scholarly journals Comparison of Postoperative Visual Performance Between Bifocal and Trifocal Intraocular Lens Based on Randomized Controlled Trails: A Meta-Analysis

2018 ◽  
Author(s):  
Shanshan Jin ◽  
David S. Friedman ◽  
MM Kai Cao ◽  
MA Mayinuer Yusufu ◽  
MM Jingshang Zhang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Clinical Performance ◽  
Meta Analysis ◽  
Intraocular Lenses ◽  
Visual Performance ◽  
Posterior Capsular Opacification ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Corrected Distance Visual Acuity ◽  
The Difference

Abstract Background：To compare the clinical performance of bifocal and trifocal intraocular lenses (IOLs) in cataract surgery, a meta-analysis on randomized controlled trials was conducted. Methods: A comprehensive literature retrieval of PubMed and Science Direct was performed in this systematic review. Clinical outcomes included visual acuity (VA), contrast sensitivity (CS), spectacle independence, postoperative refraction and surgical satisfaction. Results: There were 8 RCTs included in this study. The difference of uncorrected near VA (UNVA) between the bifocal IOLs and trifocal IOLs had no clinical significance [MD=-0.01, 95%CI: (-0.02,0.00), p=0.97]. There was no difference for the distant-corrected near VA (DCNVA) with MD of 0.01[95%CI (-0.02, 0.05), p=0.86]. Compared with trifocal group, bifocal group showed a significantly worse uncorrected intermediate visual acuity (UIVA) [MD=0.09,95%CI:(0.01,0.17), p＜0.01]. No difference was found in distance-corrected intermediate VA(DCIVA) [MD= 0.09, 95%CI: (-0.04, 0.23) , p＜0.01] between two groups. For the AT LISA group, the subgroup analysis also indicated the bifocal group had worse intermediate VA than trifocal group (AT LISA tri 839M) [MD= 0.18, 95%CI: (0.12, 0.24), p=0.35 for UIVA and MD= 0.19, 95%CI: (0.13, 0.25), p=0.21 for DCIVA]. However, there was no statistically significant difference between the two groups in the uncorrected distance VA(UDVA) and corrected distance visual acuity (CDVA) [MD=0.01, 95%CI: (-0.01,0.04), p=0.51 for UDVA; MD=0.00, 95%CI: (-0.01,0.01), p=0.94 for CDVA]. The postoperative refraction of bifocal group was similar to that of trifocal group [MD=-0.08, 95% CI: (-0.19, 0.03), p=0.51 for spherical equivalent; MD=-0.09, 95%CI: (-0.21, 0.03), p=0.78 for cylinder; MD=-0.09, 95% CI: (-0.27, 0.08), p=0.28 for sphere]. No difference was found for spectacle independence, Posterior capsular opacification (PCO) incidence and patient satisfaction between bifocal IOLs and trifocal IOLs. [RR=0.92, 95% CI: (0.74, 1.15), p=0.93 for spectacle independence; RR=0.81, 95% CI: (0.74, 1.15), p=0.65 for PCO; RR=0.98, 5% CI: (0.86, 1.12), p=0.97 for satisfaction]. Conclusion: Patients receiving trifocal IOLs have a better intermediate VA than bifocal IOLs, especially for the AT LISA subgroup. Near and distance visual performance, spectacle independence, postoperative refraction and surgical satisfaction of bifocal IOLs were similar to those of trifocal IOLs.

scholarly journals Comparison of Postoperative Visual Performance Between Bifocal and Trifocal Intraocular Lens Based on Randomized Controlled Trails: A Meta-Analysis

2019 ◽  
Author(s):  
Shanshan Jin ◽  
David S. Friedman ◽  
MM Kai Cao ◽  
MA Mayinuer Yusufu ◽  
MM Jingshang Zhang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Clinical Performance ◽  
Meta Analysis ◽  
Intraocular Lenses ◽  
Visual Performance ◽  
Posterior Capsular Opacification ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Corrected Distance Visual Acuity ◽  
The Difference

Abstract Background：To compare the clinical performance of bifocal and trifocal intraocular lenses (IOLs) in cataract surgery, a meta-analysis on randomized controlled trials was conducted. Methods: A comprehensive literature retrieval of PubMed, Science Direct and EMBASE was performed in this systematic review. Clinical outcomes included visual acuity (VA), contrast sensitivity (CS), spectacle independence, postoperative refraction and surgical satisfaction. Results: There were 8 RCTs included in this study. The difference of uncorrected near VA (UNVA) between the bifocal IOLs and trifocal IOLs had no clinical significance [MD=-0.01, 95%CI: (-0.02,0.00), p=0.97]. There was no difference for the distant-corrected near VA (DCNVA) with MD of 0.01[95%CI (-0.02, 0.05), p=0.86]. Compared with trifocal group, bifocal group showed a significantly worse uncorrected intermediate visual acuity (UIVA) [MD=0.09,95%CI:(0.01,0.17), p＜0.01]. No difference was found in distance-corrected intermediate VA(DCIVA) [MD= 0.09, 95%CI: (-0.04, 0.23) , p＜0.01] between two groups. For the AT LISA group, the subgroup analysis also indicated the bifocal group had worse intermediate VA than trifocal group (AT LISA tri 839M) [MD= 0.18, 95%CI: (0.12, 0.24), p=0.35 for UIVA and MD= 0.19, 95%CI: (0.13, 0.25), p=0.21 for DCIVA]. However, there was no statistically significant difference between the two groups in the uncorrected distance VA(UDVA) and corrected distance visual acuity (CDVA) [MD=0.01, 95%CI: (-0.01,0.04), p=0.51 for UDVA; MD=0.00, 95%CI: (-0.01,0.01), p=0.94 for CDVA]. The postoperative refraction of bifocal group was similar to that of trifocal group [MD=-0.08, 95% CI: (-0.19, 0.03), p=0.51 for spherical equivalent; MD=-0.09, 95%CI: (-0.21, 0.03), p=0.78 for cylinder; MD=-0.09, 95% CI: (-0.27, 0.08), p=0.28 for sphere]. No difference was found for spectacle independence, Posterior capsular opacification (PCO) incidence and patient satisfaction between bifocal IOLs and trifocal IOLs. [RR=0.89, 95% CI: (0.71, 1.12), p=0.69 for spectacle independence; RR=0.81, 95% CI: (0.74, 1.15), p=0.65 for PCO; RR=0.98, 5% CI: (0.86, 1.12), p=0.97 for satisfaction]. Conclusion: Patients receiving trifocal IOLs have a better intermediate VA than bifocal IOLs, especially for the AT LISA subgroup. Near and distance visual performance, spectacle independence, postoperative refraction and surgical satisfaction of bifocal IOLs were similar to those of trifocal IOLs.

scholarly journals Comparison of Postoperative Visual Performance Between Bifocal and Trifocal Intraocular Lens Based on Randomized Controlled Trails: A Meta-Analysis

2019 ◽  
Author(s):  
Shanshan Jin ◽  
David S. Friedman ◽  
Kai Cao ◽  
Mayinuer Yusufu ◽  
Jingshang Zhang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Patient Satisfaction ◽  
Cataract Surgery ◽  
Clinical Performance ◽  
Meta Analysis ◽  
Intraocular Lenses ◽  
Visual Performance ◽  
Posterior Capsular Opacification ◽  
Randomized Controlled ◽  
Significant Difference

Abstract Background：To compare the clinical performance of bifocal and trifocal intraocular lenses (IOLs) in cataract surgery, a meta-analysis on randomized controlled trials was conducted. Methods: A comprehensive literature retrieval of PubMed, Science Direct and EMBASE was performed in this systematic review. Clinical outcomes included visual acuity (VA), contrast sensitivity (CS), spectacle independence, postoperative refraction and surgical satisfaction. Results: There were 8 RCTs included in this study. The difference of uncorrected near VA (UNVA) between the bifocal IOLs and trifocal IOLs had no clinical significance [MD=-0.01, 95%CI: (-0.02,0.00)]. There was no significant difference in the distant-corrected near VA (DCNVA) with MD of 0.04 [95%CI (-0.02, 0.10)]. Compared with trifocal group, the uncorrected intermediate visual acuity (UIVA) [MD=0.09,95%CI:(0.01,0.17)] was significantly worse in the bifocal group. No difference was found in distance-corrected intermediate VA(DCIVA) [MD= 0.09, 95%CI: (-0.04, 0.23)] between two groups. Analysis on AT LISA subgroup indicated the bifocal group had worse intermediate VA than trifocal group (AT LISA tri 839M) [MD= 0.18, 95%CI: (0.12, 0.24) for UIVA and MD= 0.19, 95%CI: (0.13, 0.25) for DCIVA]. However, there was no statistically significant difference between the two groups in the uncorrected distance VA(UDVA) and corrected distance visual acuity (CDVA) [MD=0.01, 95%CI: (-0.01,0.04) for UDVA; MD=0.00, 95%CI: (-0.01,0.01) for CDVA]. The postoperative refraction of bifocal group was similar to that of trifocal group [MD=-0.08, 95% CI: (-0.19, 0.03) for spherical equivalent; MD=-0.09, 95%CI: (-0.21, 0.03) for cylinder; MD=-0.09, 95% CI: (-0.27, 0.08) for sphere]. No difference was found for spectacle independence, posterior capsular opacification (PCO) incidence and patient satisfaction between bifocal IOLs and trifocal IOLs. [RR=0.89, 95% CI: (0.71, 1.12) for spectacle independence; RR=1.81, 95% CI: (0.50, 6.54) for PCO incidence; RR=0.98, 5% CI: (0.86, 1.12) for patient satisfaction]. Conclusion: Patients receiving trifocal IOLs, especially AT LISA tri 839M, have a better intermediate VA than those receiving bifocal IOLs. Near and distance visual performance, spectacle independence, postoperative refraction and surgical satisfaction of bifocal IOLs were similar to those of trifocal IOLs. Keywords: bifocal; trifocal; intraocular lenses; cataract surgery; randomized; IOLs; meta-analysis.

scholarly journals Comparison of Postoperative Visual Performance Between Bifocal and Trifocal Intraocular Lens Based on Randomized Controlled Trails: A Meta-Analysis

2019 ◽  
Author(s):  
Shanshan Jin ◽  
David S. Friedman ◽  
Kai Cao ◽  
Mayinuer Yusufu ◽  
Jingshang Zhang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Patient Satisfaction ◽  
Cataract Surgery ◽  
Clinical Performance ◽  
Meta Analysis ◽  
Intraocular Lenses ◽  
Visual Performance ◽  
Posterior Capsular Opacification ◽  
Randomized Controlled ◽  
Significant Difference

Abstract Background：To compare the clinical performance of bifocal and trifocal intraocular lenses (IOLs) in cataract surgery, a meta-analysis on randomized controlled trials was conducted. Methods: A comprehensive literature retrieval of PubMed, Science Direct and EMBASE was performed in this systematic review. Clinical outcomes included visual acuity (VA), contrast sensitivity (CS), spectacle independence, postoperative refraction and surgical satisfaction. Results: There were 8 RCTs included in this study. The difference of uncorrected near VA (UNVA) between the bifocal IOLs and trifocal IOLs had no significance [MD=0.02, 95%CI: (-0.03,0.06)]. There was no significant difference in the distant-corrected near VA (DCNVA) with MD of 0.04 [95%CI (-0.02, 0.10)]. Compared with trifocal group, the uncorrected intermediate visual acuity (UIVA) [MD=0.09,95%CI:(0.01,0.17)] was significantly worse in the bifocal group. No difference was found in distance-corrected intermediate VA(DCIVA) [MD= 0.09, 95%CI: (-0.04, 0.23)] between two groups. Analysis on AT LISA subgroup indicated the bifocal group had worse intermediate VA than trifocal group (AT LISA tri 839M) [MD= 0.18, 95%CI: (0.12, 0.24) for UIVA and MD= 0.19, 95%CI: (0.13, 0.25) for DCIVA]. However, there was no statistically significant difference between the two groups in the uncorrected distance VA(UDVA) and corrected distance visual acuity (CDVA) [MD=0.01, 95%CI: (-0.01,0.04) for UDVA; MD=0.00, 95%CI: (-0.01,0.01) for CDVA]. The postoperative refraction of bifocal group was similar to that of trifocal group [MD=-0.08, 95% CI: (-0.19, 0.03) for spherical equivalent; MD=-0.09, 95%CI: (-0.21, 0.03) for cylinder; MD=-0.09, 95% CI: (-0.27, 0.08) for sphere]. No difference was found for spectacle independence, posterior capsular opacification (PCO) incidence and patient satisfaction between bifocal IOLs and trifocal IOLs. [RR=0.89, 95% CI: (0.71, 1.12) for spectacle independence; RR=1.81, 95% CI: (0.50, 6.54) for PCO incidence; RR=0.98, 5% CI: (0.86, 1.12) for patient satisfaction]. Conclusion: Patients receiving trifocal IOLs, especially AT LISA tri 839M, have a better intermediate VA than those receiving bifocal IOLs. Near and distance visual performance, spectacle independence, postoperative refraction and surgical satisfaction of bifocal IOLs were similar to those of trifocal IOLs. Keywords: bifocal; trifocal; intraocular lenses; cataract surgery; randomized; IOLs; meta-analysis.

scholarly journals Comparison of Patient Outcomes following Implantation of Trifocal and Extended Depth of Focus Intraocular Lenses: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-17
Author(s):  
Yining Guo ◽  
Yinhao Wang ◽  
Ran Hao ◽  
Xiaodan Jiang ◽  
Ziyuan Liu ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Meta Analysis ◽  
Visual Disturbance ◽  
Intraocular Lenses ◽  
Cochrane Library ◽  
Depth Of Focus ◽  
Near Vision ◽  
Extended Depth Of Focus ◽  
Significant Difference ◽  
Comprehensive Search

Purpose. The purpose is to compare the outcomes of implantation of trifocal intraocular lenses (TIOLs) and extended depth of focus (EDOF) intraocular lenses (IOLs). Methods. A comprehensive search of PubMed, Cochrane Library, EMBASE, and ClinicalTrial.gov was conducted in March 2020 to identify relevant studies. A meta-analysis of the results was performed. Patients implanted with EDOF IOLs or TIOLs in previous studies were included. The primary outcomes of the study were uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), and defocus curve. Results. TIOLs and EDOF IOLs provided comparable binocular UDVA (MD = -0.01, 95% CI: -0.04, 0.03, logMAR). However, EDOF IOLs provided better UIVA (MD: -0.08, 95% CI: -0.14, -0.01, logMAR) and worse UNVA (MD: 0.10, 95% CI: 0.06, 0.14, logMAR) than TIOLs. Fewer patients achieved spectacle independence after implantation of EDOF IOLs (RR: 0.74, 95% CI: 0.63, 0.87) than after implantation of TIOLs, especially for near vision (RR = 0.82, 95% CI: 0.68, 0.99). There was no statistically significant difference in contrast sensitivity (CS) under photopic or mesopic conditions with both IOLs. Patient satisfaction after implantation of both IOLs was high. Conclusion. EDOF IOLs and TIOLs provide comparable distance vision. However, EDOF IOLs provide better intermediate vision and worse near vision than TIOLs. The advantages of EDOF IOLs over TIOLs in terms of CS, aberrations, and visual disturbance are not significant. Patients are satisfied with both types of IOLs.

scholarly journals Comparative Efficacy Between Trifocal and Bifocal Intraocular Lens Among Patients Undergoing Cataract Surgery: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Ziran Zhang ◽  
Haiyang Jiang ◽  
Hongwei Zhou ◽  
Fang Zhou
Keyword(s):  
Systematic Review ◽  
Cataract Surgery ◽  
Meta Analysis ◽  
Intraocular Lenses ◽  
Cochrane Library ◽  
Posterior Capsular Opacification ◽  
Comparative Efficacy ◽  
Patient’S Satisfaction ◽  
Randomized Controlled ◽  
Secondary Outcomes

The comparative efficacy of trifocal and bifocal intraocular lenses (IOLs) remained uncertain among patients undergoing cataract surgery. A systematic review and meta-analysis was performed to answer this question. PubMed, Cochrane Library and Embase were searched to capture relevant randomized controlled trials (RCTs). Visual acuity (VA) and patient's satisfaction were regarded as primary outcomes. Secondary outcomes included residual sphere, spherical equivalence, residual cylinder, posterior capsular opacification (PCO), spectacle independence, and other complications. Statistical analysis was done using RevMan 5.2.0. A total of 9 studies (11 RCTs) with 297 participants (558 eyes) were included. Meta-analysis showed significant differences between trifocal and bifocal IOLs in the uncorrected near VA (mean difference [MD], −0.008; 95% confidence interval [Cl], −0.015 to −0.001; P = 0.028) and uncorrected intermediate VA (MD, −0.06; 95% CI, −0.10 to −0.02; P < 0.01). Trifocal IOLs were associated with decreased PCO incidence when compared to bifocal IOLs (relative risk [RR], 0.54; 95% CI, 0.31 to 0.95; P = 0.03). Trifocal IOLs may be superior to bifocal IOLs because of its improved intermediate VA and reduced incidence of PCO.

scholarly journals Toric phakic IOLs in keratoconus—evaluation of preoperative parameters on the outcome of phakic anterior chamber lens implantation in patients with keratoconus

2021 ◽  
Author(s):  
Isaak R. Fischinger ◽  
Jascha Wendelstein ◽  
Kristin Tetz ◽  
Matthias Bolz ◽  
Manfred R. Tetz
Keyword(s):  
Visual Acuity ◽  
Anterior Chamber ◽  
Intraocular Lenses ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Significant Difference ◽  
Corrected Distance Visual Acuity ◽  
Lens Implantation ◽  
Efficacy Index ◽  
The Mean

Abstract Purpose To evaluate the influence of the type of the keratectasia and preoperative keratometry readings on the efficacy of implantation of iris-fixated phakic anterior chamber intraocular lenses (pIOL) in patients with keratoconus. Methods In this retrospective study, iris-fixated pIOLs (Artisan/Artiflex (Ophtec®), Verisyse/Veriflex (AMO®)) were implanted in 38 eyes of 22 patients with stable keratoconus. Thirty-six eyes underwent corneal crosslinking (CXL) prior to the lens implantation. The refractive outcome was evaluated 6 weeks postoperatively and the influence of preoperative refraction and topo- and tomographical factors were analyzed. Results The mean postoperative uncorrected distance visual acuity (UDVApost) was 0.25 ± 0.15 logMAR and was not statistically different from the mean preoperative corrected distance visual acuity (CDVApre), which was 0.24 ± 0.13 logMAR. Twenty-seven eyes (71%) reached UDVApost/CDVApre ≥ 1 (efficacy index), whereas patients with PMD-like ectasia (n = 14) showed significantly (p = 0.003) higher efficacy index (100%) than patients diagnosed with keratoconus (n = 24) (54%). Higher eccentricity of the maximum posterior elevation showed a significant beneficial influence on the efficacy index (p = 0.021). Furthermore, a higher Amsler-Krumeich stage and preoperative MAE were correlated with a worse UDVApost. The mean absolute spherical equivalent was significantly decreased from 5.71 ± 4.96 D to 1.25 ± 1.20 D (p < 0.001). No significant difference was found in endothelial cell count. Conclusion The results indicate that the implantation of phakic iris-fixated anterior chamber IOLs is a reasonable refractive option for patients with keratoconus. Keratoconus patients with a pellucidal marginal degeneration (PMD)-like appearance ectasia seem to benefit most from such procedures.

scholarly journals Corneal wavefront guided versus aberration free transepithelial photorefractive keratectomy in myopic patients with high pre-existing corneal higher order aberrations

2019 ◽  
Author(s):  
Amin Faisal Ellakwa ◽  
Marwa Ali Zaki ◽  
Rana Mohammed Ashour
Keyword(s):  
Visual Acuity ◽  
Higher Order ◽  
Single Step ◽  
Photorefractive Keratectomy ◽  
Higher Order Aberrations ◽  
Distance Visual Acuity ◽  
Randomized Controlled ◽  
Uncorrected Distance Visual Acuity ◽  
Significant Difference ◽  
Corrected Distance Visual Acuity

Abstract Objectives:to compare the efficacy, safety and predictability of corneal wavefront guided (WFG) and aberration free ablation in single-step transepithelial photorefractive keratectomy (TransPRK) in myopic patients with high pre-existing corneal higher order aberrations (HOAs). Background: Corneal WFG and aberration free treatments have been proposed as methods to achieve better visual, refractive, and optical outcomes. Methods:Non-randomized controlled trialwas conducted in El-HekmaEye-LASIK center, Menoufia governorate, Egypt during the period from January 2017 to December 2017. TransPRK was performed to eligible myopic patients with or without astigmatism with corneal HOAs ≥ 0.35 µmat 6 mm diameter utilizing either optimized (aberration free) or corneal WFG patterns (SCHWIND eye-tech-solutions, Kleinostheim, Germany). Uncorrected distance visual acuity (UDVA), manifest and cycloplegic refractions, best spectacle corrected distance visual acuity (CDVA), thorough slit lamp examination and corneal topography were assessed and repeated six months postoperatively. Results: Six months postoperatively, 97.6% and 100% of patients achieved MRSE within ± 1D with 76.2% and 66.67% of patients achieved UDVA of ≥20/20 in aberration free and corneal WFG groups respectively. Both groups showed increase in spherical and total corneal HOAs, with no significant difference in corneal WFG (p=0.08, p=0.28 respectively) while significantly higher postoperatively in aberration free group (p<0.001, p=0.001 respectively). Coma and trefoil aberrations declined after corneal WFG technique, yet increased after aberration free one. Conclusions: both aberration free and corneal WFG TransPRK were safe, effective and predictable in treatment of myopia in patients with high pre-existing corneal HOAs at 6 mm diameter with better aberrometric outcomes in corneal WFG group.

scholarly journals Comparison of Visual Performance between Refractive and Diffractive Multifocal Intraocular Lenses

2019 ◽  
Author(s):  
Lingying Ye ◽  
Tianyu Chen ◽  
Zhixiang Hu ◽  
Qiudong Su ◽  
Jin Li
Keyword(s):  
Visual Acuity ◽  
Life Quality ◽  
Optical Quality ◽  
Intraocular Lenses ◽  
Visual Performance ◽  
Distance Visual Acuity ◽  
Multifocal Intraocular Lenses ◽  
Good Visual Acuity ◽  
Significant Difference ◽  
Near Visual Acuity

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.

scholarly journals The Use of Propofol versus Dexmedetomidine for Patients Receiving Drug-Induced Sleep Endoscopy: A Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 10 (8) ◽  
pp. 1585
Author(s):  
Yi-Ting Chen ◽  
Cheuk-Kwan Sun ◽  
Kuan-Yu Wu ◽  
Ying-Jen Chang ◽  
Min-Hsien Chiang ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Sleep Endoscopy ◽  
Drug Induced ◽  
Randomized Controlled ◽  
Drug Induced Sleep Endoscopy ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
The Difference

The sedation outcomes associated with dexmedetomidine compared with those of propofol during drug-induced sleep endoscopy (DISE) remains unclear. Electronic databases (i.e., the Cochrane controlled trials register, Embase, Medline, and Scopus) were searched from inception to 25 December 2020 for randomized controlled trials (RCTs) that evaluated the sedation outcomes with dexmedetomidine or propofol in adult patients diagnosed with obstructive sleep apnea (OSA) receiving DISE. The primary outcome was the difference in minimum oxygen saturation (mSaO2). Five RCTs (270 participants) published between 2015 and 2020 were included for analysis. Compared with dexmedetomidine, propofol was associated with lower levels of mSaO2 (mean difference (MD) = −7.24, 95% confidence interval (CI) −12.04 to −2.44; 230 participants) and satisfaction among endoscopic performers (standardized MD = −2.43, 95% CI −3.61 to −1.26; 128 participants) as well as a higher risk of hypoxemia (relative ratios = 1.82, 95% CI 1.2 to 2.76; 82 participants). However, propofol provided a shorter time to fall asleep and a lower risk of failed sedation compared with dexmedetomidine. No significant difference was found in other outcomes. Compared with propofol, dexmedetomidine exhibited fewer adverse effects on respiratory function and provided a higher level of satisfaction among endoscopic performers but was associated with an elevated risk of failed sedation.

scholarly journals Corneal wavefront guided versus aberration free transepithelial photorefractive keratectomy in myopic patients with high pre-existing corneal higher order aberrations

2019 ◽  
Author(s):  
Amin Faisal Ellakwa ◽  
Marwa Ali Zaki ◽  
Rana Mohammed Ashour
Keyword(s):  
Visual Acuity ◽  
Higher Order ◽  
Single Step ◽  
Photorefractive Keratectomy ◽  
Higher Order Aberrations ◽  
Distance Visual Acuity ◽  
Randomized Controlled ◽  
Uncorrected Distance Visual Acuity ◽  
Significant Difference ◽  
Corrected Distance Visual Acuity

Abstract Objectives to compare the efficacy, safety and predictability of corneal wavefront guided (WFG) and aberration free ablation in single-step transepithelial photorefractive keratectomy (TransPRK) in myopic patients with high pre-existing corneal higher order aberrations (HOAs). Background Corneal WFG and aberration free treatments have been proposed as methods to achieve better visual, refractive, and optical outcomes. Methods Non-randomized controlled trailwas conducted in El-HekmaEye-LASIK center, Menoufia governorate, Egypt during the period from January 2017 to December 2017. TransPRK was performed to eligible myopic patients with or without astigmatism with corneal HOAs ≥ 0.35 µ utilizing either aberration free or corneal WFG patterns provided by ORKCAM software (SCHWIND eye-tech-solutions, Kleinostheim, Germany). Uncorrected distance visual acuity (UDVA), manifest and cycloplegic refractions, best spectacle corrected distance visual acuity (CDVA), thorough slit lamp examination and corneal topography were assessed and repeated six months postoperatively. Results Six months postoperatively, 97.6% and 100% of patients achieved MRSE within ± 1D with 76.2% and 66.67% of patients achieved UDVA of ≥20/20 in aberration free and corneal WFG groups respectively. Both groups showed increase in spherical and total corneal HOAs, with no significant difference in corneal WFG (p=0.08, p=0.28 respectively) while significantly higher postoperatively in aberration free group (p<0.001, p=0.001 respectively). Coma and trefoil aberrations declined after corneal WFG technique, yet increased after aberration free one. Conclusions both aberration free and corneal WFG TransPRK were safe, effective and predictable in treatment of myopia in patients with high pre-existing corneal HOAs with better aberrometric outcomes in corneal WFG group.

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