scholarly journals Clinical outcomes with a diffractive trifocal intraocular lens

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.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ahmed A. Zein El-Dein ◽  
Ahmed Elmassry ◽  
Hazem M. El-Hennawi ◽  
Ehab F. Mossallam

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.


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.


2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Florian T. A. Kretz ◽  
Detlev Breyer ◽  
Vasilios F. Diakonis ◽  
Karsten Klabe ◽  
Franziska Henke ◽  
...  

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.


2021 ◽  
Author(s):  
Ahmed A. Zein El-Dein ◽  
Ahmed Elmassry ◽  
Hazem M. El Hennawi ◽  
Ehab F. Mossallam

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 feet) while mean Uncorrected intermediate visual acuity was 0.82 ± 0.31 decimal (snellen equivalent 25 feet) and mean Uncorrected near visual acuity (UCNVA)was 0.87 ± 0.20 decimal (snellen equivalent 23 feet). 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.


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.


2011 ◽  
Vol 21 (6) ◽  
pp. 723-731 ◽  
Author(s):  
Gonzalo Muñoz ◽  
César Albarrán-Diego ◽  
Ma Ángeles Galotto ◽  
Javier Pascual ◽  
Teresa Ferrer-Blasco

Purpose. To determine whether implantation of acrylic intraocular lens (IOL) with aspheric design (Tecnis Z9003, AMO) results in improved visual acuity or contrast sensitivity compared with conventional spherical acrylic IOL (AR40e, AMO). Methods. In an intraindividual randomized prospective study of 60 patients with bilateral cataract, the Tecnis Z9003 IOL was compared with the AR40e IOL. Ocular aberrations for a 4.0-mm pupil and 6.0-mm pupil were measured with a Hartmann-Shack aberrometer. Quality of vision was measured using visual acuity and contrast sensitivity under mesopic and photopic conditions. Results. Eyes with the Tecnis Z9003 IOL had significantly less spherical aberration and greater Strehl ratio after surgery, showing a better optical quality in comparison with the standard spherical IOL. However, visual acuity and both mesopic and photopic contrast sensitivity were not significantly different between the groups. Conclusions. The significantly better optical quality achieved with the aspheric acrylic IOL design did not result in improved visual acuity or contrast sensitivity in comparison with a conventional spherical acrylic IOL.


2020 ◽  
Vol 5 (1) ◽  
pp. e000497
Author(s):  
Emilio Pedrotti ◽  
Francesco Carones ◽  
Pietro Talli ◽  
Erika Bonacci ◽  
Federico Selvi ◽  
...  

ObjectiveTo evaluate objective and subjective outcomes after bilateral implantation of two different multifocal intraocular lenses, which correct pseudophakic presbyopia in an adequate and homogeneous population court.Methods and analysisFifty patients were evaluated at 3 months after bilateral implantation, at the Eye Clinic of University of Verona and at the Carones Ophthalmology Center Milano, as follows: Tecnis Symfony (25 patients), Alcon PanOptix (25 patients). Main outcomes were uncorrected and best-corrected distance visual acuity (UDVA and BCVA) at 4 m, 60 cm (best distance corrected intermediate visual acuity (BDCIVA) and uncorrected intermediate visual acuity), 40 cm (best distance corrected near visual acuity (BDCNVA) and uncorrected near visual acuity (UNVA)), objective refractive outcome, defocus curve, contrast sensitivity (Modulation Transfer Function (MTF) cut-off), optical quality (Strehl ratio), aberrometry (root mean square RMS 4 mm), subjective quality of life (National Eye Institute Refractive Error Quality of Life score (NEI-RQL-42 score) test).ResultsSymfony and PanOptix showed BCVA and UDVA comparable results. Symfony presented significant better outcomes at BDCIVA (p=0.001), while PanOptix showed better performances at BDCNVA and UNVA (p=0.01). Symfony achieved better results in RMS 4 mm (p=0.024) and in MTF cut-off (p=0.041). In the questionnaire NEI-RQL-42, PanOptix presented better scores in ‘near vision’ and ‘spectacles independence’, whereas Symfony in ‘symptoms’ and ‘clarity of vision’.ConclusionBoth intraocular lenses are valid options to avoid pseudophakic presbyopia, even though they present different features which make them unique. Symfony allows patients to achieve a better objective and subjective quality of vision and contrast sensitivity; PanOptix provides better outcomes in near vision and spectacles independence requirements.


2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Hui Zhang ◽  
Jing Wang

Objective. To evaluate intraocular scattering in eyes with posterior capsule opacification by means of an objective scatter index (OSI) obtained from double-pass images of optical quality assessment system (OQAS TM II) and to determine the indication for laser capsulotomy when patients report visual disturbances without decreased visual acuity. Methods. In this prospective, observational, and nonconsecutive case series study, a total of 32 eyes of 29 patients are diagnosed with posterior capsule opacification after age-associated cataract were analyzed. Patient examination included age, the period after cataract surgery, logMAR best corrected visual acuity (BCVA), and OSI. Results. We found a significant decrease in the BCVA and increase in the OSI with the development of posterior capsule opacification. The decrease of BCVA was statistically correlated with the increase of OSI (r=0.812, P<0.01). In patients who reported visual disturbances without decreased visual acuity, OSI decreased to <1.3 and subjective symptoms were resolved in all cases although there was no significant improvement in visual acuity after laser capsulotomy. Conclusions. The results of our study showed that OSI is also a useful parameter for objectively evaluating posterior capsule opacification. OSI may help predict laser capsulotomy in patients who report visual disturbances without decreased visual acuity.


2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
John S. M. Chang ◽  
Jack C. M. Ng ◽  
Vincent K. C. Chan ◽  
Antony K. P. Law

Purpose. To report visual performance and quality of life after implantation of a bifocal diffractive multifocal intraocular lens (MIOL) in postmyopic laser in situ keratomileusis (LASIK) patients.Methods. Prospective, observational case series. Patients with prior myopic LASIK who had implantation of Tecnis ZMA00/ZMB00 MIOL (Abbott Medical Optics) at Hong Kong Sanatorium and Hospital were included. Postoperative examinations included monocular and binocular distance, intermediate and near visual acuity (VA), and contrast sensitivity; visual symptoms (0–5); satisfaction (1–5); spectacle independence rate; and quality of life.Results. Twenty-three patients (27 eyes) were included. No intraoperative complications developed. Mean monocular uncorrected VA at distance, intermediate, and near were0.13±0.15(standard deviation),0.22±0.15, and0.16±0.15, respectively. Corresponding mean values for binocular uncorrected VA were0.00±0.10,0.08±0.13, and0.13±0.10, respectively. No eyes lost >1 line of corrected distance VA. Contrast sensitivity at different spatial frequencies between operated and unoperated eyes did not differ significantly (allP>0.05). Mean score for halos, night glare, starbursts, and satisfaction were1.46±1.62,1.85±1.69,0.78±1.31, and3.50±1.02, respectively. Eighteen patients (78%) reported complete spectacle independence. Mean composite score of the quality-of-life questionnaire was90.31±8.50out of 100.Conclusions. Implantation of the MIOL after myopic LASIK was safe and achieved good visual performance.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Sylwia Wagner ◽  
Grzegorz Wagner ◽  
Ewa Mrukwa-Kominek

Purpose. Long-term evaluation of the visual refractive outcomes and the quality of life after implantation of the WIOL-CF (Medicem, Czech Republic) in both eyes. Design. retrospective, nonrandomized noncomparative case series. Methods. 50 eyes of 25 patients, including 11 women (44%) and 14 men (56%). The age range of the patients was 38 to 77 years (mean age 55.48 ± 10.97 years). All patients underwent bilateral implantation of the WIOL-CF. Exclusion criteria were previous ocular surgeries except for cataract surgery and refractive lens exchange, irregular corneal astigmatism of >1.0 diopter, and ocular pathologies or corneal abnormalities. Postoperative examinations were performed at 14 days and 3, 6, 12 months of surgery; the last follow-up was between 24 and 36 months after the procedure. All exams included manifest refraction, monocular uncorrected visual acuity (UCVA) and distance-corrected visual acuity (DCVA) in 5 m (Snellen), monocular uncorrected visual acuity in 70 cm and 40 cm (Jeager) and binocular UCVA, DCVA in 5 m, 70 cm, and 40 cm, binocular contrast sensitivity (CS) under photopic conditions, binocular defocus curves, high-order aberrations, quality-of-vision VF-14 questionnaire, and spectacle independence. Results. Significant improvement in monocular visual acuity at all distances was demonstrated; the mean postoperative spherical equivalent was 0.32 ± 0.45D. The postoperative means of binocular distance UCVA and BCVA were also improved ( p  < .001) and so were the mean uncorrected intermediate VA (2.053 ± 1.268) and near uncorrected VA (2.737 ± 1.447). There was a significant improvement in contrast sensitivity at all spatial frequencies and higher-order aberration, compared to preoperative results. Conclusions. The evaluation of a WIOL-CF showed good distance, intermediate, and near visual acuity. Contrast sensitivity increased after surgery in all spatial frequencies. Patient satisfaction was high despite some optical phenomena. The rate of postoperative spectacle independence also turned out high. Financial Disclosure. No author has a financial or proprietary interest in any material or method mentioned.


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