scholarly journals Monocular Clinical Outcomes and Range of Near Vision following Cataract Surgery with Implantation of an Extended Depth of Focus Intraocular Lens

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Rahul T. Pandit

Importance. A full range of near and intermediate vision has not been clinically evaluated for the Symfony extended depth of focus intraocular lens (EDOF IOL). Background. To evaluate the monocular range of near visual acuity with an EDOF IOL. Design. Retrospective case series. Participants. Consecutive patients of a single surgeon from January 2017 through March 2018. Methods. Phacoemulsification with implantation of an EDOF IOL. Main Outcome Measures. Uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), corrected distance visual acuity (CDVA), distance-corrected near visual acuity (DCNVA), range of DCNVA, and optimal near focal length. Results. Seventy-six eyes of 48 patients (34 or 71% female, mean age: 68 years) were included with a mean follow-up of 68 days. Mean values were as follows: logarithm of the minimum angle of resolution (logMAR) UDVA 0.02 ± 0.09, logMAR UNVA 0.12 ± 0.09 at a mean distance of 51 cm, logMAR CDVA −0.05 ± 0.07, logMAR DCNVA 0.08 ± 0.07 at a mean distance of 51 cm, and a spherical equivalent of −0.16 diopters ±0.35. Percentage of eyes achieving DCNVA of 20/30 were 84% at 36 cm, 92% at 41 cm, 99% at 51 cm, 93% at 61 cm, and 74% at 71 cm. DCNVA of 20/40 or better was achieved in nearly 100% of eyes over a range of 35 cm. Conclusions and Relevance. The Symfony EDOF IOL achieved excellent distance visual acuity while providing a 35 cm range of near visual acuity at levels useful for many tasks in nearly all patients.

2021 ◽  
pp. 112067212110640
Author(s):  
Marco Coassin ◽  
Tommaso Mori ◽  
Antonio Di Zazzo ◽  
Maria Poddi ◽  
Roberto Sgrulletta ◽  
...  

Purpose To evaluate overall patient satisfaction, spectacle independence, visual acuity, and prevalence of optical phenomena following bilateral implantation of a new non-diffractive extended depth-of-focus intraocular lens targeted for minimonovision. Methods Multicenter prospective case series. Postoperative far and near visual acuity at 3 months and patient quality of life by NEI-VFQ-25 questionnaire were assessed. Postoperative evaluation included defocus curves analysis, spectacle independence assessment, and recording of photic phenomena. Results The study enrolled 97 eyes of 59 patients that underwent femtosecond-assisted cataract surgery with AcrySof IQ Vivity intraocular lens implantation. Thirty subjects (60 eyes) were eligible for analysis. After 3 months, postoperative achieved binocular uncorrected visual acuity was −0.03  ±  0.06 logarithm of the minimum angle of resolution for distance, 0.06  ±  0.06 logarithm of the minimum angle of resolution for intermediate, and 0.19  ±  0.03 logarithm of the minimum angle of resolution for near. Defocus curve showed a smooth profile with no abrupt decrease of visual acuity. Minimonovision significantly improved visual acuity compared to when minimonovision was neutralized, for values of defocus curves from −1 to −3 D ( p < 0.05). Twenty-six (87%) patients reported complete spectacle independence. High levels of satisfaction for distance and near vision resulted at VFQ-25 questionnaire. Only two patients complained of halos (6.7%) and one of them also of glare (3.3%). Conclusions Implantation of this new non-diffractive extended depth-of-focus intraocular lens with minimonovision resulted in satisfying far, intermediate, and near visual acuity with a consistent reduction of spectacle dependence and improvement in patient's quality of life.


PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0259470
Author(s):  
Ryu Takabatake ◽  
Makiko Takahashi ◽  
Takuya Yoshimoto ◽  
Fumiaki Higashijima ◽  
Yuka Kobayashi ◽  
...  

Purpose To investigate the postoperative course of patients who explanted a diffractive bifocal intraocular lens (IOL) due to waxy vision and implanted with an extended depth of focus IOL. Methods This study evaluated 29 eyes of 25 patients who underwent diffractive bifocal IOL explantation followed by TECNIS Symfony® implantation because of dissatisfaction due to waxy vision at the Takabatake West Eye Clinic between January 2018 and November 2019. The indication criteria for this surgery were patients with uncorrected distance visual acuity of 0.05 logMAR or better, without eye diseases that may affect visual function, and no dissatisfactions about photic phenomena. We investigated patient demographics, uncorrected and corrected visual acuity, manifest refraction, contrast sensitivity, subjective symptoms, time to IOL explantation, explanted IOL type, and spectacle independence. Results The time to the IOL exchange after the initial IOL implantation was 55.3 ± 50.4 days (range: 14–196 days). The logMAR corrected distance visual acuity before and after IOL exchange were −0.13 ± 0.06 and −0.14 ± 0.06, respectively (p = 0.273). After IOL exchange surgery, the area under log contrast sensitivity function increased significantly from 1.07 ± 0.12 to 1.21 ± 0.12 (p < 0.001), and the waxy vision symptoms improved. The spectacle independence rate at the last visit was 88.0%. Conclusion For patients who complain of waxy vision despite good visual acuity after diffractive bifocal IOL implantation, exchange to extended depth of focus IOL was considered one of the useful surgical options.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yueyang Zhong ◽  
Kai Wang ◽  
Xiaoning Yu ◽  
Xin Liu ◽  
Ke Yao

AbstractThis meta-analysis aimed to evaluate the clinical outcomes following implantation of trifocal intraocular lenses (IOLs) or a hybrid multifocal-extended depth of focus (EDOF) IOL in cataract or refractive lens exchange surgeries. We examined 13 comparative studies with bilateral implantation of trifocal (898 eyes) or hybrid multifocal-EDOF (624 eyes) IOLs published through 1 March 2020. Better uncorrected and corrected near visual acuity (VA) were observed in the trifocal group (MD: − 0.143, 95% CI: − 0.192 to − 0.010, P < 0.001 and MD: − 0.149, 95% CI: − 0.217 to − 0.082, P < 0.001, respectively), while the hybrid multifocal-EDOF group presented better uncorrected intermediate VA (MD: 0.055, 95% CI: 0.016 to 0.093, P = 0.005). Trifocal IOLs were more likely to achieve spectacle independence at near distance (RR: 1.103, 95% CI: 1.036 to 1.152, P = 0.002). The halo photic effect was generated more frequently by the trifocal IOLs (RR: 1.318, 95% CI: 1.025 to 1.696, P = 0.031). Contrast sensitivity and subjective visual quality yielded comparable results between groups. Trifocal IOLs demonstrated better performance at near distance but apparently led to more photic disturbances. Our findings provided the most up-to-date and comprehensive evidence by comparing the benefits of advanced IOLs in clinical practice.


2018 ◽  
Vol 28 (4) ◽  
pp. 419-424 ◽  
Author(s):  
Jorge L Alió ◽  
Ana B Plaza-Puche ◽  
Jorge L Alió del Barrio ◽  
Pedro Amat-Peral ◽  
Vicente Ortuño ◽  
...  

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.


2018 ◽  
Vol 29 (4) ◽  
pp. 426-430 ◽  
Author(s):  
Omer Trivizki ◽  
David Smadja ◽  
Michael Mimouni ◽  
Samuel Levinger ◽  
Eliya Levinger

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.


2016 ◽  
Vol 7 (3) ◽  
pp. 496-504 ◽  
Author(s):  
John S.M. Chang ◽  
Jack C.M. Ng ◽  
Vincent K.C. Chan ◽  
Antony K.P. Law

Purpose: To report visual outcomes and complications after cataract surgery in nanophthalmic eyes with a phacoemulsification system using the active fluidics control strategy. Methods: This is a retrospective case series. All eyes with an axial length of less than 20 mm that underwent cataract surgery or refractive lens exchange using the Centurion Vision System (Alcon Laboratories Inc.) in Hong Kong Sanatorium and Hospital were evaluated. The visual acuity and intraoperative and postoperative complications were reported. Prior approval from the Hospital Research Committee has been granted. Results: Five eyes of 3 patients were included. The mean follow-up period was 10.2 ± 5.3 months (range, 4–18). Two eyes (40%) had a one-line loss of corrected distance visual acuity. No uveal effusion and posterior capsular tear developed. An optic crack and haptic breakage in the intraocular lens developed in 1 eye (20%) and 2 eyes (40%), respectively. Additional surgeries to treat high postoperative intraocular pressure were required in 1 eye (20%). Conclusion: The use of a new phacoemulsification system, which actively monitors and maintains the intraoperative pressure, facilitated anterior chamber stability during cataract surgery in nanophthalmic eyes. This minimized the risk of major complications related to unstable anterior chambers such as uveal effusion and posterior capsular tear. Development of intraoperative crack/breakage in a high-power intraocular lens was common.


2016 ◽  
Vol 16 (2) ◽  
pp. 23-27
Author(s):  
P Ziak ◽  
J Halicka ◽  
P Mojzis ◽  
M Kralik ◽  
J Nikel

Abstract Introduction: A cataract is a clouding of the lens in the eye leading to a decrease in vision. Cataracts are the cause of half of blindness and 33% of visual impairment worldwide. Surgery with phacoemulsification followed by implantation of intraocular lens (IOL) is gold standard treatment for cataract. In some cases multifocal IOLs are used. This is the first published use of rotational asymmetric multifocal IOL in cataract surgery in Slovakia. Method: In the study 78 eyes of 58 patients (mean age 62.3 years) were implanted for a cataract with the rotational asymmetric multifocal IOL. Corrected and uncorrected distance and near visual acuities were analysed preoperatively, 1 month and 6 months postoperatively. Contrast sensitivity was tested at 6 months postoperatively. The Friedman Two -Way Analysis of Variance and Multiple Comparison Test were used for all parameter comparisons, in all cases, the same level of statistical significance (p < 0.05) was considered significant. Results: Average preoperative uncorrected distance visual acuity has increased from 0.32 to 0.87 and 0.93 respectively in 1 month and 6 months after surgery (p < 0.05, n = 78). Average preoperative uncorrected near visual acuity (UCNVA) has increased from 0.2 to 0.77 and 0.79 respectively in 1 month and 6 months after surgery (p < 0.05). Average preoperative best corrected distance visual acuity has increased from 0.65 to 0.95 and 1.03 respectively in 1 month and 6 months after surgery (p < 0.05). Significant improvement was found also between preoperative best corrected near visual acuity and UCNVA 1 and 6 month after surgery (p < 0.05). In conclusion, the rotational asymmetric multifocal IOL LS-313 MF 30 provides good visual rehabilitation for near and distance vision after cataract surgery. Contrast sensitivity outcomes account for the patient satisfaction with this innovative IOL technology.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Toshihiro Sakisaka ◽  
Keiichiro Minami ◽  
Keita Takada ◽  
Yosai Mori ◽  
Kazunori Miyata

Abstract Background The prospective comparative case series aimed to evaluate all-distance visual acuity, contrast sensitivity, and functional visual acuity (FVA) of eyes with diffractive extended depth-of-focus (EDOF) intraocular lenses (IOLs) using an echelett optics and monofocal IOLs with the same platform. Methods Diffractive EDOF and monofocal IOLs were implanted in 27 eyes of 27 patients each. At 3 months after implantation, all-distance visual acuities at distances of 0.3, 0.5, 0.7, 1, 2, 3, and 5 m were measured under distance-corrected. Static visual function was also examined using photopic contrast sensitivity and area under the logarithmic contrast sensitivity function (AULCSF). Dynamic visual function was examined with FVA, and mean FVA value, visual maintenance ratio (VMR), mean response time, and number of blinks were evaluated. These outcomes were compared between the two IOLs. Results The mean distance-corrected visual acuities were better at distances of 0.7 m or nearer in eyes with EDOF IOLs. There was no difference in the contrast sensitivities (P > 0.22). In the FVA results, no difference was found in mean FVA and VMR (P > 0.68). Conclusion The static and dynamic evaluations of postoperative visual functions demonstrated that the visual function of eyes with EDOF IOLs under photopic and distance-corrected conditions was comparable to eyes with monofocal IOLs.


2019 ◽  
Author(s):  
Jing Liu ◽  
Yi Dong ◽  
Yan Wang

Abstract Background : This study aims to evaluate the efficacy and safety of extended depth of focus (EDOF) intraocular lenes (IOLs) in cataract surgery. Methods: All comparative clinical trials that involved bilaterally implanting EDOF IOLs in patients with cataract were retrieved from the literature database. We used random effects models to pool weighted mean differences (WMD) and risk ratio (RR) for continuous and dichotomous variables, respectively. Results: Nine studies with a total of 1336 eyes were identified. The subgroup analysis was conducted according to the type of IOLs used in the control group. Compared with monofocal IOLs, EDOF IOLs produced better uncorrected intermediate visual acuity (WMD: -0.17, 95% CI: -0.26 to -0.08, P = 0.0001) and uncorrected near visual acuity (WMD: -0.17, 95% CI: -0.21 to -0.12, P < 0.00001). EDOF IOLs resulted in reduced contrast sensitivity, more frequent halos, however, higher spectacle independence (RR: 2.81, 95% CI: 1.06 to 7.46, P = 0.04) than monofocal IOLs. Compared with trifocal IOLs, EDOF IOLs produced worse near visual acuity (MD: 0.10, 95% CI: 0.07 to 0.13, P<0.0001). EDOF IOLs performed better than trifocal IOls in contrast sensitivity, and there were no significant difference in halos and spectacle independence. Serious postoperative complications were rare, with no adverse events were reported in most studies. Conclusions: Increasing the risk of contrast reduction and more frequent halos, EDOF IOLs provided better intermediate and near VAs than monofocal IOLs. At the expense of near vision, patients receiving EDOF IOLs have better contrast sensitivity than those receiving trifocal IOLs. Halo incidence and spectacle independence of EDOF IOLs were similar to those of trifocal IOLs.


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