Long-term objective and subjective outcomes following bilateral implantation of diffractive bifocal or trifocal intraocular lenses

2020 ◽  
pp. 112067212092687
Author(s):  
Veronica Vargas ◽  
Jorge L Alio ◽  
Renan F. Oliveira ◽  
Antonio Renna ◽  
Pilar Yebana
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Contrast Sensitivity ◽  
Intraocular Lens ◽  
Study Groups ◽  
Intraocular Lenses ◽  
Significant Difference ◽  
Visual Function Questionnaire ◽  
Objective Outcomes ◽  
Subjective Outcomes

Objective To evaluate and compare the objective and subjective outcomes after the bilateral implantation of a diffractive bifocal and trifocal intraocular lens. Methods This is a case–control, single-center observational study which included 27 patients; 16 patients were implanted bilaterally with the bifocal AcrySof IQ ReSTOR+3.0D and 11 patients with the trifocal AT LISA tri 839MP. Uncorrected visual acuity at distance, intermediate, and near under mesopic and photopic conditions using ETDRS charts with 10% and 100% contrast, corrected distance visual acuity, and binocular defocus curve in photopic conditions; binocular contrast sensitivity under mesopic and photopic conditions for far and near distances were assessed. The Visual Function Questionnaire-25 questionnaire was used to assess patients' satisfaction. All the measurements were performed 6–24 months after cataract surgery. Results The ReSTOR group had better binocular uncorrected near visual acuity in photopic conditions with low and high contrast charts ( p = 0.040 and p = 0.033, respectively), as well as in far contrast sensitivity measurement under mesopic conditions with a spatial frequency of 3 cycles per degree ( p = 0.034). There was not a significant difference between the two study groups in uncorrected near, intermediate or distance vision under mesopic conditions. The AT LISA tri study group had better subjective outcomes. Conclusion Both intraocular lenses restore visual acuity after cataract surgery. The ReSTOR intraocular lens provides better objective outcomes than the AT LISA tri, although the latter provides better subjective outcomes. The relevance of this study is the evaluation of both objective and subjective outcomes.

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 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.

Pediatric Cataract Surgery: Comparison between Ages at Surgery and Contrast Sensitivity Outcomes

2019 ◽  
Vol 43 (1) ◽  
pp. 50
Author(s):  
Aquirina Caesari Putri ◽  
Rozalina Loebis
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Contrast Sensitivity ◽  
Cataract Extraction ◽  
Significant Negative Correlation ◽  
Natural World ◽  
P Value ◽  
Pediatric Cataract ◽  
Low Contrast ◽  
Significant Difference

Background: Pediatric cataracts are major causes of children’s blindness. Surgery has proven to be beneficial in terms of visual function prognosis. Contrast sensitivity evaluation after surgery is as important as visual acuity considering that natural world consists of various objects in low-to-medium contrasts. The purpose of this study is to analyze the difference of contrast sensitivity outcomes based on ages at surgery. Method: Retrospective data of children with pediatric developmental cataract from July 2013 to November 2015 were collected. All children who underwent cataract surgery at 60-months-old or less were randomized into two groups, ≤24 months and >24-to-60 months. Contrast sensitivity was then examined with preferential-looking method using Hiding Heidi low-contrast test face chart. The main outcome measures were contrast sensitivity of both groups. Age-at-evaluation, cataract onset, duration of follow-up, duration of deprivation and visual acuity were also noted. Result: Of 14 children (23 eyes), 11 eyes (47,8%) were in ≤24 months group, 12eyes (52,2%) were in >24-to-60 months group. All eyes underwent cataract extraction and similar type of intraocular lens implantation. Mean age-at-surgery was 28,2 months±16,8 (SD). Mean contrast sensitivity for each group was 47,50 %±42,29 and 18,33%±27,38, respectively, with p-value 0,031. Further analysis of Spearman’s correlation test demonstrated significant negative correlation (rs = -0,559; p = 0,006) between the two groups. Conclusion: There was statistically significant difference in contrast sensitivity between those who underwent surgery at ≤24 months and >24-to-60 months. Children who underwent surgery at older ages tend to have better contrast sensitivity afterwards.

scholarly journals Comparison of Visual Outcomes and Patient Satisfaction Between two Diffractive Trifocal Intraocular Lenses

2021 ◽  
Author(s):  
asli cetinkaya yaprak ◽  
Mustafa Unal
Keyword(s):  
Visual Acuity ◽  
Patient Satisfaction ◽  
Cataract Surgery ◽  
Intraocular Lenses ◽  
World Health ◽  
Uncorrected Distance Visual Acuity ◽  
Significant Difference ◽  
Prospective Comparative Study ◽  
Health Organization ◽  
Clinical Trials Registry

Abstract Purpose To evaluate the clinical outcomes and visual quality of patients undergoing cataract surgery with the implantation of two different models of diffractive trifocal intraocular lenses (IOLs).MethodsThis randomized prospective comparative study included 60 eyes of 15 patients who scheduled to undergo bilateral cataract surgery with the implantation of two models of diffractive trifocal IOLs (RayOne Trifocal and AcrySof IQ PanOptix IOL). Monocular and binocular corrected and uncorrected distance visual acuity (CDVA, UDVA), intermediate visual acuity (DCIVA, UIVA) at 60 and 80 cm, near visual acuity (DCNVA, UNVA), and patient satisfaction were compared over a three-month follow-up.ResultsEach group comprised 30 eyes of 15 patients. No statistically significant differences were determined between the groups in terms of CDVA, UDVA, DCNVA and UNVA. The monocular and binocular UIVA values at 60 cm were better in the PanOptix IOL group (p=0.04 and p=0.01, respectively), and the DCIVA and UIVA values at 80 cm were better in the RayOne IOL group (p=0.01, p=0.047, p<0.001, and p=0.042, respectively). No statistically significant difference was found between the groups in relation to the frequency and severity of visual symptoms evaluated. Regarding discomfort, the RayOne IOL group had more bothersome halos and starbursts (p=0.026 and p=0.01, respectively).ConclusionBoth IOLs provided very good restoration of visual acuity. However, with the AcrySof IQ PanOptix IOL, the likelihood of patients experiencing bothersome halos and starbursts was less. The RayOne Trifocal IOL might be a better choice for patients who require further intermediate vision.The study was registered under the World Health Organization international clinical trials registry platform: NCT04655274, 30/11/2020, prospectively registered.

scholarly journals Visual performance of four types of diffractive multifocal intraocular lenses and a review of articles

2021 ◽  
Vol 14 (3) ◽  
pp. 356-365
Author(s):  
Farideh Doroodgar ◽  
◽  
Azad Sanginabadi ◽  
Farid Karimian ◽  
Sana Niazi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Intraocular Lenses ◽  
Multifocal Intraocular Lenses ◽  
Spatial Frequencies ◽  
Signed Rank ◽  
Pubmed Database ◽  
Significant Difference ◽  
The One ◽  
Post Hoc

AIM: To compare the clinical outcomes of a variety of multifocal intraocular lenses (MIOLs) in patients diagnosed with presbyopia or cataracts. METHODS: This clinical trial study included 141 patients (282 eyes) with different MIOLs implantation. The Symfony (60 eyes), the ReSTOR (100 eyes), the AT LISAtri (60 eyes), and the PanOptix (62 eyes) intraocular lenses were evaluated in this prospective interventional study. The near, intermediate, and distant visual acuities, contrast sensitivity, and defocus curve were measured as valid criteria. To statistically analyze the results, we used the Statistical Package for Social Science software, the non-parametric Wilcoxon signed-rank t, the one-way analysis of variance and the Tukey's post-hoc test in our analysis. Moreover, we conducted a detailed literature search on the PubMed database in English about MIOLs, in total 59 studies were included in this review article. RESULTS: The four approaches did not show any significant difference in the best-corrected distance visual acuity (P>0.05). The defocus curves at the contrast of 100% showed that trifocal IOLs had better intermediate performance than the bifocal IOL (P<0.05). There were no statistically significant differences between AT LISAtri and PanOptix lenses for visual acuity at all distances. The eyes with PanOptix, Symfony, and AT LISAtri IOL showed better contrast sensitivity than those ReSTOR at spatial frequencies of 1, 3, and 6 cpd in photopic and mesopic conditions (P<0.001). CONCLUSION: All four groups of the multifocal lenses were satisfying in terms of distance and near vision. Also, the group of trifocal lenses led to satisfactory outcomes in intermediate vision, without degradation in quality of vision.

scholarly journals Analyzing the reasons for patients’ dissatisfaction with the results of multifocal intraocular lens implantation

2014 ◽  
Vol 95 (4) ◽  
pp. 515-519
Author(s):  
K S Ivonin
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Intraocular Lens ◽  
Intraocular Lenses ◽  
Intraocular Lens Implantation ◽  
Multifocal Intraocular Lens ◽  
Multifocal Intraocular Lenses ◽  
Spatial Contrast Sensitivity ◽  
Lens Implantation ◽  
Light Side

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.

Changes of anthropometric parameters of an eye during the implantation of toric intraocular lenses in children with congenital cataracts.

2021 ◽  
pp. 101-104
Author(s):  
A.I. Shilov ◽  
◽  
K.K. Shefer ◽  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lenses ◽  
Pediatric Cataract ◽  
Congenital Cataracts ◽  
Positive Effects ◽  
Postoperative Astigmatism ◽  
Toric Iols ◽  
Significant Difference ◽  
Pediatric Cataract Surgery

Aim. The aim of the study is to examine changes in the anthropometric and refractive parameters of the eyeball in children with congenital cataracts who have been implanted with various types of IOLs (toric or classic monofocal). Materials and methods. In this work, we retrospectively studied the medical history of 34 children (42 eyes) aged 4 to 15 years, who underwent phacoemulsification of congenital cataracts with implantation of various types of IOLs: toric and simple monofocal. Further, in these groups, by statistical methods, the dynamics of refraction in the first three years after the operation, the incidence of postoperative astigmatism, and its dynamics were assessed. We also assessed the rate of change in the anteroposterior axis of the eyeball, the dynamics of refraction in terms of the total spheroequivalent and maximum visual acuity in 3 years after the operation. Results. According to the results of the study, it was shown that toric IOLs significantly better stimulate the process of emmetropization of the eyeball, and also have a significant tendency to completely eliminate postoperative astigmatism, within 3 years after surgery. However, there were no significant differences in maximally corrected visual acuity between the 2 compared groups. There were also no data showing a significant difference in the more frequent development of myopia in the group receiving the toric IOL. Conclusion. The correct choice and calculation of the IOL remains one of the most difficult tasks in pediatric cataract surgery. New technologies are introduced annually and require constant testing. In this study, we have shown the possibility of using toric IOLs and their positive effects in pediatric cataract surgery and in the prevention and treatment of obscuration amblyopia. Key words: pediatric cataract, intraocular lenses, myopia, refraction, phacoemulsification, amblyopia.

scholarly journals Comparison of visual and optical quality of monofocal versus multifocal intraocular lenses

2019 ◽  
Vol 30 (2) ◽  
pp. 299-306 ◽  
Author(s):  
Irene Altemir-Gomez ◽  
Maria S Millan ◽  
Fidel Vega ◽  
Francisco Bartol-Puyal ◽  
Galadriel Gimenez-Calvo ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Transfer Function ◽  
Contrast Sensitivity ◽  
Intraocular Lens ◽  
Modulation Transfer Function ◽  
Area Under The Curve ◽  
Optical Quality ◽  
Intraocular Lenses ◽  
Modulation Transfer ◽  
Multifocal Intraocular Lenses

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.

scholarly journals Clinical Results of Diffractive, Refractive, Hybrid Multifocal, and Monofocal Intraocular Lenses

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Agnieszka Dyrda ◽  
Ana Martínez-Palmer ◽  
Daniel Martín-Moral ◽  
Amanda Rey ◽  
Antonio Morilla ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Patient Satisfaction ◽  
Cataract Surgery ◽  
Contrast Sensitivity ◽  
Clinical Results ◽  
Intraocular Lenses ◽  
Link Type ◽  
Better Than

Purpose. To present the outcomes of hybrid multifocal and monofocal intraocular lenses (IOLs) and to compare with refractive and diffractive multifocal IOLs (MFIOLs).Methods. Three hundred twenty eyes (160 patients) underwent cataract surgery with randomized IOLs bilateral implantation. Changes in uncorrected and distance-corrected logMAR distance, intermediate and near (UNVA and DCNVA) visual acuity (VA), contrast sensitivity (CS), presence of dysphotopsia, spectacle independence, and patient satisfaction were analyzed.Results. Postoperative VA in the hybrid (OptiVis) group was improved in all distances (p<0.001). OptiVis acted superiorly to monofocal IOLs in UNVA and DCNVA (p<0.001for both) and to refractive ones in DCNVA (p<0.005). Distance, mesopic, without glare CS in OptiVis was lower than in the monofocal group and similar to other MFIOLs. No differences in dysphotopsia pre- and postoperatively and spectacle independence in near for OptiVis and refractive MFIOLs were detected. OptiVis patients were more satisfied than those with monofocal IOLs (p=0.015).Conclusions. After cataract surgery, patients with OptiVis improved VA in all distances. Near and intermediate VA was better than monofocal, and DCNVA was better than the refractive group. CS was lower in OptiVis than in the monofocal group, but there was no difference between MFIOLs. Patient satisfaction was higher in OptiVis than in the monofocal group. This trial is registered withNCT03512626.

Visual Function and Subjective Quality of Life in Chinese Cataract Patients after Implantation with Aspheric Intraocular Lenses

2011 ◽  
Vol 21 (6) ◽  
pp. 732-740
Author(s):  
Yanwen Fang ◽  
Yi Lu ◽  
Xinhua Wu ◽  
Aizhu Miao ◽  
Yi Luo
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Visual Function ◽  
Spherical Aberration ◽  
Visual Quality ◽  
Intraocular Lenses ◽  
Subjective Quality Of Life ◽  
Significant Difference ◽  
The Mean ◽  
Cataract Patients

Purpose. To evaluate and compare the objective and subjective visual function after implantation of 2 aspheric intraocular lenses (IOLs) in Chinese cataract patients. Methods. Forty-one eyes of 28 patients with cataract were randomly assigned to receive either the MC X11 ASP IOL or the AcrySof IQ IOL. Three months postoperatively, best-corrected visual acuity (BCVA), contrast sensitivity, wavefront aberrations, and subjective visual quality were measured. The degree of posterior capsule opacification (PCO) was recorded at last follow-up. Results. Postoperative mean monocular BCVA was 0.05±0.13 logMAR in the MC X11 group and 0.05±0.08 logMAR in the IQ group. There was no significant difference in visual acuity, contrast sensitivity, subjective visual quality, and degree of PCO between the 2 groups. For a 6-mm pupil diameter, the mean spherical aberration (Z40) was 0.075±0.076 μm in the MC X11 group and 0.056±0.111 μm in the IQ group. However, 45.5% and 57.9% of the eyes in the MC X11 and IQ groups had values >0.10 μm, respectively. The mean RMS values of the high-order aberrations were similar between the 2 groups except the higher fifth- and sixth-order aberrations, which were significantly higher in the MC X11 group. Conclusions. Both IOLs provided similar and good visual outcomes. However, the data suggest that the amount of negative spherical aberration generated by current available aspheric IOLs might not be optimal for Chinese eyes.

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