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Qu H, Abulimiti A, Liang J, Zhou S, Wu Z, Chen Y, Ju R, Wang Z, Xu R, Chen X. Comparison of short-term clinical outcomes of a diffractive trifocal intraocular lens with phacoemulsification and femtosecond laser assisted cataract surgery. BMC Ophthalmol 2024; 24:189. [PMID: 38658894 PMCID: PMC11040763 DOI: 10.1186/s12886-024-03440-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 04/09/2024] [Indexed: 04/26/2024] Open
Abstract
PURPOSE To evaluate short-term visual and refractive outcomes after implantation of a diffractive trifocal intraocular lens (IOL) in cataract patients with phacoemulsification (PHACO) and femtosecond laser assisted cataract surgery (FLACS). SETTING Department of Ophthalmology, Shanghai Aier Eye Hospital, China. DESIGN A retrospective, observational study. METHODS Patients who underwent cataract surgery combined with Acrysoft IQ PanOptix trifocal IOL implantation were enrolled and divided into three groups: PHACO group, LAstig-FLACS group (astigmatism less then 1D) and HAstig-FLACS group (astigmatism more than 1D). Logarithm of the minimum angle of resolution (logMAR) visual acuity of uncorrected distance (UDVA), intermediate (UIVA), near visual (UNVA), defocus curve, surgically induced astigmatism (SIA) were evaluated in 1 months postoperatively and wavefront aberrations were evaluated in 6 months. RESULTS 101 eyes of 60 patients were included with 31 eyes in PHACO group, 45 eyes in LAstig-FLACS group and 25 eyes in HAstig-FLACS group. Significant difference was found of internal Strehl Ratio (SR) between PHACO and LAstig-FLACS group (P = 0.026). In PHACO group, 79.31%, 86.21%, 72.41% of eyes gain visual acuity LogMAR 0.1 or more in UDVA, UIVA and UNVA, while 83.72%, 93.02%, 93.02% of those in LAstig-FLACS group and 92.00%, 84.00%, 76.00% in HAstig-FLACS group. CONCLUSIONS Panoptix diffractive trifocal IOL provides satisfied visual outcome in no matter FLACS or PHACO. Besides, trifocal IOL implantation via FLACS can provide a better accumulative visual acuity outcome at all distance than PHACO in 1 month. Femtosecond laser assisted limbal relaxing incisions (FLLRIs) is an excellent way to reduce a patient's corneal astigmatism.
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Affiliation(s)
- Haokun Qu
- Aier Eye Hospital, Jinan University, No. 191, Huanshi Middle Road, Yuexiu District, Guangzhou, Guangdong, China
- Jinan University, No.601, Huangpu Road West, Guangzhou, China
| | - Adilamu Abulimiti
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai, China
| | - Jianheng Liang
- Aier Eye Hospital, Jinan University, No. 191, Huanshi Middle Road, Yuexiu District, Guangzhou, Guangdong, China
| | - Suowang Zhou
- Jinan University, No.601, Huangpu Road West, Guangzhou, China
| | - Zheming Wu
- Aier Eye Hospital, Jinan University, No. 191, Huanshi Middle Road, Yuexiu District, Guangzhou, Guangdong, China
| | - Yun Chen
- Aier Eye Hospital, Jinan University, No. 191, Huanshi Middle Road, Yuexiu District, Guangzhou, Guangdong, China
| | - Ruihong Ju
- Aier Eye Hospital, Jinan University, No. 191, Huanshi Middle Road, Yuexiu District, Guangzhou, Guangdong, China
| | - Zheng Wang
- Aier Eye Hospital, Jinan University, No. 191, Huanshi Middle Road, Yuexiu District, Guangzhou, Guangdong, China
- Jinan University, No.601, Huangpu Road West, Guangzhou, China
| | - Rong Xu
- Hankou Aier Eye Hospital, Wuhan, China
| | - Xu Chen
- Jinan University, No.601, Huangpu Road West, Guangzhou, China.
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai, China.
- Department of Ophthalmology, Shanghai Aier Qingliang Eye Hospital, Qingpu, Shanghai, China.
- Department of Ophthalmology & Optometry, SinoUnited Health Clinic, Shanghai, China.
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Wei W, Lin H, Zheng X, Wang S, Bai S, Zhao Z. Refractive outcomes of scleral-sutured posterior chamber intraocular lenses in post-traumatic eyes. Int Ophthalmol 2023; 43:423-429. [PMID: 35997929 DOI: 10.1007/s10792-022-02439-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 07/05/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE To evaluate the refractive outcomes of scleral-sutured IOL 2 mm posterior to the limbus in post-traumatic eyes using SRK/T formula. METHODS This single-center retrospective case series included 35 eyes from 35 post-traumatic patients undergoing scleral-suture of ErgomaX IOLs by a single experienced surgeon. Preoperative predicted refraction, procedure-related complications, and postoperative spherical equivalent (SE) at least 1 month after surgery were recorded. The prediction error (PE) was calculated as the difference between the postoperative SE and preoperative predicted refraction. RESULTS Of the 35 post-traumatic patients, 28 patients were aphakia without capsular support, and 7 patients were traumatic lens dislocation or subluxation. The mean age at surgery was 56.03 ± 14.56 years and 28 patients were men (80%). The mean postoperative spherical equivalent (SE) and postoperative astigmatism were - 1.23 ± 0.82 D and 1.57 ± 1.14 D, respectively. The mean prediction error (ME) of SRK/T formula was - 0.17 D. The mean absolute error (MAE) was 0.48D. The prediction accuracy was 60.0% for refractive errors of ± 0.50 D and 85.7% for refractive errors of ± 1.00D. Multiple linear regression analyses revealed that IOL power has positive correlation with PE. CONCLUSION Assumption of in-the-bag IOL position when calculating IOL (52501TY, ErgomaX) power for standardizing scleral-sutured IOL 2 mm posterior to the limbus demonstrates acceptable refractive outcomes. The accuracy of IOL power calculation using the SRK/T formula for eyes needing low IOL power or high IOL power may be affected by the uncertain position of postoperative IOL and further studies are needed.
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Affiliation(s)
- Wenlong Wei
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027, China
| | | | - Xuanli Zheng
- Wenzhou Medical University, Wenzhou, 325027, China
| | - Siyi Wang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027, China
| | - Shengsheng Bai
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027, China
| | - Zhenquan Zhao
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027, China.
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Liu P, Yu D, Zhang B, Zhou S, Zhu H, Qin W, Ye X, Li X, Zhang Y, Bai Y, Wang Y, Shao Z. Influence of optical zone on myopic correction in small incision lenticule extraction: a short-term study. BMC Ophthalmol 2022; 22:409. [PMID: 36271372 PMCID: PMC9585829 DOI: 10.1186/s12886-022-02631-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 10/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the influence of preoperative optical zone on myopic correction in small incision lenticule extraction. METHODS In this retrospective clinical study, 581 eyes from 316 patients underwent SMILE were selected, including 117 eyes in the small optical zone group (range from 6.0 to 6.4 mm) and 464 eyes in the large optical zone group (range from 6.5 to 6.8 mm). The measurements included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical, and cylinder were measured preoperatively and 3 months postoperatively. Propensity score match (PSM) analysis was performed with age, gender, eye (right/left), keratometry and preoperative spherical equivalent between two different groups. The influence of optical zones on postoperative refractive outcomes were evaluated using univariate regression analysis. RESULTS In total, 78 pairs of eyes were selected by PSM (match ratio 1:1). There were no differences in the age, gender, eye (right/left), keratometry or preoperative spherical equivalent between the small and large optical zone groups. However, the difference of postoperative spherical equivalent was significantly between groups. Patients with larger optical zones had a trend towards less undercorrection (P = 0.018). Univariate linear regression model analysis found that each millimeter larger optical zone resulted in 8.13% or 0.39D less undercorrection (P < 0.001). The dependency between the optical zones and postoperative spherical equivalent was significant in the higher preoperative myopia group (r = 0.281, P < 0.001), but not significant in the lower myopia group (r = 0.028, P = 0.702). CONCLUSION The diameter of optical zones would affect postoperative refractive outcomes in small incision lenticule extraction. This study indicated that larger optical zones induced less undercorrection, especially in patients with high myopia.
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Affiliation(s)
- Pan Liu
- Department of Ophthalmology, the Second Affiliated Hospital of Harbin Medical University, No.246 Xuefu Road, Nangang District, 150086, Harbin, Heilongjiang Province, China
| | - Dongyu Yu
- Department of Ophthalmology, the Second Affiliated Hospital of Harbin Medical University, No.246 Xuefu Road, Nangang District, 150086, Harbin, Heilongjiang Province, China
| | - Boyu Zhang
- Department of Ophthalmology, the Second Affiliated Hospital of Harbin Medical University, No.246 Xuefu Road, Nangang District, 150086, Harbin, Heilongjiang Province, China
| | - Shiqi Zhou
- Harbin Medical University, No.157 Baojian Road, Nangang District, 150081, Harbin, Heilongjiang Province, China
| | - Haoran Zhu
- Department of Ophthalmology, the Second Affiliated Hospital of Harbin Medical University, No.246 Xuefu Road, Nangang District, 150086, Harbin, Heilongjiang Province, China
| | - Wanyun Qin
- Department of Ophthalmology, the Second Affiliated Hospital of Harbin Medical University, No.246 Xuefu Road, Nangang District, 150086, Harbin, Heilongjiang Province, China.,Future Medical Laboratory, the Second Affiliated Hospital of Harbin Medical University, No.246 Xuefu Road, Nangang District, 150086, Harbin, Heilongjiang Province, China
| | - Xinqi Ye
- Department of Ophthalmology, the Second Affiliated Hospital of Harbin Medical University, No.246 Xuefu Road, Nangang District, 150086, Harbin, Heilongjiang Province, China.,Future Medical Laboratory, the Second Affiliated Hospital of Harbin Medical University, No.246 Xuefu Road, Nangang District, 150086, Harbin, Heilongjiang Province, China
| | - Xianghui Li
- Department of Ophthalmology, the Second Affiliated Hospital of Harbin Medical University, No.246 Xuefu Road, Nangang District, 150086, Harbin, Heilongjiang Province, China.,Future Medical Laboratory, the Second Affiliated Hospital of Harbin Medical University, No.246 Xuefu Road, Nangang District, 150086, Harbin, Heilongjiang Province, China
| | - Yan Zhang
- Department of Ophthalmology, the Second Affiliated Hospital of Harbin Medical University, No.246 Xuefu Road, Nangang District, 150086, Harbin, Heilongjiang Province, China.,Future Medical Laboratory, the Second Affiliated Hospital of Harbin Medical University, No.246 Xuefu Road, Nangang District, 150086, Harbin, Heilongjiang Province, China
| | - Ying Bai
- Department of Ophthalmology, the Second Affiliated Hospital of Harbin Medical University, No.246 Xuefu Road, Nangang District, 150086, Harbin, Heilongjiang Province, China.,Future Medical Laboratory, the Second Affiliated Hospital of Harbin Medical University, No.246 Xuefu Road, Nangang District, 150086, Harbin, Heilongjiang Province, China
| | - Yuan Wang
- Department of Ophthalmology, the Second Affiliated Hospital of Harbin Medical University, No.246 Xuefu Road, Nangang District, 150086, Harbin, Heilongjiang Province, China.,Future Medical Laboratory, the Second Affiliated Hospital of Harbin Medical University, No.246 Xuefu Road, Nangang District, 150086, Harbin, Heilongjiang Province, China
| | - Zhengbo Shao
- Department of Ophthalmology, the Second Affiliated Hospital of Harbin Medical University, No.246 Xuefu Road, Nangang District, 150086, Harbin, Heilongjiang Province, China. .,Future Medical Laboratory, the Second Affiliated Hospital of Harbin Medical University, No.246 Xuefu Road, Nangang District, 150086, Harbin, Heilongjiang Province, China.
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Kokame GT, Tanji TT, Yanagihara RT, Shantha JG, Nirwan RS, Tanji TM. Refractive Outcomes of Combined Cataract Surgery and Vitrectomy Compared to Cataract Surgery Alone. Ophthalmologica 2022; 246:39-47. [PMID: 35858534 PMCID: PMC10906474 DOI: 10.1159/000526039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 05/18/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE The aim of the study was to evaluate the refractive outcomes of combined cataract surgery and vitrectomy compared to cataract surgery alone. METHODS This retrospective chart review study included two groups: (1) combined surgery in 103 eyes (101 patients) who underwent cataract surgery with posterior chamber intraocular lens (PCIOL) placement by a single cataract surgeon and vitrectomy by a single vitreoretinal surgeon at the same surgical setting; (2) cataract surgery alone by the same surgeon in 107 eyes (84 patients). Refractive outcomes and complications between the combined and cataract surgery alone group were compared. The predicted refractive error was compared to postoperative refractive outcomes in both groups, surgically induced astigmatism (SIA), intraoperative or postoperative complications of either cataract surgery or vitrectomy, and cystoid macular edema. RESULTS There was no statistically significant difference between predicted and actual postoperative refractive outcomes between the combined and cataract surgery alone groups (within ±0.5 diopters [D], p = 0.099; within ±1.0 D, p = 0.721). There was no difference in SIA refractive outcomes between the two groups (p = 0.509). The use of intraoperative gas for retina tamponade did not significantly affect postoperative refractive outcomes. Both cataract surgery and vitrectomy were successfully performed without unexpected complications from either procedure affecting the other. DISCUSSION/CONCLUSION Combined cataract surgery and vitrectomy allows excellent refractive outcomes equal to cataract surgery alone, allowing each procedure to be performed independently by separate anterior and posterior segment surgeons. Combined procedures can be performed in eyes with a variety of retinal indications and can include fluid-gas exchange with minimal risk of PCIOL malposition or change in targeted refraction.
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Affiliation(s)
- Gregg T. Kokame
- Division of Ophthalmology, Department of Surgery, University of Hawaii School of Medicine, Honolulu, Hawaii, USA
- Hawaii Macula and Retina Institute, Aiea, Hawaii, USA
- Retina Consultants of Hawaii, Honolulu, Hawaii, USA
| | - Tarin T. Tanji
- Hawaii Macula and Retina Institute, Aiea, Hawaii, USA
- Retina Consultants of Hawaii, Honolulu, Hawaii, USA
| | - Ryan T. Yanagihara
- Hawaii Macula and Retina Institute, Aiea, Hawaii, USA
- Retina Consultants of Hawaii, Honolulu, Hawaii, USA
- Department of Ophthalmology, University of Washington, Seattle, Washington, USA
| | - Jessica G. Shantha
- Department of Ophthalmology, Francis I. Proctor Foundation, University of California, San Francisco, California, USA
| | - Rajinder S. Nirwan
- Division of Ophthalmology, Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Troy M. Tanji
- Division of Ophthalmology, Department of Surgery, University of Hawaii School of Medicine, Honolulu, Hawaii, USA
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Wei Wei DY, Shen L, Manotosh R, Wee Tien AT, Hui-Chen CC. Relationship between Postoperative Intraocular Pressure and Refractive Outcomes in Patients after Deep Anterior Lamellar Keratoplasty. J Curr Ophthalmol 2022; 34:30-36. [PMID: 35620381 PMCID: PMC9128438 DOI: 10.4103/joco.joco_211_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 11/14/2021] [Accepted: 11/14/2021] [Indexed: 11/04/2022] Open
Abstract
Purpose To study the effect of intraocular pressure (IOP) on refractive outcomes after deep anterior lamellar keratoplasty (DALK). Methods This retrospective study included eyes which underwent DALK. DALK technique involved either modified Anwar big-bubble if possible or manual anterior lamellar dissection. Our main outcome measures are postoperative IOP and refractive outcomes at postoperative week and months 1, 3, 6, and 12. Results Fifty-nine eyes of 59 patients were included. DALK was performed for optical (93.2%) and tectonic (6.8%) purposes. 76.3% of the patients had keratoconus. Anwar's big-bubble technique was successful in 30 cases. Linear mixed-model was used to analyze the effect of the highest postoperative IOP measured prior to measurement of postoperative cylinder. Patients with greater maximum postoperative IOP measured had worse postoperative cylinder (P = 0.015) and spherical equivalent (P = 0.012). Those with IOP more than 21 mmHg had worse postoperative cylinder (P = 0.050) and spherical equivalent (P = 0.054). The method of DALK and presence of suture removal were not shown to statistically affect postoperative cylinder. Conclusion Our study shows a positive correlation between postoperative IOP and worse spherical equivalent and cylinder post-DALK, emphasizing the need for good IOP control with IOP-lowering medication(s).
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Affiliation(s)
- Dayna Yong Wei Wei
- Department of Ophthalmology, National University Hospital, National University Health System, Singapore
| | - Liang Shen
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ray Manotosh
- Department of Ophthalmology, National University Hospital, National University Health System, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Anna Tan Wee Tien
- Department of Ophthalmology, National University Hospital, National University Health System, Singapore
| | - Charmaine Chai Hui-Chen
- Department of Ophthalmology, National University Hospital, National University Health System, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Comba OB, Albayrak S, Karakaya M. Effect of capsule tension ring on short-term refractive stabilization and visual performance in trifocal intraocular lens implantation. J Fr Ophtalmol 2021; 44:1168-1173. [PMID: 34325923 DOI: 10.1016/j.jfo.2021.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 11/15/2020] [Accepted: 01/11/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To provide refractive stability and increase visual performance with the use of a capsular tension ring in trifocal intraocular lens implantation. METHODS This prospective randomized study was conducted in the Yeniyüzyıl university ophthalmology department between February 2018 and September 2019. Eighty-six eyes of 43 patients with visual loss due to uncomplicated cataract in both eyes were randomly divided into two groups, A and B. The eyes in both groups underwent refractive lens exchange with implantation of the same design of trifocal IOL (plate haptic design). In group B, a capsular tension ring was inserted into the capsular bag before trifocal IOL implantation. Both groups were examined at 1day, 1week, 1month, and 3months postoperatively. At 3months after surgery, visual acuity, refractive errors and refractive prediction errors were analyzed and compared between groups A and B. RESULTS The postoperative values in group A were spherical equivalent (mean±SD), 0.07±0.79 diopters (D); refractive sphere (mean±SD), 0.43±0.84 diopters (D); uncorrected distance acuity, 0.20±0.04 (logMAR); best-corrected distance acuity, 0±0.02 (logMAR). Group B values were 0.14±0.5 diopters (D), 0.61±0.45 diopters (D), 0.25±0.20 (logMAR), 0.01±0.04 (logMAR), respectively. There was no significant difference between the two groups with respect to the postoperative evaluation. CONCLUSION The use of CTR in the implantation of the trifocal intraocular lens had no statistically significant impact on refractive stability.
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Affiliation(s)
- O B Comba
- Yeni Yuzyil University School of Medicine, Department of Ophthalmology, Istanbul, Turkey.
| | - S Albayrak
- Yeni Yuzyil University School of Medicine, Department of Ophthalmology, Istanbul, Turkey.
| | - M Karakaya
- Yeni Yuzyil University School of Medicine, Department of Ophthalmology, Istanbul, Turkey.
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Shaheen MS, AbouSamra A, Helaly HA, Said A, Elmassry A. Comparison between refractive outcomes of femtosecond laser-assisted cataract surgery and standard phacoemulsification. BMC Ophthalmol 2020; 20:1. [PMID: 31898534 PMCID: PMC6941343 DOI: 10.1186/s12886-019-1277-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 12/16/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND To compare the visual and refractive outcomes of femtosecond laser assisted cataract surgery (FLACS) using Victus platform (Technolas Bausch and Lomb (B&L), Munich, Germany) and conventional phacoemulsification cataract surgery (CPCS). METHODS A retrospective study of 100 eyes operated for cataract. FLACS was performed in 50 eyes and CPCS was done in another 50 eyes. Preoperative and 6 months postoperative visual and refractive evaluation (efficacy, safety, predictability, and surgically induced astigmatism) as well as higher-order aberrations were analyzed. Efficacy index which equals post-operative mean of uncorrected distance visual acuity (UDVA) divided by preoperative mean corrected distance visual acuity (CDVA) was calculated in both groups. Safety index equals post-operative mean of corrected distance visual acuity (CDVA) divided by preoperative mean CDVA. RESULTS Logarithm of the Minimum Angle of Resolution (LogMAR), UDVA improved in both groups after surgery (p < 0.05). It was 0.23 ± 0.20 and 0.291 ± 0.311 log MAR in FLACS and CPCS groups respectively. Safety index was 1.777 in FLACS group and 1.744 in CPCS groups showing high degree of safety of both measures. Mean surgically induced astigmatism (SIA) was 0.35 ± 0.67 D and 0.901 ± 0.882 D in FLACS and CPCS groups respectively (p = 0.015). The post-operative comparison between both groups was in favor of CPCS group vs. FLACS group regarding total aberrations (0.563 ± 0.386 vs. 0.91 ± 1.20) (p = 0.03), while low order aberrations were significantly less in FLACS group vs. CPCS group (0.64 + 0.63 vs. 2.07 + 3.15) (p = 0.027). RMS high order aberration was higher in FLACS group vs. CPCS group but of no statistical significance 0.54 ± 0.96 vs. 0.328 ± 0.360 (p = 0.082). CONCLUSION Femtosecond laser -assisted cataract surgery was a safe and precise procedure but enhanced visual outcomes only minimally when compared to conventional cataract surgery in experienced hands. Both FLACS and manual surgeries can achieve a high efficacy, predictability and safety with slight superior outcomes in FLACS. TRIAL REGISTRATION NUMBER PACTR201804003256258 (date: 27 Mar 2018) Available at: https://pactr.samrc.ac.za/.
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Affiliation(s)
- Mohamed Shafik Shaheen
- Ophthalmology Department, Faculty of Medicine, Alexandria University, 30 Roshdystreet, Roshdy, Alexandria, Egypt
| | - Amir AbouSamra
- Ophthalmology Department, Faculty of Medicine, Alexandria University, 30 Roshdystreet, Roshdy, Alexandria, Egypt
| | - Hany Ahmed Helaly
- Ophthalmology Department, Faculty of Medicine, Alexandria University, 30 Roshdystreet, Roshdy, Alexandria, Egypt
| | - Amr Said
- Ophthalmology Department, Faculty of Medicine, Alexandria University, 30 Roshdystreet, Roshdy, Alexandria, Egypt
| | - Ahmed Elmassry
- Ophthalmology Department, Faculty of Medicine, Alexandria University, 30 Roshdystreet, Roshdy, Alexandria, Egypt
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Srivannaboon S, Chirapapaisan C. Comparison of refractive outcomes using conventional keratometry or total keratometry for IOL power calculation in cataract surgery. Graefes Arch Clin Exp Ophthalmol 2019; 257:2677-82. [PMID: 31486917 DOI: 10.1007/s00417-019-04443-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 08/10/2019] [Accepted: 08/15/2019] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To compare the refractive outcomes following cataract surgery using conventional keratometry (K) and total keratometry (TK) for intraocular lens (IOL) calculation in the SRK/T, HofferQ, Haigis, and Holladay 1 and 2, as well as Barrett and Barrett TK Universal II formulas. METHODS Sixty eyes of 60 patients from Siriraj Hospital, Thailand, were prospectively enrolled in this comparative study. Eyes were assessed using a swept-source optical biometer (IOLMaster 700; Carl Zeiss Meditec, Jena, Germany). Posterior keratometry, K, TK, central corneal thickness, anterior chamber depth, lens thickness, axial length, and white-to-white corneal diameter were recorded. Emmetropic IOL power was calculated using K and TK in all formulas. Selected IOL power and predicted refractive outcomes were recorded. Postoperative manifest refraction was measured 3 months postoperatively. Mean absolute errors (MAEs), median absolute errors (MedAEs), and percentage of eyes within ± 0.25, ± 0.50, and ± 1.00 D of predicted refraction were calculated for all formulas in both groups. RESULTS Mean difference between K and TK was 0.03 D (44.56 ± 1.18 vs. 44.59 ± 1.22 D), showing excellent agreement (ICC = 0.99, all p < 0.001). Emmetropic IOL powers in all formulas for both groups were very similar, with a trend toward lower MAEs and MedAEs for TK when compared with K. The Barrett TK Universal II formula demonstrated the lowest MAEs. Proportion of eyes within ± 0.25, ± 0.50, and ± 1.00 D of predicted refraction were slightly higher in the TK group. CONCLUSIONS Conventional K and TK for IOL calculation showed strong agreement with a trend toward better refractive outcomes using TK. The same IOL constant can be used for both K and TK.
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Kim M, Eom Y, Song JS, Kim HM. Comparative evaluation of refractive outcomes after implantation of two types of intraocular lenses with different diopter intervals (0.25 diopter versus 0.50 diopter). BMC Ophthalmol 2018; 18:176. [PMID: 30021633 PMCID: PMC6052586 DOI: 10.1186/s12886-018-0840-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 06/29/2018] [Indexed: 11/10/2022] Open
Abstract
Background Intraocular lenses (IOLs) with different diopter (D) intervals may have different tolerance, and may provide different accuracy of refractive outcome after cataract surgery. The aim of the study is to compare the accuracy of refractive outcome after implantation of IOLs with different D intervals after cataract surgery. Methods A total of 80 eyes from 40 patients who underwent phacoemulsification with implantation of a 0.50 D interval Akreos AO IOL in one eye and a 0.25 D interval Softec HD™ IOL in the other eye were enrolled. The percentages of eyes with refractive prediction error within ±0.50 D at one month after surgery were compared. To evaluate the effect of the dioptric errors of the IOL itself on refractive prediction error, the percentage of eyes with refractive prediction error within ±0.25 D of the IOL with a standard deviation (SD) of ±0.40 D was compared with that of the IOL with a SD of ±0.11 D through Monte Carlo simulations. Results In this clinical study, the percentage of eyes with refractive prediction error within ±0.50 D by the Haigis formula in the Softec HD™ group (85.0%) was significantly greater than that in the Akreos AO group (57.5%; P = 0.027). In Monte Carlo simulations, all percentages of eyes with refractive prediction error within ±0.25 D by the Haigis and SRK/T formulas in the Softec HD™ group were significantly greater than those in the Akreos AO group. Conclusions The IOL with a 0.25 D interval was more accurate than the IOL with a 0.50 D interval in predicting refractive outcome after cataract surgery. Trial registration Current Controlled Trials KCT0002192, Retrospectively registered (Date of registration: 6 January 2017).
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Affiliation(s)
- Minjung Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea
| | - Youngsub Eom
- Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea. .,Department of Ophthalmology, Ansan Hospital, Korea University College of Medicine, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, South Korea.
| | - Jong Suk Song
- Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea
| | - Hyo Myung Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea
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Miao H, Chen X, Tian M, Chen Y, Wang X, Zhou X. Refractive outcomes and optical quality after implantation of posterior chamber phakic implantable collamer lens with a central hole (ICL V4c). BMC Ophthalmol 2018; 18:141. [PMID: 29898694 PMCID: PMC6001218 DOI: 10.1186/s12886-018-0805-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Accepted: 05/30/2018] [Indexed: 02/03/2023] Open
Abstract
Background To investigate refractive outcomes and optical quality after implantation of posterior chamber phakic implantable collamer lens with a central hole (ICL V4c) to correct high myopia. Methods Sixty seven eyes of 38 patients who underwent ICL V4c implantation were enrolled. The mean preoperative spherical equivalent (SE) was − 12.44 ± 3.15 D (range: − 6.63 to − 20.50 D). The refractive outcomes and optical quality of the eyes at postoperative 1 and 3 months were evaluated and compared. Results At 3 months postoperatively, the mean safety and efficacy indexes were 1.33 ± 0.22 and 1.14 ± 0.23, respectively. The mean SE was − 0.32 ± 0.52 D; no patient lost 1 or more lines of corrected distance visual acuity (CDVA), 13% remained unchanged, 45% gained 1 line and 42% gained 2 or more lines. The mean modulation transfer function cutoff frequency (MTFcutoff), Strehl in two dimensions ratio, and objective scatter index (OSI) were 38.20 ± 9.96 cycles per degree, 0.21 ± 0.06, and 1.00 ± 0.73, respectively. No significant difference was found in any of the above parameters (P > 0.05) between 1 and 3 months. The postoperative intraocular pressure (IOP) did not change when compared with preoperative values (P > 0.05). Conclusions ICL V4c implantation is a safe, effective, and stable solution for high myopia. Patients will acquire high and stable postoperative optical quality. ICL V4c implantation has little influence on IOP.
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Affiliation(s)
- Huamao Miao
- Department of Ophthalmology, Eye and ENT Hospital of Fudan Universtity, NHC Key Laboratory of Myopia (Fudan Universtity), No.83 FenYang Road, Shanghai, 200031, People's Republic of China
| | - Xun Chen
- Department of Ophthalmology, Eye and ENT Hospital of Fudan Universtity, NHC Key Laboratory of Myopia (Fudan Universtity), No.83 FenYang Road, Shanghai, 200031, People's Republic of China
| | - Mi Tian
- Department of Ophthalmology, Eye and ENT Hospital of Fudan Universtity, NHC Key Laboratory of Myopia (Fudan Universtity), No.83 FenYang Road, Shanghai, 200031, People's Republic of China
| | - Yingjun Chen
- Department of Ophthalmology, Eye and ENT Hospital of Fudan Universtity, NHC Key Laboratory of Myopia (Fudan Universtity), No.83 FenYang Road, Shanghai, 200031, People's Republic of China
| | - Xiaoying Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan Universtity, NHC Key Laboratory of Myopia (Fudan Universtity), No.83 FenYang Road, Shanghai, 200031, People's Republic of China.
| | - Xingtao Zhou
- Department of Ophthalmology, Eye and ENT Hospital of Fudan Universtity, NHC Key Laboratory of Myopia (Fudan Universtity), No.83 FenYang Road, Shanghai, 200031, People's Republic of China.
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Abstract
Background To retrospectively analyse strategies for adjusting refractive surgery plans with reference to the preoperative manifest refraction. Methods We constructed seven nomograms based on the refractive outcomes (sphere, cylinder, axis [SCA]) of 150 consecutive eyes treated with laser in situ keratomileusis for myopic astigmatism. We limited the initial data to the SCA of the manifest refraction. All nomograms were based on the strategy: if for x diopters (D) of attempted metric, y D is achieved; we can reverse this sentence and state for achieving y D of change in the metric, x D will be planned. The effects of the use of plus or minus astigmatism notation, spherical equivalent, sphere, principal meridians notation, cardinal and oblique astigmatism, and astigmatic axis were incorporated. Results All nomograms detected subtle differences in the spherical component (p < 0.0001). Nomograms 5 and 7 (using power vectors) and 6 (considering axis shifts) detected significant astigmatic differences (nomogram 5, p < 0.001; nomogram 6, p < 0.05; nomogram 7, p < 0.005 for cardinal astigmatism, p = 0.1 for oblique astigmatism). We observed mild clinically relevant differences (~ 0.5 D) in sphere or astigmatism among the nomograms; differences of ~ 0.25 D in the proposals for sphere or cylinder were not uncommon. All nomograms suggested minor improvements versus actual observed outcomes, with no clinically relevant differences among them. Conclusions All nomograms anticipated minor improvements versus actual observed outcomes without clinically relevant differences among them. The minimal uncertainties in determining the manifest refraction (~ 0.6 D) are the major limitation to improving the accuracy of refractive surgery nomograms.
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Affiliation(s)
- Samuel Arba Mosquera
- 1Recognized Research Group in Optical Diagnostic Techniques, University of Valladolid, Valladolid, Spain.,SCHWIND eye-tech-solutions, Mainparkstr. 6-10, D-63801 Kleinostheim, Germany.,3Department of Ophthalmology and Sciences of Vision, University of Oviedo, Oviedo, Spain
| | | | - Shwetabh Verma
- SCHWIND eye-tech-solutions, Mainparkstr. 6-10, D-63801 Kleinostheim, Germany.,5Experimental Radiation Oncology, University Medical Center Mannheim, Heidelberg University, Heidelberg, Germany.,6Interdisciplinary Center for Scientific Computing (IWR), Heidelberg University, Heidelberg, Germany.,7Central Institute for Computer Engineering (ZITI), Heidelberg University, Heidelberg, Germany
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El-Naggar MT, Hovaghimian DG. Assessment of refractive outcome of femtosecond-assisted LASIK for hyperopia correction. Electron Physician 2017; 9:3958-3965. [PMID: 28461870 PMCID: PMC5407228 DOI: 10.19082/3958] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Accepted: 02/18/2017] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Laser vision correction for hyperopia is challenging. The purpose of the study was to assess the refractive outcomes of femtosecond-assisted laser in situ keratomileusis (LASIK) for hyperopic correction using wavefront-optimized ablation profiles. METHODS This retrospective case series study included 20 Egyptian patients (40 eyes) with hyperopia or hyperopic astigmatism with a mean manifest refraction spherical equivalent (MRSE) of +2.55D±1.17 (range from +1.00 to +6.00) who had uneventful femtosecond-a assisted LASIK with wavefront-optimized aspheric ablation profile using refractive surgery suite (WaveLight FS200 Femtosecond Laser and WaveLight EX500 Excimer Laser) performed in the Research Institute of Ophthalmology and International Eye Hospital, Giza, Egypt. Statistical analysis was done using Microsoft Excel (Microsoft Corporation, Seattle, WA, USA). RESULTS The procedure significantly reduced the MRSE and cylinder post-operatively (95% were ± 0.50D and 100% ± 1.00 D), with stability of refraction and UDVA over the follow-up period (up to 12 months) after surgery. No eye lost any line of the CDVA, which reflects the excellent safety profile of the procedure; on the other hand, one eye (5%) gained one line and one eye (5%) even gained two lines. There were no significant complications during the procedure. CONCLUSIONS Femtosecond-assisted laser in situ keratomileusis for hyperopia showed predictable, effective, and safe refractive outcomes that were stable through 12 months. Longer follow-up period is required to detect any further regression.
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Kanellopoulos AJ, Asimellis G. Standard manual capsulorhexis / Ultrasound phacoemulsification compared to femtosecond laser-assisted capsulorhexis and lens fragmentation in clear cornea small incision cataract surgery. Eye Vis (Lond) 2016; 3:20. [PMID: 27478858 PMCID: PMC4967293 DOI: 10.1186/s40662-016-0050-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 06/25/2016] [Indexed: 01/19/2023]
Abstract
Background Femtosecond-laser assisted clear cornea cataract surgery may hold promise in safer and more effective procedures. We decided to perform a comparative study to standard manual incision phacoemulsification surgery. Methods This is a single-center, single-intervention, and prospective comparative data evaluation of 133 consecutive cases subjected to cataract surgery. Group-A (Phaco), manual capsulorhexis & ultrasound phacoemulsification (n = 66); Group-B femtosecond-laser assisted capsulorhexis and lens fragmentation (n = 67), employing the LenSx laser (Alcon Surgical, Ft. Worth, TX). All cases were evaluated for refraction, visual acuity, keratometry, tomography, pachymetry, endothelial cell counts, intraocular pressure, and type of intraocular lens (IOL) implanted. The groups were matched for age, gender, pre-operative vision metrics, and cataract grade, and were followed up to 1 year. Results In group-A post-operative uncorrected distance visual acuity (UDVA) was 20/20 or better in 61.5 % and 20/25 or better in 78.5 % of the eyes. The femtosecond laser group-B had improved outcomes (p = 0.075 and p = 0.042, respectively): post-operative UDVA was 20/20 or better in 62.7 % of the eyes and 20/25 or better in 85.1 %. Linear regression scatterplots of achieved versus attempted spherical equivalent had excellent regression coefficients (r2 = 0.983 in group-A and 0.979 in group-B). There were 75.2 % cases in group-A and 80.6 % in group-B (p = 0.8732) within ±0.50 D of targeted refractive equivalent. Slight trend of under-correction was noted in group-A. Average residual manifest cylinder in the toric subgroup-A was -0.50 D (95 % Limit-of-Agreement (LoA) = -0.78 D), and in toric subgroup-B -0.45 D (LoA = -0.45 D). Conclusions Mean spherical equivalent refraction and visual acuity are comparable with laser cataract surgery compared with manual capsulorhexis & ultrasound phacoemulsification. Improved astigmatism correction may be among the benefits of femtosecond laser–assisted cataract surgery. Transient corneal edema may be a first day transient disadvantage in femtosecond laser–assisted cataract surgery.
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Affiliation(s)
- Anastasios John Kanellopoulos
- Laservision.gr Clinical and Research Eye Institute, Athens, Greece ; Department of Ophthalmology, NYU Medical School, New York, NY USA
| | - George Asimellis
- Laservision.gr Clinical and Research Eye Institute, Athens, Greece
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Kirwan C, Nolan JM, Stack J, Dooley I, Moore J, Moore TC, Beatty S. Introduction of a Toric Intraocular Lens to a Non-Refractive Cataract Practice: Challenges and Outcomes. Int J Ophthalmol Clin Res 2016; 3. [PMID: 27830188 DOI: 10.23937/2378-346x/1410056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIM To identify challenges inherent in introducing a toric intraocular lens (IOL) to a non-refractive cataract practice, and evaluate residual astigmatism achieved and its impact on patient satisfaction. METHODS Following introduction of a toric IOL to a cataract practice with all procedures undertaken by a single, non-refractive, surgeon (SB), pre-operative, intra-operative and post-operative data was analysed. Attenuation of anticipated post-operative astigmatism was examined, and subjectively perceived visual functioning was assessed using validated questionnaires. RESULTS Median difference vector (DV, the induced astigmatic change [by magnitude and axis] that would enable the initial surgery to achieve intended target) was 0.93D; median anticipated DV with a non-toric IOL was 2.38D. One eye exhibited 0.75D residual astigmatism, compared to 3.8D anticipated residual astigmatism with a non-toric IOL. 100% of respondents reported satisfaction of ≥ 6/10, with 37.84% of respondents entirely satisfied (10/10). 17 patients (38.63%) reported no symptoms of dysphotopsia (dysphoptosia score 0/10), only 3 respondents (6.8%) reported a clinically meaningful level of dysphotopsia (≥ 4/10). Mean post-operative NEI VF-11 score was 0.54 (+/-0.83; scale 0 - 4). CONCLUSION Use of a toric IOL to manage astigmatism during cataract surgery results in less post-operative astigmatism than a non-toric IOL, resulting in avoidance of unacceptable post-operative astigmatism.
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Affiliation(s)
- Clare Kirwan
- Biomedical Science Research Institute, University of Ulster, Coleraine, Northern Ireland; Institute of Eye Surgery, and Institute of Vision Research, Whitfield Clinic, Cork Road, Waterford, Ireland; Macular Pigment Research Group, Waterford Institute of Technology, Waterford, Ireland
| | - John M Nolan
- Macular Pigment Research Group, Waterford Institute of Technology, Waterford, Ireland
| | - Jim Stack
- Macular Pigment Research Group, Waterford Institute of Technology, Waterford, Ireland
| | - Ian Dooley
- University College Hospital Limerick, Ireland
| | - Johnny Moore
- Biomedical Science Research Institute, University of Ulster, Coleraine, Northern Ireland
| | - Tara Cb Moore
- Biomedical Science Research Institute, University of Ulster, Coleraine, Northern Ireland
| | - Stephen Beatty
- Institute of Eye Surgery, and Institute of Vision Research, Whitfield Clinic, Cork Road, Waterford, Ireland; Macular Pigment Research Group, Waterford Institute of Technology, Waterford, Ireland
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