scholarly journals Comparison of the visual performance of iris-fixated phakic lens and implantable collamer lens to correct high myopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiao-ling Jiao ◽  
Jun Li ◽  
Zhe Yu ◽  
Ping-hui Wei ◽  
Hui Song

Abstract Background To compare visual performance between the iris-fixated phakic intraocular len (pIOL) and implantable collamer len (ICL) to correct high myopia. Methods Twenty-four eyes underwent iris-fixated pIOL implantation and 24 eyes underwent ICL implantation. At the 6-month follow-up, the best-corrected visual acuity (BCVA) and uncorrected distance visual acuity (UDVA) were compared between the iris-fixated pIOL and ICL groups. The objective scatter index (OSI), modulation transfer function (MTF) cutoff, and ocular aberrations were performed to evaluate postoperative visual quality between the two groups. Results No significant difference was found in UDVA, BCVA, and spherical equivalent between the iris-fixated pIOL and ICL groups (P > 0.05). Six months after surgery, the following values were significantly higher in the ICL group than in the iris-fixated pIOL group: MTF cutoff, strehl ratio and optical quality analysis system values at contrasts of 9 %, 20 %, and 100 % (P < 0.01). The OSI in the iris-fixated pIOL group was higher than in the ICL group 6 months after surgery (P < 0.01). All high-order aberrations were slightly more severe in the iris-fixated pIOL group than in the ICL group 6 months after surgery, although only trefoil (P = 0.023) differed significantly in this regard. Conclusions Both iris-fixated lenses and ICLs can provide good visual acuity. ICLs confer better visual performance in MTF-associated parameters and induce less intraocular light scattering than iris-fixated pIOLs.

2021 ◽  
Author(s):  
Gang Liang ◽  
Miao Zhou ◽  
Chen-Wei Pan

Abstract Background: To investigate the differences in visual quality after laser epithelial keratomileusis (LASEK), femtosecond laser in situ keratomileusis (FS-LASIK) and small-incision lenticule extraction (SMILE) in different degrees of myopia.Methods: This prospective study incorporated 200 consecutive myopic subjects (200 eyes). Myopia was subdivided into 3 levels based on the preoperative spherical equivalent (SE) value: low myopia (SE ≥ -3.0 D), moderate myopia (−3.0 D > SE ≥ −6.0 D), and high myopia (SE < −6.0 D). Visual quality was recorded and analyzed both objectively using the Optical Quality Analysis System II (OQAS II), and subjectively with uncorrected distance visual acuity (UDVA) and a questionnaire, preoperatively, 1 month and 6 months postoperatively. Results: Six months after LASEK, FS-LASIK and SMILE in myopia, the logarithm of the minimum angle of resolution (LogMAR) UDVA statistically decreased compared with preoperative values (all P < 0.001). While preoperatively, in three surgical procedure groups, objective visual quality parameters demonstrated no significant difference among three degrees of myopia (all P > 0.05), at 6 months postoperatively, after FS-LASIK and SMILE, the modulation transfer function (MTF) cutoff frequency in low myopia was significantly higher than that in high myopia (both P < 0.05). Moreover, intergroup differences in LASEK, FS-LASIK and SMILE groups were not statistically significant, before and 6 months after surgery (all P > 0.05), except that FS-LASIK provided a significantly higher preoperative LogMAR UDVA than SMILE in high myopia (P < 0.05).Conclusion: LASEK, FS-LASIK and SMILE could achieve similar improvement in visual quality to each other after myopia correction. Low myopic patients may achieve better postoperative visual quality after FS-LASIK and SMILE than high myopic patients.Trial registration: This is a prospective study. The study followed the Declaration of Helsinki and was approved by the Institutional Review Board of the Second People’s Hospital of Yunnan Province.


2019 ◽  
Author(s):  
Lingying Ye ◽  
Tianyu Chen ◽  
Zhixiang Hu ◽  
Qiudong Su ◽  
Jin Li

Abstract AIM To compare the visual performance of asymmetric refractive multifocal intraocular lenses (MIOLs) with all optic zone diffractive MIOLs.METHODS A prospective study. Patients underwent phacoemulsification were divided into two groups according to the type of MIOLs: 25 patients were implanted with asymmetric refractive MIOLs and 25 patients with all optic zone diffractive MIOLs. Visual acuity, refraction, defocus curves, objective optical quality and the questionnaire of life quality were measured 3 months after surgery.RESULTS There was no significant difference between two groups in uncorrected distance visual acuity、uncorrected near visual acuity、best corrected distance visual acuity or distance corrected near visual acuity. However, the uncorrected intermediate visual acuity was 0.24±0.10 in refractive group and 0.31±0.13 in diffractive group (P<0.05); the distance corrected intermediate visual acuity was 0.22±0.09 in refractive group and 0.31±0.14 in diffractive group (P<0.05). Defocus curves showed two crests in both groups. However, the curve between two crests of refractive group was smoother than diffractive group. The Modulated transfer function cut-off frequency was (22.74±12.29)c/d in refractive group and(30.50±10.04)c/d in diffractive group (P<0.05); the OQAS values 100% (OV100%) were 0.75±0.41 in refractive group and 1.02±0.34 in diffractive group(P<0.05),OV20% were 0.52±0.34 in refractive group and 0.71±0.25 in diffractive group (P<0.05).There was no significant difference between two groups at overall satisfaction, independence spectacles ratio or visual interference phenomenon.CONCLUSIONS Both MIOLs achieve good visual acuity at distance and near. The asymmetric refractive MIOLs show better intermediate visual acuity, and the all optic zone diffractive MIOLs appear to have better objective visual quality.


2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Jun Li ◽  
Zhe Yu ◽  
Hui Song

Purpose. To investigate the effects of capsulotomy shape on the visual acuity and visual quality after neodymium: yttrium aluminum garnet laser capsulotomy. Methods. In this study, a total of 42 eyes from 35 patients with posterior capsule opacification were divided into the circular and cruciate groups. The corrected distance visual acuity (CDVA), objective scatter index (OSI), modulation transfer function cutoff (MTF cutoff), Strehl ratio, and Optical Quality Analysis System values at contrasts of 100%, 20%, and 9% (OV-100, OV-20, and OV-9) were measured at precapsulotomy and 1 week and 1 month postcapsulotomy. The pseudophakic dysphotopsia questionnaire (PDQ) was used to evaluate the subjects’ satisfaction with treatment. Results. OSI values were significantly higher in the cruciate group than in the circular group at 1 week and 1 month after capsulotomy (P=0.013 and P<0.001). No significant difference was found in the OSI values between the two groups before capsulotomy (t = 0.52; P=0.61). The decrease in OSI was higher in the circular group than in the cruciate group at 1 week and 1 month after capsulotomy (P=0.036 and P=0.019). No significant differences were found in the Strehl ratio, MTF cutoff, CDVA, OV-100, OV-20, and OV-9 between the two groups at 1 week and 1 month after capsulotomy (P>0.05). The PDQ results showed that patients with circular-shaped capsulotomy complained less with intolerance of bright lights than those with cruciate-shaped capsulotomy. Conclusions. Circular-shaped capsulotomy can induce less intraocular light scattering and increase patient satisfaction.


2019 ◽  
Author(s):  
Qing-Qing Tan ◽  
Jia Lin ◽  
Jing Tian ◽  
Xuan Liao ◽  
Chang-Jun Lan

Abstract Backgroud To compare the postoperative optical quality in eyes with customized selection and random selection of aspheric intraocular lens (IOL) implantation. Methods A prospective, nonrandomized study was implemented in adult cataract patients who underwent unilateral phacoemulsification with aspheric IOL implantation. Patients were allocated into two treatment groups: a customized group and a control group. In the customized group, the aspheric IOL selection was based on the corneal spherical aberration to enable the postoperative target ocular spherical aberration closest to zero; in the control group, the aspheric IOLs were chosen using a random strategy. Primary outcome measurements included the following objective optical quality assessments: higher-order aberrations obtained by a Hartmann-shack aberrometer at 4mm and 6mm pupil diameters; objective scatter index (OSI), modulation transfer function (MTF) cut-off, Strehl ratio (SR) and a simulated contrast visual acuity—optical quality analysis system value (OV) obtained by a double-pass system with a 4-mm aperture. Subjective visual acuity was measured as secondary outcome. All the patients were followed up for 3 months. Results Eighty-four patients in the customized group and 78 patients in the control group were evaluated. There was no significant difference in postoperative visual acuity between the two groups (P>0.05). Significantly less ocular higher-order aberrations were shown in the customized group (P<0.05). No significant difference was shown in OSI, MTF cut-off, SR and OV between the two groups (P>0.05). Conclusions Although customized selection of aspheric IOL implantation showed less postoperative ocular aberrations, it performed similarly to random selection of aspheric IOL implantation in terms of postoperative visual acuity, simulated contrast visual acuity, intraocular scatter, modulation transfer function and Strehl ratio.


2021 ◽  
Vol 14 (3) ◽  
pp. 371-377
Author(s):  
Hui Liu ◽  
◽  
Hai-Jun Xia ◽  
Jin Zhou ◽  
◽  
...  

AIM: To analyze postoperative clinical results after implantation of trifocal intraocular lenses (IOLs) in highly myopic eyes with different axial lengths (ALs). METHODS: This retrospective study describes 61 eyes of 44 patients that were implanted with trifocal diffractive IOLs (AT LISA tri 839MP). Twenty-one eyes (15 patients) were included in the AL<26 mm group, 19 eyes (13 patients) in the AL≥26 mm and <28 mm group, and 21 eyes (16 patients) in the AL≥28 mm group. Postoperative outcomes, including corrected and uncorrected distance visual acuity (UDVA), intermediate and near visual acuity at 167 cd/m2 luminance, depth of focus at 85 cd/m2 luminance, and objective optical quality parameters assessed using the Optical Quality Analysis System (OQAS), were compared among the groups at 3mo. RESULTS: There were no significant differences in the mean UDVA, uncorrected intermediate visual acuity, uncorrected near visual acuity, corrected distance visual acuity, distance-corrected intermediate visual acuity, and distance-corrected near visual acuity (DCNVA) among the three groups (P>0.05). Better near and intermediate visual acuity (from -1.5 D to -3.0 D) were noted on the defocus curve of the AL<26 mm group (P<0.01 vs AL≥28 mm group). Significantly higher objective scatter index (OSI) values and lower modulation transfer function (MTF) cut-off values, Strehl ratio (SR), and OQAS values (OVs) were observed in the AL≥28 mm group (P<0.01 vs AL<26 mm group). All OQAS parameters had statistically significant correlations with DCNVA and visual acuity at the vergence of -2.5 D (P<0.05 to P<0.01). CONCLUSION: Implantation of trifocal IOLs provides good short-term visual and refractive outcomes in highly myopic eyes with different ALs. However, the near vision decreases in the extremely myopic eyes at lower luminance, which is associated with the lower objective optical quality in these eyes.


2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Miaomiao Zhu ◽  
Jilin Tan ◽  
Zhongxiu Zhao ◽  
Xialu Liu ◽  
Yanli Peng

Purpose. To evaluate the safety, efficacy, and predictability of implantable collamer lens (ICL) implantation combined with a LenSx femtosecond laser-assisted limbal relaxing incision (LRI) for the correction of corneal astigmatism. Methods. This prospective study enrolled 64 eyes (54 patients) with high myopia with low to moderate regular corneal astigmatism. They were divided into an ICL group with ICL implantation (18 patients, 20 eyes), a TICL group with toric ICL implantation (17 patients, 23 eyes), and a LenSx + ICL group with a LenSx femtosecond laser-assisted LRI and an ICL implantation (19 patients, 21 eyes). Visual acuity, astigmatism correction ability, and visual quality were measured before and 1, 3, and 6 months after surgery. Results. The postoperative visual acuity of the 3 groups was higher than the preoperative visual acuity ( P < 0.01 ), and the improvements in the LenSx + ICL group and the TICL group were greater than those in the ICL group ( P < 0.01 ). The LenSx + ICL and TICL groups had less residual astigmatism and a higher astigmatism correction index (CI) than the ICL group ( P < 0.01 ). There was no significant difference among the three groups in total high-order aberrations (HOAs) before and after surgery ( P > 0.05 ). Conclusion. LenSx femtosecond laser-assisted LRI can effectively correct low to moderate corneal astigmatism during ICL implantation surgery. It can achieve similar clinical effects in the short term compared with TICL implantation.


2019 ◽  
Author(s):  
Tianrui He ◽  
Yi Zhu ◽  
Jibo Zhou

Abstract Background The current study compared optical quality before and after implantation of a posterior chamber phakic intraocular lens with a central hole [V4c implantable collamer lens (ICL)] under bright and dark lighting conditions by means of the Optical Quality Analysis System™ (OQAS; Visiometrics, Terrassa, Spain). Methods This prospective study involved 91 eyes of 46 consecutive patients undergoing implantation of a V4c ICL (15 males and 31 females). The modulation transfer function (MTF) cutoff frequency, Strehl ratio, objective scattering index (OSI), and predicted visual acuities (PVAs; 100%, 20%, and 9%), under different lighting conditions, were measured before and 1 week, 1 month, and 3 months after surgery. Results All optical parameters showed significant improvements, at all time points, under dark condition after surgery. We observed no significant changes in PVA 9% at 1 week (P=0.12) or 1 month after surgery (P=0.08) under light condition; but all other postoperative parameters improved significantly. Comparing the two lighting conditions, the OSI decreased more under dark conditions at 1 week (P=0.02), 1 month (P=0.004), and 3 months (P=0.002), but there was no significant difference in any other parameter. In addition, patients were divided into a high myopia group (group H) and a super-high myopia group (group S), the group S improved significantly more than group H in all parameters, under both bright and dark conditions. Conclusions V4c ICL implantation improved optical quality under both bright and dark lighting conditions, and had a better ability to reduce the extent of scattering in the dark. Furthermore, group S achieved greater improvement in visual quality, which should be considered by physicians before surgery.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Xiao Wang ◽  
Haixia Tu ◽  
Yong Wang

Purpose. To compare the short-term visual outcomes and intraocular optical performance of a rotationally asymmetric multifocal intraocular lens (MIOL) (SBL-3, Lenstec, Inc., Christ Church, Barbados) and an apodized diffractive MIOL (the Acrysof IQ ResTOR SN6AD1, Alcon Laboratories, Inc., Fort Worth, Texas, United States). Methods. A prospective, comparative, nonrandomized, and single-center study. Sixty-eight age-related cataract patients (81 eyes) after phacoemulsification cataract surgery and in-the-bag MIOL implantation were enrolled. Thirty-eight eyes received SBL-3, and 43 eyes received SN6AD1. Ophthalmological evaluation included uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), corrected distance visual acuity (CDVA), modulation transfer function (MTF), Strehl ratio (SR), intraocular aberrations (4 mm optical zone), and defocus curve at 3 months postoperatively. The Chinese version of the visual function index-14 (VF-12-CN) and spectacle independence were assessed in all patients. Results. There was no statistically significant difference between groups in postoperative UDVA (p=0.186). Postoperative UIVA and UNVA were significantly better for the SBL-3 group than for the SN6AD1 group (p<0.01). Statistically significant differences were revealed in defocus levels from –3.50 D to −4.00 D with better visual acuities for the SBL-3 group (p<0.01). For intraocular optical quality outcomes, statistically significant differences between groups were observed in RMS of intraocular total aberrations, coma, and trefoil high-order aberrations, presenting significantly higher values of these parameters in the eyes of the SBL-3 group (p < 0.01). Statistically significant differences were revealed in the MTF values at spatial frequencies of 5 and 10 cycles/degree between groups. There were no significant differences in scores of VF-12-CN, and spectacle independence between the groups (p>0.05). Conclusions. Both MIOLs were able to successfully restore visual function after cataract surgery. SBL-3 provided better UIVA and UNVA with a wider range of intermediate vision.


2020 ◽  
Author(s):  
Miaomiao Zhu ◽  
Zhao Zhongxiu ◽  
Xialu Liu ◽  
Yanli Peng

Abstract BackgroundTo evaluate the safety, efficacy, and predictability of the LenSx femtosecond laser-assisted limbal relaxing incision (LRI) for correction of high myopia with low to moderate corneal astigmatism (-0.75 to -1.50D) in implantable collamer lens implantation (ICL).MethodsThis prospective clinical control study included 56 eyes from 46 patients. They were divided into an ICL group with ICL implantation (14 patients,16 eyes); a TICL group with toric ICL implantation (17 patients, 23 eyes); and a LenSx + ICL group with a LenSx femtosecond laser-assisted LRI and an ICL implantation (15 patients, 17 eyes). The visual acuity, astigmatism correction ability and visual quality were measured before and 1, 3, and 6 months after surgery.ResultsThe postoperative visual acuity of the 3 groups were higher than the preoperative visual acuity (P < 0.01), and the improvements in the LenSx + ICL group and the TICL group were greater than those in the ICL group (P < 0.01). The LenSx + ICL and TICL groups had less residual astigmatism and higher astigmatism correction index (CI) than the ICL group (P < 0.01). There was no significant difference in the three groups of total high order aberrations (HOAs) before and after surgery (P > 0.05).ConclusionLenSx femtosecond laser-assisted LRI combined with ICL implantation can effectively correct low to moderate corneal astigmatism in high myopia. Compared with TICL implantation, it can achieve similar clinical effects in the short term.Trial registrationThis article has been retrospectively registered at the Chinese Clinical Trial Registry in 10 June 2019. (NO: ChiCTR1900023743).


2021 ◽  
Vol 14 (5) ◽  
pp. 737-743
Author(s):  
Zheng Jiang ◽  
◽  
Dong-Qiang Luo ◽  
Jiao Chen ◽  
◽  
...  

AIM: To compare clinical outcomes and refractive stability of implantable collamer lens (ICL) implantation and femtosecond laser assisted laser in situ keratomileusis (FS-LASIK) for high myopia correction. METHODS: The Optical Quality Analysis System (OQAS) was used to evaluate clinical outcomes objectively after operation for high myopia correction. We compared the two procedures in terms of 1-year changes in uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), safety index, efficacy index, spherical equivalent, modulation transfer function (MTF) cutoff frequency, strehl ratio (SR) and objective scatter index (OSI). RESULTS: At 1y postoperatively, the safety indices were 1.33±0.27 in ICL group, and 1.17±0.24 in FS-LASIK group. 39.58% in the ICL group and 27.59% in the FS-LASIK group gained CDVA in 2 lines or better than that in preoperative CDVA. The efficacy indices were 1.28±0.22 in ICL group, and 1.13±0.26 in FS-LASIK group. The changes of spherical equivalent from 1wk to 1y postoperatively was -0.12±0.37 D in ICL group, and -0.79±0.58 D in FS-LASIK group (P&#x003C;0.05). Spherical equivalent within ±0.50 D was achieved in 97.92% in ICL group and 68.97% in FS-LASIK group. MTF cutoff frequency were higher with ICL as compared to FS-LASIK (P&#x003C;0.05) at each postoperative follow-up stage; for postoperative 1mo later, SR was statistically significant difference between two groups (P&#x003C;0.05); with no statistically significant difference in OSI between two groups (P&#x003E;0.05) in postoperative 3mo later. CONCLUSION: ICL implantation and FS-LASIK procedures both provide good safety and predictability in high myopia correction. ICL implantation provides better clinical outcomes and refractive stability than FS-LASIK.


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