scholarly journals Blended Vision Achieved by Combining High and Low Addition Power Diffractive Intraocular Lenses with Micromonovision: A Clinical Outcome

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Masayuki Ouchi ◽  
Takuya Shiba

Purpose. To evaluate the clinical outcome of blended vision combined with micromonovision (MMBV) using a + 4 diopter (D) addition power (add) diffractive intraocular lens (MIOL) and a + 2.75 D add MIOL with a myopic target of −0.5 D. Methods. One hundred twenty eyes of 60 cases were enrolled. The +4 D add MIOLs were placed in the nondominant eye, the +2.75 D add MIOLs were placed in the dominant eye with a myopic target of −0.5 D in 30 cases (the MMBV group), and the +4 D add MIOLs were placed in both eyes in another 30 cases (controls). Postoperative clinical outcomes were compared between the two groups. Results. Compared with the controls, binocular uncorrected intermediate vision at 70 cm was significantly better in the MMBV group (p=0.02). Contrast sensitivity at 12 cycles per degree and the 6% and 12.5% low-contrast visual acuities were also significantly better in the MMBV group compared with the controls (p values = 0.05, 0.05, and 0.04, respectively). Uncorrected and corrected distance and near VA did not differ significantly between the two groups. Conclusion. MMBV provided a better intermediate VA, contrast sensitivity, and low-contrast VA than bilateral implantation of the +4 D add MIOL, while preserving comparable near and distance vision.

2018 ◽  
Vol 28 (4) ◽  
pp. 425-432 ◽  
Author(s):  
Daniel Pilger ◽  
David Homburg ◽  
Tobias Brockmann ◽  
Necip Torun ◽  
Eckart Bertelmann ◽  
...  

Purpose: The purpose of this study was to assess the clinical outcome after a bilateral implantation of an extended depth of focus intraocular lens in comparison to a monofocal intraocular lens. Setting: Department of Ophthalmology, Charité—Medical University Berlin, Germany. Patients and Methods: A total of 60 eyes of 30 patients were enrolled in this prospective, single-center study. The cataract patients underwent phacoemulsification with bilateral implantation of a TECNIS® Symfony (Abbott Medical Optics, Santa Ana, CA, USA, 15 patients) or a TECNIS Monofocal ZCB00 (Abbott Medical Optics, Santa Ana, CA, USA, 15 patients). Postoperative evaluations were performed after 1 and 3 months, including visual acuities at far, intermediate, and near distance. Mesopic, scotopic vision, and contrast sensitivity were investigated. Aberrometry was performed using an iTrace aberrometer with a pupil scan size of 5.0 mm. Results: After 3 months, the TECNIS Symfony group reached an uncorrected visual acuity at far distance of −0.02 logMAR compared to −0.06 logMAR in the TECNIS Monofocal group ( p = 0.03). Regarding the uncorrected vision at intermediate and near distance the following values were obtained: intermediate visual acuity −0.13 versus 0.0 logMAR (TECNIS Symfony vs TECNIS Monofocal, p = 0.001) and near visual acuity 0.11 versus 0.26 logMAR (TECNIS Symfony vs TECNIS Monofocal, p = 0.001). Low-contrast visual acuities were 0.27 versus 0.20 logMar (TECNIS Symfony vs TECNIS Monofocal, p = 0.023). Conclusion: The TECNIS Symfony intraocular lens can be considered an appropriate alternative to multifocal intraocular lenses because of good visual results at far, intermediate, and near distance as well as in low-contrast vision.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jungah Huh ◽  
Youngsub Eom ◽  
Seul Ki Yang ◽  
Young Choi ◽  
Hyo Myung Kim ◽  
...  

Abstract Background To compare clinical outcomes and optical performance of a new monofocal with enhanced intermediate function intraocular lenses (IOLs) with that of conventional monofocal IOLs. Methods Sixty eyes of 30 patients who underwent phacoemulsification with bilateral implantation of the ICB00 (15 patients) or ZCB00 (15 patients) IOLs were enrolled. Binocular corrected distance visual acuity (CDVA), distance corrected near visual acuity (DCNVA), and distance corrected intermediate visual acuity (DCIVA) were measured at 4 weeks after surgery. Patient satisfaction for overall, near, intermediate, and distance vision were assessed. The binocular defocus curves were measured. The root mean square of modulation transfer function (MTFRMS) was measured in the optical bench study. Results The mean binocular DCIVA was significantly better in the ICB00 group (0.01 logMAR) compared to the ZCB00 group (0.13 logMAR), but CDVA and DCNVA were not. The patient satisfaction for near and intermediate vision was significantly higher in the ICB00 group compared to the ZCB00. However, there was no difference in patient satisfaction for overall and distance vision between two groups. The defocus curves showed that mean visual acuity of the ICB00 group was significantly better than that of the ZCB00 group at between − 1.00 D to − 3.00 D of defocus. The ICB00 IOL had higher MTFRMS values at between − 0.50 D to − 2.00 D of defocus compared to the ZCB00 IOL. Conclusions The ICB00 IOL provides better binocular intermediate vision and higher satisfaction for near and intermediate vision than the ZCB00 IOL while maintaining excellent distance vision.


2014 ◽  
Vol 95 (4) ◽  
pp. 515-519
Author(s):  
K S Ivonin

Aim. To analyze the causes for patients’ dissatisfaction with the results of multifocal intraocular lens implantation. Methods. The research is based on the results of cataract surgeries in 220 patients (50 patients were implanted multifocal refractive intraocular «M-flex» lens, 40 - multifocal intraocular «Gradiol» lens, 64 - multifocal intraocular «Accord» lens, 66 - monofocal intraocular lens). Pre-and post-operative examination included visual acuity test (with and without correction to near, far and moderate distances), determination of the nearest point of clear vision, contrast sensitivity study using the «Zebra» software, stereo vision test, pupil diameter measuring, refractometry, keratometry, binocular vision color tests, patient questioning. Pre-operative evaluation was performed 1 day prior to surgery. Post-operative observation was carried out 1 week, 1, 3, 6 and 12 months after the surgery. Results. No statistically significant difference (p 0.05) in uncorrected visual acuity at different light intensity - 102 lux and 416 lux - was found between the groups with different types of multifocal intraocular lenses. In groups with multifocal intraocular lenses light side effects were observed in 46-52.5% of patients. However, there was no link between the light side effects and patients’ satisfaction with results of the surgery. Reduction of spatial contrast sensitivity parameters was registered in all groups of multifocal intraocular lenses patients compared to patients with monofocal intraocular lenses (p 0.05). According to the survey results, 92.5 to 94% of patients with multifocal intraocular lenses did not report decreased visual acuity on moderate distance. Conclusion. The most important reason for patients’ dissatisfaction with the results of the multifocal intraocular lenses implanting was the reduction of spatial-contrast sensitivity parameters. Bilateral multifocal intraocular lenses implanting improved the contrast ratio.


2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Sri Ganesh ◽  
Sheetal Brar ◽  
Archana Pawar ◽  
Kirti J. Relekar

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.


2019 ◽  
Vol 30 (2) ◽  
pp. 299-306 ◽  
Author(s):  
Irene Altemir-Gomez ◽  
Maria S Millan ◽  
Fidel Vega ◽  
Francisco Bartol-Puyal ◽  
Galadriel Gimenez-Calvo ◽  
...  

Objective: To compare visual quality in patients implanted with Tecnis® monofocal (ZCB00) and multifocal (ZMB00) intraocular lenses taking into account their optical quality measured in vitro with an eye model. Methods: In total, 122 patients participated in this study: 44 implanted with monofocal and 78 with multifocal intraocular lenses. Measurements of visual acuity and contrast sensitivity were performed. The optical quality of the intraocular lenses was evaluated in three image planes (distance, intermediate and near) using an eye model on a test bench. The metric considered was the area under the curve of the modulation transfer function. Results: Optical quality at the far focus of the monofocal intraocular lens (area under the curve of the modulation transfer function = 66.97) was considerably better than that with the multifocal lens (area under the curve of the modulation transfer function = 32.54). However, no significant differences were observed between groups at the distance-corrected visual acuity. Distance-corrected near vision was better in the multifocal (0.15 ± 0.20 logMAR) than that in the monofocal group (0.43 ± 0.21 logMAR, p < 0.001), which correlated with the better optical quality at near reached by the multifocal intraocular lens (area under the curve of the modulation transfer function = 29.11) in comparison with the monofocal intraocular lens (area under the curve of the modulation transfer function = 5.0). In intermediate vision, visual acuity was 0.28 ± 0.16 logMAR (multifocal) and 0.36 ± 0.14 logMAR (monofocal) with p = 0.014, also in good agreement with the values measured in the optical quality (area under the curve of the modulation transfer function = 10.69 (multifocal) and 8.86 (monofocal)). The contrast sensitivity was similar in almost all frequencies. Pelli–Robson was slightly better in the monofocal (1.73) than in the multifocal group (1.64; p = 0.023). Conclusion: Patients implanted with multifocal ZMB00 achieved a distance visual acuity similar to those implanted with monofocal ZCB00, but showed significantly better intermediate and near visual acuity. A correlation was found between intraocular lenses’ optical quality and patients’ visual acuity. Contrast sensitivity was very similar between the multifocal and monofocal groups.


Author(s):  
Jae Hyuck Lee ◽  
Ho Seok Chung ◽  
Su Young Moon ◽  
Hun Lee ◽  
Jae Yong Kim ◽  
...  

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 &plusmn; 0.09 in EDOF IOL eyes, 0.12 &plusmn; 0.11 in DMF IOL eyes, and 0.02 &plusmn; 0.05 in both eyes. UIVA was 0.11 &plusmn; 0.11 in EDOF IOL eyes, 0.16 &plusmn; 0.12 in DMF IOL eyes, and 0.04 &plusmn; 0.07 in both eyes. UNVA was 0.25 &plusmn; 0.15 in EDOF IOL eyes, 0.22 &plusmn; 0.16 in DMF IOL eyes, and 0.13 &plusmn; 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.


2021 ◽  
pp. 112067212110464
Author(s):  
Oya Donmez ◽  
Bilgehan Sezgin Asena ◽  
Yonca Aydin Akova

Purpose: To evaluate the clinical outcomes and quality of life following implantation of PanOptix toric intraocular lens (IOL) and to compare the outcomes following femtosecond laser assisted cataract surgery (FLACS) and standard cataract surgery (SCS). Methods: This comparative retrospective study included 79 eyes of 55 patients underwent cataract or refractive lens exchange surgery between April 2017 and January 2020 in Bayindir Hospital and Kaskaloglu Eye Hospital. Corneal (CA) and refractive astigmatism (RA), uncorrected visual acuities for distant, intermediate, and near (UDVA, UIVA, and UNVA), low contrast distance visual acuity, rotational stability, defocus curves, photopic and mesopic contrast sensitivity (CS), visual function-14 (VF-14) test, presence of dysphotopsia, and need for spectacles were evaluated at postoperative third month. Outcomes were compared between FLACS and SCS group. Results: The mean UDVA, UIVA, and UNVA were 0.05 ± 0.07, 0.08 ± 0.08, and 0.06 ± 0.07 logMAR, respectively. All patients achieved ⩾0.3 logMAR uncorrected visual acuity for all distances. UDVA was found significantly better in FLACS group ( p = 0.03). All eyes had ⩽1 D of subjective postoperative RA. Defocus curve had two peaks at 0 and −1.50 D. Spectacle independence was achieved in 88.7% of patients. Photopic and mesopic CS was within normal range in all patients. The mean VF-14 score was 98 ± 2. The mean IOL axis rotation was 2.1° ± 2.3°. Only one patient reported seeing disturbing halos. Conclusions: This trifocal toric IOL effectively reduced refractive astigmatism and provided excellent visual outcomes with high spectacle independence, patients’ satisfaction, and good rotational stability. FLACS might have an impact on optimal postoperative results.


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