Refractive corneal inlay for near vision improvement after cataract surgery

Correction for presbyopia in cataract patients is a significant challenge for ophthalmologists and cataract surgeons, however, an increasingly diverse array of intraocular lenses (IOLs) that are capable of providing good quality near vision is available. Currently available synthetic lenses use different technologies to correct for presbyopia. The latest iterations of the AcrySof® ReSTOR® IOLs combine an optic with a central apodized diffractive zone, a peripheral refractive zone, an aspheric anterior to combat corneal aberrations, and an ultraviolet (UV)- and blue-light filtering chromophore. The AcrySof® IQ ReSTOR® IOLs provide excellent near vision restoration with increased spectacle independence and minimal severe side effects. As a result, it may represent a significant advance over other presbyopia-correcting technologies. IOLs such as the AcrySof® IQ ReSTOR® are increasingly replicating the full visual capabilities of the crystalline lens and are an important advancement in the treatment of presbyopia in cataract patients.

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Clinical Outcomes after Mix-and-Match Implantation of Extended Depth of Focus and Diffractive Multifocal Intraocular Lenses

Journal of Ophthalmology ◽

10.1155/2021/8881794 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Jae Hyuck Lee ◽

Ho Seok Chung ◽

Su Young Moon ◽

So Young Park ◽

Hun Lee ◽

...

Keyword(s):

Visual Acuity ◽

Patient Satisfaction ◽

Cataract Surgery ◽

Clinical Outcomes ◽

Intraocular Lenses ◽

Prospective Clinical Study ◽

Depth Of Focus ◽

Near Vision ◽

Extended Depth Of Focus ◽

Mix And Match

Purpose. To evaluate the clinical outcomes after bilateral mix-and-match cataract surgery using extended depth of focus (EDOF) and diffractive multifocal (DMF) intraocular lenses (IOLs). Setting. Asan Medical Center, Seoul, South Korea. Design. Prospective clinical study. Methods. Thirty-seven patients underwent TECNIS Symfony EDOF IOL (ZXR00) implantation in the dominant eye, and TECNIS +3.25 DMF IOL (ZLB00) implantation in the nondominant eye. Patients were followed up for 3 months; uncorrected and corrected distance visual acuity (UDVA and CDVA), uncorrected intermediate and near visual acuity (UIVA and UNVA), contrast sensitivity, defocus curves, stereopsis, and patient satisfaction were assessed. Results. At 3 months, the mean logarithm of the minimum angle of resolution (logMAR) of UDVA was 0.07 ± 0.09 in EDOF IOL eyes, 0.12 ± 0.11 in DMF IOL eyes, and 0.02 ± 0.05 in both eyes. UIVA was 0.11 ± 0.11 in EDOF IOL eyes, 0.16 ± 0.12 in DMF IOL eyes, and 0.04 ± 0.07 in both eyes. UNVA was 0.25 ± 0.15 in EDOF IOL eyes, 0.22 ± 0.16 in DMF IOL eyes, and 0.13 ± 0.13 in both eyes. Thirty patients (81.1%) were more than satisfied with near vision, and 8 patients (21.6%) complained of severe glare and halo. Spectacle independence for near vision was achieved in 34 patients (91.9%), and 31 patients (83.8%) had better than a 50-second arc of stereopsis. Conclusion. Mix-and-match cataract surgery with EDOF and DMF IOL implantation provided good visual outcomes for all distances. Additionally, excellent patient satisfaction was achieved with a high level of spectacle independence and acceptable photic phenomena.

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A 3-year follow-up study of a new corneal inlay: clinical results and outcomes

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-314314 ◽

2019 ◽

Vol 104 (5) ◽

pp. 723-728 ◽

Cited By ~ 1

Author(s):

Sandra Maria Canelas Beer ◽

Liliana Werner ◽

Eliane Mayumi Nakano ◽

Rodrigo T Santos ◽

Flavio Hirai ◽

...

Keyword(s):

Visual Acuity ◽

Anterior Segment ◽

Optical Quality ◽

Quality Analysis ◽

Power Correction ◽

Blurred Vision ◽

Clinical Trial Registration ◽

Near Vision ◽

Corneal Inlay

PurposeHere, we report the results of a 3-year follow-up analysis of the outcomes of the Flexivue Microlens corneal inlay.PatientsNon-dominant eyes (n=31) of emmetropic presbyopic patients (spherical equivalent: −0.5 to 1.00 dioptre).MethodsA Flexivue Microlens corneal inlay was implanted after the creation of a 300 μm deep stromal pocket using a femtosecond laser. Patients were followed up according to a clinical protocol involving refraction, anterior segment imaging analysis (Oculyser), optical quality analysis (OPD-Scan), monocular binocular uncorrected and corrected visual acuity tests, contrast sensitivity measurements (photopic and mesopic), satisfaction questionnaire results and adverse event reporting.ResultsThirty patients were examined at the 3-year follow-up in this ongoing study. The mean uncorrected near visual acuity improved to Jaeger 1 in 76.9% of eyes treated with the inlays (vs 87.1% at the 1-year follow-up). All eyes improved four lines in all visits, except for four patients for whom the inlay was explanted. Patients reported that their near vision was good or excellent in 73.3% of cases (vs 90.3% in the first year). The UDVA remained stable over time. Three patients were explanted due to blurred vision for near-point and far-point distances. One patient developed a superficial corneal ulcer after 20 months. Two patients underwent cataract removal. Four patients underwent inlay exchange to increase near power correction.ConclusionsThe Presbia Flexivue Microlens provided presbyopia treatment by improving near vision. Manageable complications may occur over the long term.Clinical trial registration numberU1111-1185-5684 and 0310451200000550.

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Cataract Surgery with a Trifocal Intraocular Lens - Patient Outcomes and Satisfaction Levels

Journal of Ophthalmology & Clinical Research ◽

10.24966/ocr-8887/100081 ◽

2021 ◽

Vol 8 (2) ◽

pp. 1-5

Author(s):

Raymond Stein ◽

Keyword(s):

Patient Satisfaction ◽

Surgical Technique ◽

Cataract Surgery ◽

Patient Outcomes ◽

Intraocular Lens ◽

High Probability ◽

High Patient Satisfaction ◽

Near Vision ◽

Refractive Outcomes

The PanOptix® IOL used for cataract surgery showed high patient satisfaction and a high probability of spectacle independence for distance and near vision. The postoperative refractive outcomes demonstrated a low spheroequivalent and cylinder, primarily related to careful IOL measurements, advanced IOL formulas, and surgical technique.

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Clinical Outcomes After Mix-and-Match Implantation of Extended Depth of Focus and Diffractive Multifocal Intraocular Lenses

10.20944/preprints202004.0423.v1 ◽

2020 ◽

Author(s):

Jae Hyuck Lee ◽

Ho Seok Chung ◽

Su Young Moon ◽

Hun Lee ◽

Jae Yong Kim ◽

...

Keyword(s):

Visual Acuity ◽

Patient Satisfaction ◽

Cataract Surgery ◽

Clinical Outcomes ◽

Intraocular Lenses ◽

Depth Of Focus ◽

Near Vision ◽

Extended Depth Of Focus ◽

Dominant Eye ◽

Mix And Match

Purpose: To evaluate clinical outcomes after bilateral mix-and-match cataract surgery using extended depth of focus (EDOF) and diffractive multifocal (DMF) intraocular lenses (IOLs). Methods: Thirty-seven patients received Tecnis Symfony EDOF IOL (ZXR00) implantation in the dominant eye, and Tecnis +3.25 DMF IOL (ZLB00) in the non-dominant eye. Patients were followed for 3 months, and uncorrected and corrected distance visual acuity (UDVA, CDVA) , uncorrected intermediate and near visual acuity (UIVA, UNVA), contrast sensitivity, defocus curves, stereopsis, and patient satisfaction were assessed. Results: At 3 months, mean logMAR UDVA was 0.07 ± 0.09 in EDOF IOL eyes, 0.12 ± 0.11 in DMF IOL eyes, and 0.02 ± 0.05 in both eyes. UIVA was 0.11 ± 0.11 in EDOF IOL eyes, 0.16 ± 0.12 in DMF IOL eyes, and 0.04 ± 0.07 in both eyes. UNVA was 0.25 ± 0.15 in EDOF IOL eyes, 0.22 ± 0.16 in DMF IOL eyes, and 0.13 ± 0.13 in both eyes. Thirty patients(81.1%) were more than satisfied with near vision, and 8 patients(21.6%) complained of severe glare and halo. Spectacle independence for near vision was achieved in 34 patients(91.9%), and 31 patients(83.8%) had better than a 50 second arc of stereopsis. Conclusion: Mix-and-match cataract surgery with EDOF and DMF IOL implantation provided good visual outcomes through all distances. Also excellent patient satisfaction was achieved with high level of spectacle independence and minimal photic phenomena.

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Cataract Surgery with a Refractive Corneal Inlay in Place

Case Reports in Ophthalmological Medicine ◽

10.1155/2015/230801 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

N. R. Stojanovic ◽

S. I. Panagopoulou ◽

I. G. Pallikaris

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Power Calculation ◽

Iol Power Calculation ◽

Uncorrected Distance Visual Acuity ◽

Usual Manner ◽

Corneal Inlay ◽

Standard Manner ◽

One Year ◽

The One

Purpose. To present a case of cataract surgery performed in a patient with a refractive corneal inlay in place.Methods. A 48-year-old female patient presented to our institute with bilateral cataract. The patient had undergone refractive corneal inlay implantation three years ago in her right, nondominant eye for presbyopia correction. Biometry and intraocular lens (IOL) power calculation were performed without removing the inlay. Phacoemulsification and IOL insertion were carried out in both eyes in a usual manner.Results. On day one postoperatively, the patient achieved binocular uncorrected distance visual acuity 20/20 and uncorrected near visual acuity J1. The vision remained stable during the one-year follow-up period.Conclusion. Cataract surgery was performed in a standard manner in a patient with Presbia Microlens corneal inlay in place. Visual outcomes for both near and distance vision were satisfactory.

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Corneal-Based Surgical Presbyopic Therapies and Their Application in Pseudophakic Patients

Journal of Ophthalmology ◽

10.1155/2016/5263870 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Grace L. Paley ◽

Roy S. Chuck ◽

Linda M. Tsai

Keyword(s):

Quality Of Life ◽

Laser Ablation ◽

Natural History ◽

Cataract Surgery ◽

Refractive Surgery ◽

Corneal Inlay ◽

History Of ◽

Surgical Options ◽

Laser Refractive Surgery

Purpose. The purpose of this review is to provide a summary of laser refractive surgery and corneal inlay approaches to treat presbyopia in patients after cataract surgery.Summary. The presbyopic population is growing rapidly along with increasing demands for spectacle independence. This review will focus on the corneal-based surgical options to address presbyopia including various types of corneal intrastromal inlays and laser ablation techniques to generate either a multifocal cornea (“PresbyLASIK”) or monovision. The natural history of presbyopia develops prior to cataracts, and these presbyopic surgeries have been largely studied in phakic patients. Nevertheless, pseudophakic patients may also undergo these presbyopia-compensating procedures for enhanced quality of life. This review examines the published reports that apply these technologies to patients after cataract surgery and discusses unique considerations for this population.

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Reading and Quality of Life Differences between Tecnis ZCB00 Monofocal and Tecnis ZMB00 Multifocal Intraocular Lenses

European Journal of Ophthalmology ◽

10.5301/ejo.5000925 ◽

2017 ◽

Vol 27 (4) ◽

pp. 443-453 ◽

Cited By ~ 4

Author(s):

Francisco de Asís Bartol-Puyal ◽

Paula Talavero ◽

Galadriel Giménez ◽

Irene Altemir ◽

José M. Larrosa ◽

...

Keyword(s):

Quality Of Life ◽

Cataract Surgery ◽

Intraocular Lenses ◽

Life Questionnaire ◽

Near Vision ◽

Multifocal Iol ◽

Multifocal Intraocular Lenses ◽

Optical Correction ◽

Monofocal Iol

Purpose To compare the NEI-RQL-42 quality of life questionnaire and the Radner Vissum reading test outcomes after bilateral cataract surgery with implantation of Tecnis ZCB00 monofocal and Tecnis ZMB00 multifocal intraocular lens (IOL). Methods Forty-two eyes of 21 patients who had phacoemulsification were implanted with Tecnis ZCB00 IOL and 82 eyes of 41 patients were implanted with Tecnis ZMB00 IOL. They answered the NEI-RQL-42 questionnaire before cataract surgery and 3 months after it. The Radner Vissum test was performed 3 months after the surgery with optical correction for near vision in patients with monofocal IOL, but without it in patients with multifocal IOL. Results Regarding the NEI-RQL-42 test, the multifocal group obtained better results in items 2, 7, 8, 11, 13, 31, and 40, and in the following categories: near vision, dependence on correction, and suboptimal correction (p<0.05). The monofocal group only showed better results in item 17. As for the Radner Vissum test, the multifocal group obtained significantly better results in phrases 1, 3, 4, and 5, and in the number of incorrect syllables (p<0.05). Conclusions Patients with Tecnis ZMB00 multifocal IOL report a higher quality of life regarding the lack of need for optical correction for near vision in their daily activities, but halos in vision at night. Additionally, patients with multifocal IOL achieve similar or better reading quality at near vision and under photopic lighting conditions than patients with monofocal IOL with near vision optical correction.

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