scholarly journals Secondary multifocal intraocular lens implantation: A novel management strategy for white cataracts

2018 ◽  
Vol 6 ◽  
pp. 2050313X1775033
Author(s):  
Jiawen Ling ◽  
Yiyong Qian ◽  
Peirong Lu

Objectives: This study was designed to analyse the outcomes of secondary multifocal intraocular lens implantation in eyes with white cataracts. Methods: White cataract patients undergoing secondary multifocal intraocular lens implantation between June 2014 and January 2015 were evaluated prospectively. As opposed to a conventional primary intraocular lens implantation for an optimal patient, the white cataract was first extracted, followed by optical biometry measurements. Whether or not the patient had adequate visual acuity was identified, and the multifocal intraocular lens was implanted secondarily. A total of five appropriate white cataract patients were enrolled in this secondary multifocal intraocular lens implantation study and were retrospectively reviewed. Results: All five secondary implantations of the multifocal intraocular lenses were successful, without obvious adverse events. The uncorrected near visual acuity LogMAR was 0.4–0.5, and the distance visual acuity was −0.1 to 0.1 after 12 months of the multifocal intraocular lens implantation. All patients achieved satisfactory near and distance visual acuities and spectacle freedom. Conclusion: Two-stage multifocal intraocular lens implantation is a safe and novel technique for the management of white cataract patients to optimise near and distance visual acuities.

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 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.


Author(s):  
Neepa R. Gohil ◽  
Sandeep Kumar Yadav ◽  
Kaumudi Shinde

Visual rehabilitation in aphakia has been a challenge with a wide variety of surgical options available for ophthalmologist. We report the visual outcome with retropupillary iris claw lens secondary to intra operative complications and secondary implantation in aphakia. An interventional study on 4 eyes of 4 patients was conducted. Preoperative visual acuity, slit lamp examination and fundus examination were carried out. Anterior vitrectomy and retropupillary fixation of iris claw lens were done. The primary outcome measure was best-corrected visual acuity and secondary postoperative complication was recorded at various intervals. All patients had visual acuity of ≥6/18 postoperatively. Sutureless retropupillary iris claw intraocular lens implantation is a good alternative of scleral-fixated intraocular lenses in aphakic patients.


2020 ◽  
Author(s):  
Ho Ra ◽  
Ho Sik Hwang ◽  
Hyun Seung Kim ◽  
Man Soo Kim ◽  
Eun Chul Kim

Abstract Background: To evaluate the effect of toric intraocular lens implantation in cataract patient with corneal opacity and high astigmatism. Methods: 31 eyes of 31 patients who underwent cataract surgery with toric intraocular lens implantation were included. All patients had corneal opacity with astigmatism. Preoperative total corneal astigmatism was determined considering posterior astigmatism using a rotating Scheimpflug camera (Pentacam®: Oculus, Wetzlar, Germany). At 2 months after toric intraocular lens implantation, we evaluated residual astigmatism, uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA).Results: Postoperative UCVA and BCVA (0.30 ± 0.17, 0.22 ± 0.16LogMAR) were statistically improved compared to preoperative UCVA and BCVA (1.2 ± 0.34, 1.1 ± 0.30LogMAR, respectively) (P<0.01). Postoperative residual refractive astigmatism (1.2 ± 0.35D) was statistically reduced compared to preoperative refractive astigmatism (2.4 ± 0.65D) (P<0.05). Preoperative and postoperative total corneal astigmatism values were not statistically different. All eyes achieved postoperative visual acuity as good as or better than preoperative one. The size of corneal opacity covering pupil had significant negative correlation with postoperative UCVA and BCVA (logMAR) (R=0.91 P<0.05 and R=0.92 P<0.05, respectively)Conclusion: Toric intraocular lens implantation can improve UCVA, BCVA, and refractive astigmatism in cataract patient with corneal opacity. The size of corneal opacity covering pupil is the major prognostic factor for postoperative visual improvement. Therefore, toric intraocular lens implantation should be considered for cataract patients who have corneal opacity with high astigmatism.


2019 ◽  
Author(s):  
Ho Ra ◽  
Ho Sik Hwang ◽  
Hyun Seung Kim ◽  
Man Soo Kim ◽  
Eun Chul Kim

Abstract Purpose: To evaluate the effect of toric intraocular lens implantation in cataract patient with corneal opacity and high astigmatism. Methods: 31 eyes of 31 patients who underwent cataract surgery with toric intraocular lens implantation were included. All patients had corneal opacity with astigmatism. Preoperative total corneal astigmatism was determined considering posterior astigmatism using a rotating Scheimpflug camera (Pentacam®: Oculus, Wetzlar, Germany). At 2 months after toric intraocular lens implantation, we evaluated residual astigmatism, uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA). Results: Postoperative UCVA and BCVA (0.30 ± 0.17, 0.22 ± 0.16LogMAR) statistically improved compared to preoperative UCVA and BCVA (1.2 ± 0.34, 1.1 ± 0.30LogMAR, respectively) (P<0.01). Postoperative residual refractive astigmatism (1.2 ± 0.35D) was statistically reduced compared to preoperative refractive astigmatism (2.4 ± 0.65D) (P<0.05). Preoperative and postoperative total corneal astigmatism values were not statistically different. All eyes achieved postoperative visual acuity as good as or better than preoperative one. The size of corneal opacity covering pupil had significant negative correlation with postoperative UCVA and BCVA (logMAR) (R=0.91 P<0.05 and R=0.92 P<0.05, respectively). Conclusion: Toric intraocular lens implantation can improve UCVA, BCVA, and refractive astigmatism in cataract patient with corneal opacity. The size of corneal opacity covering pupil is the major prognostic factor for postoperative visual improvement. Therefore, toric intraocular lens implantation should be considered for cataract patients who have corneal opacity with high astigmatism.


2019 ◽  
Author(s):  
Ho Ra ◽  
Ho Sik Hwang ◽  
Hyun Seung Kim ◽  
Man Soo Kim ◽  
Eun Chul Kim

Abstract Purpose: To evaluate the effect of toric intraocular lens implantation in cataract patient with corneal opacity and high astigmatism. Methods: 31 eyes of 31 patients who underwent cataract surgery with toric intraocular lens implantation were included. All patients had corneal opacity with astigmatism. Preoperative total corneal astigmatism was determined considering posterior astigmatism using a rotating Scheimpflug camera (Pentacam®: Oculus, Wetzlar, Germany). At 2 months after toric intraocular lens implantation, we evaluated residual astigmatism, uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA). Results: Postoperative UCVA and BCVA (0.30 ± 0.17, 0.22 ± 0.16LogMAR) statistically improved compared to preoperative UCVA and BCVA (1.2 ± 0.34, 1.1 ± 0.30LogMAR, respectively) (P<0.01). Postoperative residual refractive astigmatism (1.2 ± 0.35D) was statistically reduced compared to preoperative refractive astigmatism (2.4 ± 0.65D) (P<0.05). Preoperative and postoperative total corneal astigmatism values were not statistically different. All cases achieved visual acuity were as good as or better than that preoperatively. The percentage of corneal opacity covering pupillary area had significant negative correlation with postoperative UCVA and BCVA (logMAR) (R=-0.88 P<0.00001 and R=-0.87 P<0.00001, respectively) Conclusion: Toric intraocular lens implantation can improve UCVA, BCVA, and refractive astigmatism in cataract patient with corneal opacity. The percentage of central corneal opacity covering pupillary area is the major prognostic factor for postoperative visual improvement. Therefore, toric intraocular lens implantation should be considered for cataract patients who have corneal opacity with high astigmatism.


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