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Cerviño A, Esteve-Taboada JJ, Chiu YF, Yang CH, Tseng WC, Lee W. Tolerance to decentration of biaspheric intraocular lenses with refractive phase-ring extended depth of focus and diffractive trifocal designs. Graefes Arch Clin Exp Ophthalmol 2024; 262:2541-2550. [PMID: 38526773 PMCID: PMC11271318 DOI: 10.1007/s00417-024-06458-1] [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: 09/24/2023] [Revised: 02/04/2024] [Accepted: 03/16/2024] [Indexed: 03/27/2024] Open
Abstract
PURPOSE This study aimed to investigate the in vitro tolerance to decentration of biaspheric intraocular lens (IOLs) with refractive phase-ring extended depth-of-focus (EDOF) and diffractive trifocal designs. METHODS This experimental study was carried out at the Department of Optics and Optometry and Vision Science, University of Valencia, Spain. The modulation transfer function (MTF) of the ETLIO130C EDOF and the TFLIO130C trifocal IOLs (AST Products Inc., Billerica, MA, USA) were determined at different levels of decentration for a given wavelength and pupil diameter using the PMTF optical bench (Lambda-X Ophthalmics, Nivelles, Belgium). The modulation transfer function (MTF) curves, the through-focus MTF curves, and the Strehl ratios were measured at 3-mm pupil aperture for 0.25-, 0.50- and 0.75-mm decentration. RESULTS The optical design of the trifocal TFLIO130C IOL is robust to small decentrations, with virtually no change in MTF response for 0.25 mm decentration. For greater decentration levels, the MTF response is slightly reduced with increasing decentration. The ETLIO130C EDOF design is robust to decentration, as the MTF response is only minimally affected when increasing the decentration up to 0.75 mm. CONCLUSIONS MTF responses are slightly reduced with greater levels of decentration, but the range of focus provided by both trifocal and EDOF designs are preserved. The effects for average levels of decentration reported in the literature are minimum for both IOL designs.
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Affiliation(s)
- Alejandro Cerviño
- Department of Optics & Optometry & Vision Sciences, University of Valencia, C / Dr. Moliner, 50., 46100, Burjassot, Valencia, Spain.
| | - Jose Juan Esteve-Taboada
- Department of Optics & Optometry & Vision Sciences, University of Valencia, C / Dr. Moliner, 50., 46100, Burjassot, Valencia, Spain
| | | | | | - Wen-Chu Tseng
- ICARES Medicus, Inc, Hsinchu County, Taiwan
- AST Products, Inc, Billerica, MA, USA
| | - William Lee
- ICARES Medicus, Inc, Hsinchu County, Taiwan
- AST Products, Inc, Billerica, MA, USA
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You J, Jang M. Influence of corneal astigmatism on near and far vision in eyes with bifocal intraocular lenses. JOURNAL OF THE OPTICAL SOCIETY OF AMERICA. A, OPTICS, IMAGE SCIENCE, AND VISION 2024; 41:730-738. [PMID: 38568674 DOI: 10.1364/josaa.517377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/12/2024] [Indexed: 04/05/2024]
Abstract
Here, we present a full wave propagation model that quantitatively assesses the effect of astigmatism on visual functions in eyes with diffractive bifocal IOLs. The proposed model with bifocal IOLs evaluated the image quality of each focus at varying degrees of corneal astigmatism with the metrics of modulation transfer function and light-in-the-bucket. The results show that corneal astigmatism alters the distance-near image quality balance. Positive (negative) astigmatism has more detrimental effects on far (near) vision. Additionally, bifocal IOLs are more vulnerable to corneal astigmatism, highlighting the need to consider multifocal toric IOLs with astigmatism greater than 1.0 D. The numerical results closely agreed with previous relevant clinical findings, suggesting the clinical usability of the presented method in predicting the postoperative visual function of patients.
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Farag CS, Gouda J, Maher S, El-Fayoumi D, Elhilali H. Incidence and predisposing factors of intraocular Lens tilt following secondary ciliary sulcus implantation in children: An ultrasound biomicroscopic study. Eur J Ophthalmol 2024:11206721241229468. [PMID: 38303122 DOI: 10.1177/11206721241229468] [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: 02/03/2024]
Abstract
PURPOSE To evaluate the incidence and causes of intraocular lens (IOL) tilt and changes in anterior chamber angle after secondary IOL sulcus implantation following congenital cataract removal. METHODS A retrospective observational study was conducted on children who underwent secondary sulcus IOL implantation following pediatric cataract removal in the period from 2017-2020 in Cairo university Hospitals. Children were examined for IOL position, centration, and tilt. Intraocular pressure (IOP) measurement, fundus and gonioscopic examination was performed. Ultrasound biomicroscopy (UBM) was performed on both eyes in children with clinically detected tilt. RESULTS Ciliary sulcus secondary IOL implantation was performed in 102 eyes (57 children). IOL tilt was detected clinically in 16 eyes of 14 children (15.7%). UBM showed clinically undetected tilt in the fellow eye in additional 4 eyes. The mean angle of tilt was 12.8 ± 3.9° in clinically detected tilt compared to 7.5 ± 1.2° in UBM detected tilt. Mean anterior chamber depth (ACD) was 2.4 ± 0.5 mm IOP was >21 mmHg in 1.9% of eyes. Narrowing of the anterior chamber angle (ACA) after sulcus implantation occurred in 40% of eyes with open angle. Sulcus proliferations and obliterated sulcus were detected in all 20 eyes. Sommering's ring was found in 7 eyes (35%). Axial length, corneal diameter, and presence of persistent fetal vasculature did not affect IOL position. CONCLUSION The presence of residual lens matter or an obliterated ciliary sulcus is associated with a higher incidence of IOL malposition following ciliary sulcus implantation.
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Affiliation(s)
| | - Jylan Gouda
- Ophthalmology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Sara Maher
- Ophthalmology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dina El-Fayoumi
- Ophthalmology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hala Elhilali
- Ophthalmology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Can E, Senel EC, Holmström STS, Piñero DP. Comparison of the optical behaviour of five different multifocal diffractive intraocular lenses in a model eye. Sci Rep 2023; 13:19646. [PMID: 37950090 PMCID: PMC10638301 DOI: 10.1038/s41598-023-47102-y] [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: 04/21/2023] [Accepted: 11/09/2023] [Indexed: 11/12/2023] Open
Abstract
The purpose of this study was to investigate and compare the optical performance of five trifocal intraocular lenses (IOLs) following the ISO 11979-2 standards, analysing the impact of tilt and decentration. Five different diffractive trifocal IOLs were evaluated in this experimental study: Acriva Trinova (VSY-Biotechnology) (AT), FineVision HP (PhysIOL) (FVHP), AT LISA tri 839 MP (Zeiss) (ATLT), PanOptix TFNT00 IOL (Alcon) (PO), and Tecnis Synergy (J&J Vision) (TS). In-vitro optical quality analysis of them was performed with the Lambda PMTF system that has an aberration neutral cornea model (Lambda-X Ophthalmics). Measurements were performed on-axis, with 5º of IOL tilt and with 0.5 mm of IOL decentration using 543-nm monochromatic light. Finally, IOL dimensions and diffractive disk profile inspection was performed using the VisIOLA system (Rotlex). On-axis measurements showed a far through-focus MTF > 0.3 at 3 mm aperture, except for TS. FVHP and PO showed better far MTFs for larger apertures (3.75 mm and 4.5 mm) while AT showed good intermediate and near vision for such apertures. With 5º of IOL tilt, the better optical performance at all distances was found with AT for medium-sized pupils (3 mm) and an important reduction of MTF was found for ATLT and PO, especially in the intermediate focus. The induction of 0.5 mm of IOL decentration especially affected the intermediate focus of ATLT and TS and the far focus of FVHP and PO. IOL dimensions and diffractive profile were consistent with those described by the manufacturer. In conclusion, there are differences in the optical performance according to the pupil aperture of the five trifocal IOLs evaluated and this should be considered in clinical practice when selecting the most appropriate implant in each specific case. IOL tilt and decentration can affect significantly in most of the designs evaluated the performance of the IOL at intermediate vision range. It should be noted that measurements were made with an aberration-free cornea, being necessary future studies analysing the impact of different levels of corneal aberrations.
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Affiliation(s)
- Efe Can
- R & D Department, VSY Biotechnology GMBH, Esslinger Str. 7, 70771, Leinfelden Echterdingen, Germany
| | - Esat Can Senel
- R & D Department, VSY Biotechnology GMBH, Esslinger Str. 7, 70771, Leinfelden Echterdingen, Germany
| | - Sven T S Holmström
- R & D Department, VSY Biotechnology GMBH, Esslinger Str. 7, 70771, Leinfelden Echterdingen, Germany
| | - David P Piñero
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig S/N, 03690, San Vicente del Raspeig, Alicante, Spain.
- Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain.
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Comparative visual outcomes of EDOF intraocular lens with FLACS vs conventional phacoemulsification. J Cataract Refract Surg 2023; 49:55-61. [PMID: 36104008 PMCID: PMC9788925 DOI: 10.1097/j.jcrs.0000000000001027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 07/20/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE To investigate the visual quality after femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification surgery (CPS) with the implantation of an extended depth-of-focus (EDOF) intraocular lens (IOL) TECNIS Symfony. SETTING Eye Center, the Second Affiliated Hospital of Zhejiang University, Zhejiang, China. DESIGN Prospective cohort study. METHODS Patients were given the option to choose FLACS or CPS and were implanted with a TECNIS Symfony. Main outcome measures were postoperative examinations that included defocus curves, contrast sensitivity (CS), optic path difference aberrometry scan, anterior segment photography, and questionnaires. RESULTS 261 patients (261 eyes) were enrolled. The circularity index of FLACS was more precise than that of CPS ( P = .001). FLACS demonstrated a significantly lower IOL decentration ( P = .011) and IOL tilt ( P = .009). FLACS presented a significantly lower total aberration ( P < .001), higher-order aberrations (HOAs) ( P = .001), coma ( P = .001), and spherical aberration ( P < .001). With IOL decentration of more than 0.40 mm, total internal aberration ( P = .023) and HOAs ( P = .045) were significantly deteriorated. As for defocus curve, FLACS was better at -1.00 diopter ( P < .01). The FLACS group achieved higher CS at 6 to 18 cycles per degree under glare condition ( P < .05). With regard to photic phenomena, the FLACS group received better outcomes ( P < .05). CONCLUSIONS With the implantation of an EDOF IOL, FLACS could precisely control the shape and size of the capsulotomy and induce a significantly better-centered IOL, leading to higher visual performance compared with CPS.
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Wang D, Liu C, Guan W, Lu Z, Zhao Y, Zhao Y. Effect of larger corneal spherical aberration in improving the near visual acuity of eyes implanted with the TECNIS Symfony. Front Med (Lausanne) 2023; 10:1094966. [PMID: 36910491 PMCID: PMC9995440 DOI: 10.3389/fmed.2023.1094966] [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: 11/10/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023] Open
Abstract
Purpose To explore the effect of corneal spherical aberration on the visual acuity and visual quality of eyes implanted with the TECNIS Symfony intraocular lens (IOL). Methods A total of 43 patients with age-related cataract (60 eyes) undergoing phacoemulsification and TECNIS Symfony IOL implantation were enrolled in this study. The uncorrected distance (UDVA), intermediate (UIVA), near visual acuity (UNVA), corrected distance visual acuity (CDVA), contrast sensitivity, and ocular spherical aberration were recorded 3 months after surgery. Preoperative and postoperative corneal spherical aberration were also measured using the iTrace device. Objective scattering index (OSI), modulation transfer function cut-off frequency (MTF cut-off), and Strehl ratio (SR) were measured by the Optical Quality Analyzing System. Catquest-9SF questionnaire were applied too. Spearman's correlation analysis was used to evaluate the relationship between spherical aberration and visual quality parameters. Results Patients were satisfied with their postoperatively visual quality. And the postoperative logMAR UDVA, UIVA, UNVA, and CDVA was 0.05 ± 0.07, 0.04 ± 0.06, 0.15 ± 0.07, and 0.03 ± 0.05, respectively. The mean preoperative corneal spherical aberration was 0.24 ± 0.10 μm, which is the only factor influencing postoperatively UNVA, and it was negatively correlated with UNVA and glare contrast sensitivity under 18 cpd (cycle/degree, cpd) spatial frequency (r = -0.403, -0.300, -0.360; all P < 0.05). Additionally, the greater the residual spherical aberration of the cornea, the better the near vision after operation. The mean postoperative ocular spherical aberration was -0.03 ± 0.07 μm, it was not correlated with visual acuity, contrast sensitivity, and visual quality (all P > 0.05). Conclusion Preoperative positive spherical aberration can benefit near vision while decrease contrast sensitivities at high spatial frequencies when implanted with the TECNIS Symfony IOL.
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Affiliation(s)
- Dandan Wang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Disease, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chunlu Liu
- Zhejiang University School of Medicine Children's Hospital, Hangzhou, Zhejiang, China
| | - Weichen Guan
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ziyi Lu
- Joint Shantou International Eye Center (JSIEC), The Shantou University, The Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Yinying Zhao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Disease, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yune Zhao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Disease, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
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In Vitro Chromatic Performance of Three Presbyopia-Correcting Intraocular Lenses with Different Optical Designs. J Clin Med 2022; 11:jcm11051212. [PMID: 35268303 PMCID: PMC8910850 DOI: 10.3390/jcm11051212] [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: 01/19/2022] [Revised: 02/20/2022] [Accepted: 02/22/2022] [Indexed: 01/05/2023] Open
Abstract
Most of the new premium models of intraocular lenses for presbyopia correction use diffractive optics in their optical design. The presence of multiple foci and the difference of the diffractive efficiency for different wavelengths have a great impact in the lens optical performance. In this context, there is a limited information available for clinicians to understand the optical principles that differentiate each design and their potential influence on clinical outcomes. Optical bench studies with polychromatic light are necessary to solve this limitation. In this work, a custom made optical bench was employed to assess with polychromatic light the through the focus optical quality of three different IOL designs: trifocal, EDOF effect; and enhanced monofocal. By using different and complimentary approaches: images of the USAF test, axial PSFs and TF-MTFs, each design revealed its intrinsic features, which were not previously reported for these IOLs models in a comparative way. It was found that the chromatic aberration plays a very important role in the performance of each IOL. Our results could help clinicians to understand the optical principle of each lens and also provide useful information for choosing the lens that best suits the needs of the individual patient.
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