A comparative study of the visual outcomes between a new trifocal and an extended depth of focus intraocular lens

2017 ◽  
Vol 28 (2) ◽  
pp. 182-187 ◽  
Author(s):  
Ramón Ruiz-Mesa ◽  
Antonio Abengózar-Vela ◽  
María Ruiz-Santos

Purpose: To evaluate and compare the visual outcomes and ocular optical performance of the PanOptix trifocal intraocular lens (IOL) and Symfony extended range of vision IOL. Methods: Sixty-eight eyes of 34 patients were divided into 2 groups: 20 patients with the PanOptix IOL and 14 patients with the Symfony IOL. Binocular uncorrected distance visual acuity, best-corrected distance visual acuity (BCDVA), distance-corrected intermediate visual acuity (DCIVA) at 80 and 60 cm, and distance-corrected near visual acuity (DCNVA) at 40 cm were evaluated. Additionally, preferred reading distance with best-corrected distance and visual acuity at that distance, binocular defocus curves, mesopic and photopic contrast sensitivity, photic phenomena, and monocular total higher order aberrations (HOAs) were also measured. Results: The visual outcomes for PanOptix and Symfony IOL groups, respectively, were as follows: BCDVA: -0.03 ± 0.03 and -0.02 ± 0.03 logMAR; DCIVA at 80 cm: 0.06 ± 0.06 and 0.06 ± 0.04 logMAR; DCIVA at 60 cm: 0.06 ± 0.10 and 0.05 ± 0.04 logMAR; DCNVA: 0.04 ± 0.06 and 0.20 ± 0.07 logMAR (p<0.001). Similar preferred reading distances were found for both groups (37.0 ± 4.6 and 38.9 ± 5.7 cm, respectively). The visual acuities at those distances were 0.09 ± 0.08 and 0.19 ± 0.08 logMAR (p<0.001), respectively. The defocus curves showed significantly better outcomes for the PanOptix IOL from -2.0 to -4.0 D (p<0.001). No significant differences were found for contrast sensitivity, halometry, or HOAs between the groups. Conclusions: The PanOptix and Symfony IOLs showed comparable visual performance at distance and intermediate. However, the PanOptix IOL provided better near and preferred reading distance VAs and showed a more continuous range of vision than the Symfony IOL.

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Ugur Unsal ◽  
Gonen Baser

Purpose.To compare near, intermediate, and distance vision and quality of vision, when refractive rotational multifocal intraocular lenses with 3.0 diopters or diffractive multifocal intraocular lenses with 2.5 diopters near addition are implanted.Methods.41 eyes of 41 patients in whom rotational +3.0 diopters near addition IOLs were implanted and 30 eyes of 30 patients in whom diffractive +2.5 diopters near addition IOLs were implanted after cataract surgery were reviewed. Uncorrected and corrected distance visual acuity, intermediate visual acuity, near visual acuity, and patient satisfaction were evaluated 6 months later.Results. The corrected and uncorrected distance visual acuity were the same between both groups (p=0.50andp=0.509, resp.). The uncorrected intermediate and corrected intermediate and near vision acuities were better in the +2.5 near vision added intraocular lens implanted group (p=0.049,p=0.005, andp=0.001, resp.) and the uncorrected near vision acuity was better in the +3.0 near vision added intraocular lens implanted group (p=0.001). The patient satisfactions of both groups were similar.Conclusion. The +2.5 diopters near addition could be a better choice in younger patients with more distance and intermediate visual requirements (driving, outdoor activities), whereas the + 3.0 diopters should be considered for patients with more near vision correction (reading).


2017 ◽  
Vol 27 (4) ◽  
pp. 460-465 ◽  
Author(s):  
Ramón Ruiz-Mesa ◽  
Antonio Abengózar-Vela ◽  
Ana Aramburu ◽  
María Ruiz-Santos

Purpose To compare visual outcomes after cataract surgery with bilateral implantation of 2 intraocular lenses (IOLs): extended range of vision and trifocal. Methods Each group of this prospective study comprised 40 eyes (20 patients). Phacoemulsification followed by bilateral implantation of a FineVision IOL (group 1) or a Symfony IOL (group 2) was performed. The following outcomes were assessed up to 1 year postoperatively: binocular uncorrected distance visual acuity (UDVA), binocular uncorrected intermediate visual acuity (UIVA) at 60 cm, binocular uncorrected near visual acuity (UNVA) at 40 cm, spherical equivalent (SE) refraction, defocus curves, mesopic and photopic contrast sensitivity, halometry, posterior capsule opacification (PCO), and responses to a patient questionnaire. Results The mean binocular values in group 1 and group 2, respectively, were SE -0.15 ± 0.25 D and -0.19 ± 0.18 D; UDVA 0.01 ± 0.03 logMAR and 0.01 ± 0.02 logMAR; UIVA 0.11 ± 0.08 logMAR and 0.09 ± 0.08 logMAR; UNVA 0.06 ± 0.07 logMAR and 0.17 ± 0.06 logMAR. Difference in UNVA between IOLs (p<0.05) was statistically significant. There were no significant differences in contrast sensitivity, halometry, or PCO between groups. Defocus curves were similar between groups from 0 D to -2 D, but showed significant differences from -2.50 D to -4.00 D (p<0.05). Conclusions Both IOLs provided excellent distance and intermediate visual outcomes. The FineVision IOL showed better near visual acuity. Predictability of the refractive results and optical performance were excellent; all patients achieved spectacle independence. The 2 IOLs gave similar and good contrast sensitivity in photopic and mesopic conditions and low perception of halos by patients.


2016 ◽  
Vol 27 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Jose M. Martinez-de-la-Casa ◽  
Jesús Carballo-Alvarez ◽  
Javier Garcia-Bella ◽  
Jose M. Vazquez-Molini ◽  
Laura Morales ◽  
...  

Purpose To assess photopic and mesopic vision in patients implanted with 2 different trifocal intraocular lenses (IOLs). Methods Fifty patients with cataract in both eyes had surgery with bilateral implantation of a trifocal FineVision (FV, n = 25) or AT LISA tri 839MP (LisaTri, n = 25) IOL. Three months after surgery, high-contrast photopic uncorrected distance visual acuity and corrected distance visual acuity (CDVA) were determined using the Early Treatment Diabetic Retinopathy Study test. Intermediate (65 cm) and near (40 cm) visual acuity were also measured, both with best distance correction (DCIVA and DCNVA, respectively). The CSV1000 test chart was used for binocular and monocular contrast sensitivity. Defocus curves were constructed under photopic and mesopic conditions. Results Mean patient age was 68.4 ± 5.5 years (FV) and 67.3 ± 5.6 years (LisaTri) (p = 0.540). No differences were found in terms of visual acuity between the groups. The CDVA, DCIVA, and DCNVA were 0.05 ± 0.06, 0.25 ± 0.10, and 0.13 ± 0.10 logMAR for FV and -0.04 ± 0.11, 0.32 ± 0.09, and 0.12 ± 0.11 logMAR for LisaTri, respectively (p = 0.09, p = 0.08, and p = 0.12). Photopic and mesopic defocus curves were comparable between the 2 IOL groups (p>0.05). Mesopic values were significantly worse than photopic in both groups for all the measured values (p<0.001). No differences in contrast sensitivity were observed between the 2 IOL groups (p>0.05). Conclusions Both trifocal diffractive IOLs provided good visual quality with a statistically significant decrease in mesopic conditions.


2016 ◽  
Vol 16 (2) ◽  
pp. 23-27
Author(s):  
P Ziak ◽  
J Halicka ◽  
P Mojzis ◽  
M Kralik ◽  
J Nikel

Abstract Introduction: A cataract is a clouding of the lens in the eye leading to a decrease in vision. Cataracts are the cause of half of blindness and 33% of visual impairment worldwide. Surgery with phacoemulsification followed by implantation of intraocular lens (IOL) is gold standard treatment for cataract. In some cases multifocal IOLs are used. This is the first published use of rotational asymmetric multifocal IOL in cataract surgery in Slovakia. Method: In the study 78 eyes of 58 patients (mean age 62.3 years) were implanted for a cataract with the rotational asymmetric multifocal IOL. Corrected and uncorrected distance and near visual acuities were analysed preoperatively, 1 month and 6 months postoperatively. Contrast sensitivity was tested at 6 months postoperatively. The Friedman Two -Way Analysis of Variance and Multiple Comparison Test were used for all parameter comparisons, in all cases, the same level of statistical significance (p < 0.05) was considered significant. Results: Average preoperative uncorrected distance visual acuity has increased from 0.32 to 0.87 and 0.93 respectively in 1 month and 6 months after surgery (p < 0.05, n = 78). Average preoperative uncorrected near visual acuity (UCNVA) has increased from 0.2 to 0.77 and 0.79 respectively in 1 month and 6 months after surgery (p < 0.05). Average preoperative best corrected distance visual acuity has increased from 0.65 to 0.95 and 1.03 respectively in 1 month and 6 months after surgery (p < 0.05). Significant improvement was found also between preoperative best corrected near visual acuity and UCNVA 1 and 6 month after surgery (p < 0.05). In conclusion, the rotational asymmetric multifocal IOL LS-313 MF 30 provides good visual rehabilitation for near and distance vision after cataract surgery. Contrast sensitivity outcomes account for the patient satisfaction with this innovative IOL technology.


2021 ◽  
Vol 10 (17) ◽  
pp. 3776
Author(s):  
Majid Moshirfar ◽  
Rachel Huynh ◽  
Nour Bundogji ◽  
Alyson N. Tukan ◽  
Thomas M. Sant ◽  
...  

Previous studies have demonstrated safety and efficacy using 6.0 and 6.5 mm optical zones in the WaveLight EX500 Excimer Laser System but have not evaluated if differing optical zone sizes influence refractive outcomes. This study examines visual outcomes between two study populations undergoing LASIK with either a 6.0 mm (1332 patients) or 6.5 mm (1332 patients) optical zone. Outcomes were further stratified by severity of myopia (low, moderate, and high) and astigmatism (low and high). Patients were matched by age and preoperative manifest sphere and cylinder. Postoperative measurements were then compared. The 6.5 mm group demonstrated better postoperative manifest refractive spherical equivalent (MRSE), manifest sphere, and absolute value of the difference in actual and target spherical equivalent refraction (|∆ SEQ|), within the total population, moderate myopia, and low astigmatism groups, but this did not lead to improved postoperative uncorrected distance visual acuity (UDVA) or best corrected distance visual acuity (CDVA). Though astigmatic correction and postoperative angle of error were similar between optical zone sizes, they were significantly worse with high myopia. Overall, this study demonstrates differences in visual outcomes between the 6.0 and 6.5 mm optical zone sizes that may warrant consideration; however, essentially, the results are comparable between them.


2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Florian T. A. Kretz ◽  
Detlev Breyer ◽  
Vasilios F. Diakonis ◽  
Karsten Klabe ◽  
Franziska Henke ◽  
...  

Purpose.To evaluate visual, refractive, and contrast sensitivity outcomes, as well as the incidence of pseudophakic photic phenomena and patient satisfaction after bilateral diffractive trifocal intraocular lens (IOL) implantation.Methods. This prospective nonrandomized study included consecutive patients undergoing cataract surgery with bilateral implantation of a diffractive trifocal IOL (AT LISA tri 839MP, Carl Zeiss Meditec). Distance, intermediate, and near visual outcomes were evaluated as well as the defocus curve and the refractive outcomes 3 months after surgery. Photopic and mesopic contrast sensitivity, patient satisfaction, and halo perception were also evaluated.Results.Seventy-six eyes of 38 patients were included; 90% of eyes showed a spherical equivalent within ±0.50 diopters 3 months after surgery. All patients had a binocular uncorrected distance visual acuity of 0.00 LogMAR or better and a binocular uncorrected intermediate visual acuity of 0.10 LogMAR or better, 3 months after surgery. Furthermore, 85% of patients achieved a binocular uncorrected near visual acuity of 0.10 LogMAR or better.Conclusions.Trifocal diffractive IOL implantation seems to provide an effective restoration of visual function for far, intermediate, and near distances, providing high levels of visual quality and patient satisfaction.


2020 ◽  
Author(s):  
JUNJIE PIAO ◽  
Woong-Joo Whang ◽  
Choun-Ki Joo

Abstract Background This study clinically evaluated the visual outcomes after refractive surgery for myopia using femtosecond laser-assisted in situ keratomileusis (femto-LASIK) and epi-LASIK (flap-off). Methods In this prospective cohort study, 40 eyes of 27 patients were divided into two groups depending on the technique used for refractive surgery. Femto-LASIK flaps and epi-LASIK flaps (flap-off) were created using femtosecond laser and Epi-K TM epikeratome, respectively. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction (MR), corneal asphericity (Q-value), and corneal higher-order aberrations (HOAs) were assessed pre- and postoperatively. Results The improvement in LogMAR UDVA after refractive surgery was statistically significant for both groups ( P < 0.001 for all groups); it was significantly improved in the femto-LASIK group, 1 day and 1 week postoperatively ( P < 0.001, P = 0.019, respectively). With regard to the front and total corneal HOAs, there were significant differences in spherical aberrations (Z 4,0 ) between the femto-LASIK and flap-off epi-LASIK groups ( P = 0.016 and P = 0.017, respectively). With regard to the back corneal HOAs, there were significant differences in vertical coma (Z 3,-1 ) aberration, 0.027 ± 0.027 μm (femto-LASIK) and 0.001 ± 0.034 μm (flap-off epipolis LASIK); horizontal secondary astigmatism (Z 4,2 ) aberration, -0.008 ± 0.012 μm (femto-LASIK) and 0.007 ± 0.018 μm (flap-off epipolis LASIK); oblique tetrafoil (Z 4,-4 ) aberration, -0.008 ± 0.029 μm (femto-LASIK) and 0.015 ± 0.026 μm (flap-off epi-LASIK), respectively ( P = 0.018, P = 0.007, and P = 0.022, respectively). However, the back corneal HOA changes did not have a significant effect on the total corneal HOA changes. Conclusion Femto-LASIK yielded better early visual outcomes than did flap-off epi-LASIK, but there was no significant difference between the outcomes of the two procedures, 1 week postoperatively.


2019 ◽  
Author(s):  
Fang Liu ◽  
Ting Zhang ◽  
Quan Liu

Abstract Background: To investigate long term safety and efficacy of aspheric micro-monovision LASIK for correction of presbyopia and myop ic astigmatism. Methods: One hundred and fourteen eyes of 57 patients with a mean age 48 ± 4.05 years (range: 43 to 62 years) undergoing aspheric micro-monovision LASIK treatment using the MEL 80 excimer laser (Carl Zeiss Meditec AG, Jena, Germany) were enrolled. Visual acuity, manifest refraction, amplitude of accommodation and patients’ subjective rating was evaluated from 1 day to 3 years postoperatively. Results: There were no eyes in which spherical equivalent changed by over 0.75D between 1 day and 3 years. Ninety five percent of eyes were within ±0.50 D of target correction of spherical equivalent. The percentage of monocular uncorrected distance visual acuity ≧20/20 was 95%,and all eyes achieved 20/25 or better. The percentage of binocular uncorrected near visual acuity ≧J2 was 93%,and all patients achieved J4 or better. Ninety one percent of the patients could see uncorrected both 20/20 and J2 or better binocularly. Six percent (6/108) eyes lost 1 line and no eyes lost 2 lines of corrected distance visual acuity. The overall satisfaction score for surgery was 93±6. Conclusions: The aspheric micro-monovision LASIK using the Carl Zeiss Meditec MEL 80 Platform was an efficacious option for older myopia patients with presbyopia. Three years postoperative outcomes in Chinese population indicated improvements in uncorrected binocular vision at far and near distances with high satisfaction.


2020 ◽  
Vol 7 ◽  
Author(s):  
Dan Fu ◽  
Jing Zhao ◽  
Li Zeng ◽  
Xingtao Zhou

Purpose: To explore the safety, efficacy, and satisfaction of the PresbyMAX monocular mode for the correction of presbyopia.Methods: Prospective study. Twenty-two patients (mean age 50.6 ± 6.2 years, 11 myopia patients and 11 hyperopia patients) were enrolled. The dominant eye was fully corrected for distance vision; the non-dominant eye was corrected using central PresbyMAX monocular mode. Binocular uncorrected distance visual acuity (BUDVA), near visual acuity (BUNVA), intermediate visual acuity (BUIVA), corrected distance visual acuity (CDVA), and mean spherical equivalent (SE) were tested at 1 day, 1 week, 1 month, 3 months, and 1 year postoperatively. Questionnaire was performed preoperatively, 1 month, 3 months, and 1 year after surgery.Results: At the final visit, the mean safety index was 1.03 ± 0.14. There were 85.7% eyes with the same or better CDVA than the preoperative value, and 17.1% and 2.9% eyes gained 1 line and 2 lines of CDVA, respectively. All treated eyes achieved 20/25 or better BUDVA, and 95.5% achieved 20/32 or better BUNVA, which improved significantly compared with preoperative values (P &lt; 0.001). BUDVA maintained stability from 1 month postoperatively, BUNVA and BUIVA kept stable since 1 week after surgery. Overall satisfaction was 95.5% (21/22) at 3 months visit, and 100% at the last visit. No differences in terms of visual acuity and satisfaction were found between the myopia and hyperopia groups.Conclusion: The PresbyMAX monocular ablation profile was safe and effective in treating presbyopia, with great satisfaction achieved at postoperative 1 year.


2017 ◽  
Vol 28 (3) ◽  
pp. 287-293 ◽  
Author(s):  
Nikolaus Luft ◽  
Jakob Siedlecki ◽  
Walter Sekundo ◽  
Christian Wertheimer ◽  
Thomas C. Kreutzer ◽  
...  

Purpose: To evaluate the outcomes of myopic small incision lenticule extraction (SMILE) monovision in presbyopic patients. Methods: This study included 49 presbyopic patients older than 45 years seeking surgical correction of myopia or myopic astigmatism who underwent bilateral SMILE with planned monovision in the SMILE Eyes Clinic Linz, Austria. Target refraction was plano for dominant (distance) eyes and ranged between -1.25 and -0.50 D for nondominant (near) eyes. Best-corrected distance visual acuity, uncorrected distance visual acuity (UDVA), uncorrected near visual acuity, as well as spectacle dependence were assessed after a mean postoperative period of 7.2 ± 4.8 months. Results: Mean age was 49 ± 3 years and female to male ratio was 30:19. Distance eyes achieved a spherical equivalent correction of ±0.50 D from target refraction in 80% of patients and 96% were within ±1.0 D. Binocular UDVA of 20/20 or better was achieved by 90% of patients and all patients achieved 20/25 or better. The proportion of patients with a binocular UDVA of 20/20 or better who could read J2 or better amounted to 84%. Complete spectacle independence was achieved by 84% of patients and independence from reading glasses was achieved in 92% of cases. No patient requested refractive enhancement or monovision reversal. Conclusions: This first evaluation of SMILE monovision endorses the approach as a safe and effective option for the correction of presbyopia in myopic patients seeking refractive surgery.


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