Clinical observation of multifocal intraocular lens with aspheric astigmatism in cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: By comparing the aspheric and multifocal Toric intraocular lens and the aspheric intraocular lens in cataract patients,to observe the patients` visual quality,to evaluate the patients` distance visual acuity,near visual acuity,Pseudo-accommodative power,residual astigmatism,the rotational stability of AcrySof IQ Toric Restor intraocular lens (IOLs),contrast the rate of off-distance glass,the rate of off-near glass and patient satisfaction after the implantation of AcrySof IQ Toric Restor IOL in the cataract patients with preexisting corneal astigmatism.METHODS:Carried out in 46 patients (48 eyes) with age-rated cataract who receiving phacoemulsification and implantation of artificial lens in our department during February 2014 to June 2016.All the cases were randomly divided into 2 groups: experimental group: 23 cases (24 eyes),AcrySof IQ ReSTOR Toric IOL was implanted after phacoemulsification;control group: 23 cases (24 eyes),AcrySof IQ was implanted.Uncorrected distance visual acuity (UCDVA) and best corrected distance visual acuity (BCDVA),uncorrected near visual acuity (UCNVA) and best-corrected near visual acuity(BCNVA),Pseudo-accommodative power,residual astigmatism,preoperative and postoperative corneal astigmatism,the rate of off-distance glass,the rate of off-near glass and patient satisfaction were measured at 6mo postoperatively follow-up.RESULTS: BCDVA and BCNVA were not statistically different between the two groups(P<0.05).At 1wk,1,3 and 6mo postoperatively of UCDVA the experimental group were statistically better than the control group (P<0.05).UCNVA were also statistically better than the control group (P<0.05).The mean residual astigmatisms 1wk,1,3 and 6mo postoperatively were statistically differences between the control group and experimental group (P<0.05).At 6mo postoperatively,patients satisfaction of experimental group were significantly better than control group (P<0.05).Spectacles independence for near vision achieved 83% and 17% in experimental group and control group,experimental group were statistically better than control group(P<0.05).Spectacles independence for distance vision achieved 92% and 67% in experimental group and control group,experimental group were statistically better than control group(P<0.05).CONCLUSION:The results indicate that AcrySof IQ ReSTOR Toric IOLs may provide a better uncorrected distance visual acuity and uncorrected near visual acuity,which can significantly reduce preexisting corneal astigmatism in cataract surgery,improve spectacles independence for distance vision and spectacles independence for near vision,have a high patient satisfaction.

Comparison of Improvement Rates between Distance and Near Visual Acuity in Children with Unilateral Amblyopia

PURPOSE: To compare the improvement rates of distance visual acuity (VA) with that of near VA in amblyopic eyes of children with unilateral amblyopia. METHODS: The medical records of children with unilateral amblyopia successfully treated with patching were reviewed. During subsequent visits for amblyopia treatment, subjects had best-corrected VA measured at 4 meters and 1/3 meters every 2 months. Duration of treatment to achieve equal VA between both eyes and improvement rates were compared between distance and near, and analyzed according to the cause and severity of amblyopia, or age. RESULTS: A total of 76 children with amblyopia due to anisometropia and/or strabismus started amblyopia treatment at a mean age of 5.8 years and were followed up during a mean period of 16.4 months. Baseline VA was better at near than at distance in 52 children (68.4%), and better at distance than at near in 4 (5.3%). The mean duration of treatment was 5.4 months at distance and 3.9 months at near. However, the improvement rate considering the amount of improvement of VA was faster at distance; 0.11 log MAR/month at distance, and 0.08 log MAR/month at near (p = 0.016). The improvement rate differences between distance and near did not differ based on the cause of amblyopia, or age, whereas in mild amblyopia the improvement rate of distance VA was significantly faster than near. Additionally, children with better initial near VA tended to have a faster improvement rate of distance VA. CONCLUSIONS: Although baseline VA was better at near than at distance in more patients, the improvement rate was faster at distance than at near. Children with better initial near VA appeared to have a faster improvement rate of distance VA.

Clinical Results of Crystalens(R) (AT-45) Accommodating Intraocular Lens

PURPOSE: To evaluate one-year clinical results of Crystalens(R) (AT-45, Eyeonics, CA, USA) accommodating IOL implantation. METHODS: In this retrospective study, 25 eyes of 18 patients had phacoemulsification and Crystalens(R) accommodating IOL implantation. Distance and near visual acuity (VA) during the 12-months were measured. RESULTS: At two months, uncorrected distance visual acuity (VA) of 13 eyes (52.0%) and 21 eyes (84.0%) were 20/25 and 20/40 or better, respectively. At six months, 11 eyes (44.0%) and 21 eyes (84.0%) were 20/25 and 20/40 or better, respectively. At 12 months, 11 eyes (44.0%) and 17 eyes (68.0%) were 20/25 and 20/40 or better, respectively. At two months, the uncorrected near VAs of 11 eyes (44.0%) and 17 eyes (68.0%) were 20/25 and 20/40 or better, respectively. At six months, 9 eyes (36.0%) and 16 eyes (64.0%) were 20/25 and 20/40 or better, respectively. After 12 months, 6 eyes (24.0%) and 16 eyes (64.0%) were 20/25 and 20/40 or better, respectively. CONCLUSIONS: The uncorrected near VAs gradually decreased with the passage of time until 12 months after Crystalens(R) accommodating IOL implantation.

Clinical Results of Crystalens(R) (AT-45) Accommodating Intraocular Lens

PURPOSE: To evaluate one-year clinical results of Crystalens(R) (AT-45, Eyeonics, CA, USA) accommodating IOL implantation. METHODS: In this retrospective study, 25 eyes of 18 patients had phacoemulsification and Crystalens(R) accommodating IOL implantation. Distance and near visual acuity (VA) during the 12-months were measured. RESULTS: At two months, uncorrected distance visual acuity (VA) of 13 eyes (52.0%) and 21 eyes (84.0%) were 20/25 and 20/40 or better, respectively. At six months, 11 eyes (44.0%) and 21 eyes (84.0%) were 20/25 and 20/40 or better, respectively. At 12 months, 11 eyes (44.0%) and 17 eyes (68.0%) were 20/25 and 20/40 or better, respectively. At two months, the uncorrected near VAs of 11 eyes (44.0%) and 17 eyes (68.0%) were 20/25 and 20/40 or better, respectively. At six months, 9 eyes (36.0%) and 16 eyes (64.0%) were 20/25 and 20/40 or better, respectively. After 12 months, 6 eyes (24.0%) and 16 eyes (64.0%) were 20/25 and 20/40 or better, respectively. CONCLUSIONS: The uncorrected near VAs gradually decreased with the passage of time until 12 months after Crystalens(R) accommodating IOL implantation.

Clinical Results of Unilateral Implantation of AMO Array Multifocal Intraocular Lens

PURPOSE: We evaluated the clinical results of unilateral implantation of AMO Array(r) intraocular lens in unilateral or bilateral cataract patients with minimum follow-up of 6 months. METHODS: This prospective study comprised two groups of 20 eyes each: one with AMO Array(r) intraocular lens(multi group) and the other with monofocal silicone intraocular lens(mono group). Main outcome measures were Snellen distance visual acuities; near acuities with Birkhauser reading chart. RESULTS: The difference between two groups in mean distance visual acuity was not statistically significant. Both monocular and binocular uncorrected near visual acuity in the multi group were significantly better than mono group. Four of 20 patients(20%) in monofocal group and 13 of 20 patients(65%) in multifocal group noticed light sensation(glare, halo etc.) after surgery, with the majority not being bothered by all of these. More than 90% patients were satisfied after surgery in both groups. CONCLUSIONS: With appropriate patient selection, near vision without spectacles was functionally acceptable in a majority of unilateral multifocal intraocular lens implantation cases. And, there was no significant problem in unilateral implantation of AMO Array intraocular lens. AMO Array lens can be used in unilateral cataract surgery.

Clinical Results of AMO ARRAY Multifocal Intraocular Lens

Various kinds of multifocal intraocular lenses(IOLs) have been developed for the improvement of near and far visual acuity after cataract operation. This prospective study was performed to compare a function of AMO ARRAY multifocal IOL(Array group) with conventional monofocal IOL(Mono group). Each type of IOL was implanted into 25 eyes and uncorrected visual acuity(UCVA) and best corrected visual acuity(BCVA) at near, intermediate and far distance were evaluated before and 2 months after operation in both groups. Contrast sensitivity, photophobia and glare were also evaluated as subjective symptoms in both groups. Mean UCVA at distant and near distance before operation was 0.23+/-0.15 and 0.25+/-0.20 in mono group, and 0.13+/-0.11 and 0.14+/-0.11 in Array group. Mean UCVA/BCVA at distant and near distance 2 month after operation was improved to 0.79+/-0.28/0.87+/-0.27 and 0.34+/-0.15/0.82+/-0.26 in mono group and 0.83+/-0.19/0.86+/-0.19 and 0.50+/-0.15/0.79+/-0.15 in Array group. The difference of UCVA at near distance was statistically significant(P<0.05), while that of BCVA at near and far distance was not statistically significant between two groups(P<0.05). Array group had less contrast sensitivity at all spatial frequencies(1.5, 3, 6, 12, 18 cycles/degree) and more glare than the mono group after operation. AMO ARRAY multifocal IOL induces a good result of visual rehabilitation in both near and far distance, but it may cause more glare and less contrast sensitivity than the monofocal IOL.