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Danzinger V, Schartmüller D, Schwarzenbacher L, Röggla V, Abela-Formanek C, Menapace R, Leydolt C. Clinical prospective intra-individual comparison after mix-and-match implantation of a monofocal EDOF and a diffractive trifocal IOL. Eye (Lond) 2024; 38:321-327. [PMID: 37524833 PMCID: PMC10811191 DOI: 10.1038/s41433-023-02682-x] [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: 11/28/2022] [Revised: 07/14/2023] [Accepted: 07/19/2023] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVES To assess intra-individually visual acuity (VA) and subjective outcome after mix-and-match implantation of a monofocal EDOF IOL and a diffractive trifocal IOL. METHODS The monofocal EDOF Isopure IOL was implanted in the dominant eye and the trifocal FineVision HP IOL in the non-dominant eye. Postoperative evaluation included VA at various distances, contrast acuity, monocular defocus curves, decentration and tilt, wavefront aberrometry, VF-7 questionnaire and a halo and glare simulator. RESULTS 50 eyes of 25 subjects were enroled. The trifocal IOL performed better at monocular DCNVA (p < 0.01) and at defocus levels of -1.5D to -4.0D (p < 0.01), the monofocal EDOF IOL was better at -0.5D (p = 0.013). No differences in monocular BCDVA, DCIVA, contrast acuity, decentration or tilt were observed (p > 0.05). Wavefront analysis revealed lower HOAs in the trifocal group at 5 mm (p < 0.01) and no difference (p = 0.107) at 3 mm pupil aperture. The monofocal EDOF IOL displayed increased negative SA at 5 mm (p < 0.01) and 3 mm (p < 0.01) pupil diameter. Low values of optical phenomena and satisfying results of the VF-7 questionnaire were obtained. CONCLUSION Excellent visual performance and low rates of optical phenomena were achieved after mix-and-match implantation of the monofocal EDOF Isopure IOL and the trifocal FineVision HP IOL. Trifocal IOL implantation in the non-dominant eye may decrease optical disturbing phenomena. Similar results were observed for monocular distance, intermediate and contrast VA. The trifocal IOL provided better monocular near VA. Decentration and tilt and HOAs were low.
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Affiliation(s)
- Victor Danzinger
- Medical University of Vienna, Department of Ophthalmology and Optometry, Vienna, Austria
| | - Daniel Schartmüller
- Medical University of Vienna, Department of Ophthalmology and Optometry, Vienna, Austria
| | - Luca Schwarzenbacher
- Medical University of Vienna, Department of Ophthalmology and Optometry, Vienna, Austria
| | - Veronika Röggla
- Medical University of Vienna, Department of Ophthalmology and Optometry, Vienna, Austria
| | | | - Rupert Menapace
- Medical University of Vienna, Department of Ophthalmology and Optometry, Vienna, Austria
| | - Christina Leydolt
- Medical University of Vienna, Department of Ophthalmology and Optometry, Vienna, Austria.
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Kohnen T, Nouri SA, Carson D. Vehicle Headlight Halo Simulation of Presbyopia-Correcting Intraocular Lenses. Transl Vis Sci Technol 2023; 12:19. [PMID: 38127324 PMCID: PMC10746926 DOI: 10.1167/tvst.12.12.19] [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: 02/23/2023] [Accepted: 10/16/2023] [Indexed: 12/23/2023] Open
Abstract
Purpose This optical bench study was designed to evaluate and compare the halos generated by presbyopia-correcting intraocular lenses (PCIOLs) and monofocal intraocular lenses (IOLs), with or without lens decentration, using an optical bench to simulate the headlight of a distant vehicle in mesopic conditions. Methods Halos generated by six nondiffractive and 10 diffractive IOLs with different dioptric add powers were evaluated using a high dynamic range bench system. Halo intensities were compared by assessing the area under the measured intensity profile curve to compute the relative halo magnitude (RHM). Results Nondiffractive PCIOLs produced smaller and less intense bench halo images than diffractive ones. RHM measurements ranged from 964 to 1896. Monofocal IOLs produced lower RHM values, whereas diffractive PCIOLs generated higher ones. When decentered by 0.5 mm with respect to the system aperture, more obviously asymmetric halo image profiles were observed in diffractive compared with nondiffractive PCIOLs. Conclusions Simulated bench halos of nondiffractive PCIOLs are smaller and less intense than those of diffractive PCIOLs. Additional clinical studies assessing standardized patient-reported outcomes measures are required to correlate these bench results with patient satisfaction. Translational Relevance This study contrasts the design-related simulated bench halos of nondiffractive and diffractive PCIOLs, aiming to elucidate their impact on halo perception.
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Affiliation(s)
- Thomas Kohnen
- Department of Ophthalmology, Goethe University, Frankfurt, Germany
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Mencucci R, Morelli A, Cennamo M, Roszkowska AM, Favuzza E. Enhanced Monofocal Intraocular Lenses: A Retrospective, Comparative Study between Three Different Models. J Clin Med 2023; 12:jcm12103588. [PMID: 37240694 DOI: 10.3390/jcm12103588] [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: 04/10/2023] [Revised: 05/16/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023] Open
Abstract
The purpose of this study was to compare the visual performance and optical quality between three new enhanced monofocal intraocular lenses (IOLs). This retrospective study included patients affected by cataracts with corneal astigmatism less than 0.75 D and no ocular comorbidities who underwent cataract surgery with bilateral implantation of Tecnis Eyhance ICB00 (Johnson & Johnson Vision Care, Inc., Jacksonville, FL, USA), Vivinex Impress XY1-EM (Hoya Surgical Optics, Singapore) or IsoPure 123 (PhysIOL, Liege, Belgium) IOLs. Three months postoperatively, monocular and binocular uncorrected and corrected distant, and intermediate and near visual acuities were measured. Binocular defocus curve, photopic contrast sensitivity, Point Spread Function (PSF), low order aberrations (LOAs), high order aberrations (HOAs), objective scatter index (OSI), halo and glare perception were also evaluated. This study included a total of 72 eyes from 36 patients. Visual acuity outcomes, PSF, LOAs, HOAs and OSI were similar between groups. There were no statistically significant differences in terms of photopic contrast sensitivity, halo or glare perception. In patients without ocular comorbidities, the Eyhance ICB00 IOL, the Vivinex Impress IOL and the Isopure IOL-even though based on different optical properties-provided similar results in terms of visual acuity, contrast sensitivity and intraocular aberrations, with no influence on photic phenomena.
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Affiliation(s)
- Rita Mencucci
- Eye Clinic, Careggi Hospital, Department of Neurosciences, Psychology, Pharmacology and Child Health (NEUROFARBA), University of Florence, 50134 Florence, Italy
| | - Alberto Morelli
- Eye Clinic, Careggi Hospital, Department of Neurosciences, Psychology, Pharmacology and Child Health (NEUROFARBA), University of Florence, 50134 Florence, Italy
| | - Michela Cennamo
- Eye Clinic, Careggi Hospital, Department of Neurosciences, Psychology, Pharmacology and Child Health (NEUROFARBA), University of Florence, 50134 Florence, Italy
| | - Anna Maria Roszkowska
- Ophthalmology Clinic, Department of Biomedical Sciences, University of Messina, 98100 Messina, Italy
| | - Eleonora Favuzza
- Eye Clinic, Careggi Hospital, Department of Neurosciences, Psychology, Pharmacology and Child Health (NEUROFARBA), University of Florence, 50134 Florence, Italy
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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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Lago CM, de Castro A, Benedí-García C, Aissati S, Marcos S. Evaluating the effect of ocular aberrations on the simulated performance of a new refractive IOL design using adaptive optics. BIOMEDICAL OPTICS EXPRESS 2022; 13:6682-6694. [PMID: 36589555 PMCID: PMC9774854 DOI: 10.1364/boe.473573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/30/2022] [Accepted: 11/01/2022] [Indexed: 05/02/2023]
Abstract
Adaptive optics (AO) visual simulators are excellent platforms for non-invasive simulation visual performance with new intraocular lens (IOL) designs, in combination with a subject own ocular aberrations and brain. We measured the through focus visual acuity in subjects through a new refractive IOL physically inserted in a cuvette and projected onto the eye's pupil, while aberrations were manipulated (corrected, or positive/negative spherical aberration added) using a deformable mirror (DM) in a custom-developed AO simulator. The IOL increased depth-of-focus (DOF) to 1.53 ± 0.21D, while maintaining high Visual Acuity (VA, -0.07 ± 0.05), averaged across subjects and conditions. Modifying the aberrations did not alter IOL performance on average.
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Affiliation(s)
- Carmen M. Lago
- Visual Optics and Biophotonics Laboratory, Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Calle Serrano 121, Madrid, 28006, Spain
- 2EyesVision S.L., Plaza de la Encina 10, Madrid, 28760, Spain
| | - Alberto de Castro
- Visual Optics and Biophotonics Laboratory, Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Calle Serrano 121, Madrid, 28006, Spain
| | - Clara Benedí-García
- Visual Optics and Biophotonics Laboratory, Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Calle Serrano 121, Madrid, 28006, Spain
| | - Sara Aissati
- Visual Optics and Biophotonics Laboratory, Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Calle Serrano 121, Madrid, 28006, Spain
- Center for Visual Sciences; The Institute of Optics and Flaum Eye Institute, University of Rochester,14642, New York, USA
| | - Susana Marcos
- Visual Optics and Biophotonics Laboratory, Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Calle Serrano 121, Madrid, 28006, Spain
- Center for Visual Sciences; The Institute of Optics and Flaum Eye Institute, University of Rochester,14642, New York, USA
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