Prospective Comparison of Clinical Performance and Subjective Outcomes Between Two Diffractive Trifocal Intraocular Lenses in Bilateral Cataract Surgery

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.

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Association between conventional or blue light-filtering intraocular lenses and survival in bilateral cataract surgery patients

iScience ◽

10.1016/j.isci.2020.102009 ◽

2020 ◽

pp. 102009

Author(s):

John E. Griepentrog ◽

Xianghong Zhang ◽

Oscar C. Marroquin ◽

Michael B. Garver ◽

AnnaElaine L. Rosengart ◽

...

Keyword(s):

Cataract Surgery ◽

Blue Light ◽

Intraocular Lenses ◽

Bilateral Cataract

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Simultaneous Bilateral Cataract Surgery in Premature Babies With and Without Retinopathy of Prematurity

US Ophthalmic Review ◽

10.17925/usor.2013.06.02.94 ◽

2013 ◽

Vol 06 (02) ◽

pp. 94

Author(s):

William F Astle ◽

Andrea Papp ◽

Eva Stifter ◽

Emi Sanders ◽

◽

...

Keyword(s):

Cataract Surgery ◽

Contact Lenses ◽

Glaucoma Surgery ◽

Intraocular Lenses ◽

Posterior Chamber ◽

Bilateral Cataract ◽

Premature Babies ◽

Primary Implantation ◽

Visual Correction

Background:Four premature babies (eight eyes) undergoing simultaneous bilateral cataract surgery are presented and discussed.Methods:All four babies underwent simultaneous bilateral cataract surgery. Three babies (six eyes) had primary implantation of posterior chamber intraocular lenses (IOLs) and one baby (two eyes) had primary lensectomies with secondary visual correction with contact lenses. Results: In all eight eyes, there was no endophthalmitis and no spontaneous choroidal hemorrhages. All eyes experienced large myopic shifts, as high as –15.00 D. All six eyes with IOLs required secondary membranectomies, which did not reoccur. Case 4 had Lowe’s syndrome, was bilaterally aphakic post-op, and subsequently developed glaucoma requiring bilateral glaucoma surgery. Conclusions: Simultaneous bilateral cataract surgery in severely premature babies can be successful in restoring vision over the long term. Strategies to successfully deal with the timing of surgery, IOLs, secondary membranes, secondary glaucoma, appropriate IOL powers, and IOL formulas is discussed. Successful long-term successful visual outcomes are now possible in this complex group of premature babies.

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IMMEDIATELY SEQUENTIAL BILATERAL CATARACT SURGERY - «FOR» AND «CONS»

Clinical Practice ◽

10.17816/clinpract89585 ◽

2021 ◽

Author(s):

Dmitry Fedorovich Pokrovskiy

Keyword(s):

Cataract Surgery ◽

Intraocular Lenses ◽

Refractive Errors ◽

Careful Selection ◽

Bilateral Cataract ◽

Intracameral Antibiotics ◽

Pros And Cons ◽

Safety Recommendations ◽

Selection Of Patients ◽

Selection Of

This review presents the main pros and cons of Immediately Sequential Bilateral Cataract Surgery (ISBCS) versus Delayed Sequential Bilateral Cataract Surgery (DSBCS). The main arguments against ISBCS versus DSBCS are the likelihood of postoperative bilateral endophthalmitis and refractive errors. At the same time, careful selection of patients, the implementation of safety recommendations and the use of intracameral antibiotics, combined with the improvement of formulas for calculating intraocular lenses, provide the advantages of ISBCS associated with the rapid rehabilitation of patients after surgery and economic reasons.

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Limitations in cataract surgical services for children in Ethiopia: a nationwide survey of pediatric cataract surgeons

BMC Ophthalmology ◽

10.1186/s12886-021-02190-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mulusew Asferaw ◽

Kumale Tolesa ◽

Sadik Taju Sherief ◽

Bezawit Tadegagne ◽

Mandefro Sintayehu ◽

...

Keyword(s):

Cataract Surgery ◽

Addis Ababa ◽

Nationwide Survey ◽

Intraocular Lenses ◽

World Health ◽

Pediatric Ophthalmology ◽

Pediatric Cataract ◽

Factors Affecting ◽

Bilateral Cataract ◽

Health Organization

Abstract Background Bilateral cataract is a significant cause of blindness in children in Ethiopia. This study aimed to identify the resources available for cataract surgery in children, and to assess current surgical practices, surgical output and factors affecting the outcome of surgery in Ethiopia. Methods A Google Forms mobile phone questionnaire was emailed to nine ophthalmologists known to perform cataract surgery in young children (0–5 years). Results All nine responded. All but one had received either 12- or 3–5-month’s training in pediatric ophthalmology with hands-on surgical training. The other surgeon had received informal training from an experienced colleague and visiting ophthalmologists. The surgeons were based in seven health facilities: five in the capital (Addis Ababa) and eight in six public referral hospitals and one private center. Over 12 months (2017–2018) 508 children (592 eyes) aged 0–18 years (most < 15 years) were operated by these surgeons. 84 (17%) had bilateral cataract, and 424 (83%) had unilateral cataract mainly following trauma. A mean of 66 (range 18–145) eyes were operated per surgeon. Seventy-one additional children aged > 5 years were operated by other surgeons. There were substantially fewer surgeons per million population (nine for 115 million population) than recommended by the World Health Organization and they were unevenly distributed across the country. Methylcellulose and rigid intraocular lenses were generally available but less than 50% of facilities had a sharp vitrectomy cutter and cohesive viscoelastic. Mean travel time outside Addis Ababa to a facility offering pediatric cataract surgery was 10 h. Conclusion Despite the high number of cases per surgeon, the output for bilateral cataracts was far lower than required. More well-equipped pediatric ophthalmology teams are urgently required, with deployment to under-served areas.

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

10.21203/rs.1.10/v4 ◽

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.

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