Prevention of Hyperopic Surprise after LASIK in Patients with Refractive Multifocal Intraocular Lenses

2011 ◽  
Vol 21 (6) ◽  
pp. 826-829 ◽  
Author(s):  
César Albarrán-Diego ◽  
Gonzalo Muñoz ◽  
Teresa Ferrer-Blasco ◽  
Santiago García-Lázaro
Keyword(s):  
Intraocular Lenses ◽  
Laser In Situ Keratomileusis ◽  
Simple Method ◽  
Iol Implantation ◽  
Multifocal Iol ◽  
Multifocal Intraocular Lenses ◽  
Uncorrected Visual Acuity ◽  
Defocus Curve ◽  
Refractive Surprise

Purpose. Three cases of patients who developed a similar hyperopic defect in refraction following laser in situ keratomileusis (LASIK) after multifocal intraocular lens (IOL) implantation are described. Methods. Ophthalmologic evaluation including refractive status, corrected and uncorrected visual acuity (both at far and near), and corneal topography in patients presenting similar hyperopic refractive surprise in one eye as a result of LASIK refinement of residual ametropia after refractive multifocal IOL implantation. Results. Laser in situ keratomileusis enhancement for residual ametropia of −1.00 to −1.50 D in patients with a prior implantation of refractive multifocal IOL resulted in a refractive surprise of +2.25 to +2.50 D. After excluding other possible sources of error, an explanation for such a refractive surprise is suggested, and a simple method for avoiding this error is presented. Conclusions. Proper knowledge of the defocus curve and the use of a systematic method for determining subjective refraction in patients implanted with refractive multifocal IOLs will reduce the possibility of refractive surprise after LASIK enhancement in a bioptics procedure.

Predictability and Vector Analysis of Laser In Situ Keratomileusis for Residual Errors in Eyes Implanted With Different Multifocal Intraocular Lenses

Cornea ◽  
2016 ◽  
Vol 35 (11) ◽  
pp. 1404-1409 ◽  
Author(s):  
Marcony R. Santhiago ◽  
Bruna V. Ventura ◽  
Ramon C. Ghanem ◽  
Newton Kara-Junior ◽  
Haroldo V. Moraes ◽  
...  
Keyword(s):  
Intraocular Lenses ◽  
Vector Analysis ◽  
Laser In Situ Keratomileusis ◽  
Multifocal Intraocular Lenses ◽  
Residual Errors

scholarly journals MODERN ASPECTS OF MULTIFOCAL INTRAOCULAR CORRECTION: A REVIEW

2017 ◽  
Vol 72 (4) ◽  
pp. 268-275 ◽  
Author(s):  
T. A. Morozova ◽  
D. F. Pokrovskiy ◽  
I. B. Medvedev ◽  
T. Z. Kerimov
Keyword(s):  
Visual Acuity ◽  
Power Level ◽  
Visual Quality ◽  
Functional Results ◽  
Clinical Results ◽  
Intraocular Lenses ◽  
Multifocal Iol ◽  
Multifocal Intraocular Lenses ◽  
Uncorrected Visual Acuity ◽  
Additional Segment

During the last decade multifocal intraocular lenses (IOL) became widely used in cataract surgery and proved to be effective in recovery of visual functions. Lots of clinical studies with different multifocal IOL models showed high effectiveness of multifocal correction to achieve good visual quality for far, intermediate, and near distances. Uncorrected visual acuity at a distance is equal to multifocal and monofocal correction, while uncorrected near vision is significantly better with multifocal IOLs. Additional segment position in asymmetric multifocal IOL models did not significantly influence on visual acuity. Multiple multifocal IOL designs (bifocal, trifocal) and ADD power level provide different functional results for near and intermediate distances which allows to select the specific IOL model depending on the patient`s needs. The review covers the following aspects of multifocal intraocular correction: update for classification of multifocal IOLs, visual acuity (functional results) at different distances after multifocal IOL implantation, comparison of clinical results with different multifocal IOL designs and add power levels, influence of add segment position in asymmetric multifocal IOLs on visual quality, comparison between multifocal and monofocal correction.

scholarly journals Comparison of visual outcomes after implantation of AtLisa tri 839 MP and Symfony intraocular lenses

2020 ◽  
Vol 40 (10) ◽  
pp. 2553-2562
Author(s):  
Wojciech Lubiński ◽  
Karolina Podborączyńska-Jodko ◽  
Marta Kirkiewicz ◽  
Maciej Mularczyk ◽  
Michał Post
Keyword(s):  
Case Series ◽  
Cataract Extraction ◽  
Intraocular Lenses ◽  
Group Differences ◽  
Difficult Situation ◽  
Iol Implantation ◽  
Visual Outcomes ◽  
Defocus Curve ◽  
The Mean ◽  
Prospective Case Series

Abstract Purpose To compare visual outcomes after implantation of AtLisa tri 839 MP and Symfony intraocular lenses (IOLs). Methods All subjects underwent sequential bilateral cataract extraction with AtLisa tri 839 MP or Symfony IOL implantation. The design is prospective case series. Each group consists of 20 patients (40 eyes). At 1 year postoperatively, the following parameters were analysed: binocular uncorrected visual acuity (log MAR): for distance (UDVA) at 4 m, for intermediate distances (UIVA) at 60, 70, 80 cm and for near (UNVA) at 40 cm, defocus curve, mesopic and photopic contrast sensitivities (CSs), spectacle independence, visual function test questionnaire modified VFQ-25), photopic phenomena and postoperative complications. Results In the AtLisa tri 839 MP group, the mean binocular UNVA and UIVA were significantly better than in the Symfony group (UNVA: − 0.01 ± 0.04 vs. 0.21 ± 0.15; p = 0.000; 60 cm UIVA: − 0.01 ± 0.04 vs. 0.09 ± 0.09, p = 0.001; 70 cm UIVA − 0.05 ± 0.06 vs. 0.11 ± 0.08, p = 0.002; 80 cm UIVA − 0.01 ± 0.06 vs. 0.15 ± 0.08, p = 0.019). There were no significant between-group differences in the mean binocular UDVA and CS, with one exception: the mean binocular distance CS (18 cpd) under mesopic conditions was significantly better in the Symfony group than in the AtLisa tri 839 MP group (1.39 ± 0.22 vs. 1.17 ± 0.27; p = 0.015). The defocus curve analysis revealed significant between-group differences at vergences of 2.0 to − 4.0 D (p < 0.05), except for 2.0, 1.0, 0 and − 1.5. All subjects in AtLisa tri 839 MP group and 18 subjects (90%) in Symfony group were spectacle independent. Patients from both groups highly rated their overall vision quality in the VFQ-25 (1.67 ± 0.47 vs. 1.85 ± 0.5 in the Symfony and AtLisa tri 839 MP group, respectively, p = NS). The scores for daytime driving (1.00 ± 0.00 vs. 1.21 ± 0.36; p = 0.002), night driving (1.57 ± 0.55 vs. 2.13 ± 1.15; p = 0.027) and difficult situation driving (1.14 ± 0.31 vs. 1.53 ± 0.56; p = 0.049) were significantly better in the AtLisa tri 839 MP group than in the Symfony group. The incidence and perception level of halo and glare were significantly reduced (p = 0.00) in the Symfony group as compared to the AtLisa tri 839 MP group. The postoperative course was uneventful in all subjects. Conclusions Visual outcomes achieved with both IOLs are comparable. In both groups, 90% of patients achieved spectacle independence. Whereas the AtLisa tri 839 MP IOL implantation was associated with slightly better intermediate distance VA and significantly better near VA, photic phenomena were less perceived by patients with Symfony IOLs.

scholarly journals Correction of High Astigmatism after Penetrating Keratoplasty with Toric Multifocal Intraocular Lens Implantation

2017 ◽  
Vol 8 (2) ◽  
pp. 385-388 ◽  
Author(s):  
Raffaele Nuzzi ◽  
Francesca Monteu
Keyword(s):  
Intraocular Lens ◽  
Penetrating Keratoplasty ◽  
Multifocal Intraocular Lens ◽  
Iol Implantation ◽  
Multifocal Iol ◽  
Therapeutic Choice ◽  
Lens Implantation ◽  
Corneal Leukoma ◽  
Relaxing Incisions

After penetrating keratoplasty (PK), high astigmatism is often induced, being frequently about 4–6 dpt. According to the entity and typology of astigmatism, different methods of correction can be used. Selective suture removal, relaxing incisions, wedge resections, compression sutures, photorefractive keratectomy, and laser-assisted in situ keratomileusis can reduce corneal astigmatism and ametropia, but meanwhile they can cause a reduction in the corneal integrity and cause an over- or undercorrection. In case of moderate-to-high regular astigmatisms, the authors propose a toric multifocal intraocular lens (IOL) implantation to preserve the corneal integrity (especially in PK after herpetic corneal leukoma keratitis). We evaluated a 45-year-old patient who at the age of 30 was subjected to PK in his left eye due to corneal leukoma herpetic keratitis, which led to high astigmatism (7.50 dpt cyl. 5°). The patient was subjected to phacoemulsification and customized toric multifocal IOL implantation in his left eye. The correction of PK-induced residual astigmatism with a toric IOL implantation is an excellent choice but has to be evaluated in relation to patient age, corneal integrity, longevity graft, and surgical risk. It seems to be a well-tolerated therapeutic choice and with good results.

scholarly journals Two Different Corneal Incision Designs for Correcting Corneal Astigmatism During Cataract Surgery With Multifocal Intraocular Lens Implantation

2021 ◽  
Author(s):  
Dan Liu ◽  
Cong Fan ◽  
Chunyan Li ◽  
Jian Jiang
Keyword(s):  
Cataract Surgery ◽  
Corneal Astigmatism ◽  
Intraocular Lenses ◽  
Corneal Incision ◽  
Multifocal Iol ◽  
Clear Corneal Incision ◽  
Corneal Aberrations ◽  
Multifocal Intraocular Lenses ◽  
Post Surgery ◽  
The Mean

Abstract Background: Multifocal intraocular lenses (IOLs) is very intolerant to residual corneal astigmatism and patients with more than 1.0 D of residual corneal astigmatism are not suitable candidates for implantation of multifocal IOLs. The purpose of this study was to evaluate the efficacy of a single clear corneal incision (CCI) or an opposite clear corneal incision (OCCI) made on a steep meridian for correction of low to moderate corneal astigmatism during implantation of multifocal IOLs.Methods: This is a retrospective cohort study. A total of 50 patients with pre-operative total corneal astigmatism, ranging between 0.5 and 2.0 diopters (D), who underwent cataract surgery and received multifocal IOLs were included. Correction of corneal astigmatism was done via single CCIs on steep meridians in patients with 0.5–1.2 D total corneal astigmatisms, and OCCIs in patients with 1.3–2.0 D total corneal astigmatisms. Visual acuity, corneal astigmatism, ocular aberrations, corneal aberrations, and subjective vision quality were evaluated after surgery.Results: At 12-weeks post-surgery, the mean uncorrected distance vision (UCDV) was 0.06±0.09 logarithm of the minimum angle of resolution (logMAR) and 0.03±0.09 logMAR, and the mean uncorrected near vision (UCNV) was 0.08±0.11 logMAR and 0.09±0.09 logMAR in the CCI and OCCI groups, respectively. The change in corneal astigmatism was 0.52 ± 0.22D and 1.06 ± 0.23D in the CCI and OCCI groups, respectively (P<0.001). Total corneal higher-order aberrations (HOAs) and trefoil increased in both groups (P<0.05); however, there was no difference in the change in total corneal HOAs between the two groups (P>0.05). Conclusions: CCI and OCCI made on a steep axis could be an option for correction of mild-to-moderate astigmatism during cataract surgery with multifocal IOL implantation.

scholarly journals Comparison of visual performance between monofocal and multifocal intraocular lenses of the same material and basic design

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hirotaka Tanabe ◽  
Hitoshi Tabuchi ◽  
Tomohiro Shojo ◽  
Tomofusa Yamauchi ◽  
Kosuke Takase
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Wald Test ◽  
Intraocular Lenses ◽  
Visual Performance ◽  
Basic Design ◽  
Night Time ◽  
Multifocal Iol ◽  
Multifocal Intraocular Lenses ◽  
Near Visual Acuity

Abstract To compare the visual performance of a monofocal intraocular lens (IOL) (ZCB00) and a multifocal IOL (ZMB00) of the same material and basic design, we evaluated postoperative parameters at 10 weeks after the last surgery in cataract patients who underwent bilateral ZCB00 or ZMB00 implantation from December 13, 2010, to July 29, 2019, with the right and left lenses implanted within 3 months of each other. The study enrolled 2,230 eyes of 1,115 patients. The monofocal group comprised 904 eyes of 452 patients (72.3 ± 6.8 years; females/males, 268/184), and the multifocal group comprised 1,326 eyes of 663 patients (67.0 ± 7.8 years; females/males, 518/145). Contrast sensitivity (4.0/2.5/1.6/1.0/0.7 degrees), contrast sensitivity with glare (1.6/1.0/0.7 degrees), and the VFQ-25 score for driving at night were significantly better in the monofocal group (p < 0.00068, Wald test). Uncorrected intermediate/near visual acuity and near spectacle independence were significantly better in the multifocal group (p < 0.00068, Wald test). The two IOL groups had different characteristics in terms of contrast sensitivity, night-time driving, uncorrected intermediate/near visual acuity and near spectacle independence.

scholarly journals Long-Term Outcomes of Radial Keratotomy, Laser In Situ Keratomileusis, and Astigmatic Keratotomy Performed Consecutively over a Period of 21 Years

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Priyanka Chhadva ◽  
Florence Cabot ◽  
Anat Galor ◽  
Sonia H. Yoo
Keyword(s):  
Visual Acuity ◽  
Laser In Situ Keratomileusis ◽  
Radial Keratotomy ◽  
Manifest Refraction ◽  
Uncorrected Visual Acuity ◽  
Initial Improvement ◽  
Astigmatic Keratotomy ◽  
The Right

Purpose. To describe a case of 3 refractive procedures performed in one eye over 2 decades.Methods. Case report.Results. A 41-year-old patient presented for refractive surgery evaluation. His ocular history includes bilateral radial keratotomy performed 21 years ago for moderate myopia: spherical equivalence of −4.25 D bilaterally. Postoperative uncorrected visual acuity (UCVA) was 20/30; however, over time he developed a hyperopic shift and UCVA decreased to 20/40 in the right eye. Thus, laser-assisted in situ keratomileusis (LASIK) was performed at an outside institution 6.5 years later, and the patient had initial improvement of UCVA to 20/25. Due to a change in refractive error, the patient underwent uneventful astigmatic keratotomy 13 years after LASIK in the right eye, and 1.5 years after surgery best-corrected visual acuity was 20/25 with manifest refraction of −1.00+5.50×134°.  Conclusion. We report the outcomes and natural refractive progression in a patient who underwent three corneal refractive procedures over two decades. This case underlines the difficulties of long-term management of post-RK hyperopia and astigmatism.

Laser in situ Keratomileusis following the Implantation of Iris-Fixated Phakic Intraocular Lenses

2008 ◽  
Vol 222 (2) ◽  
pp. 69-73 ◽  
Author(s):  
Christian Meltendorf ◽  
Magdalena Cichocki ◽  
Thomas Kohnen
Keyword(s):  
Intraocular Lenses ◽  
Laser In Situ Keratomileusis ◽  
Phakic Intraocular Lenses
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