scholarly journals Comparison of Patient Outcomes following Implantation of Trifocal and Extended Depth of Focus Intraocular Lenses: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-17
Author(s):  
Yining Guo ◽  
Yinhao Wang ◽  
Ran Hao ◽  
Xiaodan Jiang ◽  
Ziyuan Liu ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Meta Analysis ◽  
Visual Disturbance ◽  
Intraocular Lenses ◽  
Cochrane Library ◽  
Depth Of Focus ◽  
Near Vision ◽  
Extended Depth Of Focus ◽  
Significant Difference ◽  
Comprehensive Search

Purpose. The purpose is to compare the outcomes of implantation of trifocal intraocular lenses (TIOLs) and extended depth of focus (EDOF) intraocular lenses (IOLs). Methods. A comprehensive search of PubMed, Cochrane Library, EMBASE, and ClinicalTrial.gov was conducted in March 2020 to identify relevant studies. A meta-analysis of the results was performed. Patients implanted with EDOF IOLs or TIOLs in previous studies were included. The primary outcomes of the study were uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), and defocus curve. Results. TIOLs and EDOF IOLs provided comparable binocular UDVA (MD = -0.01, 95% CI: -0.04, 0.03, logMAR). However, EDOF IOLs provided better UIVA (MD: -0.08, 95% CI: -0.14, -0.01, logMAR) and worse UNVA (MD: 0.10, 95% CI: 0.06, 0.14, logMAR) than TIOLs. Fewer patients achieved spectacle independence after implantation of EDOF IOLs (RR: 0.74, 95% CI: 0.63, 0.87) than after implantation of TIOLs, especially for near vision (RR = 0.82, 95% CI: 0.68, 0.99). There was no statistically significant difference in contrast sensitivity (CS) under photopic or mesopic conditions with both IOLs. Patient satisfaction after implantation of both IOLs was high. Conclusion. EDOF IOLs and TIOLs provide comparable distance vision. However, EDOF IOLs provide better intermediate vision and worse near vision than TIOLs. The advantages of EDOF IOLs over TIOLs in terms of CS, aberrations, and visual disturbance are not significant. Patients are satisfied with both types of IOLs.

scholarly journals Comparison of trifocal or hybrid multifocal-extended depth of focus intraocular lenses: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yueyang Zhong ◽  
Kai Wang ◽  
Xiaoning Yu ◽  
Xin Liu ◽  
Ke Yao
Keyword(s):  
Systematic Review ◽  
Visual Acuity ◽  
Meta Analysis ◽  
Visual Quality ◽  
Intraocular Lenses ◽  
Depth Of Focus ◽  
Refractive Lens Exchange ◽  
Extended Depth Of Focus ◽  
Refractive Lens ◽  
Near Visual Acuity

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.

scholarly journals Comparison of two extended depth of focus intraocular lenses with a monofocal lens: a multi-centre randomised trial

2020 ◽  
Author(s):  
Thomas Reinhard ◽  
Philip Maier ◽  
Daniel Böhringer ◽  
Eckart Bertelmann ◽  
Tobias Brockmann ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Randomised Trial ◽  
Final Analysis ◽  
Intraocular Lenses ◽  
Depth Of Focus ◽  
Extended Depth Of Focus ◽  
Significant Difference ◽  
Monofocal Iol ◽  
Monocular Depth ◽  
Binocular Depth

Abstract Purpose The AT LARA 829MP is a next-generation extended depth of focus (EDOF) intraocular lens (IOL) providing continuous vision over a range of distances. The aim of this prospective multi-centre randomised trial was to compare two EDOF IOLs and one monofocal IOL. Methods Cataract patients between 50 and 80 years were randomised for bilateral implantation with either the AT LARA 829MP (EDOF), the TECNIS Symfony (EDOF) or the CT ASPHINA 409MP (monofocal). Follow-up was at 1 to 2 weeks, 1 month and 4 to 6 months. Results A total of 211 patients were randomised and included in the final analysis. Monocular depth of focus was significantly better for AT LARA 829MP eyes compared with that for TECNIS Symfony at all thresholds (p = 0.024, 0.001 and 0.006, for 0.1, 0.2 and 0.3 logMAR respectively) with no significant difference for binocular depth of focus. LARA eyes had significantly better monocular depth of focus at all levels compared with ASPHINA eyes (all p < 0.0001), while there was no significant difference between Symfony and ASPHINA eyes at 0.1 logMAR and 0.2 logMAR. Both EDOF IOLs were significantly better than the monofocal ASPHINA at all levels for binocular depth of focus (LARA: all p < 0.0001; Symfony: all p = 0.002). Distance visual acuity was similar for all IOLs at 6 months; intermediate and near visual acuity were significantly better for the EDOF IOLs than for the monofocal (p < 0.0001). Refraction improved in all groups relative to baseline. Contrast sensitivity was higher with the CT ASPHINA 409MP but both EDOF lenses had a better spectacle independence rate. At 6 months, all IOLs were well centred with no cases of tilt. No general safety issues were raised for any of the groups. Conclusion The two EDOF intraocular lenses investigated provided good visual outcomes with comparable visual acuity at all distances. The AT LARA 829MP provided the widest monocular depth of focus at 0.1 and 0.2 logMAR, with a clear superiority compared with the monofocal IOL. TECNIS Symfony was superior to the monofocal control at 0.3 logMAR. Spectacle independence and patient satisfaction were comparable. Trial registration Trial registered on https://clinicaltrials.gov/ under the identification NCT03172351 (date of registration 1 June May 2017).

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

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.

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

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 &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.

scholarly journals Efficacy and safety of extended depth of focus intraocular lenses in cataract surgery: a systematic review and meta-analysis

2019 ◽  
Author(s):  
Jing Liu ◽  
Yi Dong ◽  
Yan Wang
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Contrast Sensitivity ◽  
Intraocular Lenses ◽  
Control Group ◽  
Efficacy And Safety ◽  
Depth Of Focus ◽  
Extended Depth Of Focus ◽  
Significant Difference ◽  
Near Visual Acuity

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.

scholarly journals One-year post-operative comparison of visual function and patient satisfaction with trifocal and extended depth of focus intraocular lenses

2021 ◽  
pp. 112067212110697
Author(s):  
Elizabeth M. Law ◽  
Rajesh K. Aggarwal ◽  
Hetal Buckhurst ◽  
Hosam E. Kasaby ◽  
Jonathan Marsden ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Early Period ◽  
Intraocular Lenses ◽  
Depth Of Focus ◽  
Extended Depth Of Focus ◽  
Quality Of Vision ◽  
Significant Difference ◽  
One Year

Purpose To evaluate visual performance with trifocal and extended depth of focus IOL at 1 year post-operatively. Setting BMI Southend Hospital. Design Cohort study. Methods An age-matched cohort of forty subjects bilaterally implanted with the AT LISA 839MP trifocal IOL (20 patients, 40 eyes) and the Tecnis Symfony extended depth of focus IOL (20 patients, 40 eyes) were assessed at 3–6 months and 12–18 months post-operatively. Primary outcome measures were distance (6 m), intermediate (70 cm), near visual acuity (40 cm), and analysis of defocus profiles. Secondary outcomes included contrast sensitivity, Radner reading performance, quality of vision and assessment of halos. Results Distance visual acuity (VA) and defocus areas were similar ( p = 0.07). No significant difference in intermediate VA was noted but the intermediate area of focus was greater in the EDoF (0.31 ± 0.12 LogMAR*m−1) compared to the trifocal (0.22 ± 0.08LogMAR*m−1) ( p = 0.02). However, all near metrics were significantly better in the trifocal group. 80% of trifocal subjects were spectacle independent compared to 50% EDoF subjects. Quality of vision questionnaire found no significant differences between groups, however halo scores were greater at 3–6 months in the trifocal group ( p < 0.01) but no differences were noted at 12–18 months. Conclusions Near vision is significantly better for the trifocal, thus greater levels of spectacle independence. The range of intermediate vision was greater for the EDoF but no difference in intermediate VA. In the early period, differences in contrast sensitivity and halo size/intensity were noted, however, by one-year these measures were not significantly different.

scholarly journals Efficacy and safety of extended depth of focus intraocular lenses in cataract surgery: a systematic review and meta-analysis

2019 ◽  
Author(s):  
Jing Liu ◽  
Yi Dong ◽  
Yan Wang
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Contrast Sensitivity ◽  
Intraocular Lenses ◽  
Control Group ◽  
Efficacy And Safety ◽  
Depth Of Focus ◽  
Extended Depth Of Focus ◽  
Significant Difference ◽  
Near Visual Acuity

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. 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.

scholarly journals Influence of Angle Alpha on Visual Quality after Implantation of Extended Depth of Focus Intraocular Lenses

2021 ◽  
Author(s):  
Miaomiao Qin ◽  
Min Ji ◽  
Tianqiu Zhou ◽  
Yurong Yuan ◽  
Jiawei Luo ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Spherical Aberration ◽  
Visual Quality ◽  
Intraocular Lenses ◽  
Patient Questionnaire ◽  
Modulation Transfer ◽  
Depth Of Focus ◽  
Extended Depth Of Focus ◽  
Postoperative Changes ◽  
Angle Alpha

Abstract Background: To assess postoperative changes in angle alpha, and to evaluate the postoperative visual quality of patients with different angle alpha values after implantation of extended depth of focus (EDOF) intraocular lenses (IOLs).Methods: Seventy-nine eyes of 79 patients who had phacoemulsification with EDOF IOLs implantation were enrolled. A cut-off value of 0.3 mm, 0.4 mm, and 0.5 mm in preoperative angle alpha was chosen to divide eyes into groups. Distance, intermediate, and near visual acuities, modulation transfer function (MTF), and aberrations were recorded during a 6-month follow-up. A patient questionnaire was completed. Results: There were no significant differences in angle alpha postoperatively compared to preoperatively. No significant differences were found in visual acuity and MTF between all groups. With 5mm pupil diameter, there were significant differences of higher-order aberrations and spherical aberration in ocular aberration and internal aberration between angle alpha＜0.4 mm and angle alpha≥ 0.4 mm. Additionally, significant differences of coma were also added in cut-off value of 0.5 mm. When the value of angle alpha is 0.4 mm or higher, there were significant differences in the score of halos and glare.Conclusions: Angle alpha did not affect visual acuity, but the value of 0.4 mm or higher in angle alpha affected the visual quality under scotopic conditions and occurrence of halos and glare. For patients with 0.4 mm or higher in angle alpha, the decision to implant a EDOF IOL should be carefully considered.

scholarly journals Functional visual acuity after implantation of diffractive extended depth-of-focus intraocular lenses using an echelett optics

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Toshihiro Sakisaka ◽  
Keiichiro Minami ◽  
Keita Takada ◽  
Yosai Mori ◽  
Kazunori Miyata
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Visual Function ◽  
Case Series ◽  
Intraocular Lenses ◽  
Depth Of Focus ◽  
Mean Response Time ◽  
Extended Depth Of Focus ◽  
Functional Visual Acuity ◽  
The Mean

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.

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