1
|
Cao D, Hu M, Zhi D, Liang J, Tan Q, Lei Q, Li M, Cheng H, Wang L, Dai W. Systematic evaluation of machine learning-enhanced trifocal IOL power selection for axial myopia cataract patients. Comput Biol Med 2024; 173:108245. [PMID: 38531253 DOI: 10.1016/j.compbiomed.2024.108245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 03/03/2024] [Accepted: 03/04/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE This study aimed to evaluate and optimize intraocular lens (IOL) power selection for cataract patients with high axial myopia receiving trifocal IOLs. DESIGN A multi-center, retrospective observational case series was conducted. Patients having an axial length ≥26 mm and undergoing cataract surgery with trifocal IOL implanted were studied. METHODS Preoperative biometric and postoperative outcome data from 139 eyes were collected to train and test various machine learning (ML) models (support vector machine, linear regression, and stacking regressor) using five-fold cross-validation. The models' performance was further validated externally using data from 48 eyes enrolled from other hospitals. Performance of seven IOL calculation formulas (BUII, Kane, EVO, K6, DGS, Holladay I, and SRK/T) were examined with and without ML models. RESULTS The results of cross-validation revealed improvements across all IOL calculation formulas, especially for K6 and Holladay I. The model increased the percentage of eyes with a prediction error (PE) within ±0.50 D from 71.94% to 79.14% for K6, and from 35.25% to 51.80% for Holladay I. In external validation involving 48 patients from other centers, six out of seven formulas demonstrated a reduction in the mean absolute error (MAE). K6's PE within ±0.50 D improved from 62.50% to 77.08%, and Holladay I from 16.67% to 58.33%. CONCLUSIONS In this study, we conducted a comprehensive evaluation of seven IOL power calculation formulas in high axial myopia cases and explored the effectiveness of the Stacking Regressor model in augmenting their accuracy. Of these formulas, K6 and Holladay I exhibited the most significant improvements, suggesting that integrating ML may have varying levels of effectiveness across different formulas but holds substantial promise in improving the predictability of IOL power calculations in patients with long eyes.
Collapse
Affiliation(s)
- Danmin Cao
- Aier Institute of Digital Ophthalmology & Visual Science, Changsha Aier Eye Hospital, Changsha, China; Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; Aier Eye Hospital of Wuhan University, Wuhan, China
| | - Min Hu
- Aier Institute of Digital Ophthalmology & Visual Science, Changsha Aier Eye Hospital, Changsha, China; Institute of Computing Technology, Chinese Academy of Sciences, Beijing, China
| | - Danlin Zhi
- The First Affiliated Hospital of University of South China, Hengyang, China
| | - Jianheng Liang
- Guangzhou Aier Eye Hospital, Jinan University, Guangzhou, China
| | - Qian Tan
- Aier Institute of Digital Ophthalmology & Visual Science, Changsha Aier Eye Hospital, Changsha, China
| | - Qiong Lei
- Aier Eye Hospital of Wuhan University, Wuhan, China
| | - Maoyan Li
- Aier Institute of Digital Ophthalmology & Visual Science, Changsha Aier Eye Hospital, Changsha, China
| | - Hao Cheng
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
| | - Li Wang
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA
| | - Weiwei Dai
- Aier Institute of Digital Ophthalmology & Visual Science, Changsha Aier Eye Hospital, Changsha, China.
| |
Collapse
|
2
|
Cerviño A, Esteve-Taboada JJ, Chiu YF, Yang CH, Tseng WC, Lee W. Tolerance to decentration of biaspheric intraocular lenses with refractive phase-ring extended depth of focus and diffractive trifocal designs. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06458-1. [PMID: 38526773 DOI: 10.1007/s00417-024-06458-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 02/04/2024] [Accepted: 03/16/2024] [Indexed: 03/27/2024] Open
Abstract
PURPOSE This study aimed to investigate the in vitro tolerance to decentration of biaspheric intraocular lens (IOLs) with refractive phase-ring extended depth-of-focus (EDOF) and diffractive trifocal designs. METHODS This experimental study was carried out at the Department of Optics and Optometry and Vision Science, University of Valencia, Spain. The modulation transfer function (MTF) of the ETLIO130C EDOF and the TFLIO130C trifocal IOLs (AST Products Inc., Billerica, MA, USA) were determined at different levels of decentration for a given wavelength and pupil diameter using the PMTF optical bench (Lambda-X Ophthalmics, Nivelles, Belgium). The modulation transfer function (MTF) curves, the through-focus MTF curves, and the Strehl ratios were measured at 3-mm pupil aperture for 0.25-, 0.50- and 0.75-mm decentration. RESULTS The optical design of the trifocal TFLIO130C IOL is robust to small decentrations, with virtually no change in MTF response for 0.25 mm decentration. For greater decentration levels, the MTF response is slightly reduced with increasing decentration. The ETLIO130C EDOF design is robust to decentration, as the MTF response is only minimally affected when increasing the decentration up to 0.75 mm. CONCLUSIONS MTF responses are slightly reduced with greater levels of decentration, but the range of focus provided by both trifocal and EDOF designs are preserved. The effects for average levels of decentration reported in the literature are minimum for both IOL designs.
Collapse
Affiliation(s)
- Alejandro Cerviño
- Department of Optics & Optometry & Vision Sciences, University of Valencia, C / Dr. Moliner, 50., 46100, Burjassot, Valencia, Spain.
| | - Jose Juan Esteve-Taboada
- Department of Optics & Optometry & Vision Sciences, University of Valencia, C / Dr. Moliner, 50., 46100, Burjassot, Valencia, Spain
| | | | | | - Wen-Chu Tseng
- ICARES Medicus, Inc, Hsinchu County, Taiwan
- AST Products, Inc, Billerica, MA, USA
| | - William Lee
- ICARES Medicus, Inc, Hsinchu County, Taiwan
- AST Products, Inc, Billerica, MA, USA
| |
Collapse
|
3
|
Moore J, Østergaard J, Kretz F. Visual performance and patient preference with bilateral implantation of an extended depth of focus or combined implantation of an extended depth of focus/trifocal intraocular lens. Int Ophthalmol 2024; 44:80. [PMID: 38356027 PMCID: PMC10866775 DOI: 10.1007/s10792-024-03030-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 01/11/2024] [Indexed: 02/16/2024]
Abstract
PURPOSE Evaluate postoperative visual performance in patients with bilaterally implanted AT LARA or AT LARA/AT LISA tri (Carl Zeiss AG, Jena, Germany) intraocular lenses. METHODS Multicentered, comparative, open-label, retrospective/prospective study. Post-IOL implantation, patients were prospectively enrolled into this study; preoperative patient data were collected retrospectively. Follow-up was at 2-4 and 5-8 months post-surgery. The primary endpoint was binocular best corrected distance visual acuity (CDVA). The study was retrospectively registered on clinicaltrials.gov (#NCT05462067). RESULTS Seventy-one patients (142 eyes) were enrolled; 67 patients (134 eyes) have 5-8 months data. The mean binocular CDVA at 2-4 months was -0.10 ± 0.06 logMAR in the bilateral AT LARA group ("bilateral") and -0.11 ± 0.09 logMAR in the combined implantation AT LARA/ AT LISA tri group ("combined implantation"); (P = 0.4856). At 5-8 months, mean binocular CDVA was -0.13 ± 0.06 logMAR in the bilateral group and -0.11 ± 0.09 in the combined implantation group (P = 0.4003). At 5-8 months, more eyes in the bilateral group attained 0.2 logMAR or better binocular uncorrected intermediate VA (UIVA; 67 cm) than those in the combined implantation group (100% vs. 94%, respectively). The bilateral group achieved a mean of 0.24 ± 0.11 logMAR in uncorrected near VA (UCNVA), compared to a mean of 0.16 ± 0.12 logMAR in the combined implantation group at 5-8 months (P = 0.0041). CONCLUSIONS A combined implantation approach (AT LARA in the distance dominant eye/AT LISA tri in the non-dominant eye) produced similar CDVA outcomes but better UCNVA as bilateral implantation with the AT LARA. UIVA was comparable between groups. No new safety concerns were reported.
Collapse
Affiliation(s)
| | | | - Florian Kretz
- Augentagesklinik Rheine, Osnabrücker Straße 233 -235, 48429, Rheine, Germany.
| |
Collapse
|
4
|
Mori Y, Miyata K, Suzuki H, Noguchi S, Ichikawa K, Maeda N. Clinical Performance of a Hydrophobic Acrylic Diffractive Trifocal Intraocular Lens in a Japanese Population. Ophthalmol Ther 2023; 12:867-878. [PMID: 36542257 PMCID: PMC9768760 DOI: 10.1007/s40123-022-00634-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION In this study, clinical performance of a hydrophobic acrylic diffractive trifocal intraocular lens (IOL) with double C-loop haptics was evaluated in Japanese cataract eyes. METHODS Twenty-three patients had bilateral cataract surgery with the implantation of a trifocal IOL with double C-loop haptics. Postoperative examinations at 6 months included assessing uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA) at 5 m, uncorrected intermediate visual acuity (UIVA), distance-corrected intermediate visual acuity (DCIVA) at 80 cm, uncorrected near visual acuity (UNVA) and distance-corrected near visual acuity (DCNVA) at 40 cm. Binocular defocus, contrast sensitivity, spectacle independence, symptoms of photic phenomena and quality of vision (QOV) were also observed. RESULTS Twenty-three patients received 46 IOLs binocularly. Manifest refraction spherical equivalent was - 0.227 ± 0.385 D (mean ± standard deviation) at 6 months postoperatively. Binocular UDVA, binocular UIVA and binocular UNVA were - 0.101 ± 0.065, - 0.021 ± 0.079 and 0.022 ± 0.095 logMAR units, respectively. Binocular CDVA, binocular DCIVA and binocular DCNVA were - 0.151 ± 0.044, - 0.042 ± 0.067 and - 0.011 ± 0.080 logMAR, respectively. Binocular CDVA of 0.00 logMAR or better was obtained in the defocus from - 3.0 D until + 0.5 D. Only 8.7% of patients required the use of spectacles postoperatively. There were no symptoms of glare, halo and light disturbance in 78.3%, 56.5% and 69.6% of patients, respectively. QOV scores significantly improved postoperatively (P < 0.0001). CONCLUSION The hydrophobic acrylic trifocal IOL with double C-loop haptics provides good visual performance at all distances and produces high spectacle independence rate and patient satisfaction. TRIAL REGISTRATION NUMBER NCT04699266 (Clinicaltrials.gov).
Collapse
Affiliation(s)
- Yosai Mori
- Miyata Eye Hospital, 6-3, Kuraharacho, Miyakonojo, Miyazaki, 885-0051, Japan.
| | - Kazunori Miyata
- Miyata Eye Hospital, 6-3, Kuraharacho, Miyakonojo, Miyazaki, 885-0051, Japan
| | | | | | | | | |
Collapse
|
5
|
Zhu D, Ren S, Mills K, Hull J, Dhariwal M. Rate of Complete Spectacle Independence with a Trifocal Intraocular Lens: A Systematic Literature Review and Meta-Analysis. Ophthalmol Ther 2023; 12:1157-1171. [PMID: 36745314 PMCID: PMC10011212 DOI: 10.1007/s40123-023-00657-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 01/13/2023] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION A systematic literature review and meta-analysis was conducted to identify and obtain a precise single summary estimate on complete spectacle independence after bilateral implantation of a trifocal intraocular lens (IOL) (AcrySof PanOptix, TFNTXX/TFATXX) for patients undergoing cataract surgery. METHODS A search was conducted in PubMed from January 2017 to September 2021. Relevant congress presentations were also searched to include data from completed studies not yet published. Search terms included the intervention (TFNTXX, TFATXX, PanOptix) and outcomes of interest (patient-reported spectacle independence rates). A Bayesian random-effects meta-analysis was conducted, providing a pooled estimate (median and its 95% credible interval) of complete spectacle independence rates among cataract surgery patients. Subgroup analyses evaluated spectacle independence after cataract surgery across different working distances (near, intermediate, far). RESULTS Nineteen unique clinical studies were identified. Based on a meta-analysis of 13 studies (N = 513 patients), the complete spectacle independence rate after cataract surgery with TFNTXX/TFATXX IOL was 91.6% (95% credible interval 86.8-95.9%). Additionally, the spectacle independence rates at each focal point (N = 13 studies, 603 patients) were 89.6% (near), 96.3% (intermediate), and 95.9% (far). CONCLUSIONS This meta-analysis demonstrated that at least nine out of ten patients receiving TFNTXX/TFATXX trifocal IOL during cataract surgery can expect to achieve complete spectacle independence. This study provides informative data for clinicians and patients to feel confident in the use of trifocal intraocular lenses as presbyopia-correcting IOLs that offer high rates of complete spectacle independence.
Collapse
Affiliation(s)
- Dagny Zhu
- NVISION Eye Centers, 17980 Castleton Street, Rowland Heights, CA, 91748, USA.
| | - Shijie Ren
- The University of Sheffield, Sheffield, UK.,ConnectHEOR Limited, London, UK
| | | | | | - Mukesh Dhariwal
- Alcon Vision LLC, Forth Worth, TX, USA.,Health Economics and Outcomes Research, Alcon Vision LLC, Fort Worth, Texas, 76134, USA
| |
Collapse
|
6
|
Šivec Trampuž I, Mikek K, Krampf M. Clinical and self-reported outcomes after multifocal intraocular lens implantation of patients with stable keratoconus. Int Ophthalmol 2022. [PMID: 35357638 DOI: 10.1007/s10792-022-02302-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 03/10/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Multifocal intraocular lens (IOL) implantation is generally not considered in patients with keratoconus; however, it may provide good optical results in selected patients based on two case reports. AIMS To evaluate patient satisfaction and clinical outcomes in this patient population. METHODS This is a retrospective single-center, non-comparison study. All patients with frank keratoconus who had undergone a trifocal IOL implantation between 2016 and 2019 were invited to participate in this study (18 eyes of 9 patients were included). Postoperatively, refractive outcomes, contrast sensitivity, and ocular aberrations were recorded. A questionnaire was used for determining patient satisfaction and their quality of life. The mean follow-up time was 31.22 ± 6.38 months. RESULTS Postoperatively the patients' uncorrected distance visual acuity improved from 1.13 ± 0.93 logMAR to 0.10 ± 0.17 (p ˂ 0.001), corrected distance visual acuity went from 0.10 ± 0.11 to 0.05 ± 0.09 (p = 0.19), mean refractive spherical equivalent changed from -4.34 ± 4.31 to 0.05 ± 0.51 D (p ˂ 0.001), and manifest astigmatism from 2.44 ± 1.92 to 0.88 ± 1.81 D (p = 0.017). A postoperative MRSE of less than ± 0.50 D was achieved in 17 eyes (94%). Three eyes (17%) lost 1 line of best corrected visual acuity and no patient lost two or more lines. The patients were independent of glasses in 78% for all distances. One patient who required an IOL exchange due to photic phenomena was lost to follow-up. CONCLUSIONS Use of a trifocal IOL provided relatively predictable refractive outcomes and spectacle independence in most of this small cohort of patients with stable frank keratoconus.
Collapse
|
7
|
McNeely RN, Moutari S, Stewart S, Moore JE. Visual outcomes and patient satisfaction 1 and 12 months after combined implantation of extended depth of focus and trifocal intraocular lenses. Int Ophthalmol 2021; 41:3985-3998. [PMID: 34546493 PMCID: PMC8572828 DOI: 10.1007/s10792-021-01970-3] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/16/2021] [Indexed: 12/27/2022]
Abstract
Purpose To assess the 1-month and 12-month postoperative visual performance and subjective 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 trifocal IOL. Uncorrected (UDVA) and best-corrected (CDVA) distance visual acuities, uncorrected intermediate (UIVA) and near (UNVA) visual acuities, and subjective questionnaires were evaluated 1 month and 12 months postoperatively. Results The study enrolled 58 consecutive patients. Binocular UDVA, UIVA and UNVA were − 0.08 ± 0.07 logMAR, 0.15 ± 0.14 logMAR and 0.17 ± 0.11 logMAR at 1 month, compared to − 0.09 ± 0.06 logMAR (P = .323), 0.11 ± 0.10 logMAR (P = .030) and 0.13 ± 0.10 logMAR (P = 0.008) at 12 months. Satisfaction was high with 93.1% of patients fulfilled or more than fulfilled postoperatively, and 84.5% and 86.3% reported spectacle independence for near at the respective postoperative assessments. The mean daytime and nighttime quality of vision (QoV) scores were 9.12 ± 0.94 and 7.88 ± 1.74 at 1 month, compared to 9.24 ± 0.78 (P = .183) and 8.26 ± 1.38 (P = .043) at 12 months. Conclusions This IOL combination provides good unaided visual acuity at 1 and 12 months postoperatively, with high functional vision and postoperative satisfaction reported at 1 and 12 months. However, a significant improvement in overall nighttime QoV at the 12 months assessment was found.
Collapse
Affiliation(s)
- Richard N McNeely
- Cathedral Eye Clinic, 89-91 Academy Street, Belfast, BT1 2 LS, Northern Ireland, UK
| | - Salissou Moutari
- School of Mathematics and Physics, Queens University Belfast, Belfast, Northern Ireland, UK
| | - Stephen Stewart
- Cathedral Eye Clinic, 89-91 Academy Street, Belfast, BT1 2 LS, Northern Ireland, UK
| | - Jonathan E Moore
- Cathedral Eye Clinic, 89-91 Academy Street, Belfast, BT1 2 LS, Northern Ireland, UK. .,Biomedical Sciences Research Institute, University of Ulster, Coleraine, Northern Ireland, UK. .,Tianjin Medical University, Tianjin, China. .,Aston University, Birmingham, UK.
| |
Collapse
|
8
|
Abstract
Funktionelle Ergebnisse und das Auftreten von Nebenwirkungen (insbesondere photischer Phänomene) können beim Einsatz multifokaler Intraokularlinsen (IOL) schwer vorhergesagt werden. Des Weiteren können Patienten im Laufe des Lebens Erkrankungen entwickeln, bei denen eine multifokale Optik von Nachteil sein kann. In diesen Fällen ist ein Austausch der IOL die einzige Therapieoption. Die Implantation einer monofokalen oder monofokal-torischen IOL in den Kapselsack und einer additiven trifokalen IOL in den Sulcus ciliaris in einer als Duett-Verfahren bezeichneten Operation ermöglicht Trifokalität, die bei Bedarf vergleichsweise einfach wieder rückgängig gemacht werden kann.
Collapse
Affiliation(s)
- Ramin Khoramnia
- International Vision Correction Research Centre (IVCRC), Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Deutschland
| | - Timur M. Yildirim
- International Vision Correction Research Centre (IVCRC), Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Deutschland
| | - Hyeck-Soo Son
- International Vision Correction Research Centre (IVCRC), Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Deutschland
| | - Grzegorz Łabuz
- International Vision Correction Research Centre (IVCRC), Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Deutschland
| | - Christian S. Mayer
- International Vision Correction Research Centre (IVCRC), Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Deutschland
| | - Gerd U. Auffarth
- International Vision Correction Research Centre (IVCRC), Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Deutschland
| |
Collapse
|
9
|
Bissen-Miyajima H, Ota Y, Hayashi K, Igarashi C, Sasaki N. Results of a clinical evaluation of a trifocal intraocular lens in Japan. Jpn J Ophthalmol 2020; 64:140-149. [PMID: 31900871 DOI: 10.1007/s10384-019-00712-4] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 11/21/2019] [Indexed: 01/08/2023]
Abstract
PURPOSE To evaluate the effectiveness and safety of a new trifocal intraocular lens (IOL) after cataract removal in patients living in Japan. STUDY DESIGN Prospective multicenter clinical study. METHODS One hundred and thirty-five eyes of 68 patients (19 men, 49 women; mean age, 66.3 ± 7.4 years) were followed for 6 months. Trifocal IOLs with focal points at near, intermediate, and distance were implanted bilaterally in eyes with less than 1 diopter of corneal astigmatism. The visual acuity (VA) at distance, 60 and 40 centimeters (cm), and contrast sensitivities were measured. Patients completed quality-of-life questionnaires preoperatively and postoperatively. RESULTS The mean bilateral logarithm of the minimum angle of resolution VA at 5 meters (m), 60 cm, and 40 cm were, respectively: uncorrected, - 0.104 ± 0.095, - 0.065 ± 0.111, and - 0.042 ± 0.105; and distance-corrected, - 0.197 ± 0.076, - 0.112 ± 0.111, and - 0.073 ± 0.111. The contrast sensitivities at distance and near were within the normal range at all spatial frequencies under photopic conditions. Patients reported complete spectacle independence in 75.0% of cases. Total use of spectacles was reported by 1.5% and partial by 20.6%; the purpose of spectacle use was primarily for near visual tasks. Mild-to-moderate glare was reported by 65.7% of patients and halos by 70.1%; only 1.5% of subjects reported severe glare and halos. CONCLUSIONS This new trifocal IOL provides equally good uncorrected VAs at distance, intermediate, and near, and decreases spectacle dependence in daily life. Patients frequently report mild-to-moderate glare and halos, and patients should be informed about these before implantation.
Collapse
Affiliation(s)
- Hiroko Bissen-Miyajima
- Department of Ophthalmology, Tokyo Dental College Suidobashi Hospital, Kandamisaki-cho 2-9-18, Chiyoda-ku, Tokyo, 101-0061, Japan.
| | - Yuka Ota
- Department of Ophthalmology, Tokyo Dental College Suidobashi Hospital, Kandamisaki-cho 2-9-18, Chiyoda-ku, Tokyo, 101-0061, Japan
| | | | | | | |
Collapse
|
10
|
Yildirim TM, Auffarth GU, Son HS, Huber C, Beisse F, Khoramnia R. Bilateral trifocal IOL implantation in a pediatric case of cataract following steroid-therapy for acute lymphoblastic leukemia. Am J Ophthalmol Case Rep 2018; 13:46-49. [PMID: 30555958 PMCID: PMC6277248 DOI: 10.1016/j.ajoc.2018.11.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 11/01/2018] [Accepted: 11/17/2018] [Indexed: 12/18/2022] Open
Abstract
Purpose To present the case of a 9-year-old child with bilateral posterior subcapsular cataract developed through steroid treatment for acute lymphoblastic leukemia. Cataract surgery with trifocal intraocular lens implantation was performed in both eyes. Observations Uncorrected distance visual acuity increased from +0.3 and + 0.4 logMAR preoperatively to 0.00 and + 0.04 logMAR after surgery. Binocular uncorrected values for intermediate and near visual acuity were −0.04 logMAR and 0.02 logMAR after surgery, respectively. The patient did not report side effects like halos or glare and was able to participate in his daily activities (school and sports) without spectacles. Conclusions and Importance This report represents the first description of a bilateral implantation of trifocal intraocular lenses in a pediatric cataract case with restoration of visual function in far, intermediate and near distance. Trifocal intraocular lenses to compensate for the loss of accommodation can be an option in selected cases of children with cataract.
Collapse
Affiliation(s)
| | - Gerd U. Auffarth
- Corresponding author. Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | | | | | | | | |
Collapse
|
11
|
Xue S, Zhao G, Yin X, Lin J, Li C, Hu L, Leng L, Yang X. Effect of incision on visual outcomes after implantation of a trifocal diffractive IOL. BMC Ophthalmol 2018; 18:171. [PMID: 30005634 PMCID: PMC6045830 DOI: 10.1186/s12886-018-0846-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 07/06/2018] [Indexed: 11/21/2022] Open
Abstract
Background To evaluate visual acuity, corneal astigmatism and corneal higher-order aberrations (HOAs) after implantation of trifocal diffractive IOLs operated with either a corneal steep-axis incision or 135° incision. Method This prospective study enrolled patients randomly assigned to different groups. According to preoperative corneal astigmatism, 101 eyes of 77 patients were assigned into group A1 (0 ~ 0.50 D) or A2 (0.51 ~ 1.00 D) with a corneal steep-axis incision or group B1 (0 ~ 0.50 D) or B2 (0.51 ~ 1.00 D) with a 135° incision. Visual acuity, corneal astigmatism and corneal higher-order aberrations (HOAs) were followed-up for 3 months. Results Corneal astigmatism in group A2 significantly decreased 3 months after surgery (P < 0.01) and was significantly lower than that in group B2 1 day, 2 weeks, 1 month, and 3 months postoperatively (all values of P < 0.01). The following parameters were better in group A2 than in group B2: uncorrected intermediate visual acuity (UIVA) at 1 day, 2 weeks, 1 month, and 3 months (P = 0.00, 0.00, 0.01, 0.01, respectively);uncorrected distance visual acuity (UDVA) at 1 day and 2 weeks (P = 0.00, 0.01); and uncorrected near visual acuity (UNVA) at 1 day, 2 weeks, and 1 month postoperatively (P = 0.00, 0.01, 0.02, respectively). Conclusions After a corneal steep-axis incision, patients with preoperative corneal astigmatism of 0.51 D to 1.00 D exhibited reduced corneal astigmatism and achieved better UIVA and early postoperative UDVA/UNVA. Trial registration Retrospectively Registered Trials ISRCTN10086721, 23/06/2018.
Collapse
Affiliation(s)
- Shasha Xue
- The Affiliated Hospital of Qingdao University, No.16, Jiangsu Road, Qingdao, China
| | - Guiqiu Zhao
- The Affiliated Hospital of Qingdao University, No.16, Jiangsu Road, Qingdao, China.
| | - Xiaoni Yin
- The Affiliated Hospital of Qingdao University, No.16, Jiangsu Road, Qingdao, China
| | - Jing Lin
- The Affiliated Hospital of Qingdao University, No.16, Jiangsu Road, Qingdao, China
| | - Cui Li
- The Affiliated Hospital of Qingdao University, No.16, Jiangsu Road, Qingdao, China
| | - Liting Hu
- The Affiliated Hospital of Qingdao University, No.16, Jiangsu Road, Qingdao, China
| | - Lin Leng
- The Affiliated Hospital of Qingdao University, No.16, Jiangsu Road, Qingdao, China
| | - Xuejiao Yang
- The Affiliated Hospital of Qingdao University, No.16, Jiangsu Road, Qingdao, China
| |
Collapse
|