1
|
Rementería-Capelo LA, Villar E, Puerto B, López-Caballero C, Fernández-Cuenca S, Contreras I. Medium-term visual and refractive outcomes in patients with pseudoexfoliation implanted with a toric or multifocal intraocular lens. Eur J Ophthalmol 2024; 34:739-746. [PMID: 37697660 DOI: 10.1177/11206721231201663] [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] [Indexed: 09/13/2023]
Abstract
PURPOSE To report medium-term visual acuity and refractive outcomes of patients with pseudoexfoliation implanted with toric or multifocal intraocular lenses (IOLs). METHODS We retrospectively reviewed patients with pseudoexfoliation who had undergone phacoemulsification between 2016 and 2020 with at least 24 months follow-up. RESULTS Mean follow-up was 44.17 ± 14.95 months. Toric IOLs were implanted in 48 eyes: mean uncorrected LogMAR visual acuity one month after surgery was 0.03 ± 0.09, decreasing to 0.08 ± 0.11 at the last visit (p = .01). Mean refractive cylinder was -0.12 ± 0.36 diopters one month after surgery and -0.25 ± 0.44 diopters at the last follow-up visit, p = .012. Multifocal IOLs were implanted in 42 patients: binocular uncorrected distance visual acuity was -0.02 ± 0.04 one month after surgery and 0.01 ± 0.05 at the last visit (p = .004); near acuity was 0.01 ± 0.03 and 0.04 ± 0.06 respectively (p = .001). In eyes with pseudoexfoliation, absolute spherical equivalent prediction error was 0.22 ± 0.20 diopters for toric and 0.21 ± 0.19 diopters for multifocal IOLs. One month after surgery 68.6% of eyes with toric IOLs and 74.2% of eyes with multifocal IOLs were within ±0.25 diopters of target spherical equivalent and 91.6% and 90.5% were within ±0.5 diopters, respectively. Spherical equivalent did not change significantly during follow-up for either group. CONCLUSION Prediction error in eyes with pseudoexfoliation implanted with toric or multifocal IOLs was low and similar to values reported for normal eyes. Postoperative refractive cylinder with toric IOLs was low, with little change during follow-up. Visual function in patients receiving multifocal IOLs was excellent. Therefore, the implantation of these IOLs in eyes with pseudoexfoliation does not seem to cause medium-term problems.
Collapse
Affiliation(s)
| | | | - Beatriz Puerto
- Clínica Rementería, Madrid, Spain
- Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, Spain
| | - Cristina López-Caballero
- Clínica Rementería, Madrid, Spain
- Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, Spain
| | | | - Inés Contreras
- Clínica Rementería, Madrid, Spain
- Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, Spain
| |
Collapse
|
2
|
Boris M, Olga F, Nikolay S, Alexander B, Eliya L, Boris K, Krauthammer M, Yahalomi T, Asaf A. Visual results and subjective satisfaction after implantation of two different trifocal diffractive intraocular lenses models (AcrySof IQ PanOptix and AT LISA tri 839 MP). Eur J Ophthalmol 2024; 34:726-733. [PMID: 37770020 DOI: 10.1177/11206721231201561] [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] [Indexed: 10/03/2023]
Abstract
BACKGROUND This study aimed to compare visual results following the implantation of two distinct diffractive trifocal IOLs utilizing various vision evaluation techniques and subjective satisfaction. METHODS The study included 32 eyes receiving AcrySof IQ PanOptix implantation and 32 receiving AT LISA tri 839 MP. Post-operative examination at one year included uncorrected visual acuity (UCVA), distance-corrected visual acuity (DCVA) at 4 m, 80 cm, 60 cm, and 40 cm, Contrast sensitivity under photopic and mesopic conditions, and a questionnaire on subjective quality of vision, optical phenomena, and spectacle independence. RESULTS The two groups were similar in baseline demographics, pre-operative visual, biometric data (except for axial length), and surgical paraments. The PanOptix outperformed the AT LISA tri in the intermediate range when using the standard visual acuity testing (UCVA: 0.23 ± 0.14 logMAR vs. 0.31 ± 0.17 logMAR, p = 0.04; BCVA: 0.21 ± 0.12 vs. 0.28 ± 0.14, p = 0.03) and in the intermediate and far range when using the interactive computer program (intermediate: UNVA "E" optotype test: 0.05 ± 0.12 vs. 0.12 ± 0.13, p = 0.03; Far: UNVA "E" optotype: 0.07 ± 0.12 vs. 0.13 ± 0.10, p = 0.05). In addition, the PanOptix group had higher contrast sensitivity under photopic and mesopic conditions with and without glare at all spatial frequencies. There was no difference in subjective outcomes between the groups. CONCLUSIONS Patients who received PanOptix IOL had better visual outcomes for intermediate and far with higher contrast sensitivity under various conditions. Based on patients ' needs and demands, these results could support discussion when tailoring the optimal multifocal IOl.
Collapse
Affiliation(s)
- Malyugin Boris
- The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation
- Yevdokimov Moscow State University of Medicine and Dentistry, Department of Eye Diseases, Moscow, Russian Federation
| | - Fomina Olga
- The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation
| | - Sobolev Nikolay
- The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation
| | - Belokopytov Alexander
- Institute for Information Transmission Problems (Kharkevich Institute), Russian Academy of Sciences, Moscow, Russian Federation
| | - Levinger Eliya
- Souraski Medical Center and School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Knyazer Boris
- Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Mark Krauthammer
- Souraski Medical Center and School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tal Yahalomi
- Samson Assuta Ashdod Hospital and the faculty of Health Sciences, Ben-Gurion University of the Negev, Israel
| | - Achiron Asaf
- Souraski Medical Center and School of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
3
|
Goto S, Maeda N, Ohnuma K, Lawu T, Ogawa K, Sugiyama S, Matsumaru M, Noda T. Impact of segmented optical axial length on the performance of intraocular lens power calculation formulas. J Cataract Refract Surg 2024; 50:492-497. [PMID: 38237070 DOI: 10.1097/j.jcrs.0000000000001397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 01/08/2024] [Indexed: 04/24/2024]
Abstract
PURPOSE To investigate the difference between the segmented axial length (AL) and the composite AL on a swept-source optical coherence tomography biometer and to evaluate the subsequent effects on artificial intelligence intraocular lens (IOL) power calculations: the Kane and Hill-RBF 3.0 formulas compared with established vergence formulas. SETTING National Hospital Organization, Tokyo Medical Center, Japan. DESIGN Retrospective case series. METHODS Consecutive patients undergoing cataract surgery with a single-piece IOL were reviewed. The prediction accuracy of the Barrett Universal II, Haigis, Hill-RBF 3.0, Hoffer Q, Holladay 1, Kane, and SRK/T formulas based on 2 ALs were compared for each formula. The heteroscedastic test was used with the SD of prediction errors as the endpoint for formula performance. RESULTS The study included 145 eyes of 145 patients. The segmented AL (24.83 ± 1.89) was significantly shorter than the composite AL (24.88 ± 1.96, P < .001). Bland-Altman analysis revealed a negative proportional bias for the differences between the segmented AL and the composite AL. The SD values obtained by Hoffer Q, Holladay 1, and SRK/T formulas based on the segmented AL (0.52 diopters [D], 0.54 D, and 0.50 D, respectively) were significantly lower than those based on the composite AL (0.57 D, 0.60 D, and 0.52 D, respectively, P < .01). CONCLUSIONS The segmented ALs were longer in short eyes and shorter in long eyes than the composite ALs. The refractive accuracy can be improved in the Hoffer Q, Holladay 1, and SRK/T formulas by changing the composite ALs to the segmented ALs.
Collapse
Affiliation(s)
- So Goto
- From the Department of Ophthalmology, National Hospital Organization, Tokyo Medical Center, Meguro-ku, Tokyo, Japan (Goto, Ogawa, Sugiyama, Matsumaru, Noda); Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan (Goto, Maeda); Herbert Wertheim School Optometry and Vision Science, University of California, Berkeley, California (Goto); Laboratorio de Lente Verde, Sodegaura, Chiba, Japan (Ohnuma); VO, Toda, Saitama, Japan (Lawu)
| | | | | | | | | | | | | | | |
Collapse
|
4
|
Amado SF, Amado NM, Hermosa L. Flange depth for scleral pocket vs no pocket techniques for intrascleral intraocular lens fixation. J Cataract Refract Surg 2024; 50:505-510. [PMID: 38651698 PMCID: PMC11045402 DOI: 10.1097/j.jcrs.0000000000001383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/29/2023] [Accepted: 12/09/2023] [Indexed: 04/25/2024]
Abstract
PURPOSE To compare flange depth for a modified scleral pocket (SP) vs no scleral pocket (NSP) technique (Yamane technique) for intrascleral intraocular lens (IOL) fixation. SETTING Instituto de Oftalmología Santa Fe, Santa Fe, Argentina. DESIGN Prospective, randomized, single-surgeon, observational study. METHODS Eyes with aphakia and no capsular support were included. They were divided into 2 groups: one was programmed for a double-needle flanged intrascleral IOL fixation as originally described by Shin Yamane with NSP and the second group had a modified SP technique. Flange depth was measured with anterior-segment optical coherence tomography (AS-OCT) at 1 month, 3 months, 6 months, and 12 months postoperatively, and the results were compared. RESULTS Each group comprised 18 eyes of 18 patients, giving a total of 36 flanges per group. The groups were comparable preoperatively. At 12 months, uncorrected distance visual acuity and corrected distance visual acuity (CDVA) were not statistically different for both groups (P = .333; P = .448). Spherical equivalent (SEQ) was not significantly different between groups at 12 months postoperatively (P = .078). AS-OCT revealed a significantly deeper flange position for the SP group at 1 month, 3 months, 6 months, and 12 months postoperatively (P < .05). CONCLUSIONS When performing a double-needle intrascleral IOL fixation in aphakic eyes with no capsular support, a modified scleral pocket technique provides a significantly deeper flange position with no difference in CDVA or SEQ 12 months postoperatively.
Collapse
Affiliation(s)
| | | | - Luciano Hermosa
- From the Instituto de Oftalmología Santa Fe, Santa Fe, Argentina
| |
Collapse
|
5
|
Moussa G, Jalil A, Lippera M, Cristescu IE, Ferrara M, Ally N, Ziaei H, El-Faouri M, Patton N, Jasani KM, Dhawahir-Scala F, Ivanova T. SF 6 COMPARED WITH C 2 F 6 FOR INFERIOR RHEGMATOGENOUS RETINAL REPAIR : The Manchester Pseudophakic Retinal Detachment Study. Retina 2024; 44:791-798. [PMID: 38236936 DOI: 10.1097/iae.0000000000004051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/24/2024]
Abstract
PURPOSE To compare SF 6 relative with C 2 F 6 in the anatomical and functional outcomes following pars plana vitrectomy for uncomplicated primary pseudophakic rhegmatogenous retinal detachment with inferior causative breaks. METHODS This is a retrospective, comparative study on eyes with pseudophakic rhegmatogenous retinal detachment with inferior causative breaks that had small-gauge pars plana vitrectomy repair using SF 6 and C 2 F 6 tamponade between 2011 and 2020 at a tertiary centre in the United Kingdom. Primary outcome was single surgery anatomical success, and the secondary outcome was best-corrected visual acuity. Propensity score matching, using preoperative findings as covariates to account for relevant confounders, was performed. RESULTS From 162 pseudophakic rhegmatogenous retinal detachment eyes with inferior causative breaks, the median (interquartile range) follow-up was 82 (52-182) days. The single surgery anatomical success was 156 (96.3%) overall: 47 of 47 (100.0%) and 109 of 115 (94.8%) in the SF 6 and C 2 F 6 groups, respectively ( P = 0.182). Relative to the SF 6 group, the C 2 F 6 group had a higher mean number of tears (SF 6 : 3.1[2.0], C 2 F 6 : 4.5[2.7], P = 0.002) and greater retinal detachment extent (SF 6 : 5.3[2.9], C 2 F 6 : 6.2[2.6] clock hours, P = 0.025). Following propensity score matching analysis, 80 eyes were matched with 40 in each group to homogenize preoperative factors. No significant difference was found in single surgery anatomical success and best-corrected visual acuity between the groups following propensity score matching. CONCLUSION Primary pars plana vitrectomy with gas tamponade leads to a high single surgery anatomical success rate in uncomplicated pseudophakic rhegmatogenous retinal detachment with inferior causative breaks with no additional benefit associated with long-acting tamponade when comparing C 2 F 6 with SF 6 .
Collapse
Affiliation(s)
- George Moussa
- Manchester Royal Eye Hospital, Manchester, United Kingdom
| | - Assad Jalil
- Manchester Royal Eye Hospital, Manchester, United Kingdom
| | - Myrta Lippera
- Manchester Royal Eye Hospital, Manchester, United Kingdom
| | | | - Mariantonia Ferrara
- Manchester Royal Eye Hospital, Manchester, United Kingdom
- School of Medicine, University of Málaga, Málaga, Spain; and
| | - Naseer Ally
- Manchester Royal Eye Hospital, Manchester, United Kingdom
| | - Hadi Ziaei
- Manchester Royal Eye Hospital, Manchester, United Kingdom
| | - Muhannd El-Faouri
- Manchester Royal Eye Hospital, Manchester, United Kingdom
- The Hashemite University, Zarqa, Jordan
| | - Niall Patton
- Manchester Royal Eye Hospital, Manchester, United Kingdom
| | - Kirti M Jasani
- Manchester Royal Eye Hospital, Manchester, United Kingdom
| | | | - Tsveta Ivanova
- Manchester Royal Eye Hospital, Manchester, United Kingdom
| |
Collapse
|
6
|
Guo S, Huang H, Li B, Huang M, Gao L, Chen J, Zeng Y, Yang Y, Liu L, Cheng L, Yao S, Cheng H. Comparatively analysing the postoperative optical performance of different intraocular lenses: a prospective observational study. BMC Ophthalmol 2024; 24:198. [PMID: 38671381 PMCID: PMC11046961 DOI: 10.1186/s12886-024-03439-0] [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: 01/24/2023] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Postoperative performance, including best corrected distance visual acuity (BCDVA) and optical metrics (from the OQAS and iTrace devices), was compared among 4 different intraocular lenses (IOLs). METHODS This prospective observational study included 104 eyes from 104 subjects who underwent cataract surgery combined with implantation of 4 different IOLs: monofocal (Mon) IOLs, segmental refractive (SegRef) IOLs, diffractive (Dif) IOLs and extended depth of focus (EDoF) IOLs. Postoperative BCDVA and optical metrics were collected at the 6th month. The OQAS optical metrics included the objective scattering index (OSI), Strehl ratio (SR), modulation transfer function (MTF) cut-off frequency, and predicted visual acuity (PVA); the iTrace optical metrics included blur/double vision, glare/halo, starburst, mixed focus, night myopia, and night hyperopia. RESULTS There was no significant difference in BCDVA among the 4 groups (P = 0.059; power = 70.3%). Differences were observed in all OQAS optical metrics among the groups (all P < 0.001). Overall, Mon IOLs and EDoF IOLs exhibited better performance than Dif IOLs and SegRef IOLs. Starburst was the only iTrace optical metric that differed among the groups (P < 0.001): SegRef IOLs caused more starbursts than Mon IOLs (P = 0.001), Dif IOLs (P = 0.006) and EDoF IOLs (P < 0.001). Spearman rank correlation analysis was used to determine the relationships among the iTrace optical metrics, OQAS optical metrics and BCDVA: starburst was negatively correlated with BCDVA, PVA at contrasts of 100% and 20%, OSI, and MTF cut-off frequency (all P ≤ 0.001); mixed focus was positively correlated with BCDVA, PVA at contrasts of 100% and 20%, OSI, and MTF cut-off frequency (all P ≤ 0.001). CONCLUSIONS Postoperative BCDVA and optical metrics varied among the different IOLs, which should be taken into account in the selection and management of IOLs for cataract patients. TRIAL REGISTRATION This study was approved by the First Affiliated Hospital of Guangzhou Medical University Ethical Review Board (No. 50 2022).
Collapse
Affiliation(s)
- Shuanglin Guo
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China
| | - Hao Huang
- Department of Ophthalmology, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, #116, Changjiang South Road, Zhuzhou, Hunan, 412000, China.
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
| | - Bowen Li
- Eye Center of Xiangya Hospital, Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, 410008, China
| | - Mansha Huang
- Department of Ophthalmology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, 510240, China
| | - Lu Gao
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China
| | - Jingyi Chen
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China
| | - Yuying Zeng
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China
| | - Ye Yang
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China
| | - Lin Liu
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China
| | - Lu Cheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China
| | - Siyang Yao
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China
| | - Hao Cheng
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, #151, Yanjiang West Road, Yuexiu District, Guangzhou, Guangdong, 510120, China.
| |
Collapse
|
7
|
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.
Collapse
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.
| |
Collapse
|
8
|
Wang X, Liu S, Chen Y, Gong J, Wu N, Yao Y. Extended depth of focus IOL in eyes with different axial myopia and targeted refraction. BMC Ophthalmol 2024; 24:183. [PMID: 38649861 PMCID: PMC11036644 DOI: 10.1186/s12886-024-03442-5] [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: 10/21/2023] [Accepted: 04/09/2024] [Indexed: 04/25/2024] Open
Abstract
AIM To evaluate the objective visual outcomes following implantation of extended depth of focus intraocular lens (EDOF IOL) in individuals with varying axial lengths (AL) and targeted refraction. METHODS This retrospective study comprised age-matched eyes that underwent implantation of the EDOF IOL. Eyes were categorized based on AL into groups: control group with AL < 26 mm; high myopia group with AL ≥ 26 mm. Each group was then subdivided based on postoperative spherical equivalent (SE). Follow-up at three months included assessment of uncorrected visual acuity at different distances, contrast sensitivity (CS), refractive outcomes, and spectacle independence. RESULTS Overall, this study included 100 eyes from 100 patients, comprising 50 males (50.00%) and 50 females (50.00%), with 20 eyes in each group. In the control group, the uncorrected distance visual acuity (UDVA) at 5 and 3 m (m) in the - 1.50 to -0.75 group was inferior to that of the - 0.75 to 0.00 group (P = 0.004). Conversely, the uncorrected near visual acuity (UNVA) at 33 cm in the - 1.50 to -0.75 group was superior to that of the - 0.75 to 0.00 group (P = 0.005). Within the high myopia group, the UDVA at 5 and 3 m in the - 2.25 to -1.50 group was worse than in the - 0.75 to 0.00 group (P = 0.009 and 0.008, respectively). However, the UNVA at 33 cm in the - 2.25 to -1.50 group was better than in the - 0.75 to 0.00 group (P = 0.020). No significant differences were observed among the groups for corrected distance visual acuity (CDVA) (P > 0.05). Additionally, in the high myopia group, the CS of the - 2.25 to -1.50 group was lower compared to that of the - 0.75 to 0.00 group (P = 0.017). Among high myopia patients, 90.00% with refraction ranging from - 1.50 to -0.75 reported achieving overall spectacle independence. CONCLUSIONS Implantation of extended depth of focus intraocular lenses (IOLs) yields satisfactory visual and refractive outcomes in eyes with axial myopia. Among high myopia patients, a refraction ranging from - 1.50 to -0.75 diopters achieves superior visual quality compared to other postoperative myopic diopters.
Collapse
Affiliation(s)
- Xiaohui Wang
- Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, 350005, Fujian, Fujian, China.
- Department of Ophthalmology, Binhai campus of the First Affiliated Hospital, National Regional Medical Center, Fujian Medical University, Fujian, China.
- Fujian Institute of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
- Fujian Provincial Clinical Medical Research Center of Eye Diseases and Optometry, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
| | - Sinan Liu
- Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, 350005, Fujian, Fujian, China
- Department of Ophthalmology, Binhai campus of the First Affiliated Hospital, National Regional Medical Center, Fujian Medical University, Fujian, China
- Fujian Institute of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Fujian Provincial Clinical Medical Research Center of Eye Diseases and Optometry, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Yinqi Chen
- Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, 350005, Fujian, Fujian, China
- Department of Ophthalmology, Binhai campus of the First Affiliated Hospital, National Regional Medical Center, Fujian Medical University, Fujian, China
- Fujian Institute of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Fujian Provincial Clinical Medical Research Center of Eye Diseases and Optometry, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Jinping Gong
- Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, 350005, Fujian, Fujian, China
- Department of Ophthalmology, Binhai campus of the First Affiliated Hospital, National Regional Medical Center, Fujian Medical University, Fujian, China
- Fujian Institute of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Fujian Provincial Clinical Medical Research Center of Eye Diseases and Optometry, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Nuozhou Wu
- Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, 350005, Fujian, Fujian, China
- Department of Ophthalmology, Binhai campus of the First Affiliated Hospital, National Regional Medical Center, Fujian Medical University, Fujian, China
- Fujian Institute of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Fujian Provincial Clinical Medical Research Center of Eye Diseases and Optometry, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Yihua Yao
- Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, 350005, Fujian, Fujian, China
- Department of Ophthalmology, Binhai campus of the First Affiliated Hospital, National Regional Medical Center, Fujian Medical University, Fujian, China
- Fujian Institute of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Fujian Provincial Clinical Medical Research Center of Eye Diseases and Optometry, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| |
Collapse
|
9
|
Abstract
Photopsia is a phenomenon that sometimes disturbs patients after cataract surgery. To evaluate the impact of the edge design of intraocular lenses (IOL) on the location, shape and relative intensity of photic effects at the retina caused by photopsia in pseudophakic eyes, photopsia was simulated using ZEMAX software. The structural parameters of the pseudophakic eye model are based on the Liou-Brennan eye model parameters with a pupil diameter of 4.5 mm. The IOLs implanted in the eye model have a power of 21 diopter (D) with optical diameter of 6 mm and 7 mm. From the ray-tracing analysis, covering variations of incident ray angle of 50° to 90° from temporally, a photic image is detected at the fovea at specific ray angles of 77.5° (6 mm IOL) and 78.2° (7 mm IOL). This photic image disappears when a thin IOL with an edge thickness of 0 mm or a thick IOL with absorbing edges is replaced in the eye model. With an anti-reflective edge, this photic image remains, but with a fully reflecting edge it disappears at the critical angles and appears with different shapes at other angles. The intensity of this photic image can be reduced by changing the edge design to a frosted surface. Most of the photic patterns in IOLs are not observed with absorbing and thin edge designs. IOLs with anti-reflecting and fully reflecting edges generate disturbing photic effects at different angles on the fovea. IOLs with frosted edges reduce the contrast of the photic effects and make them less disturbing for patients.
Collapse
Affiliation(s)
- Pooria Omidi
- Department of Experimental Ophthalmology, Saarland University, Homburg, Saarland, Germany
- * E-mail:
| | - Alan Cayless
- School of Physical Sciences, The Open University, Milton Keynes, United Kingdom
| | - Achim Langenbucher
- Department of Experimental Ophthalmology, Saarland University, Homburg, Saarland, Germany
| |
Collapse
|
10
|
Abstract
PURPOSE To compare the visual/anatomical outcomes and feasibility of epiretinal membrane surgery between patients with multifocal or monofocal intraocular lenses (IOLs). METHODS We reviewed the medical records of 46 patients who underwent epiretinal membrane surgery under multifocal or monofocal IOL pseudophakia. The operation time, mean changes in best-corrected visual acuity, and central macular thickness, and complications were compared between the groups. RESULTS Macular surgery was performed in 22 and 24 eyes with multifocal and monofocal IOLs, respectively. The total operation time and the total membrane peeling time were similar in both groups (P = 0.125, P = 0.462, respectively). The mean time to create a membrane edge or flap with retinal microforceps was longer for multifocal than for monofocal IOLs (P = 0.013). The mean changes in best-corrected visual acuity and central macular thickness were similar in both groups (P = 0.682, P = 0.741, respectively). Complications were similar between groups. CONCLUSION With multifocal IOLs, vision outside the central surgical field was blurred, requiring more time to create the membrane flap. Retinal surgeons should anticipate the difficulty in precise focusing when creating a membrane flap in macular surgery in patients with multifocal IOLs and should pay more attention to the macular surgery.
Collapse
Affiliation(s)
- Jong Young Lee
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; and
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kwangsic Joo
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; and
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sang Jun Park
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; and
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Se Joon Woo
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; and
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyu Hyung Park
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; and
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
11
|
Patel KG, Yazdani A, Abbey AM. TWENTY-FIVE AND TWENTY-SEVEN-GAUGE SUTURELESS INTRASCLERAL FIXATION OF INTRAOCULAR LENSES: Clinical Outcomes and Comparative Effectiveness of Haptic Flanging in a Large Single-Surgeon Series of 488 Eyes. Retina 2021; 41:2485-2490. [PMID: 34190728 DOI: 10.1097/iae.0000000000003243] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe the clinical outcomes and surgical technique in transconjunctival sutureless intrascleral fixation of intraocular lenses, including the effectiveness of haptic flanging and peripheral iridotomy. METHOD Retrospective series of patients who underwent sutureless intrascleral fixation of three-piece intraocular lenses by a single surgeon. RESULTS A total of 488 eyes were included in this study. Mean follow-up was 444 days. Mean preoperative best-corrected visual acuity was 20/355, and mean postoperative best-corrected visual acuity was 20/39 (P < 0.001). Intraocular lens dislocation occurred during the postoperative period in 67 (13.7%), with the majority (65.7%) occurring within 3 months after surgery. Dislocation occurred in 13 of 196 (6.6%) flanged haptics versus 54 of 292 (18.5%) unflanged haptics (P < 0.001). Reverse pupillary block occurred in 7 of 231 eyes (3.0%) without intraoperative peripheral iridotomy but only in 1 of 257 eyes (0.4%) with iridotomy (P = 0.0297). Other complications included haptic exposure (1.2%), retinal detachment (1.0%), and endophthalmitis (0.4%). CONCLUSION This is the largest reported series of sutureless intrascleral fixation of intraocular lenses using trocar cannulas. This technique is an effective surgical option with low complication rates. The authors recommend that haptic flanging and peripheral iridotomy be performed in all cases.
Collapse
Affiliation(s)
- Kishan G Patel
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri; and
| | | | | |
Collapse
|
12
|
Moshiri I, Karimi-Golkar D, Schrittenlocher S, Cursiefen C, Bachmann B. Outcomes of Pseudophakic, Phakic, and Triple DMEK. Cornea 2021; 40:1253-1257. [PMID: 33859090 DOI: 10.1097/ico.0000000000002723] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 02/07/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the outcome of phakic and pseudophakic eyes treated by Descemet membrane endothelial keratoplasty (DMEK) versus DMEK combined with cataract surgery (triple DMEK). METHODS Retrospective cohort study based on the prospective Cologne DMEK data base. This study is a single-center analysis of 62 eyes undergoing phakic (age mean ± SD 52 ± 6.43), 518 eyes undergoing pseudophakic (73.5 ± 8.57), and 557 eyes undergoing triple DMEK (67.93 ± 8.57). Outcome measures were changes in best spectacle-corrected visual acuity (BSCVA), central corneal thickness, endothelial cell density (ECD), rebubbling rates within the first year after surgery, and the need for cataract surgery within the first 2 years after phakic DMEK. RESULTS The preoperative BSCVA (mean ± SD; logarithm of the minimum angle of resolution) was 0.30 ± 0.22 in the phakic, 0.63 ± 0.45 in the pseudophakic, and 0.44 ± 0.30 in the triple DMEK group (P < 0.001), which changed to 0.09 ± 0.12, 0.14 ± 0.1, and 0.1 ± 0.1 (P < 0.001) 1 year after surgery, respectively. There was no difference in central corneal thickness (P = 0.929) and endothelial cell density (P = 0.606) 1 year postoperatively. Rebubbling rates in DMEK using SF6 20% for anterior chamber tamponade were not significantly different (P = 0.839). After phakic DMEK, 40% of eyes underwent cataract surgery within the second year. However, there was a high loss to follow-up in this group. CONCLUSIONS Phakic and triple DMEK procedures tend to have a better 1-year BSCVA than pseudophakic DMEK, with no differences in all other parameters analyzed. However, patients from the pseudophakic DMEK group were older and already had worse BSCVA before surgery.
Collapse
Affiliation(s)
- Isabella Moshiri
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | | | | | | |
Collapse
|
13
|
Nguyen XTA, Almushattat H, Strubbe I, Georgiou M, Li CHZ, van Schooneveld MJ, Joniau I, De Baere E, Florijn RJ, Bergen AA, Hoyng CB, Michaelides M, Leroy BP, Boon CJF. The Phenotypic Spectrum of Patients with PHARC Syndrome Due to Variants in ABHD12: An Ophthalmic Perspective. Genes (Basel) 2021; 12:1404. [PMID: 34573385 PMCID: PMC8467809 DOI: 10.3390/genes12091404] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 08/04/2021] [Revised: 09/06/2021] [Accepted: 09/10/2021] [Indexed: 01/08/2023] Open
Abstract
This study investigated the phenotypic spectrum of PHARC (polyneuropathy, hearing loss, ataxia, retinitis pigmentosa and early-onset cataract) syndrome caused by biallelic variants in the ABHD12 gene. A total of 15 patients from 12 different families were included, with a mean age of 36.7 years (standard deviation [SD] ± 11.0; range from 17.5 to 53.9) at the most recent examination. The presence and onset of neurological, audiological and ophthalmic symptoms were variable, with no evident order of symptom appearance. The mean best-corrected visual acuity was 1.1 logMAR (SD ± 0.9; range from 0.1 to 2.8; equivalent to 20/250 Snellen) and showed a trend of progressive decline. Different types of cataract were observed in 13 out of 15 patients (87%), which also included congenital forms of cataract. Fundus examination revealed macular involvement in all patients, ranging from alterations of the retinal pigment epithelium to macular atrophy. Intraretinal spicular hyperpigmentation was observed in 7 out of 15 patients (47%). From an ophthalmic perspective, clinical manifestations in patients with PHARC demonstrate variability with regard to their onset and severity. Given the variable nature of PHARC, an early multidisciplinary assessment is recommended to assess disease severity.
Collapse
Affiliation(s)
- Xuan-Thanh-An Nguyen
- Department of Ophthalmology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands;
- Department of Ophthalmology, Amsterdam UMC, Academic Medical Center, 1105 AZ Amsterdam, The Netherlands; (H.A.); (M.J.v.S.)
| | - Hind Almushattat
- Department of Ophthalmology, Amsterdam UMC, Academic Medical Center, 1105 AZ Amsterdam, The Netherlands; (H.A.); (M.J.v.S.)
| | - Ine Strubbe
- Department of Ophthalmology, Ghent University and Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium; (I.S.); (I.J.); (B.P.L.)
| | - Michalis Georgiou
- UCL Institute of Ophthalmology, University College London, London EC1V 9EL, UK; (M.G.); (M.M.)
- Moorfields Eye Hospital NHS Foundation Trust, 162 City Road, London EC1V 2PD, UK
| | - Catherina H. Z. Li
- Department of Ophthalmology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (C.H.Z.L.); (C.B.H.)
- Donders Institute for Brain, Cognition and Behaviour, 6525 HR Nijmegen, The Netherlands
| | - Mary J. van Schooneveld
- Department of Ophthalmology, Amsterdam UMC, Academic Medical Center, 1105 AZ Amsterdam, The Netherlands; (H.A.); (M.J.v.S.)
| | - Inge Joniau
- Department of Ophthalmology, Ghent University and Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium; (I.S.); (I.J.); (B.P.L.)
| | - Elfride De Baere
- Center for Medical Genetics, Ghent University and Ghent University Hospital, 9000 Ghent, Belgium;
| | - Ralph J. Florijn
- Department of Clinical Genetics, Amsterdam UMC, Academic Medical Center, 1105 AZ Amsterdam, The Netherlands; (R.J.F.); (A.A.B.)
| | - Arthur A. Bergen
- Department of Clinical Genetics, Amsterdam UMC, Academic Medical Center, 1105 AZ Amsterdam, The Netherlands; (R.J.F.); (A.A.B.)
- Netherlands Institute for Neuroscience, Institute of the Royal Netherlands Academy of Arts and Sciences (KNAW), 1105 BA Amsterdam, The Netherlands
| | - Carel B. Hoyng
- Department of Ophthalmology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (C.H.Z.L.); (C.B.H.)
- Donders Institute for Brain, Cognition and Behaviour, 6525 HR Nijmegen, The Netherlands
| | - Michel Michaelides
- UCL Institute of Ophthalmology, University College London, London EC1V 9EL, UK; (M.G.); (M.M.)
- Moorfields Eye Hospital NHS Foundation Trust, 162 City Road, London EC1V 2PD, UK
| | - Bart P. Leroy
- Department of Ophthalmology, Ghent University and Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium; (I.S.); (I.J.); (B.P.L.)
- Center for Medical Genetics, Ghent University and Ghent University Hospital, 9000 Ghent, Belgium;
- Division of Ophthalmology, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Center for Cellular & Molecular Therapeutics, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Camiel J. F. Boon
- Department of Ophthalmology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands;
- Department of Ophthalmology, Amsterdam UMC, Academic Medical Center, 1105 AZ Amsterdam, The Netherlands; (H.A.); (M.J.v.S.)
| |
Collapse
|
14
|
Ota Y, Minami K, Oki S, Bissen‐Miyajima H, Okamoto K, Nakashima M, Tsubota K. Subjective and objective refractions in eyes with extended-depth-of-focus intraocular lenses using echelette optics: clinical and experimental study. Acta Ophthalmol 2021; 99:e837-e843. [PMID: 33191658 PMCID: PMC8518701 DOI: 10.1111/aos.14660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/11/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE To evaluate differences in subjective and objective refractions in eyes with extended-depth-of-focus intraocular lenses (EDOF IOLs) using echelette optics, and the effect of the light wavelength used during examinations. METHODS In the prospective study, subjective and objective refractions of 128 eyes of 64 patients were examined 3 months after implantation of the EDOF IOLs (ZXR00V, Johnson & Johnson Surgival Vision). Objective refractions were measured using an autorefractor with a near-infrared (NIR) light source. Clinical differences in the spherical, cylindrical and spherical equivalent (SE) refractions between the subjective and objective refractions were evaluated. Then, lens powers of monofocal, EDOF and diffractive bifocal IOLs in the use of a 850-nm light source were measured experimentally for using a lensmeter, and the differences from the monofocal IOLs were calculated. RESULTS The mean objective refractions were more myopic (p < 0.001) than the subjective refractions; the differences in the spherical, cylindrical and SE refractions were -0.71, -0.26 and -0.84 dioptre, respectively. Experimental investigation resulted that there was the mean difference of 0.83 D with the EDOF from monofocal IOLs at 850 nm, while the difference was -0.20 D with bifocal IOLs. CONCLUSIONS The diffractive EDOF IOLs using echelette gratings inherently induced constant differences in the subjective and objective refractions, which arose from the chromatic difference in IOL powers for the visible and NIR lights.
Collapse
Affiliation(s)
- Yuka Ota
- Department of OphthalmologyTokyo Dental Collage Suidobashi HospitalTokyoJapan
- Department of OphthalmologyKeio University School of MedicineTokyoJapan
| | - Keiichiro Minami
- Department of OphthalmologyTokyo Dental Collage Suidobashi HospitalTokyoJapan
| | - Shinichi Oki
- Department of OphthalmologyTokyo Dental Collage Suidobashi HospitalTokyoJapan
| | | | | | | | - Kazuo Tsubota
- Department of OphthalmologyKeio University School of MedicineTokyoJapan
| |
Collapse
|
15
|
Marmamula S, Barrenakala NR, Challa R, Kumbham TR, Modepalli SB, Yellapragada R, Bhakki M, Reddy JC, Friedman DS, Khanna RC. Visual outcomes after cataract surgery among the elderly residents in the 'homes for the aged' in South India: the Hyderabad Ocular Morbidity in Elderly Study. Br J Ophthalmol 2021; 105:1087-1093. [PMID: 32855164 PMCID: PMC8311112 DOI: 10.1136/bjophthalmol-2020-317167] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/08/2020] [Accepted: 07/23/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND/AIM To report visual outcomes and factors associated with good visual outcomes after cataract surgery among the elderly residents in 'homes for the aged' in Hyderabad, India. METHODS Individuals aged ≥60 years were recruited from 41 'homes for the aged'. All participants had a detailed eye examinations including visual acuity (VA) assessment , refraction, slit-lamp examination and fundus imaging by trained professionals. A detailed history of cataract surgery was recorded. Multivariate logistic regression was used to determine the factors associated with good visual outcomes after cataract surgery which was defined as presenting VA of 6/18 or better in the operated eye. Visual impairment (VI) is defined as presenting VA worse than 6/18 in the operated eye. RESULTS 1215 eyes of 703 individuals had cataract surgery. The mean age of these participants was 77.5 years (SD: 8.2 years; range: 60-108 years), 66.8% were women, 29.9% reported diabetes and 61% reported hypertension. 406/1215 (33.4%; 95% CI 30.8 to 36.1) eyes had VI after cataract surgery. Posterior capsular opacification (31.8%; n=129) was the leading cause of VI followed by uncorrected refractive error (24.1%; n=98). The prevalence of good outcomes was 66.6% (95% CI 63.8 to 69.2). On applying multivariable analysis, younger age, self-reported hypertension, independent mobility, surgery in a non-government (as opposed to private) hospital and undergoing paid surgery were associated with good outcomes. CONCLUSIONS One-third of the eyes of elderly individuals living in homes for the aged that had previously undergone cataract surgery had VI. Regular eye examinations with the provision of laser capsulotomy and appropriate refractive correction can substantially improve their vision.
Collapse
Affiliation(s)
- Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India
- Department of Biotechnology / Wellcome Trust India Alliance, L V Prasad Eye Institute, Hyderabad, India
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Massachusetts Eye and Ear, Harvard Medical School Department of Ophthalmology, Boston, United States of America
| | - Navya Rekha Barrenakala
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Rajesh Challa
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Thirupathi Reddy Kumbham
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Satya Brahmanandam Modepalli
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Ratnakar Yellapragada
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Madhuri Bhakki
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Jagadesh C Reddy
- Cataract and Refractive Services, L V Prasad Eye Institute, Hyderabad, India
| | - David S Friedman
- Massachusetts Eye and Ear, Harvard Medical School Department of Ophthalmology, Boston, United States of America
| | - Rohit C Khanna
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| |
Collapse
|
16
|
Yuan B, Li J, Song H. Effect of misalignment at different orientations associated with angle κ on optical performance of aspheric intraocular lenses with different surface designs. Appl Opt 2021; 60:5917-5924. [PMID: 34263818 DOI: 10.1364/ao.423000] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 06/22/2021] [Indexed: 06/13/2023]
Abstract
Intraocular lens (IOL) misalignment and angle κ have had significant negative impact on post-operative quality of vision. ZEMAX software has been used to imitate the optical performance of pseudophakic eyes with different IOL surface designs at different orientations of IOL misalignment (decentration of 0.4 mm and tilt of 7°, and with the existence of 0.5 mm angle κ). We found that an aspheric balanced curve optic surface maintained better optical performance via inducing less coma aberration. Coma aberration played an unexpectedly important role in the optical performance. With angle κ, the impact of IOL misalignment on visual quality was associated with the orientation of decentration and tilt, indicating that the coma compensation also took effect in pseudophakic eyes. Due to the high incidence of post-operative IOL misalignment, our results provide evidence of the importance of considering personalized angle κ before cataract surgery for patients.
Collapse
|
17
|
Ma KK, Yuan A, Sharifi S, Pineda R. A Biomechanical Study of Flanged Intrascleral Haptic Fixation of Three-Piece Intraocular Lenses. Am J Ophthalmol 2021; 227:45-52. [PMID: 33626366 PMCID: PMC10479968 DOI: 10.1016/j.ajo.2021.02.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 02/08/2021] [Accepted: 02/16/2021] [Indexed: 01/04/2023]
Abstract
PURPOSE Flanged intrascleral haptic fixation (FISHF) is a useful method for securing intraocular lenses (IOLs) in eyes without capsular support. Biomechanical studies were conducted to support the use of this technique. DESIGN Laboratory investigation. METHODS Haptics of 3-piece IOLs were passed through cadaveric human sclera using 30- and 27-gauge needles. Flanges were created by melting 1.0 mm from the haptic ends using cautery. The forces required to remove the flanged haptic from the sclera and disinsert the haptic from the optic were measured using a mechanical tester and a custom-fabricated mount. RESULTS The mean FISHF dislocation force using 30-gauge needles was greatest with the CT Lucia 602 (2.04 ± 0.24 newtons [N]) compared to the LI61AO (0.93 ± 0.41 N; P = .001), ZA9003 (0.70 ± 0.34 N; P = <.001), and MA60AC (0.27 ± 0.19 N; P <.001). Using 27-gauge needles with the CT Lucia resulted in a lower dislocation force (0.56 ± 0.36 N; P <.001). The FISHF dislocation force was correlated with the flange-to-needle diameter ratio (r = 0.975). The FISHF dislocation forces of the CT Lucia and LI61AO using 30-gauge needles were not significantly different from their haptic-optic disinsertion forces (P = .79 and .27, respectively). There were no differences in flange diameters between 1.0 mm and 2.0 mm haptic melt lengths across the IOLs (P = .15-.85). CONCLUSIONS These data strongly support the biomechanical stability of FISHF with the polyvinylidene fluoride haptics of the CT Lucia using small diameter instruments for the creation of an intrascleral tunnel. 1.0 mm of haptic may be the optimal melt length.
Collapse
Affiliation(s)
- Kevin K Ma
- From the Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Amy Yuan
- Department of Ophthalmology, University of Washington, Seattle, Washington, USA
| | - Sina Sharifi
- Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Roberto Pineda
- From the Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA..
| |
Collapse
|
18
|
Simpson MJ. Pre-clinical estimation of the intraocular lens A-constant, and its relationship to power, shape factor, and asphericity. Appl Opt 2021; 60:5662-5668. [PMID: 34263859 DOI: 10.1364/ao.426155] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/01/2021] [Indexed: 06/13/2023]
Abstract
Calculating the intraocular lens power for a particular patient requires an empirical "lens constant" to estimate the final axial location after surgery. This is normally calculated from clinical results for each new lens style, but it can also be estimated without clinical data by comparing a new style to an existing style. The lenses are axially positioned in a model eye at comparable locations, and image distances are used to estimate the change in lens constant. The A-constant used by the SRK/T calculation method is evaluated here, but this can be easily converted for other calculations using an average eye. Raytrace calculations demonstrate the method, and also illustrate the effects that refractive index, shape factor, and asphericity have on the refractive error. Actual lens measurements at 35°C in saline are preferable if details of the reference lens are uncertain.
Collapse
|
19
|
Viljanen A, Koskela K, Koskela H, Tuuminen R, Uusitalo H. One-year Results of Health-related and Vision-related Quality of Life After Clear Lens Extraction and Multifocal Intraocular Lens Implantation. Am J Ophthalmol 2021; 227:240-244. [PMID: 33823159 DOI: 10.1016/j.ajo.2021.03.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 03/25/2021] [Accepted: 03/25/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Multifocal intraocular lenses (MIOLs) are effective in treating presbyopia before cataracts develop. This study measured health-related quality of life (HRQoL) and vision-related quality of life (VRQoL) after clear lens extraction (CLE) and MIOL implantation. DESIGN Before-and-after study METHODS: Patients were treated in Medilaser Coronaria, CorGroup, Oulu, Finland. HRQoL was measured by a generic 15-dimension (15D) instrument. VRQoL was measured with Visual Function Index-14 (VF-14) questionnaire. RESULTS CLE and MIOL implantation was performed in 137 patients. The patient age was 57 ± 6.2 years (mean ± standard deviation), and 58% were women. The near add was 2.1±0.3 diopters (D). The overall HRQoL 15D score increased from 0.938±0.058 to 0.955±0.057 at 6 months (P < .0001 vs baseline) and to 0.948±0.060 at 1 year (P = .02 vs baseline). The VRQoL VF14 score increased from 85.32±15.57 to 96.57±5.07 at 6 months (P < .0001 vs baseline) and to 96.61±6.48 at 1 year (P < .0001 vs baseline). The increase of HRQoL was correlated with the increase of VRQoL (P < .04). CONCLUSIONS CLE and MIOL implantation improved HRQoL and VRQoL compared to spectacles in this 1-year follow-up study. Improvement of HRQoL was correlated with VRQoL.
Collapse
Affiliation(s)
- Antti Viljanen
- From the Medilaser Coronaria, Silmaasema Silmasairaala, CorGroup, Oulu.
| | - Kimmo Koskela
- From the Medilaser Coronaria, Silmaasema Silmasairaala, CorGroup, Oulu
| | - Harri Koskela
- From the Medilaser Coronaria, Silmaasema Silmasairaala, CorGroup, Oulu
| | - Raimo Tuuminen
- Helsinki Retina Research Group, University of Helsinki, Helsinki
| | - Hannu Uusitalo
- SILK, Department of Ophthalmology, Tampere University, Tays Eye Center, Tampere, Finland
| |
Collapse
|
20
|
Alarcon A, Cánovas C, Koopman B, Weeber H, Auffarth GU, Piers PA. Enhancing the Intermediate Vision of Monofocal Intraocular Lenses Using a Higher Order Aspheric Optic. J Refract Surg 2021; 36:520-527. [PMID: 32785725 DOI: 10.3928/1081597x-20200612-01] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 06/12/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To describe and evaluate a new monofocal intraocular lens (IOL) designed to improve intermediate vision using a unique refractive technology. METHODS The new monofocal lens is based on a higher order aspheric optic and is designed to improve intermediate vision. Simulated visual acuity from far to -2.00 diopters (D) was calculated using optical bench data. The effect of corneal higher order aberrations (HOAs) on simulated visual acuity, pupil size, and decentration was assessed using realistic computer eye models. The susceptibility to photic phenomena was evaluated by measuring preclinically the intensity of the light distribution in the retinal plane. The new lens design was compared to a standard aspheric monofocal IOL that shares the same platform, material, and primary spherical aberration as the new design. RESULTS Simulated defocus curves showed increased simulated visual acuity in the intermediate range compared to a standard aspheric monofocal IOL with comparable distance vision, independently of the pupil size and corneal HOAs. At -1.50 D, the new IOL design provided a gain of approximately 0.1 logMAR, whereas at distance, the difference was less than 0.05 logMAR. The tolerance to decentration was also similar in both designs. Finally, experimental results indicate that the susceptibility to photic phenomena with the new lens design was similar to that of a standard aspheric monofocal IOL. CONCLUSIONS Preclinical data showed that the new lens design improves intermediate vision while maintaining comparable distance image quality and keeping the same photic phenomena profile as a standard aspheric monofocal IOL. [J Refract Surg. 2020;36(8):520-527.].
Collapse
|
21
|
Cao D, Xu Y, Wang Y. Comparison of Toric Intraocular Lens Alignment Between Femtosecond Laser-Assisted Capsular Marking and Manual Corneal Marking. J Refract Surg 2021; 36:536-542. [PMID: 32785727 DOI: 10.3928/1081597x-20200602-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 06/02/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare toric intraocular lens (IOL) alignment between femtosecond laser-assisted capsular marking and manual corneal marking. METHODS This study prospectively included 72 consecutive eyes (from 72 patients) with cataract and anterior corneal astigmatism of 1.00 diopter (D) or greater that underwent femtosecond laser-assisted cataract surgery with implantation of a toric IOL. These eyes were randomly categorized into two groups based on the IOL alignment method. The femtosecond laser capsular marking group included 36 eyes with capsular markers using the latest femtosecond laser platform. The manual marking group included 36 eyes with manual corneal markers. The preservation of the markers was assessed. Visual acuity and refractive outcomes, as well as deviation from the target axis, were evaluated. RESULTS In the femtosecond laser capsular marking group, all capsular markers were retained for at least 3 months. In the manual marking group, 22.2% of the corneal markers disappeared within 1 month and all markers disappeared within 3 months. At 1 month postoperatively, the mean magnitudes of refractive astigmatism were -0.41 ± 0.26 and -0.45 ± 0.31 D (P = .81), and the uncorrected distance visual acuities were 0.07 ± 0.06 and 0.07 ± 0.05 logMAR (P = .56) in the femtosecond laser capsular marking and manual marking groups, respectively. The misalignment of the toric IOL within 1 hour postoperatively was 1.5° ± 1.4° in the femtosecond laser capsular marking group and 4.4° ± 2.1° in the manual marking group (P < .01). The deviation from the target axis of implantation was 1.6° ± 1.3° in the femtosecond laser capsular group and 4.8° ± 2.5° in the manual marking group (P < .01) at 1 month postoperatively. CONCLUSIONS IOL misalignment was significantly lower in the femtosecond laser-assisted capsular marking group than in the manual corneal marking group. In addition, the long-term preservation of the capsular marker is helpful in evaluating the rotation of the toric IOL. [J Refract Surg. 2020;36(8):536-542.].
Collapse
|
22
|
Song JE, Khoramnia R, Son HS, Knorz MC, Choi CY. Comparison Between Bilateral Implantation of a Trifocal IOL and Mix-and-Match Implantation of a Bifocal IOL and an Extended Depth of Focus IOL. J Refract Surg 2021; 36:528-535. [PMID: 32785726 DOI: 10.3928/1081597x-20200616-01] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/12/2020] [Indexed: 01/26/2023]
Abstract
PURPOSE To compare the clinical outcomes of mix-and-match implantation of a diffractive extended depth of focus intraocular lens (IOL) (TECNIS Symfony ZXR00; Johnson & Johnson Vision) and a diffractive bifocal IOL (TECNIS ZLB00 +3.25 diopters [D]; Johnson & Johnson Vision) and bilateral implantation of a diffractive trifocal IOL (AcrySof IQ PanOptix; Alcon Laboratories, Inc). METHODS This prospective comparative study compares the clinical outcomes of patients with age-related cataract undergoing cataract surgery using the IOLs described. Patients were divided into the mix-and-match group and the trifocal group. Assessment included monocular and binocular uncorrected distance visual acuity (UDVA), intermediate visual acuity (UIVA at 60 cm), and near visual acuity (UNVA at 40 cm), uncorrected defocus curves, contrast sensitivity, and reading speed. Quality of vision was measured with the Visual Function Questionnaire (VFQ-25). RESULTS A total of 50 patients (25 in each group) were enrolled. At 6 months postoperatively, outcomes of binocular UDVA, UIVA, and UNVA were similar in both groups. The binocular defocus curve only differed at vergences of -0.50 to -1.00 D (better for the mix-and-match group; P = .032 and .004, respectively) and at -4.00 D (better for the trifocal group; P = .001). Significantly higher reading speeds in the mix-and-match group were measured at 0.7 and 0.5 logMAR (P = .038 and .034, respectively). There were no significant differences between groups for contrast sensitivity and the results of the questionnaire. CONCLUSIONS The mix-and-match implantation seemed to be a good option for patients with high demands for distance and intermediate visual acuity, whereas the trifocal IOL appeared to be more suitable for patients with enhanced near vision demands. [J Refract Surg. 2020;36(8):528-535.].
Collapse
|
23
|
Auffarth GU, Moraru O, Munteanu M, Tognetto D, Bordin P, Belucci R, Khoramnia R, Son HS. European, Multicenter, Prospective, Non-comparative Clinical Evaluation of an Extended Depth of Focus Intraocular Lens. J Refract Surg 2021; 36:426-434. [PMID: 32644164 DOI: 10.3928/1081597x-20200603-01] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 06/02/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate clinical and safety results obtained with an extended depth of focus (EDOF) intraocular lens (IOL). METHODS In this European, multicenter, prospective, uncontrolled, interventional study, 77 patients were enrolled in the study, 71 patients received bilateral implantation of the Mini Well Ready EDOF IOL (SIFI S.p.A.), and 68 patients completed the study and were evaluated 2 to 4 months postoperatively. Each clinical examination recorded uncorrected (UDVA) and corrected (CDVA) distance visual acuity, uncorrected (UIVA) and distance-corrected (DCIVA) intermediate visual acuity, and uncorrected (UNVA), distance-corrected (DCNVA), and corrected (CNVA) near visual acuity. A defocus curve from +2.00 to -5.00 diopters (D) was obtained, contrast sensitivity and reading ability were assessed, and the perception of dysphotopsia was evaluated. RESULTS Mean binocular visual results showed UDVA, UIVA, and UNVA values of -0.01 ± 0.15, 0.03 ± 0.10, and 0.10 ± 0.11 logMAR, respectively. Mean binocular defocus curve demonstrated a visual acuity of 0.30 logMAR or better from +2.00 to -3.00 D. Mean photopic contrast sensitivity values were 1.86, 2.18, 1,97, 1.51, and 1.17 at 1.5, 3.0, 6.0, 12.0, and 18.0 cycles per degree, respectively. A fluent reading speed of 80 words per minute was reached at 0.5 logRAD by 95.31% of patients without distance correction. The mean halo size was 33.06 ± 14.25, mean halo intensity was 38.00 ± 18.51, mean glare size was 23.85 ± 10.43, and mean glare intensity was 42.23 ± 13.22. One postoperative complication, a moderate photophobia, was observed and classified as related to the lens. CONCLUSIONS The Mini Well Ready EDOF IOL provides good visual acuity across various distances and functional reading ability provided at a near range, and delivers an enhanced contrast sensitivity while causing a low incidence of photic phenomena. [J Refract Surg. 2020;36(7):426-434.].
Collapse
|
24
|
Cai L, Han X, Jiang Y, Qiu X, Qian D, Lu Y, Yang J. Three-Year Outcomes of Cionni-Modified Capsular Tension Ring Implantation in Children Under 8 Years Old With Ectopia Lentis. Am J Ophthalmol 2021; 224:74-83. [PMID: 33253663 DOI: 10.1016/j.ajo.2020.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 11/15/2020] [Accepted: 11/16/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE This study evaluated visual outcomes and complications at 3 years post-implantation of a Cionni-modified capsular tension ring (MCTR) with an intraocular lens (IOL) in ectopia lentis patients ≤8 years old. DESIGN Prospective clinical cohort study. METHODS Included were 101 eyes from 57 patients <8 years of age, who underwent surgery for nontraumatic ectopia lentis between November 2015 and December 2016. Exclusion criteria were planned IOL fixation in the ciliary sulcus, severe intraoperative complications, and incomplete follow-up. All eyes received in-the-bag implantation of a posterior IOL and Cionni-MCTR. Posterior capsulectomy and anterior vitrectomy were performed through the pars plana in 23 eyes of children <5 years of age. Patients were examined at 1 day, and 1, 6, and 12 months, and at 2 and 3 years postoperatively. Outcome; measurements included best-corrected visual acuity (BCVA), intraocular pressure (IOP), IOL centration, and posterior capsule opacification (PCO). RESULTS In all eyes, BCVA improved significantly after surgery, especially during the first 12 months (P < .05). Three years post-operatively, 44 eyes had BCVA 0.9 or better. Prophylactic Nd:YAG laser capsulotomy was performed 3 months post-surgery in 24 eyes; 34 eyes underwent this; procedure 6 months post-surgery because of PCO. A second surgery was; warranted in 4 eyes because of severe IOL decentration and combined anterior capsule contraction. No severe postoperative complications, such as retinal detachment or endophthalmitis, occurred. CONCLUSIONS Implantation of in-the-bag IOL with Cionni MCTR is effective for visual rehabilitation in young children with ectopia lentis. A close follow-up of these patients is necessary to monitor IOL centration and stability.
Collapse
Affiliation(s)
- Lei Cai
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai, People's Republic of China; Key Laboratory of Myopia, Ministry of Health, Shanghai, People's Republic of China; Key Laboratory of Visual Impairment and Restoration, Shanghai, People's Republic of China; Visual Rehabilitation Professional Committee, Chinese Association of Rehabilitation Medicine, People's Republic of China
| | - Xiaoyan Han
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai, People's Republic of China; Key Laboratory of Myopia, Ministry of Health, Shanghai, People's Republic of China; Key Laboratory of Visual Impairment and Restoration, Shanghai, People's Republic of China; Visual Rehabilitation Professional Committee, Chinese Association of Rehabilitation Medicine, People's Republic of China
| | - Yongxiang Jiang
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai, People's Republic of China; Key Laboratory of Myopia, Ministry of Health, Shanghai, People's Republic of China; Key Laboratory of Visual Impairment and Restoration, Shanghai, People's Republic of China; Visual Rehabilitation Professional Committee, Chinese Association of Rehabilitation Medicine, People's Republic of China
| | - Xiaodi Qiu
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai, People's Republic of China; Key Laboratory of Myopia, Ministry of Health, Shanghai, People's Republic of China; Key Laboratory of Visual Impairment and Restoration, Shanghai, People's Republic of China; Visual Rehabilitation Professional Committee, Chinese Association of Rehabilitation Medicine, People's Republic of China
| | - Dongjin Qian
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai, People's Republic of China; Key Laboratory of Myopia, Ministry of Health, Shanghai, People's Republic of China; Key Laboratory of Visual Impairment and Restoration, Shanghai, People's Republic of China; Visual Rehabilitation Professional Committee, Chinese Association of Rehabilitation Medicine, People's Republic of China
| | - Yi Lu
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai, People's Republic of China; Key Laboratory of Myopia, Ministry of Health, Shanghai, People's Republic of China; Key Laboratory of Visual Impairment and Restoration, Shanghai, People's Republic of China; Visual Rehabilitation Professional Committee, Chinese Association of Rehabilitation Medicine, People's Republic of China
| | - Jin Yang
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai, People's Republic of China; Key Laboratory of Myopia, Ministry of Health, Shanghai, People's Republic of China; Key Laboratory of Visual Impairment and Restoration, Shanghai, People's Republic of China; Visual Rehabilitation Professional Committee, Chinese Association of Rehabilitation Medicine, People's Republic of China.
| |
Collapse
|
25
|
Benson MD, Sia D, Seamone ME, Greve M, Hinz B, Tennant MTS, Baker C, Somani R, Ehmann DS. PHACOVITRECTOMY FOR PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT REPAIR: A Retrospective Review. Retina 2021; 41:753-760. [PMID: 32796447 DOI: 10.1097/iae.0000000000002945] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To analyze the single surgery success rate and anterior segment complications related to phacoemulsification and intraocular lens implantation in a series of patients undergoing phacovitrectomy for all types of primary rhegmatogenous retinal detachment. METHODS We performed a retrospective interventional case series on 302 eyes undergoing phacovitrectomy for primary rhegmatogenous retinal detachment repair between November 1, 2016, and February 2, 2019, in Edmonton, Canada. Primary outcomes included single surgery retinal reattachment rate and anterior segment complications. Secondary outcomes included the effects of proliferative vitreoretinopathy and macula and/or peripheral internal limiting membrane peeling on the rate of surgical success. RESULTS The single surgery success rate of phacovitrectomy for all types of primary rhegmatogenous retinal detachment was 85.1%. The presence of proliferative vitreoretinopathy was associated with lower surgical success (odds ratio, 0.33; P = 0.01). Macular internal limiting membrane peeling was associated with higher surgical success (odds ratio, 2.4; P = 0.05). Anterior segment complications included posterior capsular opacification (28.8%), posterior synechiae (10.9%), and posterior capsular rupture (2.3%). CONCLUSION Phacovitrectomy is a safe and effective treatment option for the primary repair of rhegmatogenous retinal detachments. This study provides evidence to support the safe incorporation of phacoemulsification and intraocular lens implantation with retinal surgery.
Collapse
Affiliation(s)
- Matthew D Benson
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alberta, Canada
| | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Schwarzenbacher L, Schartmüller D, Röggla V, Meyer E, Leydolt C, Menapace R. One-Year Results of Arcuate Keratotomy in Patients With Low to Moderate Corneal Astigmatism Using a Low-Pulse-Energy Femtosecond Laser. Am J Ophthalmol 2021; 224:53-65. [PMID: 33309694 DOI: 10.1016/j.ajo.2020.11.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/11/2020] [Accepted: 11/25/2020] [Indexed: 01/23/2023]
Abstract
PURPOSE To investigate corneal astigmatism (CA) reduction and corneal optical quality after surface-penetrating femtosecond laser arcuate keratotomies (Femto AK) considering anterior (CAant) and posterior corneal curvature (CApost), total corneal refractive power astigmatism (CAtot), and corneal higher-order aberrations (HOAs) through 1 year. DESIGN Prospective interventional case series. METHODS Setting: Department of Ophthalmology, Medical University of Vienna. PatientPopulation: Forty-three eyes of 43 patients with age-related cataract and CAtot between 1 and 3 diopters (D). INTERVENTION Paired keratotomies were created with a low-energy femtosecond laser (LDV Z8; Ziemer Ophthalmic Systems, Port, Switzerland) and combined with an astigmatic neutral manual posterior-limbal cataract incision. CA and HOAs measurements were obtained preoperatively and after 1 month, 3 months, and 1 year. MainOutcomeMeasure: Change of CA and HOAs after low-energy Femto AK through 1 year. RESULTS Mean preoperative CAant and CAtot (1.62 ± 0.49 D and 1.58 ± 0.44 D) were significantly reduced, to 0.66 ± 0.38 and 0.50 ± 0.30 D (P < .001) 1 year after surgery, respectively. CApost showed no significant change, from 0.31 ± 0.19 D preoperatively to 0.31 ± 0.13 D (P = .732) at the 1-year follow-up period. Astigmatism as calculated by vector astigmatism analysis stayed stable at 1 month, 3 months, and 1 year. Corneal wavefront HOAs significantly improved at 1 month, 3 months, and 1 year. CONCLUSIONS Paired surface-penetrating keratotomies created by a low-energy femtosecond laser showed efficient and stable CA reduction within 1 year after surgery. The optical quality of the cornea was preserved with lower HOAs than preoperatively.
Collapse
Affiliation(s)
| | | | - Veronika Röggla
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Elias Meyer
- Section for Medical Statistics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Christina Leydolt
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Rupert Menapace
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
| |
Collapse
|
27
|
Pedrotti E, Chierego C, Talli PM, Selvi F, Galzignato A, Neri E, Barosco G, Montresor A, Rodella A, Marchini G. Extended Depth of Focus Versus Monofocal IOLs: Objective and Subjective Visual Outcomes. J Refract Surg 2021; 36:214-222. [PMID: 32267951 DOI: 10.3928/1081597x-20200212-01] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 02/10/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE To evaluate and compare the objective and subjective outcomes between bilateral implantation of the extended depth of focus (EDOF) Mini Well intraocular lens (IOL) and the aspheric monofocal Mini-4-Ready IOL (both SIFI S.p.A., Catania, Italy). METHODS This prospective comparative study included 25 patients (50 eyes) bilaterally implanted with an EDOF Mini Well IOL (EDOF group) and 25 patients (50 eyes) bilaterally implanted with a Mini-4-Ready IOL (monofocal group). Three-month follow-up data included corrected and uncorrected distance visual acuity at 4 m and 80, 67, and 40 cm. Defocus curves, subjective and objective contrast sensitivity, and objective optical quality (modulation transfer function cutoff and Strehl ratio calculated with Optical Quality Analysis System [OQAS]; Visiometrics SL, Terrassa, Spain), halometry, and reading performance were measured. Subjective visual quality was evaluated based on National Eye Institute Refractive Error Quality of Life Instrument 42 (NEI RQL-42) scores. RESULTS Postoperative uncorrected and corrected monocular and binocular intermediate and near visual acuity was significantly better in the EDOF group (P < .001). No differences were observed for distance visual acuity (P ⩾ .312). Defocus curve outcomes for myopic values were better in the EDOF group (P < .001). No significant differences were found in hyperopic (obtained in steps of +0.50 diopters [D] from emmetropia to 1.50 D) values (P ⩾ .095), contrast sensitivity curves (P ⩾ .087), or OQAS outcomes (P ⩾ .138). Halometric values were significantly better in the monofocal group (P < .05). There was a correlation between mean keratometry values and intermediate/near visual acuity. Significantly better NEI RQL-42 subscale scores for near vision, far vision, activity limitations, glare, dependence on correction, and suboptimal correction were noted in the EDOF group (P < .05). CONCLUSIONS Intermediate and near visual acuity was better after EDOF IOL than after aspheric monofocal IOL implantation while maintaining similar levels of visual quality, except for halo perception. [J Refract Surg. 2020;36(4):214-222.].
Collapse
|
28
|
Hayashi K, Yoshida M, Igarashi C, Hirata A. Effect of Refractive Astigmatism on All-Distance Visual Acuity in Eyes With a Trifocal Intraocular Lens. Am J Ophthalmol 2021; 221:279-286. [PMID: 32777380 DOI: 10.1016/j.ajo.2020.07.051] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE To investigate the effect of refractive astigmatism on all-distance visual acuity (VA) in eyes implanted with a diffractive trifocal or bifocal intraocular lens (IOL). DESIGN Cross-sectional study. METHODS Fifty eyes with trifocal IOLs (PanOptix; Alcon) and 50 eyes with bifocal IOLs (ReSTOR +3D) were enrolled. After simulating astigmatism by adding cylindrical lenses of 0, 0.5, 0.75, 1.0, and 1.5 diopters (D), the corrected logarithm of minimal angle of resolution (logMAR) VA was measured using an all-distance vision tester. RESULTS Mean VAs at most distances significantly worsened in proportion to the added astigmatism (P ≤ .0111) with no significant differences in near VA at 0.3 m in the trifocal group or in intermediate VA at 0.7 m in the bifocal group. Mean intermediate VA at 0.5 m was significantly better in the trifocal group than in the bifocal group when the astigmatism was 0.75 D or less (P ≤ .0472), but VA at distances of ∞ and 5.0 m were significantly worse in the trifocal group when the astigmatism was 0.5 D or more (P ≤ .0457). Useful mean logMAR VA of 0.20 was achieved at all distances when the astigmatism was 0.75 D or less in the trifocal group and 1.0 D or less in the bifocal group. CONCLUSIONS All-distance VA, particularly distance VA, worsened more in proportion to astigmatism with a trifocal IOL than with a bifocal IOL. Useful VA was achieved when the astigmatism was 0.75 D or less with a trifocal IOL, suggesting that astigmatism correction is necessary when astigmatism is more than 0.75 D.
Collapse
|
29
|
Widder RA, Lappas A, Rennings C, Hild M, Dietlein TS, Roessler GF. Primary Versus Posttrabeculectomy XEN45 Gel Stent Implantation: Comparison of Success Rates and Intraocular Pressure-lowering Potential in Pseudophakic Eyes. J Glaucoma 2020; 29:1115-1119. [PMID: 33264164 DOI: 10.1097/ijg.0000000000001649] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PRECIS The XEN45 Gel Stent can be implanted after failed trabeculectomy without disadvantages compared with primary implantation. PURPOSE We aimed to compare the outcomes of XEN45 Gel Stent implantation in pseudophakic eyes after failed trabeculectomy and in pseudophakic eyes without other previous surgeries. PATIENTS AND METHODS In this retrospective study, we included 30 pseudophakic eyes of 30 patients who underwent XEN45 Gel Stent implantation after failed trabeculectomy (trabeculectomy group) and 60 eyes of 60 patients with primary XEN45 Gel Stent implantation (control group). The groups were matched for preoperative intraocular pressure (IOP), preoperative medication score, cup-to-disc ratio, follow-up time, visual acuity, and age at a ratio of 1:2. Eyes with concomitant eye diseases, those who had undergone previous surgery, and those with a follow-up duration <6 months were excluded. We compared the success rates on the basis of different criteria: Criteria A (IOP<21 mm Hg, IOP reduction>20%, no repeat surgery); Criteria B (IOP<18 mm Hg, IOP reduction>20%, no repeat surgery); and Criteria C (IOP≤15 mm Hg, IOP reduction≥40%, no repeat surgery). RESULTS After an average follow-up period of 20 months, the mean IOP was reduced from 24.4±5.7 to 14.0±4.1 mm Hg in all the study subjects (90 patients). There were no significant differences between the 2 groups in postoperative IOP, postoperative medication score, revision rate, and repeat surgery rate or success rate. CONCLUSIONS XEN45 Gel Stent implantation is a viable option after failed trabeculectomy. According to our results, it has no disadvantage compared with primary XEN45 Gel Stent implantation.
Collapse
Affiliation(s)
- Randolf A Widder
- Department of Ophthalmology, St. Martinus-Krankenhaus Düsseldorf, Düsseldorf
- Department of Ophthalmology, University of Cologne, Köln
| | | | - Corinna Rennings
- Department of Ophthalmology, St. Martinus-Krankenhaus Düsseldorf, Düsseldorf
| | - Matthias Hild
- Department of Ophthalmology, St. Martinus-Krankenhaus Düsseldorf, Düsseldorf
| | | | - Gernot F Roessler
- Department of Ophthalmology, St. Martinus-Krankenhaus Düsseldorf, Düsseldorf
- Department of Ophthalmology, RWTH Aachen, Aachen, Germany
| |
Collapse
|
30
|
Lytvynchuk LM, Thiele MV, Schmidt W, Lorenz B. Precision of bag-in-the-lens intraocular lens power calculation in different age groups of pediatric cataract patients: Report of the Giessen Pediatric Cataract Study Group. J Cataract Refract Surg 2020; 45:1372-1379. [PMID: 31564311 DOI: 10.1016/j.jcrs.2019.05.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 05/23/2019] [Accepted: 05/26/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE To evaluate the precision of bag-in-the-lens intraocular lens (BIL IOL) power calculation in different age groups of pediatric cataract patients. SETTINGS Department of Ophthalmology, Justus-Liebig-University Giessen, University Hospital Giessen and Marburg GmbH, Campus Giessen, Giessen, Germany. DESIGN Retrospective nonrandomized consecutive case series. METHODS Pediatric patients diagnosed with cataract and operated with BIL IOL implantation were divided into 4 age groups: Group 1 (0 to 3 months), Group 2 (>3 months, <12 months), Group 3 (12 to 36 months), and Group 4 (>36 months to 17 years). BIL IOL power was calculated with the SRK/T formula. The prediction error (PE) was defined as the absolute difference between the preoperative selected target and postoperative achieved refraction. The impact of age at the time of surgery, axial length (AL), keratometry, and corneal astigmatism on PE was analyzed. RESULTS The study comprised 87 eyes of 56 pediatric patients. The mean and median PEs for the entire group were 1.79 diopters (D) and 1.23 D, respectively. The mean PE in each age group was: 3.43 D in Group 1, 2.14 D in Group 2, 1.60 D in Group 3, and 1.33 D in Group 4. The mean PE in eyes with ALs shorter than 20 mm was 2.67 D, and 1.44 D in eyes with an AL of 20 mm or longer. The mean PE in eyes with corneal radii less than 7.3 mm was 2.45 D, and 1.66 D in eyes with corneal radii of 7.3 mm or more. In the age and AL subgroups, the PE differences were statistically significant (P < .05). CONCLUSIONS The PE was larger in the youngest study group, and it decreased gradually with age and in eyes with ALs shorter than 20 mm. The PE has to be considered during BIL IOL power calculation in children.
Collapse
Affiliation(s)
- Lyubomyr M Lytvynchuk
- Department of Ophthalmology, Justus-Liebig-University Giessen, Eye Clinic, University Hospital Giessen and Marburg GmbH, Giessen, Germany
| | - Maximilian V Thiele
- Department of Ophthalmology, Justus-Liebig-University Giessen, Eye Clinic, University Hospital Giessen and Marburg GmbH, Giessen, Germany
| | - Werner Schmidt
- Department of Ophthalmology, Justus-Liebig-University Giessen, Eye Clinic, University Hospital Giessen and Marburg GmbH, Giessen, Germany
| | - Birgit Lorenz
- Department of Ophthalmology, Justus-Liebig-University Giessen, Eye Clinic, University Hospital Giessen and Marburg GmbH, Giessen, Germany.
| |
Collapse
|
31
|
Hayashi K, Yoshida M, Hayashi S, Yoshimura K. Short-Term Changes in Prediction Error after Cataract Surgery in Eyes Receiving 1 of 3 Types of Single-Piece Acrylic Intraocular Lenses. Am J Ophthalmol 2020; 219:12-20. [PMID: 32479807 DOI: 10.1016/j.ajo.2020.05.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 05/15/2020] [Accepted: 05/21/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE To compare short-term changes in refractive prediction error (PE) after phacoemulsification among eyes receiving different types of single-piece acrylic intraocular lenses (IOLs). DESIGN Randomized clinical trial. METHODS A total of 195 eyes of 195 patients scheduled for implantation of a single-piece acrylic IOL were randomly assigned to receive 1 of 3 IOLs: 1) an Alcon model SN60WF, 2) a Hoya model XY-1, or 3) an AMO model ZCB00V. Manifest spherical equivalent (MRSE) value, PE, and changes in PE were examined at 1 day and at 1 and 2 months postoperatively and were compared among groups. RESULTS The mean MRSE and PE significantly changed toward myopia between 1 day and 2 months postoperatively in all groups (P < .0001). The MRSE and PE did not differ significantly among groups at 1 day and 1 month postoperatively and were significantly smaller in the SN60WF group than in the XY-1 and ZCB00V groups at 2 months (P ≤ .0006). The PE change between 1 day and 2 months postoperatively was significantly smaller in the SN60WF group than in the other groups (P = .0062). IOL type and changes in anterior chamber depth and corneal curvature independently correlated with PE changes. CONCLUSIONS The MRSE and PE showed a significant myopic change for 2 months postoperatively in eyes implanted with 1 of 3 types of single-piece acrylic IOLs and were significantly smaller in the SN60WF than in the XY-1 and ZCB00V groups. Changes in PE during the 2 postoperative months were smaller in the SN60WF IOLs than in the other IOLs, suggesting that postoperative refractive stability differs among single-piece acrylic IOLs.
Collapse
Affiliation(s)
| | | | - Shunsuke Hayashi
- Department of Ophthalmology, National Hospital Organization Saitama Hospital, Saitama, Japan; Department of Ophthalmology, Keio University Faculty of Medicine, Keio University School of Medicine, Tokyo, Japan
| | | |
Collapse
|
32
|
Fernández J, Rodríguez-Vallejo M, Martínez J, Burguera N, Piñero DP. Prediction of Visual Acuity and Contrast Sensitivity From Optical Simulations With Multifocal Intraocular Lenses. J Refract Surg 2020; 35:789-795. [PMID: 31830295 DOI: 10.3928/1081597x-20191024-01] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 10/23/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate whether the prediction of visual performance based on the modulation transfer function area (MTFa) calculated with optical simulations is better correlated with visual acuity or contrast sensitivity obtained from defocus curves in patients implanted with a trifocal intraocular lens. METHODS Biometric eye data from 43 patients were used to create a mean eye model. A trifocal intraocular lens with a power obtained from the mean of the eyes implanted was incorporated into the model and the MTFa was calculated at the 11 defocus planes corresponding the 11 defocus locations measured in clinical practice. Simulations were conducted for pupil diameters of 2.5, 3, 3.5, and 4 mm. The MTFa correlation with visual acuity and contrast sensitivity was evaluated with the mean obtained after stratification of the clinical sample in four groups according to the previous pupil diameters. RESULTS A linear model predicted the visual acuity and contrast sensitivity from MTFa with similar accuracy to nonlinear models, with R2 approximately 0.50 for visual acuity and approximately 0.42 for contrast sensitivity. A change of -0.01 logMAR and -0.02 logC was produced per unit of MTFa for visual acuity and contrast sensitivity, respectively. The mean difference between the visual acuity and contrast sensitivity obtained from the model and that measured in clinical practice was close to zero, but the bias varied depending on the defocus lens used, with higher deviation at -0.50 and -3.00 diopters of defocus. CONCLUSIONS The MTFa obtained from optical simulations can be used to predict the mean visual acuity and contrast sensitivity consistently, with contrast sensitivity being more sensitive but with higher bias. [J Refract Surg. 2019;35(12):789-795.].
Collapse
|
33
|
Shimabukuro M, Maeda N, Koh S, Abe K, Kobayashi R, Nishida K. Effects of cataract surgery on symptoms and findings of dry eye in subjects with and without preexisting dry eye. Jpn J Ophthalmol 2020; 64:429-436. [PMID: 32495157 DOI: 10.1007/s10384-020-00744-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 10/15/2019] [Accepted: 03/26/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE To compare dry eye symptoms and findings in post cataract surgery eyes' with and without preexisting dry eye. STUDY DESIGN Prospective, observational case-control study. METHODS Sixty-seven eyes that had undergone cataract surgery were included; 48 were classified into group D (preexisting dry eye) and 19 into group N (no preexisting dry eye). No subjects received perioperative treatment for dry eye. We evaluated between-group differences in symptom scores, corrected distance visual acuity (CDVA), tear film breakup time (BUT), tear film breakup pattern (BUP), and ocular surface fluorescein staining scores, at 1 week, 1 month, and 3 months postoperatively. RESULTS Symptoms were unchanged in group N, but improved in group D (P < .001) postoperatively. CDVA was improved after surgery in both groups (P < .001). BUT was shorter preoperatively in group D than in group N although this difference was absent 1 month postoperatively. Fluorescein staining scores significantly increased at 1 month postoperatively in group N (P = .01), but did not change in group D. During the perioperative period, the predominant BUP was the random break pattern in both groups (≥ 85%). From 1 week to 3 months, dimple break patterns decreased in group D (P = .007), whereas spot break patterns increased (P = .01). CONCLUSIONS Cataract surgery has an influence on tear film stability and the ocular surface. There was either a transient improvement or worsening of ocular surface wettability in some patients without preexisting dry eye.
Collapse
Affiliation(s)
- Mikiko Shimabukuro
- Department of Ophthalmology, Kansai Medical Hospital, Toyonaka, Osaka, Japan
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Room E7, Yamadaoka 2-2, Suita, Osaka, 565-0871, Japan
| | - Naoyuki Maeda
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Room E7, Yamadaoka 2-2, Suita, Osaka, 565-0871, Japan.
| | - Shizuka Koh
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Room E7, Yamadaoka 2-2, Suita, Osaka, 565-0871, Japan
| | - Keiichi Abe
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Room E7, Yamadaoka 2-2, Suita, Osaka, 565-0871, Japan
| | - Reiko Kobayashi
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Room E7, Yamadaoka 2-2, Suita, Osaka, 565-0871, Japan
| | - Kohji Nishida
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Room E7, Yamadaoka 2-2, Suita, Osaka, 565-0871, Japan
| |
Collapse
|
34
|
Pérez-Gracia J, Varea A, Ares J, Vallés JA, Remón L. Evaluation of the optical performance for aspheric intraocular lenses in relation with tilt and decenter errors. PLoS One 2020; 15:e0232546. [PMID: 32365135 PMCID: PMC7197786 DOI: 10.1371/journal.pone.0232546] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 04/16/2020] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To evaluate and compare the effect of misalignment and tilt on the optical performance of different aspheric intraocular lens (IOL) designs. METHODS Three aspheric IOLs with a different quantity of spherical aberration (SA) have been designed and the effect of IOL misalignment and tilt on the imaging quality of an eye model has been numerically assessed using a commercial optical design software. The prototypes have been manufactured by lathe turning and tested in vitro using the same optical bench (PMTF, Lambda-X) that complies with International Organization for Standardization standard 11979-2 requirements. Image quality was evaluated from the modulation transfer functions (MTFs), through-focus modulation transfer functions (TF-MTFs), root mean square (RMS) values of defocus, astigmatism and coma, and images of the United States Air Force (USAF) target were taken. A comparison with the optical performance of spherical IOLs has also been performed. RESULTS Intraocular lens misalignment and tilt increased wavefront aberrations; the effect of misalignment on root mean square (RMS) astigmatism and coma was positively correlated with the spherical aberration of the IOL. Aberration-free IOLs showed the highest MTF for all misalignment values and for IOLs with negative SA correction the MTF decays below 0.43 when they are decentered 0.50 mm. CONCLUSIONS Aspherical IOLs are more sensitive than spherical IOLs to misalignment or tilt, depending on their SA correction. The optical degradation caused by IOL misalignment had a greater effect on IOL designs with a higher amount of negative spherical aberration. In contrast, the effect of tilt on the optical performance was less sensitive to the IOL design.
Collapse
Affiliation(s)
- Jesús Pérez-Gracia
- Departamento de Física Aplicada, Universidad de Zaragoza, Zaragoza, Spain
| | - Alejandra Varea
- Departamento de Física Aplicada, Universidad de Zaragoza, Zaragoza, Spain
| | - Jorge Ares
- Departamento de Física Aplicada, Universidad de Zaragoza, Zaragoza, Spain
| | - Juan A. Vallés
- Departamento de Física Aplicada, Universidad de Zaragoza, Zaragoza, Spain
| | - Laura Remón
- Departamento de Física Aplicada, Universidad de Zaragoza, Zaragoza, Spain
| |
Collapse
|
35
|
Shajari M, Sonntag R, Niermann T, Holland D, Kohnen T, Priglinger S, Mayer WJ. Determining and Comparing the Effective Lens Position and Refractive Outcome of a Novel Rhexis-Fixated Lens to Established Lens Designs. Am J Ophthalmol 2020; 213:62-68. [PMID: 31953058 DOI: 10.1016/j.ajo.2020.01.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/05/2020] [Accepted: 01/06/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE WE sought to evaluate differences in effective lens position (ELP) based on the lens design. Intraocular lenses (IOLs) with plate-haptic, c-loop haptic, and a rhexis-fixated lens were compared. DESIGN Retrospective, multicenter, comparative case series. METHODS The study included patients having age-related cataract surgery with implantation of either a plate-haptic, c-loop haptic, or a novel rhexis-fixated IOL. Biometry and refraction measurements were conducted preoperatively and 3 months postoperatively. Lens constant optimization was performed. RESULTS Seventy eyes of 56 subjects were included. ELP for rhexis-fixated IOL was shortest (4.29 ± 0.24 mm), followed by c-loop haptic (4.41 ± 0.42 mm) and plate-haptic (4.51 ± 0.26 mm) IOL. Difference in ELP was significant between rhexis-fixated IOL and both plate-haptic (P = .001) and c-loop haptic IOL (P = .000). Anterior chamber depth adjustment based on lens design showed a significant effect on refraction and IOL power predictions for all formulas and lenses (P < .05). For the rhexis-fixated IOL the differences in refraction ranged from -0.039 diopters (D) for the Hill-Radial Basis Function to -0.096 D for Haigis. The other 2 lenses showed mean differences in refraction between +0.046 D for Hill-Radial Basis Function and +0.097 D for Haigis. CONCLUSION The difference in IOL fixation and its resulting position in the capsular bag have a significant effect on the effective lens position and consequently a significant effect on the prediction of postoperative refraction.
Collapse
Affiliation(s)
- Mehdi Shajari
- Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany; Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
| | - Ruven Sonntag
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
| | - Theresa Niermann
- Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany
| | | | - Thomas Kohnen
- Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany
| | | | - Wolfgang J Mayer
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
| |
Collapse
|
36
|
Lyu D, Shen Z, Zhang L, Qin Z, Ni S, Wang W, Zhu Y, Yao K. Comparison of Perioperative Parameters in Femtosecond Laser-Assisted Cataract Surgery Using 3 Nuclear Fragmentation Patterns. Am J Ophthalmol 2020; 213:283-292. [PMID: 31887280 DOI: 10.1016/j.ajo.2019.12.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 12/11/2019] [Accepted: 12/11/2019] [Indexed: 12/22/2022]
Abstract
PURPOSE The purpose of this study was to compare the perioperative parameters of quadrant, sextant, and grid lens fragmentation patterns in femtosecond laser-assisted cataract surgery (FLACS). DESIGN Prospective randomized clinical trial. METHODS Setting: Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. STUDY POPULATION A total of 894 eyes in 661 patients with cataracts were enrolled. Intervention or observation procedures: the nuclear density was graded according to the Emery-Little classification. Patients received lens fragmentation using a quadrant, sextant, or grid pattern after random allocation. Evaluations included intraoperative parameters, complications, and postoperative outcomes. MAIN OUTCOME MEASUREMENTS effective phacoemulsification time (EPT), intraoperative complications, visual acuity and intraocular pressure at one day postoperatively, as well as endothelial cell density, endothelial cell loss, and central corneal thickness at 1 week postoperatively. RESULTS In grade 1 nuclei, the mean EPT in the grid group was the shortest compared to those in the quadrant (P = 0.011) and sextant (P = 0.001) groups. In grade 2 nuclei, all 3 patterns showed no significant differences in the mean EPT (P > 0.05). In grade 3 nuclei, the sextant group revealed shorter mean EPT than the grid (P = 0.017) and quadrant (P > 0.05) groups. In grades 4 and 5 nuclei, the quadrant pattern had the shortest mean EPT among all 3 patterns (P < 0.05). The grid pattern is associated with higher intraocular pressure in hard nuclei (grades 4 and 5) than the other 2 patterns (P < 0.05). CONCLUSIONS The grid and quadrant patterns allow for shorter EPT in soft (grade 1) and hard (grades 4 and 5) nuclei, respectively. All 3 patterns can be selected for treating grade 2 nuclei. The sextant pattern may be the best option when treating grade 3 nuclei. The grid pattern should be avoided in hard nuclei combined with glaucoma or glaucoma suspect.
Collapse
Affiliation(s)
- Danni Lyu
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Zeren Shen
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China; Department of Plastic Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Lifang Zhang
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Zhenwei Qin
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Shuang Ni
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Wei Wang
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Yanan Zhu
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Ke Yao
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
| |
Collapse
|
37
|
McNeely RN, Moutari S, Palme C, Moore JE. Visual Outcomes and Subjective Experience After Combined Implantation of Extended Depth of Focus and Trifocal IOLs. J Refract Surg 2020; 36:326-333. [PMID: 32396644 DOI: 10.3928/1081597x-20200318-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 03/18/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate postoperative visual performance and patient-reported outcomes following combined implantation of an extended depth of focus (EDOF) intraocular lens (IOL) and a trifocal IOL. METHODS The study enrolled consecutive patients undergoing refractive lens extraction or cataract surgery with combined implantation of an EDOF IOL (dominant eye) and a trifocal IOL in the nondominant eye. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, uncorrected intermediate (UIVA) and near (UNVA) visual acuities, defocus curves, and subjective questionnaires were evaluated 1 month postoperatively. RESULTS The study enrolled 100 consecutive patients (200 eyes). The postoperative mean binocular UDVA, UIVA, and UNVA were -0.08 ± 0.07, 0.13 ± 0.12, and 0.17 ± 0.11 logMAR, respectively. The percentage of eyes within ±0.50 and ±1.00 diopters of the refractive target was 65% and 96% with EDOF IOLs, and 76% and 99% with trifocal IOLs, respectively. Of all patients, 91% were satisfied or more than satisfied with the procedure, and 87% of patients were spectacle free for near vision. On a scale from 0 (not at all) to 3 (very), mean scores of 0.52 ± 0.83, 0.71 ± 0.83, and 0.34 ± 0.73 were reported for glare, halos, and starbursts. The mean daytime and nighttime Quality of Vision scores were 9.13 ± 0.91 and 7.96 ± 1.57, respectively. CONCLUSIONS The combination of an EDOF IOL and a trifocal IOL provides good unaided visual acuity for distance and near. This IOL combination provides high postoperative satisfaction and functional vision, but some early visual side effects were reported. [J Refract Surg. 2020;36(5):326-333.].
Collapse
|
38
|
Marcos S, Romero M, Benedí-García C, González-Ramos A, Vinas M, Alejandre N, Jiménez-Alfaro I. Interaction of Monochromatic and Chromatic Aberrations in Pseudophakic Patients. J Refract Surg 2020; 36:230-238. [PMID: 32267953 DOI: 10.3928/1081597x-20200303-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 03/02/2020] [Indexed: 01/19/2023]
|
39
|
Chen J, Chen Y, Zhong Y, Li J. Comparison of visual acuity and complications between primary IOL implantation and aphakia in patients with congenital cataract younger than 2 years: a meta-analysis. J Cataract Refract Surg 2020; 46:465-473. [PMID: 32142042 DOI: 10.1097/j.jcrs.0000000000000015] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
To analyze the visual acuity and complications between primary intraocular lens (IOL) implantation and contact lens wearing, this literature search was performed with data on patients with congenital cataract younger than 2 years published in March 2019. Seven identified studies enrolling 675 eyes were selected for analysis. Patients with primary IOL implantation owned better visual acuity than those with aphakia who wore the contact lens (weighted mean difference = 0.161; 95% CI, 0.108-0.214). For visual axis opacification (VAO), primary IOL implantation increases the incidence of VAO compared with contact lens wearing (relative risk = 0.23; 95% CI, 0.13-0.42). No statistically significant difference was found between the 2 groups about the prevalence of glaucoma and strabismus. Primary IOL implantation achieved better visual outcomes after cataract extraction in patients younger than 2 years. In addition, no higher risk for complications among primary IOL implantation compared with contact lens wearing was noted. Therefore, implanting a primary IOL during congenital cataract surgery is a better therapy for children younger than 2 years than wearing a contact lens.
Collapse
Affiliation(s)
- Jiabao Chen
- From the Department of Ophthalmology, Peking University Shenzhen Hospital (J. Chen, Y. Chen, Li), Guangdong, Department of Ophthalmology, Shantou University Medical College (J. Chen), Guangdong, and Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University (Zhong), Hangzhou, Zhejiang, China
| | | | | | | |
Collapse
|
40
|
Son HS, Khoramnia R, Yildirim TM, Baur I, Labuz G, Auffarth GU. Functional Outcomes and Reading Performance After Combined Implantation of a Small-Aperture Lens and a Segmental Refractive Bifocal Lens. J Refract Surg 2020; 35:551-558. [PMID: 31498412 DOI: 10.3928/1081597x-20190806-02] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 08/06/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE Clinical evaluation of the visual outcomes after implantation of a small-aperture extended depth of focus (EDOF) intraocular lens (IOL) and a segmental refractive bifocal lens. METHODS In this prospective study, 13 patients with cataract received a small-aperture IC-8 IOL (AcuFocus, Irvine, CA) in one eye and a segmental-refractive Lentis Mplus LS-313 MF20 IOL (Oculentis, Berlin, Germany) in the fellow eye. The clinical examination included measurements of uncorrected (UDVA) and corrected (CDVA) distance visual acuity, uncorrected (UIVA) and distance-corrected (DCIVA) intermediate visual acuity, and uncorrected (UNVA) and distance-corrected (DCNVA) near visual acuity. Additionally, a defocus curve was obtained from +2.00 to -5.00 diopters (D) and a Salzburg Reading Desk was used to assess the patients' reading acuity at intermediate and near distances. A halo and glare simulator was used to evaluate the postoperative perception of dysphotopsia. RESULTS At 5 months postoperatively, the mean binocular visual results demonstrated UDVA, UIVA, and UNVA values of -0.04 ± 0.11, 0.00 ± 0.10, and 0.11 ± 0.08 logMAR, respectively. The binocular distance-corrected reading performance test also confirmed the improved visual function, with an intermediate reading acuity of 0.12 logMAR at 69.21 cm and a near reading acuity of 0.19 logMAR at 41.63 cm. The mean halo size was 32.54 ± 22.38, mean halo intensity was 34.46 ± 21.95, mean glare size was 9.00 ± 17.47, and mean glare intensity was 9.92 ± 16.84. CONCLUSIONS The new concept of a combined implantation of a small-aperture IOL and a segmental-refractive bifocal lens showed good results in far and intermediate distances and functional results at near distance, while causing minimal photic phenomena. [J Refract Surg. 2019;35(9):551-558.].
Collapse
|
41
|
Calvo-Sanz JA, Sánchez-Tena MA. Characterization of optical performance with defocusing curve: Analysis of two refractive intraocular lens models with high and medium addition. J Optom 2020; 13:35-40. [PMID: 30391111 PMCID: PMC6951828 DOI: 10.1016/j.optom.2018.10.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/20/2018] [Accepted: 10/01/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE To characterize the optical performance of two models of refractive bifocal intraocular lenses, with medium and high addition, using defocus curves. METHODS 20 eyes from 20 subjects were included in this study. 10 eyes underwent caratact surgery with an implant of a medium addition refractive bifocal intraocular lens (IOL) (Lentis LS-313 MF20) and the other 10 eyes underwent cataract surgery with an implant of a high addition refractive bifocal IOL (Lentis LS-313 MF30). Six weeks after surgery, subjective refraction and defocus curve were made. RESULTS Mean final residual refraction in spherical equivalent was +0.10±0.07D in the LS-313MF30 group and +0.12±0.10D in the LS-313MF20 group. Defocus curve showed a different optical performance in intermediate/near distance depending on the IOL model. The medium addition IOL provided good visual acuity (VA) at far and intermediate distance up to 50cms, and the high addition IOL provided better VA in near distance up to 25cms. CONCLUSIONS The high addition intraocular lens provides better visual acuity in the spatial range from infinity to the point close to 25cm. The medium addition intraocular lens provides excellent visual acuity in far and intermediate vision. The defocus curve seems to be a valid and reproducible tool for evaluating the optical behavior of multifocal sector refractive lenses.
Collapse
|
42
|
Mohan A, Kumar A, Sen P, Shah C, Jain E, Sen A. Outcome of Surgical Membranectomy With a Vitrector via Limbal Approach for Posterior Capsular Opacity in Children. J Pediatr Ophthalmol Strabismus 2020; 57:33-38. [PMID: 31972038 DOI: 10.3928/01913913-20191112-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 11/05/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the safety and efficacy of surgical membranectomy with a vitrector via a limbal approach for posterior capsular opacification (PCO) in children. METHODS In this retrospective analytical interventional study, medical records of children younger than 17 years who underwent surgical membranectomy with anterior vitrectomy via a limbal approach were analyzed. Time lag for PCO formation after cataract surgery was assessed. Any adverse events during surgery, rate of successful completion of membranectomy, postoperative complications, improvement in visual acuity, and intraocular lens (IOL) centration were recorded. RESULTS A total of 60 eyes of 58 children were included: 26 had traumatic etiology and 34 had developmental cataract. Mean time duration for PCO formation was 27.83 ± 39.83 months for traumatic cases and 53.53 ± 52.20 months for developmental cataract (P = .04). A satisfactory opening in the center of the membrane was achieved in 47 cases (n = 47, 78.3%). The complications encountered were uveitis (5 eyes), corneal edema (3 eyes), pigment deposition over IOL (2 eyes), raised intraocular pressure (1 eye), IOL drop (1 eye), and broken haptic (1 eye). Membranectomy with posterior optic buttonholing of the IOL in 9 aphakic eyes resulted in good IOL centration, no anterior chamber reaction, and no iris optic capture in the postoperative period. Mean visual acuity improved from 1.16 ± 0.52 to 0.73 ± 0.55 logMAR (P < .001). CONCLUSIONS Surgical membranectomy with a vitrector via a limbal approach is a safe and effective method for managing PCO in the pediatric population. Posterior optic buttonholing of the IOL during membranectomy or secondary IOL implantation results in good IOL centration and fewer complications. [J Pediatr Ophthalmol Strabismus. 2020;57(1):33-38.].
Collapse
|
43
|
Fernández J, Rodríguez-Vallejo M, Martínez J, Tauste A, Piñero DP. Patient selection to optimize near vision performance with a low-addition trifocal lens. J Optom 2020; 13:50-58. [PMID: 31680039 PMCID: PMC6951843 DOI: 10.1016/j.optom.2019.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 05/31/2019] [Accepted: 06/26/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE To assess the impact of ocular biometric variables on the visual performance achieved with a low addition trifocal intraocular lens (MIOL). METHODS Retrospective observational study including 34 eyes. Preoperative measured variables included mean corneal power (Km), corneal regular astigmatism (RA), anterior chamber depth (ACD), axial length (AXL), total irregular astigmatism (IA), spherical aberration (SA) and distance from pupil center to vertex normal (µ). Same variables were retrieved from the three month visit follow-up in addition to the actual lens position (ALP), the calculated effective addition (EA), the IOL centration from vertex normal (d), and the visual acuity defocus curve. The area under the defocus curve was computed along the total curve (TAUC) and ranges for far (FAUC), intermediate (IAUC) and near vision (NAUC). The sample was split in two groups of 17 eyes with TAUCs above and below the mean, and the differences among groups for different ocular parameters were assessed. RESULTS The group of eyes above TAUC of 2.03 logMAR*m-1 showed significantly lower Km and greater AXL and SA. Km was negatively correlated with TAUC and NAUC. NAUC was negatively correlated with IA and positively with d. A multiple lineal regression model including Km, d, and IA predicted NAUC (r-square = 34%). No significant differences between IA and SA were found between preoperative and postoperative values but µ significantly decreased after surgery. CONCLUSIONS The mean corneal power, irregular astigmatism, and centration from vertex normal should be considered for optimizing the near visual performance with this MIOL.
Collapse
Affiliation(s)
- Joaquín Fernández
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, 04120, Almería, Spain
| | | | - Javier Martínez
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, 04120, Almería, Spain
| | - Ana Tauste
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, 04120, Almería, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain; Department of Ophthalmology (IMQO-Oftalmar), Vithas Medimar International Hospital, Alicante, Spain
| |
Collapse
|
44
|
Fabian E, Wehner W. Prediction Accuracy of Total Keratometry Compared to Standard Keratometry Using Different Intraocular Lens Power Formulas. J Refract Surg 2019; 35:362-368. [PMID: 31185101 DOI: 10.3928/1081597x-20190422-02] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 04/22/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the accuracy of intraocular lens (IOL) power calculation based on standard keratometry (K) and the new Total Keratometry (TK). METHODS A post-hoc analysis of study data based on 145 pseudophakic astigmatic eyes was conducted. The absolute prediction error (APE) of spherical equivalent (SE) and cylinder (CYL) was calculated based on K and TK (including posterior corneal surface) data recorded 6 weeks after IOL implantation. APE was calculated as the difference between the postoperative refraction and the refractive error predicted by three classic IOL calculation methods (Haigis/Haigis-T, Barrett Universal II, Barrett Toric Calculator) and two new formulas developed for TK (Barrett TK Universal II, Barrett TK Toric). For APE in SE, the Haigis-T (K versus TK) and Barrett Universal II (K) versus Barrett TK Universal II (TK) were compared. For APE in CYL, the Haigis-T (K versus TK) and Barrett Toric Calculator (K) versus Barrett TK Toric formula (TK) were compared. RESULTS Mean APE in SE and CYL was lower based on TK values compared to K, with a mean APE difference (K - TK) of 0.011 ± 0.107 diopters (D) (SE Haigis-T; 95% confidence interval [CI]: -0.004 to infinity), 0.016 ± 0.113 D (SE: Barrett Universal II versus Barrett TK Universal II; 95% CI: 0.0005 to infinity), 0.103 ± 0.173 D (CYL: Haigis-T; 95% CI: 0.0791 to infinity), and 0.020 ± 0.148 D (CYL: Barrett Toric versus Barrett TK Toric; 95% CI: -0.0002 to infinity). APE in SE was within ±0.50 D in 86% (Barrett TK Universal II) versus 84% (Barrett Universal II) of eyes. APE in CYL was within ±0.50 D in 58% (Haigis from TK) versus 44% (Haigis from K) of eyes. CONCLUSIONS In comparison to standard K, a higher prediction accuracy can be expected by using TK values along with the two newly developed formulas. TK values are compatible with standard IOL power calculation formulas and existing optimized IOL constants. [J Refract Surg. 2019;35(6):362-368.].
Collapse
|
45
|
Ferreira TB, Ribeiro FJ. Prospective Comparison of Clinical Performance and Subjective Outcomes Between Two Diffractive Trifocal Intraocular Lenses in Bilateral Cataract Surgery. J Refract Surg 2019; 35:418-425. [PMID: 31298721 DOI: 10.3928/1081597x-20190528-02] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 05/27/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare clinical outcomes and subjective experience after bilateral implantation of two non-toric diffractive trifocal intraocular lenses (IOLs). METHODS In a prospective, comparative case series, patients were randomly allocated to receive bilateral implantation of either the preloaded RayOne Trifocal (Rayner, Worthing, UK) or the FineVision POD F (PhysIOL, Liège, Belgium). At the 3-month follow-up, the main outcomes were monocular and binocular uncorrected and corrected distance (UDVA, CDVA), intermediate at 80 cm (UIVA, DCIVA), and near at 40 cm (UNVA, DCNVA) visual acuities, refractive outcomes, and defocus curves. Patients' satisfaction in terms of visual disturbance was also evaluated. RESULTS Each group comprised 30 eyes (15 patients). The mean monocular UDVA was 0.03 ± 0.11 (RayOne Trifocal) and 0.04 ± 0.08 (FineVision POD F) logMAR (P = .605); DCIVA was 0.05 ± 0.13 and 0.05 ± 0.10 logMAR, respectively (P > .999); and DCNVA was 0.02 ± 0.12 and 0.03 ± 0.11 logMAR (P = .742). A better manifest spherical equivalent was found in the RayOne Trifocal than in the FineVision POD F group (P = .035) and depth perception issues were less severe with the RayOne Trifocal IOL (P = .042). There was no significant difference in other photic phenomena between groups. CONCLUSIONS Both IOLs provided good visual outcomes at all distances with no differences between the groups. Refractive accuracy was better for the RayOne Trifocal IOL. The results indicated that the new trifocal IOL may represent a safe and effective option for presbyopic patients. [J Refract Surg. 2019;35(7):418-425.].
Collapse
|
46
|
Rodov L, Reitblat O, Levy A, Assia EI, Kleinmann G. Visual Outcomes and Patient Satisfaction for Trifocal, Extended Depth of Focus and Monofocal Intraocular Lenses. J Refract Surg 2019; 35:434-440. [PMID: 31298723 DOI: 10.3928/1081597x-20190618-01] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 06/18/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess visual outcomes and patient satisfaction for trifocal and extended depth of focus (EDOF) intraocular lenses (IOLs) compared to monofocal IOLs with and without monovision. METHODS Consecutive patients underwent bilateral cataract extraction surgery and implantation of either monofocal IOLs, monofocal IOLs using monovision, EDOF IOLs, or trifocal IOLs. Patients with preoperative biometric data, postoperative refraction, and visual acuity who completed a questionnaire regarding satisfaction and side effects were included. Visual outcome, spectacle independence, patient satisfaction, and subjective photic phenomena were assessed. RESULTS Each group comprised 50 patients (100 eyes). The mean postoperative uncorrected distance, intermediate, and near visual acuities (logMAR) were: 0.17 ± 0.14 (Snellen 20/30), not applicable, and not applicable for monofocal; 0.08 ± 0.12 (Snellen 20/24), not applicable, and 0.07 ± 0.12 (Snellen 20/23) for monovision; 0.03 ± 0.08 (Snellen 20/21), 0.08 ± 0.12 (Snellen 20/24), and 0.23 ± 0.17 (Snellen 20/34) for EDOF; 0.07 ± 0.09 (Snellen 20/23), 0.08 ± 0.11 (Snellen 20/24), and 0.02 ± 0.06 (Snellen 20/21) for trifocal. Spectacle independence was reported by 36%, 70%, 74%, and 92% of patients, respectively. Postoperative halos and/or glare were experienced by 2%, 6%, 14%, and 38%, respectively, of which 2%, 0%, 6%, and 10%, respectively, were functionally disturbing. A total of 64%, 72%, 78%, and 76%, respectively, would choose the same IOL again. CONCLUSIONS Patient satisfaction rates were high in all groups. Trifocal IOLs were more effective in improving unaided whole range of vision, but were associated with a higher rate of photic phenomena. The EDOF IOL and monovision provided partial spectacle independence with less photic phenomena. [J Refract Surg. 2019;35(7):434-440.].
Collapse
|
47
|
Schallhorn SC, Teenan D, Venter JA, Hannan SJ, Schallhorn JM. Initial Clinical Outcomes of a New Extended Depth of Focus Intraocular Lens. J Refract Surg 2019; 35:426-433. [PMID: 31298722 DOI: 10.3928/1081597x-20190530-01] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 05/30/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate clinical and patient-reported outcomes of a new extended depth of focus intraocular lens (IOL). METHODS Data of patients treated between September 2017 and September 2018 who underwent a refractive lens exchange/cataract surgery with an implantation of the AT LARA 829MP IOL (Carl Zeiss Meditec AG, Jena, Germany) and attended the 1-week, 1-month, and 3-month follow-up visit were reviewed. RESULTS At 3 months, the percentage of eyes within ±0.50 diopters (D) of emmetropia was 86.7%. The mean binocular uncorrected distance visual acuity was -0.05 ± 0.09 logMAR and the mean binocular unaided near vision was 0.26 ± 0.14 logMAR. Of all patients, 90.3% were satisfied with their vision. The percentage of patients spectacle-free for near and distance vision was 83.6% and 95.4%, respectively. On a scale from 1 (no difficulty) to 7 (severe difficulty), there was an average 1.2 to 1.4 units increase in glare, halo, and starburst between the preoperative and 1-month visit, and a decrease of 0.2 to 0.3 units between the 1- and 3-month visit. CONCLUSIONS The new extended depth of focus IOL provided reasonable unaided near and distance vision, as well as spectacle independence and patient satisfaction. Some optical side effects were reported in the early postoperative period. [J Refract Surg. 2019;35(7):426-433.].
Collapse
|
48
|
Tarib I, Kasier I, Herbers C, Hagen P, Breyer D, Kaymak H, Klabe K, Lucchesi R, Teisch S, Diakonis VF, Hahn U, Fabian H, Kretz FTA. Comparison of Visual Outcomes and Patient Satisfaction After Bilateral Implantation of an EDOF IOL and a Mix-and-Match Approach. J Refract Surg 2019; 35:408-416. [PMID: 31298720 DOI: 10.3928/1081597x-20190417-02] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 04/15/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate visual outcomes at different distances (near, intermediate, and far), depth of focus, optical quality, quantitative dysphotopsia, and patient satisfaction in two groups. METHODS The extended depth of focus (EDOF) only group (n = 40 eyes) was implanted bilaterally with an EDOF intraocular lens (IOL) and the mixed group (n = 40 eyes) was implanted with the same EDOF IOL in the dominant eye and a trifocal IOL in the fellow eye. At the 3-month postoperative visit, refractive outcomes and monocular and binocular uncorrected (UDVA) and corrected (CDVA) distance visual acuities for far UDVA, CDVA, distance-corrected intermediate visual acuity (DCIVA) at 80 cm, uncorrected near visual acuity (UNVA), distance-corrected near visual acuity (DCNVA) at 40 cm, and binocular defocus curve were evaluated. RESULTS The mean spherical equivalent (SE) 3 months postoperatively was -0.16 ± 0.41 diopters (D) in the EDOF only group and -0.39 ± 0.63 D in the mixed group. In the EDOF only group, binocular visual acuities were: UDVA = -0.04 ± 0.07 logMAR (20/18); CDVA = -0.04 ± 0.06 logMAR (20/18); DCIVA (80 cm) = 0.07 ± 0.19 logMAR (20/23); DCNVA (40 cm) = 0.32 ± 0.15 logMAR (20/42); and UNVA (40 cm) = 0.24 ± 0.17 logMAR (20/35). In the mixed group, binocular visual acuities were: UDVA = 0.03 ± 0.09 logMAR (20/21) (P = .08); CDVA = -0.01 ± 0.07 logMAR (20/20) (P = .25); DCIVA (80 cm) = 0.24 ± 0.23 logMAR (20/35) (P = .08); DCNVA (40 cm) = 0.19 ± 0.07 logMAR (20/31) (P = .03); and UNVA (40 cm) = 0.18 ± 0.10 logMAR (20/30) (P = .37). CONCLUSIONS Effective restoration of visual acuity was demonstrated in both groups, with high levels of visual quality and patient satisfaction. Better results in near visual acuity were demonstrated in the mixed group. [J Refract Surg. 2019;35(7):408-416.].
Collapse
|
49
|
Mustafa OM, Prescott C, Alsaleh F, Dzhaber D, Daoud YJ. Refractive and Visual Outcomes and Rotational Stability of Toric Intraocular Lenses in Eyes With and Without Previous Ocular Surgeries: A Longitudinal Study. J Refract Surg 2019; 35:781-788. [PMID: 31830294 DOI: 10.3928/1081597x-20191021-03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 10/21/2019] [Indexed: 12/22/2022]
Abstract
PURPOSE To evaluate visual and refractive outcomes and rotational stability of toric intraocular lens (IOL) implantation in eyes with previous ocular surgeries. METHODS This controlled, longitudinal cohort study included a total of 133 eyes (59 study cases with a history of corneal, vitreoretinal, and/or glaucoma surgery and 74 randomly selected controls without a history of ocular surgery) that had cataract and corneal astigmatism treated with toric IOL implantation. Postoperative outcomes were recorded at postoperative 1 month and 3 to 12 months. RESULTS Refractive prediction errors were within ±1.00 diopter (D) of target in 93.5% and 88.4% of the study cases at postoperative 1 month and 3 to 12 months, respectively. They were within ±0.50 D of target in 56.5% and 60.5% of the cases during the same follow-up intervals, respectively. Study cases showed statistically significantly inferior uncorrected distance visual acuity (UDVA) compared to controls at 1 month postoperatively (0.27 ± 0.24 and 0.17 ± 0.21 logMAR, respectively, P = .027) but not during the later follow-up (0.19 ± 0.19 and 0.16 ± 0.19 logMAR, respectively, P = .431). Corrected distance visual acuity (CDVA) was slightly lower in the study cases than in controls at 1 month postoperatively (0.13 ± 0.16 and 0.07 ± 0.14, respectively, P = .005) and subsequent follow-up months (0.10 ± 0.13 and 0.03 ± 0.10, respectively, P < .001). Of the examined study cases, 93.9% and 88.4% had IOL axes within 5° of intended axis at postoperative 1 month and 3 to 12 months, respectively. CONCLUSIONS Toric IOLs provided significant and sustained improvement in visual acuity and refraction in eyes with a history of prior ophthalmic surgery. Refractive outcomes achieved postoperatively were comparable to those in eyes without a prior history of ophthalmic surgery, although the rate of visual recovery may be different. [J Refract Surg. 2019;35(12):781-788.].
Collapse
|
50
|
Pereira A, Somani S, Tam ES, Chiu H, Maini R. Comparison of Surgically Induced Astigmatism and Corneal Morphological Features Between Femtosecond Laser and Manual Clear Corneal Incisions. J Refract Surg 2019; 35:796-802. [PMID: 31830296 DOI: 10.3928/1081597x-20191024-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 10/23/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess corneal morphologic changes and surgically induced astigmatism (SIA) following clear corneal incisions (CCIs) created manually or with the Catalys femtosecond laser (Johnson & Johnson Vision, Santa Ana, CA). METHODS In this retrospective cohort analysis, patients undergoing femtosecond laser-assisted cataract surgery (FLACS) or manual cataract surgery between June and September 2018 from a single surgical center in Toronto, Canada, were considered for inclusion. Postoperative corneal astigmatism values were compared to preoperative astigmatism indices to determine the SIA at the postoperative 3-month (POM3) mark using the Alpins vector method. Secondary outcomes included postoperative corrected distance visual acuity (CDVA), central corneal thickness (CCT), and CCI morphology parameters. RESULTS Refractive outcomes from 104 eyes of 61 patients (54 eyes in the manual group and 50 eyes in the FLACS group) were included. There was no significant difference in POM3 SIA (manual: 0.45 ± 0.28 diopters [D], FLACS: 0.57 ± 0.46 D, P = .11); however, a significantly larger SIA was noted in the FLACS cohort at postoperative 1 week (P = .02) and 1 month (P = .04). FLACS led to a significantly smaller POM3 CCI thickness (P = .006), and CCI position was comparable between the two techniques (P = .44). There were no significant differences between groups in CDVA (P = .19), CCT thickness (P = .20), or phacoemulsification time (P = .59). CONCLUSIONS There was no significant difference in SIA between FLACS and manual cataract surgery at POM3. With a significantly smaller CCI thickness seen in FLACS cases, and a comparable CCI position, the reason for the increased SIA following laser CCIs in the early postoperative period was unclear. [J Refract Surg. 2019;35(12):796-802.].
Collapse
|