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.

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
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Management Strategy ◽  
Intraocular Lenses ◽  
Intraocular Lens Implantation ◽  
Multifocal Intraocular Lens ◽  
Multifocal Intraocular Lenses ◽  
Lens Implantation ◽  
Near Visual Acuity ◽  
Cataract Patients

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.

Bioptics for high hyperopia with combined multifocal intraocular lens implantation and excimer ablation in young patients

2018 ◽  
Vol 29 (4) ◽  
pp. 426-430 ◽  
Author(s):  
Omer Trivizki ◽  
David Smadja ◽  
Michael Mimouni ◽  
Samuel Levinger ◽  
Eliya Levinger
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Laser In Situ Keratomileusis ◽  
Intraocular Lens Implantation ◽  
Multifocal Intraocular Lens ◽  
Distance Visual Acuity ◽  
Lens Implantation ◽  
Near Visual Acuity ◽  
High Hyperopia

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.

scholarly journals Sutureless retropupillary iris claw intraocular lens implantation is a viable option in aphakic patients

2019 ◽  
Vol 7 (1) ◽  
pp. 350
Author(s):  
Neepa R. Gohil ◽  
Sandeep Kumar Yadav ◽  
Kaumudi Shinde
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Visual Outcome ◽  
Good Alternative ◽  
Intraocular Lenses ◽  
Intraocular Lens Implantation ◽  
Visual Rehabilitation ◽  
Lens Implantation ◽  
Iris Claw Lens ◽  
Iris Claw

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.

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.

Contrast sensitivity after refractive lens exchange with diffractive multifocal intraocular lens implantation in hyperopic eyes

2008 ◽  
Vol 34 (12) ◽  
pp. 2043-2048 ◽  
Author(s):  
Teresa Ferrer-Blasco ◽  
Robert Montés-Micó ◽  
Alejandro Cerviño ◽  
José F. Alfonso ◽  
Luis Fernández-Vega
Keyword(s):  
Contrast Sensitivity ◽  
Intraocular Lens ◽  
Intraocular Lens Implantation ◽  
Multifocal Intraocular Lens ◽  
Refractive Lens Exchange ◽  
Lens Implantation ◽  
Refractive Lens

Effect of intraocular lens implantation on visual acuity, contrast sensitivity, and depth of focus

2003 ◽  
Vol 29 (11) ◽  
pp. 2073-2081 ◽  
Author(s):  
Ying-Khay Nio ◽  
Nomdo M. Jansonius ◽  
Ed Geraghty ◽  
Sverker Norrby ◽  
Aart C. Kooijman
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Intraocular Lens ◽  
Intraocular Lens Implantation ◽  
Depth Of Focus ◽  
Lens Implantation

scholarly journals Visual Performance after Bilateral Implantation of a Four-Haptic Diffractive Toric Multifocal Intraocular Lens in High Myopes

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
John S. M. Chang ◽  
Vincent K. C. Chan ◽  
Jack C. M. Ng ◽  
Antony K. P. Law
Keyword(s):  
Contrast Sensitivity ◽  
Intraocular Lens ◽  
Case Series ◽  
Intraocular Lenses ◽  
Visual Performance ◽  
Multifocal Intraocular Lens ◽  
Multifocal Intraocular Lenses ◽  
Spatial Frequencies ◽  
High Satisfaction ◽  
Line Loss

Background. The vision with diffractive toric multifocal intraocular lenses after cataract surgery in long eyes has not been studied previously.Objectives. To report visual performance after bilateral implantation of a diffractive toric multifocal intraocular lens in high myopes.Methods. Prospective, observational case series to include patients with axial length of ≥26 mm and corneal astigmatism of >1 dioptre who underwent bilateral AT LISA 909M implantation. Postoperative examinations included photopic and mesopic distance, intermediate, and near visual acuity; photopic contrast sensitivity; visual symptoms (0–5); satisfaction (1–5); and spectacle independence rate.Results. Twenty-eight eyes (14 patients) were included. Postoperatively, mean photopic monocular uncorrected distance, intermediate, and near visual acuities (logMAR) were0.12±0.20(standard deviation),0.24±0.16, and0.29±0.21, respectively. Corresponding binocular values were-0.01±0.14,0.13±0.12, and0.20±0.19, respectively. One eye (4%) had one-line loss in vision. Under mesopic condition, intermediate vision and near vision decreased significantly (allP≤0.001). Contrast sensitivity at all spatial frequencies did not improve significantly under binocular condition (allP>0.05). Median scores for halos, night glare, starbursts, and satisfaction were 0.50, 0.00, 0.00, and 4.25, respectively. Ten patients (71%) reported complete spectacle independence.Conclusions. Bilateral implantation of the intraocular lens in high myopes appeared to be safe and achieved good visual performance and high satisfaction.

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