Effect of postoperative refractive error on visual acuity and patient satisfaction after implantation of the Array multifocal intraocular lens

Abstract Purpose: To investigate all cases of multifocal intraocular lens (MFIOL) exchange, with specific focus on indications for exchange and evaluation of postoperative outcomes, in a tertiary care, multi-specialty ophthalmology practice.Setting/Venue: Academic Referral Center/Cleveland Clinic Abu Dhabi – Abu Dhabi, United Arab EmiratesMethods: This retrospective case series identified all patients that presented to a large academic practice over a 4-year period that were intolerant to MFIOL technology and thus required intraocular lens (IOL) exchange. All patients reported poor vision despite correction of reversible ocular comorbidities, including dry eye and residual refractive error. Outcomes reviewed include subjective visual complaints, IOL-type, visual acuity, refractive error, ocular comorbidities, and surgical outcomes. Endpoints examined include mean uncorrected distance visual acuity (UDVA), mean corrected distance visual acuity (CDVA), mean refractive spherical equivalent (MRSE), and residual refractive astigmatism. Results: Six eyes of five patients required MFIOL exchange. All IOL’s exchanged were trifocal IOL’s. IOL exchange occurred between 6 to 72 months following primary phacoemulsification. Each patient had multiple ocular comorbidities, ranging from keratoconjunctivitis sicca to longstanding intermediate uveitis and macular pathology. Postoperatively, subjective visual complaints resolved in all patients. Objective mean changes in UDVA, CDVA, MRSE and residual astigmatism were not statistically significant. Conclusion: Thorough preoperative evaluation is required prior to MFIOL placement in order to rule out ocular comorbidities that may impair visual quality. In patients with MFIOL intolerance due to irreversible ocular comorbidities, IOL exchange to a monofocal IOL is safe, effective, and results in subjective improvement in vision.

Download Full-text

Clinical and Self-Reported Outcomes after Multifocal Intraocular Lens Implantation of Patients with Stable Keratoconus

10.21203/rs.3.rs-294653/v1 ◽

2021 ◽

Author(s):

Igor Šivec Trampuž ◽

Kristina Mikek ◽

Metka Krampf

Keyword(s):

Visual Acuity ◽

Patient Satisfaction ◽

Intraocular Lens ◽

Case Reports ◽

Multifocal Intraocular Lens ◽

Iol Implantation ◽

Distance Visual Acuity ◽

Refractive Outcomes ◽

Uncorrected Distance Visual Acuity ◽

Trifocal Iol

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 with stage I and II keratoconus 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-interventional, 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). 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 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 target refraction of less than ± 0.50 D was achieved in 17 eyes (94%) and one eye exhibited a hyperopic MRSE of +2.0 D. 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. Conclusions: A trifocal IOL currently gives relatively good, predictable results with most patients feeling satisfied with the results of spectacle independence for all distances.

Download Full-text

Faculty Opinions recommendation of Visual outcomes and patient satisfaction in 9366 eyes using a refractive segmented multifocal intraocular lens.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718040364.793480840 ◽

2013 ◽

Author(s):

Arun Gulani

Keyword(s):

Patient Satisfaction ◽

Intraocular Lens ◽

Multifocal Intraocular Lens ◽

Visual Outcomes

Download Full-text

A comparative study on early vision quality after implantation of refractive segmental and diffractive multifocal intraocular lens

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.36.7.3364 ◽

2020 ◽

Vol 36 (7) ◽

Author(s):

Huifang Lian ◽

Weisong Ma ◽

Qiuhong Wei ◽

Xiaoyong Yuan

Keyword(s):

Patient Satisfaction ◽

Contrast Sensitivity ◽

Intraocular Lens ◽

Visual Disturbance ◽

Early Vision ◽

Multifocal Intraocular Lens ◽

Spatial Frequencies ◽

High Order Aberration ◽

Phacoemulsification Cataract Surgery

Objectives: To compare early subjective and objective vision quality of postoperative patients undergoing phacoemulsification cataract surgery combined with implantation of refractive segmental multifocal intraocular lens (MIOL) SBL-3 and apodized diffractive MIOL SN6AD1. Methods: As a prospective study, it enrolled 53 patients (53 eyes) to undergo phacoemulsification cataract surgery combined with MIOL implantation. According to differences in MIOL implanted, patients were divided into a SBL-3 group (25 eyes) and a SN6AD1 group (28 eyes). Ophthalmological evaluation included uncorrected (UDVA) and corrected (CDVA) distance visual acuities, uncorrected intermediate (UIVA) and near (UNVA) visual acuities, distance-corrected intermediate (DCIVA) and near (DCNVA)visual acuities and corrected near(CNVA) visual acuity, contrast sensitivity, modulation transfer function (MTF) and high order aberration (4 mm pupil diameter) at three months postoperatively. Moreover, a questionnaire survey was carried out to assess near spectacle independence, patient satisfaction and symptoms of visual disturbance. Results: At three months after surgery, UIVA and UNVA in the SBL-3 group are statistically significantly superior to those of the SN6AD1 group (P<0.05). There was statistical difference in contrast sensitivity at four spatial frequencies (3, 6, 12, 18cycles/degree) under mesopic conditions and mesopic conditions with glare (P<0.05). The total ocular high order aberration, coma and trefoil were statistically significantly larger in the SBL-3 group than in the SN6AD1 group with 4.0 mm pupil diameters (P<0.05). Statistical differences were found in the MTF at spatial frequencies of 5, 10 and 15 cycles/degree between the groups. There were no significant differences in spectacle independence, patient satisfaction and visual disturbance between the groups (P>0.05). Conclusions: Both the two multifocal intraocular lens provided an excellent level of quality of vision three months postoperatively. However, the application effect of SBL-3 MIOL is superior to that of SN6AD1 MIOL as far as intermediate vision, near vision and contrast sensitivity are concerned. doi: https://doi.org/10.12669/pjms.36.7.3364 How to cite this:Lian H, Ma W, Wei Q, Yuan X. A comparative study on early vision quality after implantation of refractive segmental and diffractive multifocal intraocular lens. Pak J Med Sci. 2020;36(7):---------. doi: https://doi.org/10.12669/pjms.36.7.3364 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Download Full-text

Pseudoaccommodation and Visual Acuity With Technovision PresbyLASIK and a Theoretical Simulated Array® Multifocal Intraocular Lens

Journal of Refractive Surgery ◽

10.3928/1081597x-20080401-05 ◽

2008 ◽

Vol 24 (4) ◽

pp. 344-349 ◽

Cited By ~ 19

Author(s):

Carlos Illueca ◽

Jorge L. Alió ◽

David Mas ◽

Dolores Ortiz ◽

Jorge Pérez ◽

...

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Multifocal Intraocular Lens

Download Full-text

Bioptics for high hyperopia with combined multifocal intraocular lens implantation and excimer ablation in young patients

European Journal of Ophthalmology ◽

10.1177/1120672118797281 ◽

2018 ◽

Vol 29 (4) ◽

pp. 426-430 ◽

Cited By ~ 1

Author(s):

Omer Trivizki ◽

David Smadja ◽

Michael Mimouni ◽

Samuel Levinger ◽

Eliya Levinger

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Laser In Situ Keratomileusis ◽

Intraocular Lens Implantation ◽

Multifocal Intraocular Lens ◽

Distance Visual Acuity ◽

Lens Implantation ◽

Near Visual Acuity ◽

High Hyperopia

Purpose:To analyze the visual and refractive outcome of the bioptics procedure combining multifocal intraocular lens implantation and excimer laser surgery in young patients with high hyperopic eyes not suitable for a single surgical procedure.Methods:This retrospective case series included 10 eyes of five patients (age range 18–30 years) with high hyperopia (spherical equivalent +8.51 ± 0.85 diopters (D)). They had been treated with serial multifocal intraocular lens implantation followed 6 weeks later by laser in situ keratomileusis for residual hyperopia. Uncorrected distance visual acuity, uncorrected near visual acuity, corrected distance visual acuity, corrected near visual acuity, and manifest refraction were evaluated before surgeries, after multifocal intraocular lens implantation, and 3 months post laser in situ keratomileusis.Results:No patients were lost to follow-up (6 months). The mean spherical equivalent decreased to +2.05 ± 1.33 D after multifocal intraocular lens implantation and to −0.10 ± 0.58 D after the laser in situ keratomileusis procedure. Success of the procedures was determined by uncorrected visual acuity. LogMAR uncorrected distance visual acuity improved by a total of more than six lines from 1.05 ± 0.18 LogMAR to 0.46 ± 0.12 LogMAR post multifocal intraocular lens implantation and to 0.15 ± 0.06 LogMAR after both surgeries. The LogMAR uncorrected near visual acuity increased by 0.81 ± 0.82 LogMAR after lens implantation due to loss of accommodation, and all eyes reached a LogMAR of 0 at 1 month postoperatively following laser in situ keratomileusis.Conclusions:A bioptics approach involving multifocal intraocular lens followed 6 weeks later by a laser in situ keratomileusis procedure for the correction of very high hyperopia enabled the resolution of the residual refractive error in young very high hyperopic patients.

Download Full-text

Comparisons of Visual and Surgical Outcomes after Reuse or Replacement of Dislocated in-the-Bag Intraocular Lens

Journal of Ophthalmology ◽

10.1155/2018/7342917 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Takayuki Baba ◽

Tomohiro Nizawa ◽

Toshiyuki Oshitari ◽

Shuichi Yamamoto

Keyword(s):

Visual Acuity ◽

Endothelial Cell ◽

Intraocular Lens ◽

Refractive Error ◽

Surgical Outcomes ◽

Case Series ◽

Cell Loss ◽

Significant Difference ◽

Group A ◽

Group B

Purpose. To compare the visual and surgical outcomes after a reuse or a replacement of a dislocated in-the-bag intraocular lens (IOL). Methods. This was a retrospective, nonrandomized case series at a single ophthalmological institution. Cases with an in-the-bag dislocation of an IOL were treated by pars plana vitrectomy and the reuse or the replacement of the IOL. The lens was held by intrascleral fixation of the haptics of the IOL under both conditions. The same dislocated IOL was reused in 6 eyes (group A) or it was replaced with another IOL in the other 9 eyes (group B). The pre- and postoperative parameters analyzed included the visual acuity, refractive error, corneal endothelial cell density, and intraocular pressure (IOP). Results. There was no significant difference between the two groups in the postoperative visual acuity (P=0.388), refractive error (P=0.955), IOP (P=0.529), and endothelial cell loss (P=0.940). A breakage or a tilting of the IOL was observed and required replacement in three eyes in the reuse group (P=0.044). Conclusions. Half of the cases with reused in-the-bag dislocated IOL had a breakage or a tilting of the IOL. The replacement of the in-the-bag dislocated IOL is better than the reuse of the IOL with intrascleral haptics fixation.

Download Full-text

Refractive Lens Exchange with Multifocal Intraocular Lens for Treatment of Chronic Intermittent Spasm of the Near Reflex

Case Reports in Ophthalmology ◽

10.1159/000481705 ◽

2017 ◽

Vol 8 (3) ◽

pp. 539-544 ◽

Cited By ~ 2

Author(s):

Guy Sallet

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Spontaneous Recovery ◽

Multifocal Intraocular Lens ◽

Refractive Lens Exchange ◽

Final Treatment ◽

Uncorrected Visual Acuity ◽

Refractive Lens ◽

Near Visual Acuity ◽

Near Reflex

We report the case of an emmetropic 32-year-old female with decreased uncorrected visual acuity and diplopia due to intermittent episodes of spasm of the near reflex. Neurologic, general, and ophthalmic examination could not find an organic cause. Attempts at spontaneous recovery, psychogenic therapy, and cycloplegic therapy were unsuccessful and the symptoms persisted for almost 5 years, leading to psychogenic distress. Final treatment with refractive lens exchange and implantation of a toric trifocal intraocular lens resolved the spasm of the near reflex, resulting in an uncorrected distance and near visual acuity of 20/20.

Download Full-text