1
|
Paredes B, Mora J, Martín MD, Larrosa A, Piñero DP. Short-term clinical results with a trifocal diffractive toric intraocular lens using an optimized preoperative and intraoperative protocol. Eur J Ophthalmol 2024; 34:146-153. [PMID: 37093755 DOI: 10.1177/11206721231171427] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
PURPOSE To evaluate the short-term clinical outcomes of a specific toric diffractive trifocal intraocular lens (IOL) implanted following an optimized clinical protocol in a large population. METHODS Retrospective analysis of 337 eyes of 231 patients (mean age, 62.2 years) undergoing cataract surgery with implantation of the trifocal diffractive IOL AT.LISA tri toric 939M/MP (Carl Zeiss Meditec). A strict and careful clinical protocol was followed, including an accurate measurement of corneal astigmatism, use of a latest generation IOL power calculator, photography-based method intraoperative control of IOL alignment and IOL reposition at 1 week postoperatively if needed. Clinical outcomes in terms of visual acuity, refraction, efficacy of astigmatic correction analysed by vector analysis and patient satisfaction were evaluated during a 3-month follow-up. RESULTS A total of 82% and 98% of eyes achieved a postoperative uncorrected distance visual acuity of 0.00 and 0.10 logMAR or better, respectively. Furthermore, 99.7%, and 100.0% of eyes showed a postoperative spherical equivalent within ± 0.50 D and ± 1.00 D, with 97.9% of eyes having a postoperative cylinder ≤ 0.50 D. Uncorrected near and intermediate visual acuities were 0.2 logMAR or better in 89.0% and 99.1% of eyes, respectively. Mean difference vector, magnitude of error and angle of error were 0.02 ± 0.14 D, 0.02 ± 0.13 D and 0.11 ± 1.18°. Patient satisfaction was referred as high or very high by 97.6% of patients. CONCLUSIONS The implantation of the trifocal toric IOL evaluated following a careful clinical protocol provides an efficacious visual rehabilitation and astigmatic correction, leading to high levels of patient satisfaction.
Collapse
Affiliation(s)
| | | | | | | | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| |
Collapse
|
2
|
Fernández J, Srinivasan S, Burguera N, Martínez J, Rodríguez-Vallejo M. One-year follow-up of a multifocal intraocular lens with optimized elevated phase shift. J Cataract Refract Surg 2023; 49:1018-1024. [PMID: 37464551 DOI: 10.1097/j.jcrs.0000000000001266] [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] [Received: 03/24/2023] [Accepted: 07/13/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE To evaluate the standard outcomes of a multifocal intraocular lens (mIOL) with optimized elevated phase shift (EPS). SETTING Qvision, Ophthalmology Department, VITHAS Almería, Spain. DESIGN Retrospective observational. METHODS 41 patients, consecutively operated on cataracts or refractive lens exchange with the implantation of the Liberty 640PM (EPS 2.0) and followed during 12 months, were included in the analysis. Retrieved variables were visual acuities at far, intermediate, and near distances; defocus curves (VADC); and prediction error of 4 formulas optimized for IOLMaster 500 and Pentacam AXL Wave. Patient-reported outcomes were also obtained for assessing spectacle independence, satisfaction, bothersome to dysphotopsia, difficulties in daily life tasks, and decision to be operated with the same mIOL. RESULTS The median monocular efficacy with best distance correction was 0, 0.1, and 0.1 logMAR at far, intermediate, and near distances, respectively, with patients achieving binocularly a median of 0 logMAR at the 3 distances. VADC showed a depth of field of 3 diopters (D) above 0.2 logMAR with a median increase of 0.07 logMAR from -1.5 to -2.5 D. Complete spectacle independence was achieved at far distance, whereas 97.6% and 85.4% was achieved at intermediate and near distances, respectively. 7.3% of patients were bothered by dysphotopsia, and 92.6% of patients were likely to be operated again. CONCLUSIONS EPS 2.0 restored patients' vision in the full range of the depth of field with a nearly monotone decrease of visual performance from far to near, achieving high rates of spectacle independence at all distances and with low positive dysphotopsia rates ( ClinicalTrials.gov Identifier: NCT05735990).
Collapse
Affiliation(s)
- Joaquín Fernández
- From the Qvision, Department of Ophthalmology, VITHAS Almería Hospital, Almería, Spain (Fernández, Burguera, Martínez, Rodríguez-Vallejo); Department of Ophthalmology, University Hospital Ayr, Ayr, Scotland (Srinivasan)
| | | | | | | | | |
Collapse
|
3
|
Fernández J, Burguera N, Rocha-de-Lossada C, Rachwani-Anil R, Rodríguez-Vallejo M. Objective cataract grading methods and expected contrast sensitivity reestablishment with multifocal intraocular lenses. Int Ophthalmol 2023; 43:2825-2832. [PMID: 36871115 DOI: 10.1007/s10792-023-02680-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 02/25/2023] [Indexed: 03/06/2023]
Abstract
PURPOSE To determine the cut-off points for age and metrics provided by cataract grading objective systems for which a reestablishment in contrast sensitivity (CS) is expected after multifocal intraocular lens (MIOL) implantation. METHODS One hundred seven subjects were included in this retrospective analysis carried out during the screening for presbyopia and cataract surgery. Monocular distance corrected contrast sensitivity defocus curve (CSDC) and visual acuity were measured, and crystalline lens sclerosis was graded with three objective metrics: Ocular Scatter Index (OSI), Dysfunctional Lens Index (DLI) and Pentacam Nucleus Staging (PNS). A CS value of 0.8 logCS at far distance, following published literature on this matter, was selected to compute the cut-off that maximized the detection of eyes exceeding this value at the preoperative screening, either for age or objective metrics. RESULTS The CDCS showed a stronger correlation than CDVA with objective grading methods, whereas all objective metrics were significantly correlated between them (p < 0.05). The cut-offs for age, OSI, DLI and PNS were ≤ 62, ≤ 1.25, ≥ 7.67 and ≤ 1, respectively. The OSI provided the highest area under the receiver operating characteristic curve (0.85) followed by the age (0.84), DLI (0.74) and PNS (0.63). CONCLUSIONS Surgeons conducting clear lens exchange should communicate the possible distance CS loss after surgery with MIOL implantation according to the previous described cut-offs points. Age in combination with any cataract grading objective system is recommended to detect possible inconsistencies.
Collapse
Affiliation(s)
- Joaquín Fernández
- Qvision, Department of Ophthalmology, VITHAS Almería Hospital, 04120, Almería, Spain
| | - Noemí Burguera
- Qvision, Department of Ophthalmology, VITHAS Almería Hospital, 04120, Almería, Spain
| | - Carlos Rocha-de-Lossada
- Qvision, Department of Ophthalmology, VITHAS Almería Hospital, 04120, Almería, Spain
- Hospital Regional Universitario de Málaga, Plaza del Hospital Civil, S/N., 29009, Málaga, Spain
- Departamento de Cirugía, Universidad de Sevilla, Área de Oftalmología, Doctor Fedriani, S/N, 41009, Sevilla, Spain
| | - Rahul Rachwani-Anil
- Hospital Norte de Málaga, Avenida Poeta Muñoz Rojas, s/n, Málaga, 29200, Antequera, Spain
| | | |
Collapse
|
4
|
Zhang L, Shen W, Shen J, Wang M, Ni S, Guo H, Yang J. Effect of postoperative residual astigmatism on visual outcomes after trifocal intraocular lens implantation. Front Med (Lausanne) 2023; 10:1202793. [PMID: 37497270 PMCID: PMC10368131 DOI: 10.3389/fmed.2023.1202793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 06/22/2023] [Indexed: 07/28/2023] Open
Abstract
Purpose The aim of this study was to evaluate the effect of residual astigmatism on postoperative visual outcomes after trifocal intraocular lens implantation. Methods In this prospective observational study, we divided 156 eyes into two groups according to postoperative astigmatism measured by subjective optometry and followed them up for 3 months. Visual acuity, modulation transfer function (MTF) curves, Strehl ratio (SR), Visual Function Index-14 scores, and photic phenomena were compared. Results Linear regression analysis revealed a weak correlation between residual astigmatism and uncorrected distance visual acuity (UDVA) (r = 0.190, P = 0.016) at 3 months and a significant between-group difference at 1- and 3-month postoperative UDVA (P = 0.038, P = 0.018, respectively). MTF curve values and SR (MTF-10 total, MTF-10 cornea, MTF-30 total, MTF-30 cornea, SR Total, and SR cornea) were significantly worse (P < 0.001), and the Visual Function Index-14 scores were lower in the 0.5 < astigmatism ≤ 1.25 D group (P < 0.05) than in the astigmatism ≤ 0.5 D group. No significant differences were found in the frequency, severity, and bothersomeness of photic phenomena (P > 0.05). Conclusion Postoperative residual astigmatism affects the UDVA of the trifocal intraocular lens-implanted eyes. Although we found no significant differences in uncorrected intermediate and near visual acuity, both objective and subjective visual quality were affected, suggesting the need for surgical planning when the anticipated postoperative astigmatism is >0.5 D.
Collapse
Affiliation(s)
- Limei Zhang
- Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China
| | - Wenqian Shen
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
- Key National Health Committee Laboratory of Myopia, Fudan University, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Jiying Shen
- Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China
| | - Min Wang
- Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China
| | - Shuang Ni
- Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China
| | - Haike Guo
- Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China
| | - Jin Yang
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
- Key National Health Committee Laboratory of Myopia, Fudan University, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| |
Collapse
|
5
|
Reinstein DZ, Archer TJ, González-Méijome JM, Vida RS, Gupta R. Changes in Light Disturbance Analyzer Evaluation in SMILE for High Myopia and Astigmatism. J Refract Surg 2022; 38:725-732. [DOI: 10.3928/1081597x-20221019-02] [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]
|
6
|
Semiz F, Lokaj AS, Musa NH, Semiz CE, Demirsoy ZA, Semiz O. SMILE for the Treatment of Residual Refractive Error After Cataract Surgery. Ophthalmol Ther 2022; 11:1539-1550. [PMID: 35643966 PMCID: PMC9253212 DOI: 10.1007/s40123-022-00526-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/09/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION In the context of managing patients' expectations and satisfaction regarding visual acuity after cataract surgery, we aimed to investigate the improvement in visual acuity and patient satisfaction after small-incision lenticule extraction (SMILE) in pseudophakic (trifocal intraocular lens, IOL) patients with residual myopic refraction after cataract surgery. METHODS Seventy-six patients (82 eyes) who underwent cataract surgery with ZEISS AT LISA tri 839MP IOL implantation were included in this retrospective study. The included patients were 56-79 years old, wanted spectacle independence, and had preoperative myopic refraction between - 1.0 and - 2.25 diopters (D) and astigmatism between - 0.75 and - 1.75 D. The treatment status of these patients was defined as trifocal IOL (n = 82). SMILE was performed in patients who were dissatisfied after cataract surgery, and these patients were followed up for 1 year on average. We evaluated visual acuity and satisfaction and further examined laser vision correction and satisfaction levels in patients who were dissatisfied after trifocal IOL implantation. RESULTS The possible reasons for patient dissatisfaction were reading books, using a computer, and driving at night. After SMILE, the residual myopic refractive error (spherical) decreased significantly from - 2.08 ± 0.28 [- 2.25 to - 1.0] preoperatively to - 0.25 ± 0.20 - 0.5 to 0] 1 year postoperatively (p < 0.001). Additionally, the uncorrected distance visual acuity increased from 0.65 ± 0.08 [0.52-0.7] logMAR preoperatively to 0.09 ± 0.02 [0.05-0.1] logMAR at 1 month postoperatively (p < 0.001), 0.09 ± 0.02 [0.05-0.1] logMAR at 6 months postoperatively, and 0.06 ± 0.02 [0.05-0.1] logMAR at 12 months postoperatively (p < 0.001). Patient satisfaction measures after SMILE (reading, night driving, and using a computer) were significantly improved. CONCLUSION SMILE is a reliable method for treating residual refraction after cataract surgery, as it provides results in the shortest time without complications and increases patient satisfaction. TRIAL REGISTRATION The protocol was registered on clinicaltrials.gov (NCT04693663).
Collapse
Affiliation(s)
- Faruk Semiz
- Department of Ophthalmology, Eye Hospital, Prishtina, Kosova.
| | | | | | | | | | - Olcay Semiz
- Department of Ophthalmology, Eye Hospital, Prishtina, Kosova
| |
Collapse
|
7
|
Russo A, Reinstein DZ, Filini O, Archer TJ, Boldini A, Cardin G, Festa G, Morescalchi F, Salvalai C, Semeraro F. Visual and Refractive Outcomes Following Laser Blended Vision With Non-linear Aspheric Micro-anisometropia (PRESBYOND) in Myopic and Hyperopic Patients. J Refract Surg 2022; 38:288-297. [PMID: 35536710 DOI: 10.3928/1081597x-20220323-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To report 6-month visual and refractive outcomes following PRESBYOND Laser Blended Vision (Carl Zeiss Meditec) treatment using non-linear aspheric micro-anisometropia laser in situ keratomileusis (LASIK) for the correction of myopic and hyperopic presbyopia. METHODS A retrospective, non-comparative study of 139 consecutive patients with a mean age of 53.13 ± 5.84 years (range: 42 to 70 years) treated with LASIK-induced micro-anisometropia using the MEL 90 excimer laser and VisuMax femtosecond laser (both Carl Zeiss Meditec). The target refraction was plano for distance eyes (dominant eye) and between -0.50 and -1.50 diopters (D) for near eyes. Patients were observed for 6 months. RESULTS A total of 278 eyes (78 myopic and 200 hyperopic) from 139 patients completed the study. Mean preoperative spherical equivalent (SE) was -3.40 ± 1.83 D (range: -0.50 to -8.25 D) for myopic eyes and +1.61 ± 0.98 D (range: -1.25 to +4.63 D) for hyperopic eyes. Mean postoperative SE refraction of distance eyes was +0.20 ± 0.35 D (range: -0.38 to +1.00 D) and -0.14 ± 0.42 D (range: -1.38 to +0.88 D) for myopic and hyperopic eyes, respectively. Mean postoperative SE refraction of near eyes was -0.90 ± 0.44 D (range: -0.13 to -2.25 D) and -1.21 ± 0.48 D (range: -0.13 to -2.25 D) for myopic and hyperopic eyes, respectively. Mean binocular uncorrected near visual acuity was 0.70 ± 0.28 logMAR (range: 0.32 to 1.00 logMAR) and 0.79 ± 0.27 logMAR (range: 0.25 to 1.00 logMAR) for myopic and hyperopic eyes, respectively. Mean binocular uncorrected distance visual acuity was 1.19 ± 0.18 logMAR (range: 0.63 to 1.25 logMAR) and 1.14 ± 0.26 logMAR (range: 0.40 to 1.25 logMAR) for myopic and hyperopic eyes, respectively. Stereoacuity was better than 100 seconds of arc in 79% of myopic eyes and 85% of hyperopic eyes and all vision quality scores were greater than 90 of 100. No eyes lost two or more lines. CONCLUSIONS The non-linear aspheric micro-anisometropia protocol resulted in safe and effective visual outcomes in patients with both myopic and hyperopic presbyopia. [J Refract Surg. 2022;38(5):288-297.].
Collapse
|