scholarly journals Maximising Refractive Outcomes with an Extended Depth of Focus IOL

2018 ◽  
Vol 12 (1) ◽  
pp. 273-280 ◽  
Author(s):  
Barry Power ◽  
Rory Murphy ◽  
Antonio Leccisotti ◽  
Tara Moore ◽  
William Power ◽  
...  
Keyword(s):  
Cohort Analysis ◽  
Visual Outcome ◽  
Corneal Astigmatism ◽  
Depth Of Focus ◽  
Extended Depth Of Focus ◽  
Refractive Outcomes ◽  
Department Of Ophthalmology ◽  
Induced Astigmatism ◽  
The Impact ◽  
Corneal Incisions

Objective: To assess the impact of the magnitude of preoperative and postoperative corneal astigmatism on refractive outcomes in patients undergoing cataract surgery or lens exchange with an extended depth of focus intraocular lens. To compare visual outcomes of steep and temporal on-axis corneal incisions. Setting: Department of Ophthalmology, Blackrock Clinic, Dublin, Ireland. Design: Prospective cohort analysis. Methods: Fifty-three consecutive adult patients (94 eyes) undergoing routine phacoemulsification with Symfony IOL implantation were analysed. Exclusion criteria: targets for mini-monovision, incomplete data, other ocular pathology. Data were prospectively collected on pre- and postoperative refraction, keratometry, distance vision, near vision, surgical wound site and Surgically Induced Astigmatism (SIA). Results: The average postoperative monocular Uncorrected Distance and Near visual acuities (UDVA and UNVA) were 0.12 LogMAR (± 0.1) (6/7.5+1) and 0.34 LogMAR (± 0.09) respectively. The average binocular UDVA and UNVA were 0.05 (± 0.07) and 0.29 LogMAR (± 0.06) respectively. Low levels of preoperative corneal astigmatism (0-0.99 D) were associated with better LogMAR UDVA and UNVA when compared with higher levels (> 0.99 D): 0.11 (CI 0.103-0.107) vs. 0.206 (CI 0.122-0.290) (p =0.015, CI 95%) and 0.33 (CI 0.316 - 0.356) vs. 0.39 (CI 0.34-0.43) (p =0.034, CI 95%) respectively. When patients with steep on-axis corneal incisions were compared with temporal on-axis corneal incisions, no difference was detected in visual outcome or SIA. Conclusion: The Symfony IOL is an effective surgical means of addressing presbyopia and reducing postoperative spectacle dependence. We stress caution when offering potential spectacle independence for patients with over 1D of preoperative corneal astigmatism as these patients achieve statistically significantly inferior and less predictable visual results.

scholarly journals Minimizing Surgically Induced Astigmatism at the Time of Cataract Surgery Using a Square Posterior Limbal Incision

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Paul Ernest ◽  
Warren Hill ◽  
Richard Potvin
Keyword(s):  
Cataract Surgery ◽  
Corneal Astigmatism ◽  
Intraocular Lenses ◽  
Corneal Incision ◽  
Surgically Induced Astigmatism ◽  
Clear Corneal Incision ◽  
Refractive Outcomes ◽  
Induced Astigmatism ◽  
Surgically Induced ◽  
Corneal Incisions

Purpose. To compare the surgically induced astigmatism from clear corneal and square posterior limbal incisions at the time of cataract surgery.Methods. Surgically induced astigmatism was calculated for a set of eyes after cataract surgery using a temporal 2.2 mm square posterior limbal incision. Results were compared to similar available data from surgeons using clear corneal incisions of similar size.Results. Preoperative corneal astigmatism averaged 1.0 D and was not significantly different between the incision types. Surgically induced astigmatism with the 2.2 mm posterior limbal incision averaged0.25±0.14 D, significantly lower in magnitude than the aggregate surgically induced astigmatism produced by the 2.2 mm clear corneal incision (0.68±0.49 D).Conclusion. The 2.2 mm square posterior limbal incision induced significantly less, and significantly less variable, surgically induced astigmatism relative to a similar-sized clear corneal incision. This is likely to improve refractive outcomes, particularly important with regard to premium intraocular lenses.

scholarly journals Prediction of surgically induced astigmatism in manual and femtosecond laser-assisted clear corneal incisions

2018 ◽  
Vol 28 (4) ◽  
pp. 398-405 ◽  
Author(s):  
Joaquín Fernández ◽  
Manuel Rodríguez-Vallejo ◽  
Javier Martínez ◽  
Ana Tauste ◽  
David P Piñero
Keyword(s):  
Femtosecond Laser ◽  
Corneal Astigmatism ◽  
Toric Intraocular Lens ◽  
Surgically Induced Astigmatism ◽  
Orthogonal Components ◽  
Induced Astigmatism ◽  
The Mean ◽  
Surgically Induced ◽  
Corneal Incisions ◽  
Intraocular Lens Calculation

Purpose: To assess the surgically induced astigmatism with femtosecond laser-assisted and manual temporal clear corneal incisions and to evaluate the performance of a model for prediction of the surgically induced astigmatism based on the preoperative corneal astigmatism. Methods: Clinical data of 104 right eyes and 104 left eyes undergoing cataract surgery, 52 with manual incisions and 52 with femtosecond laser-assisted incisions in each eye group, were extracted and revised retrospectively. In all cases, manual incisions were 2.2 mm width and femtosecond incisions were 2.5 mm width, both at temporal location. A predictive model of the surgically induced astigmatism was obtained by means of simple linear regression analyses. Results: Mean surgically induced astigmatisms for right eyes were 0.14D@65° (manual) and 0.24D@92° (femtosecond) (p > 0.05) and for left eyes, 0.15D@101° (manual) and 0.19D@104° (femtosecond) (p > 0.05). The orthogonal components of the surgically induced astigmatism (XSIA, YSIA) were significantly correlated (p < 0.05) with the preoperative orthogonal components of corneal astigmatism (Xpreop, Ypreop) (r = −0.29 for X and r = −0.1 for Y). The preoperative astigmatism explained 8% of the variability of the XSIA and 3% of the variability of YSIA. The postoperative corneal astigmatism prediction was not improved by the surgically induced astigmatism obtained from the model in comparison with the simple vector subtraction of the mean surgically induced astigmatism. Conclusion: Temporal incisions induce similar astigmatism either for manual or for femtosecond procedures. This can be clinically negligible for being considered for toric intraocular lens calculation due to the great standard deviation in comparison with the mean. The usefulness of the prediction model should be confirmed in patients with high preoperative corneal astigmatism.

A COMPARATIVE STUDY OF SURGICALLY INDUCED ASTIGMATISM IN SUPERIOR AND TEMPORAL SCLERAL INCISION IN MANUAL SMALL INCISION CATARACT SURGERY

2021 ◽  
pp. 1-3
Author(s):  
Nitu Kumari ◽  
Kumari Preeti ◽  
Alka Jha ◽  
Debarshi Jana
Keyword(s):  
Comparative Study ◽  
Cataract Surgery ◽  
Visual Outcome ◽  
Small Incision Cataract Surgery ◽  
Surgically Induced Astigmatism ◽  
Small Incision ◽  
Incision Size ◽  
Department Of Ophthalmology ◽  
Induced Astigmatism ◽  
Surgically Induced

Aim: To evaluate the amount and type of surgically induced astigmatism in superior and temporal scleral incision in Manual Small Incision Cataract Surgery (MSICS). Material and Methods: A prospective randomized comparative study was carried out in Upgraded Department of Ophthalmology, DMCH, Laheriasarai, Bihar. Total 100 cases of senile or pre-senile cataract included in this study from July 2019 to December 2019. All the patients underwent MSICS under peribulbar anaesthesia. The patients with very hard cataract were excluded so as to keep the incision size uniformity (6- 6.5mm). 50 cases received superior scleral incision and 50 cases received temporal scleral incision. Post operative astigmatism was studied in both groups using Bausch & Lomb Keratometer on 1st day, 7th day, 6th week and 3rd month. Results: After 3 months of surgery, out of 50 patients in superior scleral incision group 74% patients had ATR astigmatism and 16% patients had WTR astigmatism whereas in temporal scleral incision group 56 % of the patients had WTR astigmatism and 36 % had ATR astigmatism. The mean surgically induced astigmatism (SIA) in temporal incision group was signicantly less than the superior incision group after 3 months postoperatively (t=2.33, p<0.05). Conclusion: This study reveals that temporal approach MSICS produces less postoperative astigmatism and has manifold advantages over superior incision MSICS with excellent visual outcome.

scholarly journals Comparative Analysis of Visual Performance and Astigmatism Tolerance with Monofocal, Bifocal, and Extended Depth-of-Focus Intraocular Lenses Targeting Slight Myopia

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Jie Xu ◽  
Tianyu Zheng ◽  
Yi Lu
Keyword(s):  
Contrast Sensitivity ◽  
Significant Negative Correlation ◽  
Optical Quality ◽  
Corneal Astigmatism ◽  
Intraocular Lenses ◽  
Visual Performance ◽  
Depth Of Focus ◽  
Visual Outcomes ◽  
Extended Depth Of Focus ◽  
Visual Function Questionnaire

Purpose. To compare the visual performance and astigmatism tolerance of 3 intraocular lens (IOL) groups: monofocal, bifocal, and extended depth-of-focus (EDOF) IOLs targeting slight myopia. Methods. Overall, there were 60 cataract surgery eyes from 60 patients with implantation of a monofocal, bifocal, or EDOF IOL (20 eyes in each IOL group). The EDOF IOLs targeted slight myopia (−0.25 D to −0.75 D). Intragroup comparison of visual acuity, defocus curve, objective optical quality, contrast sensitivity, visual function questionnaire scores, patients’ overall satisfaction, and the astigmatism tolerance was performed 3 months after surgery. Results. The EDOF group provided equivalently excellent distance visual outcomes (0.06 ± 0.12) as the monofocal (0.06 ± 0.09) and bifocal (0.03 ± 0.09) groups P = 0.554 , better intermediate vision than the other 2 groups P < 0.05 , and similarly satisfactory near visual outcomes (0.23 ± 0.16 at 20 cm, and 0.17 ± 0.14 at 33 cm) as the bifocal group (0.28 ± 0.14 at 20 cm and 0.08 ± 0.10 at 33 cm) P > 0.05 . The contrast sensitivity of EDOF IOL was slightly decreased compared to that of monofocal IOL, but it was better than that of bifocal IOL. The EDOF group showed significantly higher satisfaction than the bifocal group did when preoperative corneal astigmatism was 0.75 D or greater P = 0.009 . A significant negative correlation between the corneal astigmatism and patient satisfaction was observed in only the bifocal group. Conclusions. The EDOF IOLs targeting slight myopia offered satisfactory visual outcomes at an extended range from far to near distances. The EDOF and monofocal IOLs showed a better tolerance to astigmatism than did the bifocal IOL.

scholarly journals The effect of tunnel length and position on postoperative corneal astigmatism: An optical coherence tomographic study

2018 ◽  
Vol 30 (1) ◽  
pp. 104-111
Author(s):  
Serap Sonmez ◽  
Cagatay Karaca
Keyword(s):  
The Other ◽  
Corneal Astigmatism ◽  
Tunnel Length ◽  
Corneal Incision ◽  
Surgically Induced Astigmatism ◽  
Clear Corneal Incision ◽  
Induced Astigmatism ◽  
Short Tunnel ◽  
Surgically Induced ◽  
Corneal Incisions

Purpose: The purpose of this study is to evaluate the effects of variation in tunnel length of same-sized clear corneal phacoemulsification incisions on the generation of surgically induced astigmatism and corneal astigmatism. Methods: A total of 126 cataract patients treated in four study groups based on location and tunnel length of the clear corneal incisions (superior long, superior short, temporal long, temporal short) were reviewed. In the short tunnel groups, a 2.8 mm keratome was used with a motion parallel to the iris surface, while in the long tunnel groups, the same keratome was advanced in the corneal stroma until the mark on the keratome was reached. The surgically induced astigmatism and the corneal astigmatism were measured with corneal topography. The tunnel lengths were determined by anterior segment optical coherence tomography. Results: The tunnel lengths of the long tunnel groups were significantly longer than the short tunnel groups. The total and anterior corneal surgically induced astigmatism of the superior long group was significantly higher than the other groups. Posterior corneal surgically induced astigmatism was similar. The postoperative total and anterior corneal astigmatism values of the superior long group was significantly higher than the other groups. No difference was observed for mean change in corneal astigmatism between the groups. Conclusion: The tunnel length of a clear corneal incision is a significant determinant of surgically induced astigmatism for superior placed corneal incisions. Therefore, for superiorly positioned clear corneal incision, the incision should be rectangular with a shorter tunnel to keep the surgically induced astigmatism to a minimum. For squarer-shaped clear corneal incision, limbal-temporal incisions may be performed for astigmatic neutrality.

scholarly journals Effect of femtosecond laser-assisted steepest-meridian clear corneal incisions on preexisting corneal regular astigmatism at the time of cataract surgery

2020 ◽  
Vol 13 (12) ◽  
pp. 1895-1900
Author(s):  
Wei Chen ◽  
Jian Wu ◽  
Yong Wang ◽  
Jing Zhou ◽  
Rong-Rong Zhu ◽  
...  
Keyword(s):  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Corneal Astigmatism ◽  
Corneal Incision ◽  
Surgically Induced Astigmatism ◽  
Clear Corneal Incision ◽  
Case Series Study ◽  
Induced Astigmatism ◽  
Surgically Induced ◽  
Corneal Incisions

AIM: To investigate the clinical efficacy and safety of femtosecond laser-assisted steepest-meridian clear corneal incisions for correcting preexisting corneal astigmatism performed at the time of cataract surgery. METHODS: This prospective case series study comprised consecutive age-related cataract patients with corneal regular astigmatism (range: +0.75 to +2.50 D) who had femtosecond laser-assisted steepest-meridian clear corneal incisions (single or paired). Corneal astigmatism was performed with the Pentacam preoperatively and 3mo postoperatively. Total corneal astigmatism and steepest-meridian measured in the 3-mm central zone were used to guide the location, size and number of clear corneal incision. The vector analysis of astigmatic change was performed using the Alpins method. RESULTS: Totally 138 eyes of 138 patients were included. The mean preoperative corneal astigmatism was 1.31±0.41 D, and was significantly reduced to 0.69±0.34 D (equivalent to difference vector) after surgery (P<0.01). The surgically-induced astigmatism was 1.02±0.54 D. The correction index (ratio of target induced astigmatism and surgically-induced astigmatism: 0.72±0.36) as well as the magnitude of error (difference between surgically-induced astigmatism and target induced astigmatism: -0.29±0.51) represented a slight under correction. For angle of error, the arithmetic mean was 1.11±13.70, indicating no significant systematic alignment errors. CONCLUSION: Femtosecond-assisted steepest-meridian clear corneal incision is a fast, customizable, adjustable, precise, and safe technique for the reduction of low to moderate corneal astigmatism during cataract surgery.

scholarly journals Correcting Corneal Astigmatism with Corneal Arcuate Incisions during Femtosecond Laser Assisted Cataract Surgery

2019 ◽  
Vol 7 (24) ◽  
pp. 4260-4265 ◽  
Author(s):  
Nguyen Xuan Hiep ◽  
Pham Thi Minh Khanh ◽  
Do Quyet ◽  
Than Van Thai ◽  
Vu Thi Nga ◽  
...  
Keyword(s):  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Modern Method ◽  
Corneal Astigmatism ◽  
Spherical Equivalent ◽  
Efficacy And Safety ◽  
Interventional Study ◽  
Corrected Distance Visual Acuity ◽  
Induced Astigmatism ◽  
Corneal Incisions

BACKGROUND: Astigmatic management is an important step to achieve the best visual quality after refractive cataract surgery. Nowadays, along with progress in cataract surgery, the femtosecond laser can produce the arcuate incisions high precisely that help the astigmatic correction. In Vietnam, it has not yet any study about this issue, so we perform this study. AIM: To assess the efficacy and safety of arcuate corneal incisions in treatment corneal astigmatism during femtosecond laser-assisted cataract surgery. METHODS: In this clinical interventional study, forty-five cases with cataract and corneal astigmatism (> 0.50D) were treated with corneal arcuate incisions and femtosecond-laser assisted cataract surgery in Vietnam National Institute of Ophthalmology, from January 2017 to May 2018. The uncorrected and corrected distance visual acuity, refraction spherical equivalent, corneal astigmatism were measured (using an OPD-Scan III topographer) before, 1 week and 3 months after surgery. Some features of arcuate corneal incisions (quantity, depth, length and morphology), spectacle independence at a distance and complications were recorded. RESULTS: The rate of postoperative spherical refraction equivalent was within ± 0.50D and ± 1.0D at 3 months (in 95.6% and 100% of the eyes respectively). Mean length of arcuate corneal incisions was 53.78o ± 17.683o (range: 20o to 85o). The average of preoperative corneal astigmatism was 1.65 ± 0.83D, decreased to 0.59 ± 0.549D in the third month after surgery. Surgical induced astigmatism was 1.05 ± 0.449D and lower than preoperative corneal astigmatism (1.65 ± 0.83D), thereby this indicated undercorrection. However, the rate of spectacle independence was 82.3%, and no complications were recorded. CONCLUSION: Correcting of corneal astigmatism in femtosecond laser-assisted cataract surgery combined with the formation of the arcuate incisions is a new and modern method for high safety and efficacy.

Clinical outcome and higher order aberrations after bilateral implantation of an extended depth of focus intraocular lens

2018 ◽  
Vol 28 (4) ◽  
pp. 425-432 ◽  
Author(s):  
Daniel Pilger ◽  
David Homburg ◽  
Tobias Brockmann ◽  
Necip Torun ◽  
Eckart Bertelmann ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Clinical Outcome ◽  
Intraocular Lens ◽  
Intraocular Lenses ◽  
Depth Of Focus ◽  
Low Contrast ◽  
Santa Ana ◽  
Extended Depth Of Focus ◽  
Medical Optics ◽  
Department Of Ophthalmology

Purpose: The purpose of this study was to assess the clinical outcome after a bilateral implantation of an extended depth of focus intraocular lens in comparison to a monofocal intraocular lens. Setting: Department of Ophthalmology, Charité—Medical University Berlin, Germany. Patients and Methods: A total of 60 eyes of 30 patients were enrolled in this prospective, single-center study. The cataract patients underwent phacoemulsification with bilateral implantation of a TECNIS® Symfony (Abbott Medical Optics, Santa Ana, CA, USA, 15 patients) or a TECNIS Monofocal ZCB00 (Abbott Medical Optics, Santa Ana, CA, USA, 15 patients). Postoperative evaluations were performed after 1 and 3 months, including visual acuities at far, intermediate, and near distance. Mesopic, scotopic vision, and contrast sensitivity were investigated. Aberrometry was performed using an iTrace aberrometer with a pupil scan size of 5.0 mm. Results: After 3 months, the TECNIS Symfony group reached an uncorrected visual acuity at far distance of −0.02 logMAR compared to −0.06 logMAR in the TECNIS Monofocal group ( p = 0.03). Regarding the uncorrected vision at intermediate and near distance the following values were obtained: intermediate visual acuity −0.13 versus 0.0 logMAR (TECNIS Symfony vs TECNIS Monofocal, p = 0.001) and near visual acuity 0.11 versus 0.26 logMAR (TECNIS Symfony vs TECNIS Monofocal, p = 0.001). Low-contrast visual acuities were 0.27 versus 0.20 logMar (TECNIS Symfony vs TECNIS Monofocal, p = 0.023). Conclusion: The TECNIS Symfony intraocular lens can be considered an appropriate alternative to multifocal intraocular lenses because of good visual results at far, intermediate, and near distance as well as in low-contrast vision.

scholarly journals Incisional correction of corneal astigmatism during ‎phacoemulsification – a randomized trial

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 825
Author(s):  
Najah K. Mohammad ◽  
Tamer F. Elewa ◽  
Enas B. Aldehaimy ◽  
Tareq A. Almamoun
Keyword(s):  
Randomized Trial ◽  
Refractive Surgery ◽  
Corneal Astigmatism ◽  
P Value ◽  
Efficacy And Safety ◽  
Interventional Study ◽  
Corneal Incision ◽  
Clear Corneal Incision ◽  
Induced Astigmatism ◽  
Corneal Incisions

Background: Phacoemulsification is regarded as a type of refractive surgery by which it is possible to ‎reduce pre-existing corneal stigmatism.‎ This study aimed to evaluate the efficacy and safety of on-axis corneal incision with or without opposite clear corneal incisions (OCCI) to correct preoperative corneal astigmatism during uncomplicated phacoemulsification ‎surgeries.‎ Methods: A randomized, prospective, parallel two-arm interventional study, which included a ‎total 40 eyes from 40 patients, was conducted.‎ Patients were divided into two groups: 20 patients as controls underwent phacoemulsification with on-axis incision (CCI group), and 20 patients underwent phacoemulsification with OCCI (OCCI group). Results: Mean astigmatic correction was significantly higher in the OCCI group (0.665 vs 0.265 diopters, p-value <0.001), compared to the CCI group. Most of the parameters (surgical induced astigmatism, magnitude of error, and correction index) were significantly higher in the OCCI group compared to the CCI group (p-value <0.01). There were no ‎incision-related complications. Conclusions: Both incisional methods are useful methods for correction of preoperative corneal ‎astigmatism but OCCIs correct a higher amount of astigmatism than the on-axis clear ‎corneal incision.‎ Registration: ClinicalTrials.gov NCT04418986 (05/06/2020).

scholarly journals SOCIO-DEMOGRAPHIC PROFILE OF THE PATIENTS WITH OCULAR TRAUMA

2019 ◽  
Vol 3 (7) ◽  
Author(s):  
Dr. Ashay Rameshwar Dangare ◽  
Dr Amit Ashok Surana
Keyword(s):  
Ocular Trauma ◽  
Age Groups ◽  
Visual Outcome ◽  
Entire Study ◽  
Medical College ◽  
Department Of Ophthalmology ◽  
Health Care Unit ◽  
One Year ◽  
Human Eyes ◽  
The Impact

Background: Ocular trauma is an important cause of preventable visual morbidity, particularly among younger age groups as shown by different studies worldwide. The impact of trauma on the human eyes may range from minute corneal abrasions/innocuous subconjunctival haemorrhage to a badly lacerated globe.Aim: To study the Socio-demographical profile of the patients with ocular traumaMethods: An observational study was carried out at the Department Of Ophthalmology, Burdwan Medical College and Hospital, a tertiary health care unit of West Bengal. The entire study was conducted after proper consultation and recommendations from the ethical committee. The research was carried out during a period of one year (01/03/2010 to 28/02/2011). A total of 120 patients were taken into consideration for the scope of the study.Results: The patients were aged between 0-50 years were mostly suffered most ocular injuries. The research also showed that the majority of the affected patients were males, i.e. 75%. Furthermore, in the course of the study, the majority of the patients belonged to the rural population, i.e. 71.5%.Conclusion: This study indicates that ocular trauma is a significant cause of monocular and sometimes binocular visual loss in all age groups. Many injuries and their visual outcome may be prevented through education and prompt, appropriate medical care.

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