducing photic phenomena. [J Refract Surg. 2022;38(8):538-546.].
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23
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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: 12] [Impact Index Per Article: 6.0] [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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Miret JJ, Camps VJ, García C, Caballero MT, Gonzalez-Leal JM. Analysis and comparison of monofocal, extended depth of focus and trifocal intraocular lens profiles. Sci Rep 2022; 12:8654. [PMID: 35606534 PMCID: PMC9126942 DOI: 10.1038/s41598-022-12694-4] [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: 02/23/2022] [Accepted: 05/12/2022] [Indexed: 11/09/2022] Open
Abstract
To test the feasibility of using profilometers to extract information about IOL surfaces design. A standard monofocal IOL (Tecnis 1), a monofocal IOL that provided some depth of focus (Eyhance), an extended depth of focus IOL based on refractive optics (Mini Well) and a trifocal IOL based on diffractive optics were used in this study (Tecnis Synergy). The surface topography of the IOLs was measured by using a multimode optical profilometer. Posterior surface of Tecnis 1 IOL was spherical and the anterior surface aspherical. In the Eyhance IOL, posterior surface was spherical and anterior surface did not fit to any of our reference surfaces, indicating a higher order aspheric surface design. In the Mini Well Ready IOL, a best-fit sphere surface was obtained for the second surface and a high order aspherical surface design was deduced for the first surface. The anterior surface of the Synergy IOL was aspherical and the base curve of the diffractive structure fitted very well to a spherical surface. To consider an aspheric surface as possible best-fit surface provided more information than if only best-fit spherical surface was considered. The high order aspheric surface designs employed in the IOLs studied presented differences, regarding best-fit asphere surface, higher than 1 micron. These differences were correlated with the generation of spherical aberration complex profiles (with Zernike terms higher than 4th order) and with the production of distinct amounts of depth of focus. This method was also useful to deduce the base curve of diffractive surfaces.
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Affiliation(s)
- Juan J Miret
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig s/n 03016, San Vicente del Raspeig, Alicante, Spain
| | - Vicente J Camps
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig s/n 03016, San Vicente del Raspeig, Alicante, Spain.
| | - Celia García
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig s/n 03016, San Vicente del Raspeig, Alicante, Spain
| | - Maria T Caballero
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig s/n 03016, San Vicente del Raspeig, Alicante, Spain
| | - Juan M Gonzalez-Leal
- Department of Condensed Matter Physics, Faculty of Sciences, University of Cadiz, Cadiz, Spain
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Fernández-Vega-Cueto L, Madrid-Costa D, Alfonso-Bartolozzi B, Vega F, Millán MS, Alfonso JF. Optical and Clinical Outcomes of an Extended Range of Vision Intraocular Lens. J Refract Surg 2022; 38:168-176. [PMID: 35275001 DOI: 10.3928/1081597x-20220104-01] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess the in vitro optical quality and halo formation of the AcrySof IQ Vivity intraocular lens (IOL) (Alcon Laboratories, Inc) and to evaluate the clinical outcomes in patients who had bilateral implantation of this IOL. METHODS The optical quality was evaluated with the PMTF optical bench (Lambda-X). Through-focus modulation transfer function area (MTFa) curves between -5.00 and +2.00 diopters (D) were obtained for 3- and 4.5-mm pupil apertures. The halo was assessed in vitro with a test bench. The clinical study included 30 patients. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity and binocular defocus curve were evaluated 6 months postoperatively. RESULTS The through-focus MTFa curve for the 4.5-mm pupil size showed only one peak at distance focus (38.4 units). For the 3-mm pupil size, the through-focus MTFa showed a lower peak of MTFa (28.9 units), located at -0.70 D, and an extended depth of focus up to -2.20 D. The halo formed was larger and more intense compared to a standard monofocal IOL. The clinical outcomes at 6 months revealed satisfactory visual acuity outcomes. All patients achieved a binocular CDVA of 0.1 logMAR or better. The mean visual acuity was better than 0.2 logMAR between +1.00 and -2.00 D of defocus. At a vergence of -2.50 D, the visual acuity was 0.31 ± 0.09 logMAR. CONCLUSIONS The AcrySof IQ Vivity IOL provided good distance optical and visual quality and an extended range of focus of approximately 2.00 D, obtaining an optimal or functional visual acuity up to 50 to 40 cm. The halo formed was low intensity overall, but higher intensity than a monofocal IOL. [J Refract Surg. 2022;38(3):168-176.].
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Nanavaty MA, Ashena Z, Gallagher S, Borkum S, Frattaroli P, Barbon E. Visual Acuity, Wavefront Aberrations, and Defocus Curves With an Enhanced Monofocal and a Monofocal Intraocular Lens: A Prospective, Randomized Study. J Refract Surg 2022; 38:10-20. [PMID: 35020542 DOI: 10.3928/1081597x-20211109-02] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare uniocular and binocular visual acuity, wavefront aberrations, and defocus curves using the TECNIS Eyhance (Johnson & Johnson) and RayOne (Rayner) intraocular lenses (IOLs). METHODS In this prospective, randomized, comparative study, 50 patients (100 eyes) were randomized to receive the same IOL bilaterally (ClinicalTrials.gov Identifier: NCT04175951). Follow-up visits were at 1 and 3 to 9 months postoperatively. Primary outcome measures were uncorrected distance (UDVA) and uncorrected intermediate (UIVA) visual acuity (logMAR) at 66 cm. Secondary outcome measures were corrected distance (CDVA) and distance-corrected intermediate (DCIVA) visual acuity at 66 cm, manifest refraction, spherical (Z40) and vertical coma (Z3-1) aberrations (total, internal eye, and corneal) at normal pupil size, defocus curves, and Catquest 9SF and Glare and Halos questionnaire on Likert scale (1 = no glare and halos and 4 = continuous). RESULTS Uniocular UDVA (P = .02), UIVA (P = .02), and binocular UIVA (P < .01) and uniocular (P = .01) and binocular (P < .01) DCIVA were better with the TECNIS Eyhance IOL at 3 to 9 months. At 3 to 9 months, both uniocular and binocular defocus curves were significantly broader with the TECNIS Eyhance IOL between -0.50 and -3.00 diopters (D). For total and internal eye, there was a statistically but clinically insignificant difference in Z40 with the TECNIS Eyhance IOL. Rasch scores improved (TECNIS Eyhance: 2.04 ± 1.34 to 2.91 ± 0.81 and RayOne:1.61 ± 1.35 to 2.97 ± 0.16) at 3 to 9 months. Refraction, Z3-1, glare, and halos were not different. CONCLUSIONS The TECNIS Eyhance IOL provided better DCIVA and broader defocus curves than the RayOne IOL. There was no difference in CDVA or patient-reported outcomes. Although there were some differences in aberrations when measured with normal pupil size, they were not clinically significant. [J Refract Surg. 2022;38(1):10-20.].
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Pastor-Pascual F, Gómez-Gómez A, Montés-Micó R, Ruiz-Mesa R, Tañá-Rivero P. Polychromatic through-focus image quality in a wavefront-shaping presbyopia correcting intraocular lens. EXPERT REVIEW OF OPHTHALMOLOGY 2022. [DOI: 10.1080/17469899.2022.2021878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | - Robert Montés-Micó
- Anterior Segment Unit, Oftalvist, Valencia, Spain
- Optics and Optometry and Vision Sciences Department, University of Valencia, Valencia, Spain
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Moser Wurth C, Lecumberri Lopez M. Visual performance of a new Extended Depth of Focus (EDOF) intraocular lens: Preliminary results. J Fr Ophtalmol 2022; 45:529-536. [DOI: 10.1016/j.jfo.2021.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 10/13/2021] [Indexed: 10/19/2022]
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Fernández J, Rodríguez-Vallejo M, Burguera N, Rocha-de-Lossada C, Piñero DP. Spherical aberration for expanding depth of focus. J Cataract Refract Surg 2021; 47:1587-1595. [PMID: 34128496 DOI: 10.1097/j.jcrs.0000000000000713] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/05/2021] [Indexed: 11/26/2022]
Abstract
The increase in the depth of focus (DoF) for the treatment of presbyopia or cataracts is a topic of great interest for anterior segment surgeons who have seen how new surgical possibilities to achieve DoF enlargement have emerged. Nowadays, several technologies to extend the DoF are available, from corneal laser refractive surgery procedures in presbyopia to intraocular lens (IOL) implantation in cataract or refractive lens exchange. Some of these procedures are based on aspheric profiles, either in the cornea or in the IOL, which modulate the spherical aberration (SA) and, therefore, extend the light energy on different focal planes. The aim of this narrative review was to give an overall picture about the reasons why there is not a general solution persistent along time of SA induction to extend DoF, especially considering that SA depends on pupil diameter and this decreases with age.
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Affiliation(s)
- Joaquín Fernández
- From the Department of Ophthalmology (Qvision), VITHAS Hospital, Almería, Spain (Fernández, Rodríguez-Vallejo, Burguera, Rocha-de-Lossada), the Department of Ophthalmology, Hospital Virgen de las Nieves, Av. de las Fuerzas Armadas, Granada, Spain (Rocha-de-Lossada), the Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain (Piñero), and the Department of Ophthalmology (IMQO-Oftalmar), Vithas Medimar International Hospital, Alicante, Spain (Piñero)
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Jeon YJ, Yoon Y, Kim TI, Koh K. Comparison Between an Intraocular Lens With Extended Depth of Focus (Tecnis Symfony ZXR00) and a New Monofocal Intraocular Lens With Enhanced Intermediate Vision (Tecnis Eyhance ICB00). Asia Pac J Ophthalmol (Phila) 2021; 10:542-547. [PMID: 34608065 PMCID: PMC8673848 DOI: 10.1097/apo.0000000000000439] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 08/24/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE This study compared the extended depth of focus (EDOF) intraocular lens (IOL) (ZXR00; Tecnis Symfony, Johnson & Johnson Vision, Santa Ana, CA, US) to a novel, higher-order aspheric monofocal IOL (ICB00; Tecnis Eyhance, Johnson & Johnson Vision, Santa Ana, CA, US) which uses the same platform and material. METHODS Medical records of patients undergoing cataract surgery with ZXR00 or ICB00 implantation between March 2020 and January 2021 and with the data available for the 3-month visit were reviewed. The uncorrected near, intermediate, and distance visual acuity (VA); corrected distance VA; and optical quality parameters were the main outcome measures. RESULTS Among the 174 enrolled patients, 72 and 102 received the ZXR00 and ICB00, respectively. The average patient ages were 59.6 ± 10.6 (range: 49 to 70) and 65.2 ± 8.2 (range: 45 to 82) years in the ZXR00 and ICB00 groups, respectively, with significantly older patients in the ICB00 group. The other baseline parameters were not different for the 2 groups. Compared to the ICB00 group, the ZXR00 group showed markedly superior near VA (P < 0.05) at 3 months postoperatively. In terms of optical quality, ICB00 was, statistically, significantly superior to ZXR00. CONCLUSIONS The ZXR00 showed remarkable near vision and defocus curve smoothness, while the ICB00 achieved better optical quality. The 2 IOLs had comparable distance and intermediate vision.
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Affiliation(s)
- Young Joon Jeon
- Department of Opthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Republic of Korea
| | - Yisang Yoon
- Department of Opthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Republic of Korea
| | - Tae-im Kim
- Department of Opthalmology, Severance Eye Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyungmin Koh
- Department of Opthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Republic of Korea
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Laboratory Investigation of Preclinical Visual-Quality Metrics and Halo-Size in Enhanced Monofocal Intraocular Lenses. Ophthalmol Ther 2021; 10:1093-1104. [PMID: 34689301 PMCID: PMC8589924 DOI: 10.1007/s40123-021-00411-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 10/08/2021] [Indexed: 11/12/2022] Open
Abstract
Introduction This study aims to compare preclinical visual-quality metrics and halo size of intraocular lenses (IOL) with enhanced intermediate vision to a standard monofocal lens. Methods Three monofocal- IOL models with an extended-depth-of-focus (EDoF) intended for monocular implantation (Tecnis ICB00, AE2UV/ZOE, and IsoPure) and one for monovision (RayOne EMV) were compared against a standard monofocal lens (Tecnis ZCB00). An optical-metrology station was used in the assessment of IOLs' optical quality in polychromatic light. The imaging quality was compared with metrics derived from the optical transfer function. Halo size was estimated from the projection of the point spread function under scotopic pupil. Results The monofocal IOL showed the highest image quality at the far focus. The ICB00’s, the AE2UV/ZOE’s, and the IsoPure’s performance at − 1D was superior to that of the monofocal lens. The monocular defocus tolerance of the RayOne EMV was comparable with that of the ZCB00. The RayOne EMV’s intermediate range was improved in a monovision configuration (− 1D offset). This approach, however, yielded the largest halo area, i.e., 53% of the ZCB00’s halo, compared to 34% for the IsoPure, 14% for the AE2UV/ZOE, and 8% for the ICB00. Conclusion The mono-EDoF models have a clear advantage over the standard monofocal lens by expanded imaging capability beyond − 0.5D. Although the RayOne EMV provided the largest (binocular) visual-range extension, it was at the expense of monocular vision and higher susceptibility to halo. The ICB00’s and the AE2UV/ZOE’s halo-profile was similar to that of the ZCB00, indicating their low potential to induce photic phenomena. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-021-00411-9.
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Huh J, Eom Y, Yang SK, Choi Y, Kim HM, Song JS. A comparison of clinical outcomes and optical performance between monofocal and new monofocal with enhanced intermediate function intraocular lenses: a case-control study. BMC Ophthalmol 2021; 21:365. [PMID: 34656091 PMCID: PMC8520272 DOI: 10.1186/s12886-021-02124-w] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 09/28/2021] [Indexed: 01/19/2023] Open
Abstract
Background To compare clinical outcomes and optical performance of a new monofocal with enhanced intermediate function intraocular lenses (IOLs) with that of conventional monofocal IOLs. Methods Sixty eyes of 30 patients who underwent phacoemulsification with bilateral implantation of the ICB00 (15 patients) or ZCB00 (15 patients) IOLs were enrolled. Binocular corrected distance visual acuity (CDVA), distance corrected near visual acuity (DCNVA), and distance corrected intermediate visual acuity (DCIVA) were measured at 4 weeks after surgery. Patient satisfaction for overall, near, intermediate, and distance vision were assessed. The binocular defocus curves were measured. The root mean square of modulation transfer function (MTFRMS) was measured in the optical bench study. Results The mean binocular DCIVA was significantly better in the ICB00 group (0.01 logMAR) compared to the ZCB00 group (0.13 logMAR), but CDVA and DCNVA were not. The patient satisfaction for near and intermediate vision was significantly higher in the ICB00 group compared to the ZCB00. However, there was no difference in patient satisfaction for overall and distance vision between two groups. The defocus curves showed that mean visual acuity of the ICB00 group was significantly better than that of the ZCB00 group at between − 1.00 D to − 3.00 D of defocus. The ICB00 IOL had higher MTFRMS values at between − 0.50 D to − 2.00 D of defocus compared to the ZCB00 IOL. Conclusions The ICB00 IOL provides better binocular intermediate vision and higher satisfaction for near and intermediate vision than the ZCB00 IOL while maintaining excellent distance vision.
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Affiliation(s)
- Jungah Huh
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea.,Department of Ophthalmology, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 08308, South Korea
| | - Youngsub Eom
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea.,Department of Ophthalmology, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do, Republic of Korea
| | - Seul Ki Yang
- Space Optics Laboratory, Department of Astronomy, Yonsei University, Seoul, Republic of Korea.,Satellite system 2 Team, Hanwha Systems Co., Ltd., Yongin-si, Gyeonggi-do, Republic of Korea
| | - Young Choi
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea.,Department of Ophthalmology, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do, Republic of Korea
| | - Hyo Myung Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jong Suk Song
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea. .,Department of Ophthalmology, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 08308, South Korea.
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Tañá-Sanz P, Rodríguez-Carrillo MD, Elvira-Giner B, Ruiz-Santos M, Montés-Micó R, Tañá-Rivero P. Enhanced Monofocal Extended Depth of Focus IOL With a Diffractive Surface Design. J Refract Surg 2021; 37:595-600. [PMID: 34506243 DOI: 10.3928/1081597x-20210518-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the refractive and visual outcomes following cataract surgery and implantation of a new enhanced monofocal extended depth of focus (EDOF) intraocular lens (IOL). METHODS Fifty eyes of 25 consecutive patients who underwent implantation of the xact Mono-EDoF IOL (Santen Pharmaceutical Co, Ltd) were enrolled in this study. Main outcome measures were refractive error and monocular corrected (CDVA) and uncorrected (UDVA) distance visual acuity values. Monocular visual acuity at different vergences (defocus curve) was obtained. Patients were evaluated at 12 months postoperatively. RESULTS At 1 year of follow-up, all eyes showed a postoperative spherical equivalent within ±1.00 diopters (D) and 95% of eyes within ±0.50 D. The mean postoperative spherical equivalent was -0.15 ± 0.28 D. A total of 88% and 100% of eyes showed UDVA and CDVA of 20/25 or better, respectively. The mean values of UDVA and CDVA (Snellen decimal) were 0.94 ± 0.09 (range: 0.70 to 1.00) and 0.99 ± 0.03 (range: 0.79 to 1.00), respectively. Defocus curve showed good visual acuity at distance and intermediate distances with a depth of focus value of 1.25 D. No visual disturbances were reported in the whole sample during the entire follow-up. CONCLUSIONS The current study shows that this EDOF IOL provides good visual performance at far and intermediate distances. The lens may be considered for patients interested in reducing spectacle independence at intermediate distances. [J Refract Surg. 2021;37(9):595-600.].
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Kang KH, Song MY, Kim KY, Hwang KY, Kwon YA, Koh K. Visual Performance and Optical Quality after Implantation of a New Generation Monofocal Intraocular Lens. KOREAN JOURNAL OF OPHTHALMOLOGY 2021; 35:112-119. [PMID: 33845556 PMCID: PMC8046615 DOI: 10.3341/kjo.2020.1115] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/21/2021] [Indexed: 11/26/2022] Open
Abstract
Purpose To evaluate the performance of two intraocular lenses (IOLs). The new monofocal IOL using a higher-order aspheric optic (Tecnis Eyhance ICB00) was compared to a standard monofocal IOL (Tecnis monofocal ZCB00) of the identical platform and material. Methods The medical records of the patients who had undergone cataract surgery with implantation of either the ZCB00 or the ICB00 in the dominant eye from March 2020 to August 2020 and with available data from the 3-month visit were reviewed. Subjects with ocular comorbidities or corneal astigmatism greater than 1.00 diopters were excluded. The uncorrected near, intermediate, distance visual acuity and corrected distance visual acuity were the main outcome measures. Optical quality parameters measured using an optical quality analysis system, clinical records including age, sex, laterality, ocular dominance, and information related to refractory errors was also collected. Parameters related to the refractory errors were all uniformly based on the Barrett Universal II formula. Results Of the 197 recruited patients, 111 and 86 were implanted with the ICB00 and ZCB00, respectively. No statistically significant differences in baseline parameters were observed between the two groups. While no statistically significant differences in distance visual acuity or optical quality were found between the two groups, compared to the ZCB00 group, the ICB00 group showed significantly higher intermediate visual acuity (p < 0.001) and near visual acuity (p < 0.05) 3 months postoperatively. Conclusions ICB00 provided superior intermediate vision and comparable distance performance and photic phenomena compared to a standard monofocal IOL.
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Affiliation(s)
- Kyoung Hae Kang
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
| | - Mi Yeon Song
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
| | - Kook Young Kim
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
| | - Kyu-Yeon Hwang
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
| | - Young-A Kwon
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
| | - Kyungmin Koh
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
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