Clinical Outcomes after Binocular Implantation of a New Trifocal Diffractive Intraocular Lens

Purpose.To evaluate visual, refractive, and contrast sensitivity outcomes, as well as the incidence of pseudophakic photic phenomena and patient satisfaction after bilateral diffractive trifocal intraocular lens (IOL) implantation.Methods. This prospective nonrandomized study included consecutive patients undergoing cataract surgery with bilateral implantation of a diffractive trifocal IOL (AT LISA tri 839MP, Carl Zeiss Meditec). Distance, intermediate, and near visual outcomes were evaluated as well as the defocus curve and the refractive outcomes 3 months after surgery. Photopic and mesopic contrast sensitivity, patient satisfaction, and halo perception were also evaluated.Results.Seventy-six eyes of 38 patients were included; 90% of eyes showed a spherical equivalent within ±0.50 diopters 3 months after surgery. All patients had a binocular uncorrected distance visual acuity of 0.00 LogMAR or better and a binocular uncorrected intermediate visual acuity of 0.10 LogMAR or better, 3 months after surgery. Furthermore, 85% of patients achieved a binocular uncorrected near visual acuity of 0.10 LogMAR or better.Conclusions.Trifocal diffractive IOL implantation seems to provide an effective restoration of visual function for far, intermediate, and near distances, providing high levels of visual quality and patient satisfaction.

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Visual and Refractive Outcomes following Bilateral Implantation of Extended Range of Vision Intraocular Lens with Micromonovision

Journal of Ophthalmology ◽

10.1155/2018/7321794 ◽

2018 ◽

Vol 2018 ◽

pp. 1-10 ◽

Cited By ~ 11

Author(s):

Sri Ganesh ◽

Sheetal Brar ◽

Archana Pawar ◽

Kirti J. Relekar

Keyword(s):

Visual Acuity ◽

Contrast Sensitivity ◽

Intraocular Lens ◽

Reading Acuity ◽

Good Tolerance ◽

Iol Implantation ◽

Refractive Outcomes ◽

Intermediate Vision ◽

Defocus Curve ◽

Near Visual Acuity

Purpose. To evaluate the outcomes following bilateral ERV intraocular lens implantation with micromonovision.Methods. 25 subjects underwent bilateral Tecnis Symfony IOL implantation with micromonovision. The dominant eye was targeted for emmetropia and the nondominant eye for myopia of −0.75 D. Uncorrected and corrected distance (UDVA, CDVA), intermediate (UIVA, CIVA), and near visual acuity (UNVA, DCNVA); reading performance; defocus curve; and contrast sensitivity were studied. Follow-ups were conducted at 1 week and 1 and 6 months postoperatively.Results. At 6 months postoperatively, the mean binocular UDVA, CDVA, UNVA, and DCNVA were −0.036 ± 0.09, −0.108 ± 0.07, 0.152 ± 0.11, and 0.216 ± 0.10 logMAR, respectively. Binocular UIVA and DCIVA were 0.048 ± 0.09 and 0.104 ± 0.08 logMAR, respectively, at 60 cm and −0.044 ± 0.09 and 0.012 ± 0.09 logMAR, respectively, at 80 cm. All patients had ≥0.2 logMAR UDVA and UNVA. Reading acuity and reading speeds showed improvement over time. Between defocus range of −2.50 and +1.00 D, the visual acuity remained ≥0.2 logMAR. Contrast sensitivity scores were within the normal range. 4 patients used reading glasses for very fine print.Conclusion. Bilateral ERV IOL implantation leads to excellent outcomes for far and intermediate vision, satisfactory outcomes for near vision, and good tolerance to micromonovision at the end of the 6 months. This trial is registered withCTRI/2015/10/006246.

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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.

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Clinical outcomes with a diffractive trifocal intraocular lens

European Journal of Ophthalmology ◽

10.1177/1120672118762231 ◽

2018 ◽

Vol 28 (4) ◽

pp. 419-424 ◽

Cited By ~ 19

Author(s):

Jorge L Alió ◽

Ana B Plaza-Puche ◽

Jorge L Alió del Barrio ◽

Pedro Amat-Peral ◽

Vicente Ortuño ◽

...

Keyword(s):

Visual Acuity ◽

Contrast Sensitivity ◽

Intraocular Lens ◽

Case Series ◽

Optical Quality ◽

Near Vision ◽

Case Series Study ◽

Defocus Curve ◽

Near Visual Acuity

Purpose: To evaluate clinical and visual outcomes, quality of near vision, and intraocular optical quality of patients bilaterally implanted with a trifocal PanOptix intraocular lens. Methods: In this prospective consecutive case-series study, 52 eyes of 26 bilateral patients (mean age, 60.2 ± 7.4 years) were implanted with the AcrySof IQ Panoptix intraocular lens. Visual acuity, defocus curve, contrast sensitivity (Pelli-Robson test), near activity visual questionnaire, and internal aberrations with Osiris were evaluated. A prototype light-distortion analyzer was used to quantify the postoperative light-distortion indices. The follow-up was 6 months after surgery. Results: Uncorrected, corrected distance, and uncorrected near visual acuities improved with the surgery (p ≤ 0.02). Distance corrected near visual acuity was 0.13 ± 0.10, 0.13 ± 0.13, and 0.13 ± 0.08 at 1, 3, and 6 months after surgery, respectively (p = 0.82). Distance corrected intermediate visual acuities were 0.09 ± 0.13, 0.13 ± 0.15, and 0.12 ± 0.12 at 1, 3, and 6 months, postoperatively. Binocular contrast sensitivity was 1.86 ± 0.15 Log Units. Defocus curve provided a visual acuity equal or better to 0.30 LogMAR between defocus levels of +0.50 to −3.00 D. The near activity visual questionnaire scores improved significantly with the surgery (p < 0.01). Conclusion: The AcrySof IQ Panoptix intraocular lens is able to restore visual function with an acceptable intermediate and near vision after cataract surgery with good contrast sensitivity and an improvement in the near activity visual questionnaire.

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Trifocal diffractive intraocular lens implantation in patients after previous corneal refractive laser surgery for myopia

10.21203/rs.3.rs-27965/v2 ◽

2020 ◽

Author(s):

Qiu-Mei Li ◽

Feng Wang ◽

Zhe-Ming Wu ◽

Zhen Liu ◽

Chuan Zhan ◽

...

Keyword(s):

Visual Acuity ◽

Excimer Laser ◽

Subjective Quality ◽

Laser In Situ Keratomileusis ◽

Power Calculation ◽

Iol Implantation ◽

Refractive Outcomes ◽

Trifocal Iol ◽

Near Visual Acuity

Abstract Background: With the difficulties in IOL power calculation and the potential side effects occurring postoperatively, multifocal IOL implantation after previous corneal refractive surgery are rarely reported especially for the trifocal IOL. Herein we report the clinical observation of trifocal IOL implantation in patients with previous myopia excimer laser correction. In this study, a multi-formula average method was performed for the IOLs power calculation to improve the accuracy. Visual and refractive outcomes were analyzed, and the subjective quality of patients’ life was evaluated by questionnaires survey.Methods: This retrospective case series included patients with previous myopia excimer laser correction who underwent femtosecond laser assisted phacoemulsification and trifocal IOL (AT LISA tri 839 MP) implantation. Follow-up was done at 1-day, 1-month and 3-month to assess the visual outcomes. Outcome measures were uncorrected distance, intermediate and near visual acuity (UDVA, UIVA, UNVA), manifest refraction, defocus curve, and subjective quality of vision.Results: 21 Eyes from sixteen patients (14 eyes with previous laser in situ keratomileusis and 7 eyes with previous photorefractive keratectomy) were included. Mean postoperative spherical equivalent (SE) at 3-month was −0.56 D ± 0.49 SD, wherein, 10 eyes (47.6%) were within ± 0.50 D of the desired emmetropia and 19 eyes (90.5%) were within ± 1.0 D. Mean monocular UDVA, UIVA and UNVA (logMAR) at last visit were 0.02 ± 0.07, 0.10 ± 0.10, and 0.15 ± 0.11 respectively. Three patients (19%) reported halos and glare in postoperative 3 months, two of them needed to use spectacles to improve the intermediate visual acuity. Fifteen patients (94%) reported a satisfaction score of ≥3.5 out of 4.0, without any difficulty in daily activity. Thirteen patients (81%) did not need spectacles at all distances, while the other 3 patients (19%) used spectacles for near-distance related visual activity. Mean composite score of the VF-14 questionnaire was 95.00 ± 7.29 out of 100.Conclusions: Trifocal IOL implantation after myopia excimer laser correction could restore good distance, intermediate visual acuity and acceptable near visual acuity, and provide accurate refractive outcomes as well as high spectacles independence rate.

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Comparison of Clinical Outcomes, Visual Quality and Visual Function of Two Presbyopia-Correcting Intraocular Lenses Made from the Same Material, but with Different Design and Optics

Journal of Clinical Medicine ◽

10.3390/jcm10153268 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3268

Author(s):

Ladislav Viktor Nováček ◽

Marie Němcová ◽

Kateřina Tyx ◽

Kristýna Lahodová ◽

Leoš Rejmont ◽

...

Keyword(s):

Visual Acuity ◽

Contrast Sensitivity ◽

Clinical Outcomes ◽

Visual Function ◽

Comparative Investigation ◽

Optical Quality ◽

Intraocular Lenses ◽

Refractive Outcomes ◽

Uncorrected Distance Visual Acuity ◽

Near Visual Acuity

This semi-prospective, parallel, comparative investigation evaluated the clinical outcomes and quality of vision (contrast sensitivity, visual function, dysphotopsia, spectacle use, overall satisfaction) after mono- or bilateral implantation of two presbyopia-correcting intraocular lenses (IOL)—the Liberty® 677MY or the AT LISA® tri 839M—in 50 eyes of 25 cataract patients. Clinical outcomes were assessed 3 and 12 months postoperatively. Eighty-nine percent of eyes implanted with the Liberty IOL and 59% of eyes implanted with the AT LISA IOL achieved a refractive outcome ±0.5 diopters of the target (emmetropia). Refractive outcomes were stable with both lenses. The proportions of eyes with 20/20 uncorrected distance visual acuity (UDVA) and 20/20 uncorrected near visual acuity (UNVA) were higher in the Liberty group than in the AT LISA group (UDVA: 56% vs. 41%; UNVA: 83% vs. 66%). Optical quality assessment results were comparable for the two IOLs. Superior photopic contrast sensitivity was found with the Liberty lens. The rate of Nd:YAG capsulotomy at the 12-month follow-up was 16.7% in the Liberty group and 40.6% for the AT LISA IOL. Considering that both lenses are made from the same material, we propose that the noted differences in clinical outcomes may derive from differences in design and optical surface between the two IOLs.

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One-year clinical evaluation of rotationally asymmetric multifocal intraocular lens with +1.5 diopters near addition

Scientific Reports ◽

10.1038/s41598-019-49524-z ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 3

Author(s):

Tetsuro Oshika ◽

Hiroyuki Arai ◽

Yoshifumi Fujita ◽

Mikio Inamura ◽

Yasushi Inoue ◽

...

Keyword(s):

Visual Acuity ◽

Patient Satisfaction ◽

Contrast Sensitivity ◽

Intraocular Lenses ◽

Phase Iii ◽

Multifocal Intraocular Lenses ◽

Defocus Curve ◽

Near Visual Acuity ◽

One Year ◽

High Level

Abstract We conducted a one-year prospective, multicenter study to assess clinical outcomes after implantation of segmented, rotationally asymmetric multifocal intraocular lenses (IOLs) with +1.5 diopters (D) near addition. In this phase III clinical trial, 120 eyes of 65 patients undergoing phacoemulsification and implantation of Lentis Comfort LS-313 MF15 (Oculentis GmbH) were included. The ophthalmological examinations were performed before and 1 day, 1 week, 1, 3, 6, 9, and 12 months after surgery. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity, uncorrected (UIVA) and distance-corrected (DCIVA) intermediate visual acuity at 70 cm, and uncorrected (UNVA) and distance-corrected (DCNVA) near visual acuity at 30 cm were measured. A defocus curve was obtained and patients were asked about the severity of photic phenomena. Postoperative distance and intermediate visual acuity was excellent, with UDVA, CDVA, UIVA, and DCIVA of approximately 20/20, 20/16, 20/25, 20/25 were attained, respectively. The level of near visual acuity was lower; UNVA and DCNVA remained at around 20/60 and 20/70, respectively. The defocus curve indicated that postoperative uncorrected visual acuity of 20/25 and 20/40 was obtained at as close as 67 cm and 50 cm, respectively. Contrast sensitivity was within the normal range, with a minimal level of subjective symptoms and high patient satisfaction. The rotationally asymmetric multifocal IOLs with +1.5 D near addition provided excellent distance and intermediate vision, but near vision was not enough for reading small prints. Contrast sensitivity was high, with very low incidences of photic phenomena and a high level of patient satisfaction.

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Etiology and outcomes of current posterior chamber phakic intraocular lens extraction

Scientific Reports ◽

10.1038/s41598-020-78661-z ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Hideki Hayakawa ◽

Kazutaka Kamiya ◽

Wakako Ando ◽

Masahide Takahashi ◽

Nobuyuki Shoji

Keyword(s):

Visual Acuity ◽

Patient Satisfaction ◽

Intraocular Lens ◽

Posterior Chamber ◽

Phakic Intraocular Lens ◽

Distance Visual Acuity ◽

Lens Extraction ◽

Refractive Outcomes ◽

Uncorrected Distance Visual Acuity ◽

Surgical Extraction

AbstractThis study was aimed to review the etiology and the outcomes of current posterior chamber phakic intraocular lens (Visian ICL, STAAR Surgical) extraction. This review comprised 770 eyes of 403 consecutive patients undergoing ICL extraction. We evaluated prevalence, etiology, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), predictability, and patient satisfaction. ICL extraction was required in 8 of 770 (1.0%) eyes. The most common reason was the progression of the pre-existing cataract formation in 5 eyes (63%), followed by residual refractive errors in 3 eyes (38%). Of the 7 eyes targeted for emmetropia, 7 (100%) and 6 (86%) achieved UDVAs of 20/40 and 20/20 or better, respectively. Three eyes (38%) showed no change in CDVA, 3 eyes (38%) gained 1 line, 2 eyes (25%) gained 3 or more lines. 88% and 100% were within ± 0.5 and 1.0 diopter (D), respectively, of the targeted correction. Patient satisfaction improved significantly, from 3.0 ± 1.4 preoperatively, to 8.0 ± 2.4 postoperatively. No vision-threatening complications occurred. ICL extraction was required in approximately 1% of ICL-implanted eyes. Visual and refractive outcomes were good, and patient satisfaction was overall high, even in ICL-extracted eyes.

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A comparative study of the visual outcomes between a new trifocal and an extended depth of focus intraocular lens

European Journal of Ophthalmology ◽

10.5301/ejo.5001029 ◽

2017 ◽

Vol 28 (2) ◽

pp. 182-187 ◽

Cited By ~ 44

Author(s):

Ramón Ruiz-Mesa ◽

Antonio Abengózar-Vela ◽

María Ruiz-Santos

Keyword(s):

Visual Acuity ◽

Contrast Sensitivity ◽

Intraocular Lens ◽

Distance Visual Acuity ◽

Visual Outcomes ◽

Uncorrected Distance Visual Acuity ◽

Corrected Distance Visual Acuity ◽

Near Visual Acuity ◽

Reading Distance ◽

Continuous Range

Purpose: To evaluate and compare the visual outcomes and ocular optical performance of the PanOptix trifocal intraocular lens (IOL) and Symfony extended range of vision IOL. Methods: Sixty-eight eyes of 34 patients were divided into 2 groups: 20 patients with the PanOptix IOL and 14 patients with the Symfony IOL. Binocular uncorrected distance visual acuity, best-corrected distance visual acuity (BCDVA), distance-corrected intermediate visual acuity (DCIVA) at 80 and 60 cm, and distance-corrected near visual acuity (DCNVA) at 40 cm were evaluated. Additionally, preferred reading distance with best-corrected distance and visual acuity at that distance, binocular defocus curves, mesopic and photopic contrast sensitivity, photic phenomena, and monocular total higher order aberrations (HOAs) were also measured. Results: The visual outcomes for PanOptix and Symfony IOL groups, respectively, were as follows: BCDVA: -0.03 ± 0.03 and -0.02 ± 0.03 logMAR; DCIVA at 80 cm: 0.06 ± 0.06 and 0.06 ± 0.04 logMAR; DCIVA at 60 cm: 0.06 ± 0.10 and 0.05 ± 0.04 logMAR; DCNVA: 0.04 ± 0.06 and 0.20 ± 0.07 logMAR (p<0.001). Similar preferred reading distances were found for both groups (37.0 ± 4.6 and 38.9 ± 5.7 cm, respectively). The visual acuities at those distances were 0.09 ± 0.08 and 0.19 ± 0.08 logMAR (p<0.001), respectively. The defocus curves showed significantly better outcomes for the PanOptix IOL from -2.0 to -4.0 D (p<0.001). No significant differences were found for contrast sensitivity, halometry, or HOAs between the groups. Conclusions: The PanOptix and Symfony IOLs showed comparable visual performance at distance and intermediate. However, the PanOptix IOL provided better near and preferred reading distance VAs and showed a more continuous range of vision than the Symfony IOL.

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Clinical Outcomes of Sequential Intrastromal Corneal Ring Segments and an Extended Range of Vision Intraocular Lens Implantation in Patients with Keratoconus and Cataract

Journal of Ophthalmology ◽

10.1155/2018/8328134 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

C. Lisa ◽

R. Zaldivar ◽

A. Fernández-Vega Cueto ◽

R. M. Sanchez-Avila ◽

D. Madrid-Costa ◽

...

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Iol Implantation ◽

Distance Visual Acuity ◽

Refractive Outcomes ◽

Uncorrected Distance Visual Acuity ◽

Intrastromal Corneal Ring ◽

Corrected Distance Visual Acuity ◽

Extended Range ◽

The Mean

Purpose. To evaluate efficacy, safety, and predictability of sequential Ferrara-type intrastromal corneal ring segments (ICRS) and an extended range of vision intraocular lens (IOL) implantation in patients with keratoconus and cataract. Methods. This study comprised patients with keratoconus and cataract that had ICRS implantation followed 6 months later by extended range of vision IOL implantation. The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and residual refractive errors, analysed using vector analysis, were recorded preoperatively, 6 months after ICRS implantation, and 6 months after IOL implantation, respectively. Results. The study enrolled 17 eyes (11 patients). The mean UDVA (logMAR scale) was 1.15 ± 0.67 preoperatively, 0.88 ± 0.69 six months after ICRS implantation (P=0.005), and 0.27 ± 0.18 six months after IOL implantation (P<0.0001). The CDVA changed from 0.26 ± 0.15 (logMAR) before surgery to 0.17 ± 0.08 six months after Ferrara-type ICRS implantation (P=0.002) and to 0.07 ± 0.06 six months after IOL implantation (P<0.0001). The spherical equivalent and the refractive cylinder declined steeply after IOL implantation (P<0.001). The magnitude of depth of focus was 2.60 ± 1.02 D. There were no statistically significant differences in visual acuity for a defocus range from +0.50 D to −0.50 D (P>0.1). Conclusion. Sequential Ferrara-type ICRS and an extended range of vision IOL implantation provided good visual and refractive outcomes, being an effective, safe, and predictable procedure for the treatment of selected cases of patients with keratoconus and cataract. In addition, this approach provides an increase of tolerance to defocus.

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Objective and subjective evaluation of trifocal diffractive intraocular Lens after cataract extraction with phacoemulsification: a prospective clinical study

BMC Ophthalmology ◽

10.1186/s12886-021-01937-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ahmed A. Zein El-Dein ◽

Ahmed Elmassry ◽

Hazem M. El-Hennawi ◽

Ehab F. Mossallam

Keyword(s):

Visual Acuity ◽

Contrast Sensitivity ◽

Intraocular Lens ◽

Subjective Evaluation ◽

Cataract Extraction ◽

Prospective Clinical Study ◽

Gradual Change ◽

Quality Of Vision ◽

Defocus Curve

Abstract Background This study aimed to assess visual outcomes, quality of vision and patients’ satisfaction of a trifocal diffractive intraocular lens after cataract surgery with phacoemulsification. Results The study included 36 eyes that underwent implantation of trifocal diffractive intraocular lens (IOL). The residual mean postoperative spherical equivalent was − 0.40 ± 0.29 diopters. Mean Uncorrected distance visual acuity was 0.80 ± 0.16 decimal (snellen equivalent 25 ft) while mean Uncorrected intermediate visual acuity was 0.82 ± 0.31 decimal (snellen equivalent 25 ft) and mean Uncorrected near visual acuity (UCNVA) was 0.87 ± 0.20 decimal (snellen equivalent 23 ft). In defocus curve, there was infinitesimal gradual change between the three foci. Contrast sensitivity was just below the inferior limit of normal. Conclusion Trifocal diffractive IOL created a true intermediate focus proved by VA and defocus curve and better quality of vision assessed by contrast sensitivity and high order aberration. Moreover, it was safe and effective for correcting distance and near vision in these patients. Most of the patients were very satisfied and achieved spectacle independence. Trial registration Registration number and date: NCT04465279 on July 10, 2020.

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