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AIM: To compare the short-term postoperative visual acuity, visual disturbance phenomena, and spectacle independence rate in patients who underwent monocular implantation with trifocal, multifocal, or extended range of vision intraocular lens(IOL).METHODS: A retrospective analysis was conducted on 67 cataract patients(67 eyes)who underwent phacoemulsification cataract extraction combined with IOL implantation from March 2019 to December 2022. A total of 35 cases(35 eyes)received Symfony extended range of vision IOL implantation, 21 cases(21 eyes)received AcrySof IQ ReSTOR +3D multifocal IOL, and 11 cases(11 eyes)received AcrySof IQ PanOptix trifocal IOL. The preoperative uncorrected distance visual acuity(UDVA), uncorrected intermediate visual acuity(UIVA), and uncorrected near visual acuity(UNVA)and 3 mo postoperatively were documented. Moreover, defocus curves, visual disturbance phenomena, and spectacle independence rates were recorded at 3 mo postoperatively.RESULTS: At 3 mo postoperatively, no statistically significant differences were observed in UDVA among the three groups(P>0.05). A comparison of UIVA showed superior results in the Symfony and PanOptix groups compared to the ReSTOR group(all P<0.01). The UNVA of both the ReSTOR and PanOptix groups outperformed the Symfony group(all P<0.01). The defocus curves indicated that in the intermediate vision range(-1.00 to -1.50 D), the Symfony group exhibited better performance than the ReSTOR group(P<0.05); while in the near vision range(-2.50 to -3.50 D), the ReSTOR group was superior to the Symfony group(P<0.05). The PanOptix group demonstrated superior visual acuity in the near vision range(-2.00 to -3.50 D)compared to the Symfony group(P<0.05)and was also superior in the intermediate vision range(-1.00 to -2.00 D)compared to the ReSTOR group(P<0.05). No significant differences were observed in the incidence of glare or halo and binocular interference phenomena among the three groups(P>0.05). The PanOptix and ReSTOR groups exhibited a higher spectacle independence rate compared to the Symfony group(P<0.0167).CONCLUSION: Compared to Symfony extended range of vision IOL and ReSTOR multifocal IOL, PanOptix trifocal IOL offers a balanced approach to distance, intermediate, and near visual acuity, without a high incidence of glare and halo, and with a higher spectacle independence rate. Caution is still advised when considering monocular implantation with presbyopia-correcting IOLs.
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AIM: To evaluate the clinical efficacy of femtosecond laser-assisted cataract surgery combined with PanOptix trifocal intraocular lens implantation.METHODS:The retrospective study enrolled 22 cases(26 eyes)of cataract patients who underwent femtosecond laser-assisted cataract surgery combined with PanOptix trifocal intraocular lens implantation from August 2020 to August 2021. Follow-up to 3mo after surgery, the changes of far, intermediate and near visual acuity, aberration, Strehl ratio(SR)and modulation transfer function cutoff(MTF-cutoff)frequency were compared. Defocus curve at 1mo postoperatively was made, and the visual quality and satisfaction were evaluated after 3mo of surgery.RESULTS: The visual acuity of all patients was better than 0.1(LogMAR)at the far, intermediate and near distance at 1d, 1wk, 1 and 3mo postoperatively, and it was significantly improved compared with those before surgery(all P<0.01). The defocus curve transitioned smoothly between +0.5 and -3.0D at 1mo after surgery, and visual acuity was better than 0.63. The total aberration and spherical aberration in the whole eye were significantly lower after surgery than before, and the SR and MTF-cutoff were significantly improved at 1d and 1wk after surgery(all P<0.05). With high satisfaction and good visual quality, patients could watch at far, intermediate and near distance without wearing glasses at 3mo after surgery.CONCLUSION: Femtosecond laser-assisted cataract surgery combined with PanOptix trifocal intraocular lens implantation gave patients a comfortable and satisfactory full-course vision.
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Purpose: To compare four different types of intra ocular lenses (IOLs), namely, AT LISA, Eyecryl SERT trifocal, Eyhance, Eyecryl SERT extended depth of focus (EDOF) with respect to their clinical outcomes. Methods: This is a retrospective comparative study in which patients who underwent surgery and one of the four types of IOL were implanted. Postoperative evaluation was recorded at one month, postoperatively. The monocular uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) (6 m), uncorrected intermediate visual acuity (UIVA) (60 cm), distance-corrected intermediate visual acuity (CIVA), uncorrected near visual acuity (UNVA) (40 cm), and corrected near visual acuity (CNVA) were assessed postoperatively on post operative day 30, for all four IOL groups. Defocus curve and contrast sensitivity were also compared. Results: With regards to UDVA and CDVA, P value was not statistically significant. (P = 0.534 and 0.421, respectively). EDOF group of IOLs had statistically significant better UIVA and CIVA than trifocal IOL group. (P < 0.001, 0.012, <0.001) and EDOF group had statistically significant worse P value pertaining to UNVA and CNVA (P < 0.001, 0.070, <0.001, 0.190). Pertaining to contrast sensitivity, EDOF group had better contrast sensitivity than Trifocal IOL group (P < 0.001). Conclusion: All four IOLs compared in this study had good comparable distant visual acuity. Near visual acuity was better with AT LISA and Eyecryl SERT trifocal IOL while intermediate vision was better with Eyhance and Eyecryl SERT EDOF IOL. Contrast sensitivity was better in EDOF IOLs than in both trifocal IOLs
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@#AIM: To evaluate the visual quality of patients with high myopia complicated with cataract after implantation of trifocal intraocular lens by OPD-Scan Ⅲ aberration analyzer.METHODS: Totally 32 patients(38 eyes)with high myopia complicated with cataract who underwent femtosecond laser assisted cataract phacoemulsification combined with trifocal intraocular lens implantation in Foshan Aier Eye Hospital from June 2018 to December 2020 were selected. Uncorrected distance visual acuity(UCDVA), uncorrected intermediate visual acuity(UCIVA)and uncorrected near visual acuity(UCNVA)were compared before, and 1wk, 3mo after surgery; OPD-Scan Ⅲ aberration analyzer measured objective visual quality before, and 1wk and 3mo after surgery. RESULTS: There were significant differences in UCDVA, UCIVA and UCNVA before, and 1wk, 3mo after operation(<i>P</i><0.05). The average orientation and centration distance was 0.12(0.08-0.15)mm and the average axial was(212.68±90.45)°in 3mo postoperative. There were significant differences in spherical aberration(<i>P</i><0.05), Strehl ratio(SR)and area ratio(AR)before, and 1wk, 3mo after operation(<i>P</i><0.001). In comparison, SR at 1wk and 3mo postoperative was higher than that before operation, whereas AR in 1wk and 3mo postoperative were both higher than that before operation(all <i>P</i><0.001). There was a negative correlation between SR and spherical aberration at 3mo postoperative(<i>rs</i>=-0.420, <i>P</i><0.01); There was a negative correlation between SR and trefoil at 3mo postoperative(<i>rs</i>= -0.418, <i>P</i><0.01); There was a negative correlation between AR and trefoil at 3mo postoperative(<i>rs</i>=-0.400, <i>P</i><0.05).CONCLUSION: Femtosecond laser assisted cataract surgery combined with trifocal intraocular lens implantation can provide a comfortable and natural full-range vision. The orientation and centricity of trifocal intraocular lens using OPD-Scan Ⅲ has shown that there was a good reliability and consistency. The vision quality using OPD-Scan Ⅲ is satisfactory.
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Objective:To compare the one-year postoperative visual quality after trifocal intraocular lens (IOL) implantation and monofocal IOL implantation.Methods:A cohort study was conducted.Forty-one eyes from 41 age-related cataract patients who underwent phacoemulsification extraction combined with IOL implantation in Nanjing Drum Tower Hospital from May 2017 to June 2018 were enrolled.The patients were divided into trifocal IOL group (20 eyes) receiving ZEISS AT LISA tri 839MP trifocal IOL implantation and monofocal IOL group (21 eyes) receiving ZEISS 603P monofocal IOL implantation according to their willingness.One year after surgery, uncorrected distant visual acuity (UCDVA), uncorrected intermediate visual acuity (UCIVA), uncorrected near visual acuity (UCNVA), best corrected distance visual acuity (BCDVA), distance corrected intermediate visual acuity (DCIVA) and distance corrected near visual acuity (DCNVA) were detected in both groups.The patient point spread function (PSF), modulation transfer function (MTF) cutoff frequency, Strehl ratio (SR), OQAS Ⅱ values at 100%, 20%, and 9% contrast (OV 100%, OV 20%, OV 9%) and objective scattering index (OSI) were measured by OQAS Ⅱ.Wavefront aberrations including total aberration (TA), total high order aberrations (tHOAs), spherical aberration, coma, trefoil aberration, total low order aberrations (tLOAs), defocus, and astigmatism were evaluated with the iTrace visual function analyzer.All aberrations were represented by root mean square.The visual acuity of operative eyes was measured with a phoropter, and defocus curves were drawn with visual acuity better than 0.5 LogMAR.The incidence of posterior capsular opacification (PCO) in the IOL region was quantitatively analyzed by Sellman method.Visual function was scored by visual function index (VF-14). This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School (No.2018-219-01). Written informed consent was obtained from each subject prior to any medical examination.Results:One year after the operation, UCIVA, UCNVA, DCIVA, and DCNVA of trifocal IOL group were significantly better than those of monofocal IOL group, and the differences were statistically significant (all at P<0.001). OQAS Ⅱ visual quality indicators showed that the MTF cutoff frequency, SR, OV 100%, and OSI values of trifocal IOL group were significantly higher than those of monofocal IOL group, showing statistically significant differences (all at P<0.001). No significant difference in wavefront aberrations was found between the two groups (all at P>0.05). Defocus curve showed that the LogMAR visual acuity of patients at -1.0 D, -1.5 D, -2.0 D, -2.5 D, -3.0 D, and -3.5 D (namely, 1 m, 66 cm, 50 cm, 40 cm, 33 cm, and 29 cm) in monofocal IOL group were significantly better than those in trifocal IOL group (all at P<0.05). There was a higher incidence of PCO in trifocal IOL group than monofocal IOL group, with a statistically significant difference ( χ 2=41.0, P<0.001). The VF-14 score of trifocal IOL group was 87.99±1.09, which was significantly higher than 81.49±1.67 of monofocal IOL group ( t=10.301, P<0.001). Conclusions:One year after trifocal IOL implantation, the full range of vision, subjective and objective visual quality of eyes are better than eyes implanted with monofocal IOL.
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@#AIM: To observe the early visual quality of the tri-focal and the mono-focal intraocular lens(IOLs)implantation in patients with age-related cataract, under comparison and analysis.<p>METHODS: A retrospective research design. Totally 168 eyes of 119 age-related cataract patients who underwent cataract phacoemulsification combined with tri-focal and mono-focal IOLs implantation surgery in the cataract department from June 2018 to January 2021 were enrolled. In tri-focal and mono-focal group, 61 eyes of 44 cases and 107 eyes of 75 cases. One month after phacoemulsification combined with IOLs implantation, visual acuity, visual quality and contrast sensitivity were inspected. All data were under statistical analysis.<p>RESULTS: On LogMAR uncorrected distance visual acuity(UDVA),uncorrected intermediate visual acuity(UIVA), uncorrected near visual acuity(UNVA), best corrected distance visual acuity(BDVA), distance corrected intermediate visual acuity(DIVA), distance corrected near visual acuity(DNVA), tri-focal group were extremely better than mono-focal group(all <i>P</i><0.001). In terms of visual quality, the scores of modulation transfer function(MTF)cut-off frequency, optical scatter index(OSI), Strehl ratio(SR), tri-focal group were significantly higher than mono-focal group(all <i>P</i><0.05). On 18 cycle/degree(cpd)spatial frequency under dark and light adaptation conditions, contrast sensitivity scores of the mono-focal group was significantly better than those of the tri-focal group(<i>P</i><0.001). Based on the questionnaire with the VF/QOF scale, the daily life experience scores and off-glass index, the tri-focal group was significantly better than that of the mono-focal group(<i>P</i><0.05), and incidence of glare was no significant difference between the two groups(<i>P</i>>0.05).<p>CONCLUSION: Tri-focal IOLs can provide a full range of relatively better vision and visual quality in patients after age-related cataract phacoemulsification combined with IOLs implantation, and perform well under different conditions.
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@#AIM: To compare the visual related quality of life between patients who underwent binocular and unilateral AT LISA tri 839MP intraocular lens(IOL)implantation.<p>METHODS: A prospective observational study. Forty-five patients with cataract phacoemulsification combined with IOL implantation were collected in our hospital from may 2018 to August 2019 were collected. According to whether trifocal intraocular lens(AT LISA tri 839MP)was implanted in both eyes, it was divided into two groups. For bilateral group(24 people), patients accepted AT LISA tri 839MP IOL in both eyes. For unilateral group(21 people), patients accepted AT LISA tri 839MP IOL in one eye and an aspheric monofocal IOL in the other eye. After follow-up 3mo, the binocular uncorrected distant, intermediate and near visual acuity(bUCDVA, bUCIVA, bUCNVA), visual function questionnaire, daily life degroscopy rate and satisfaction degree of the two groups were compared and analyzed. <p>RESULTS: Three months after operation, there was no significant difference in bUCDVA, bUCIVA, bUCNVA between two groups(<i>P</i>>0.05). And also, there were no significant difference in VF-14-CN questionnaire score(96.2±0.50, 92.43±1.32), degroscopy rate(96%, 90%)and satisfaction(96%, 95%)between the two groups(<i>P</i>>0.05).<p>CONCLUSION: Patients who accepted AT LISA tri 839MP IOL in both eyes and who accepted AT LISA tri 839MP IOL in one eye and an aspheric monofocal IOL in the other eye, share excellent bUCDVA, bUCIVA, bUCNVA. There was no significant difference in postoperative vision-related QoL, spectacle independency and satisfaction between the two groups. For patients who are not suitable for the implantation of trifocal IOL at one eye or who have had the aspheric single-focus IOL implanted at the previous eye, trifocal IOL implantation at another eye can be considered to meet the requirements of the whole binocular vision.
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@#AIM: To evaluate the visual quality between the Tecnis Symfony extended depth of focus intraocular lens(IOL)and Zeiss trifocal IOL(At Lisa tri 839 MP)implantation.<p>METHODS: Forty-two patients(53 eyes)who underwent cataract phacomulsification with IOL implantation from Jan. 2019 to Dec. 2020 were randomly divided into group A and group B according to the type of implanted IOL. The group A with 22 patients(29 eyes)implanted the Tecnis Symfony extended depth of focus IOL, the group B with 20 patients(24 eyes)implanted Zeiss trifocal IOL. The uncorrected distance visual acuity(UDVA), uncorrected intermediate distance visual acuity(UIVA), uncorrected near distance visual acuity(UNVA), and best corrected distance visual acuity(BCVA)were measured after 3mo of surgery. The defocus curve, the quality of life and the occurrence of complications were also observed.<p>RESULTS: The visual acuity was significantly improved in both groups after 3mo of surgery. There were no significant differences in the UDVA(5m), UIVA(80cm)and BCVA(5m)between the two groups(<i>P</i>>0.05). In group B, the UIVA(60cm)and UNVA(40cm)were better than in group A(all <i>P</i><0.05). The defocus curve analysis revealed that the group A tended to be stable between +1.0D to -2.0D, and to form a platform, while the group B had double peaks(0D, -2.5D). The distance visual acuity at 0D were no significantly differences between the two groups(<i>P</i>>0.05), but the near visual acuity at -2.5D and -3.5D in group B were significantly higher than in group A(all <i>P</i><0.01). In both groups over 90% patients were spectacle independent. Patients in the two groups showed different degrees of halo, glare and other optical phenomena, but the overall satisfaction were higher. The scores of satisfactions for reading speed and night vision were significantly better in group A than in group B(all <i>P</i><0.05). <p>CONCLUSION: In both groups over 90% patients were spectacle independent, they can obtain good near,intermediate and far distance visual acuity. Symfony extended depth IOL has better continuous intermediate distance visual acuity, patients can also obtain higher satisfaction and have better night vision. The Zeiss trifocal IOL implantation is associated with significantly better near visual acuity, and it is more suitable for near vision.
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RESUMEN La tecnología de los lentes intraoculares se desarrolla constantemente, por las necesidades visuales cada vez mayores de los pacientes después de operados de catarata; de ahí que nos propusimos realizar una búsqueda acerca de los diferentes modelos de lentes, como los monofocales, los bifocales, los trifocales, los trifocales tóricos y los de foco extendido. Esta nueva tecnología exige exámenes preoperatorios cada vez de más calidad y precisión, para que los resultados quirúrgicos respondan al concepto de cirugía refractiva del cristalino, por lo que concluimos que en el futuro la tecnología de las lentes intraoculares debe estar encaminada a recuperar la visión funcional. En este sentido, cada uno tiene puntos fuertes y débiles; por lo tanto, no hay una solución universal. Se debe crear un reporte de las ventajas y desventajas para trabajar en los puntos a mejorar, sobre todo en la estandarización de la curva de desenfoque, el modulation transfer function y la sensibilidad al contraste, así como trabajar conjuntamente entre los pacientes, cirujanos y fabricantes(AU)
ABSTRACT Intraocular lens technology is in a process of permanent development, due to the increasing visual needs of patients undergoing cataract surgery. That is why we set out to do a search about the different lens models of lenses are offered, including the monofocal, bifocal, trifocal, toric trifocal and extended focus types. This new technology requires rigorous and accurate preoperative tests, so that surgical results respond to the concept of refractive crystalline lens surgery. We therefore conclude that future intraocular lens technology should be aimed at recovering functional vision. Each of the lens types has its own strengths and weaknesses, and so a universal solution does not exist. A report should be developed of advantages and disadvantages, so that work can be done on aspects requiring improvement, mainly the standardization of the improper focusing curve, the modulation transfer function and contrast sensitivity, as well as the implementation of actions to be performed jointly by patients, surgeons and manufacturers(AU)
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Humans , Cataract Extraction/methods , Phacoemulsification , Reference Standards , Multifocal Intraocular Lenses/adverse effectsABSTRACT
@#AIM: To compare the visual quality of bifocal(AT LISA 809MP)and trifocal(AT LISA tri 839MP)IOLs after implantation.<p>METHODS: Retrospective study. A total of 49 eyes of 28 patients with cataract who underwent phacoemulsification combined with multifocal IOL implantation from March 2018 to February 2019 were collected. There were 30 eyes of 18 patients in the bifocal group, aged 40-85(mean 67.08±10.80)years. The trifocal group consisted of 19 eyes of 10 patients, aged 38-79(mean 62.21±14.50)years. All patients underwent visual quality analysis system(OQAS), defocus curve and other examinations.<p>RESULTS: The near BCVA of the two focus groups was better than that of the three focus groups, and the medium UCVA and far BCVA of the three focus groups were better than those of the two focus groups(all <i>P</i><0.05). The trifocal group had better visual acuity at +1.5, -1.0, -1.5, -2, -2.5D and -3.0D defocus than the bifocal group. OQAS visual quality parameters were better in the two-focus group than in the three-focus group in OV 20%, OV 9%, and SR(all <i>P</i><0.05).<p>CONCLUSION: Both bifocal and trifocal IOL implantation can achieve good uncorrected and near visual acuity and high visual quality, while trifocal IOL can achieve better intermediate visual acuity.
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Objective: To study the effectiveness of trifocal bone transport by using monolateral rail system in the treatment of bone defects caused by post-traumatic tibial osteomyelitis. Methods: The clinical data of 28 patients with tibial defects caused by post-traumatic osteomyelitis treated with trifocal bone transport technique by using monolateral rail system between January 2012 and June 2017 were retrospectively analyzed. There were 26 males and 2 females, aged 22-59 years (mean, 41.3 years). The causes of injury included 13 cases of traffic accident injury, 9 cases of falling from height, 4 cases of heavy object injury, and 2 cases of crushing injury. The disease duration was 4.5-17.0 months (mean, 7.1 months). The length of bone defect was 6.5-16.8 cm (mean, 10.3 cm). And the range of soft tissue defect ranged from 3.5 cm×2.0 cm to 18.0 cm×11.0 cm. The bone transporting time, external fixation time, duration of regenerate consolidation, and external fixation index were recorded, and the complications were observed. At last follow-up, the bone and functional results were evaluated according to the criteria given by Association for the Study and Application of the Method of the Ilizarov (ASAMI). Results: All patients were successfully followed up after removing the external fixator with an average of 35 months (range, 24-65 months). The bone transporting time was 41-136 days (mean, 60.2 days), the external fixation time was 7.5-20.0 months (mean, 13.4 months), the external fixation index was 1.1-1.9 months/cm (mean, 1.4 months/cm), the duration of regenerate consolidation was 6.0-16.5 months (mean, 10.5 months). Pin tract infection occurred in 12 cases, delayed union on docking site was occurred in 9 cases, axial deviation was observed in 2 cases, poor regenerate consolidation was presented in 1 case, and refracture on docking site after fixator removal was occurred in 1 case. There was no recurrence of infection, amputation, vascular and neurologic complications, and osteofascial compartment syndrome. At last follow-up, according to ASAMI criterion, the bone healing results were excellent in 17 cases, good in 7 cases, and fair in 4 cases, with an excellent and good rate of 85.7%; the functional results were excellent in 15 cases, good in 10 cases, and fair in 3 cases, with an excellent and good rate of 89.3%. Conclusion: Trifocal bone transport by using monolateral rail system is an effective method in the treatment of bone defect caused by post-traumatic osteomyelitis which can reduce bone transport time, external fixation time, and complications.
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@#OBJECTIVE: To compare the visual, refractive, and patient-reported outcomes of eyes implanted with one of 3 trifocal intraocular lenses (IOLs). METHODS: This is a cross-sectional, comparative, non-interventional study wherein subjects implanted with FineVision Micro F, AT LISA tri 839MP or AcrySof IQ PanOptix trifocal IOL after phacoemulsification were recruited. Manifest refraction, uncorrected and corrected visual acuity (VA) at distance, intermediate and near vision, contrast sensitivity, modulated transfer function (MTF) values and questionnaire answers were compared among the 3 groups using analysis of variance (ANOVA). RESULTS: Fifty-seven (57) eyes were included in the study: 21 eyes with FineVision (group A), 21 eyes with LISA tri (group B), and 15 eyes with PanOptix IOL (group C). The post-operative mean manifest spherical equivalent was -0.01D, -0.07D, and 0.05D, respectively (p=0.083). Uncorrected distance VA and best-corrected distance VA were similar among the groups. Groups A and C had better uncorrected and corrected intermediate VA at 80 cm and at 60 cm compared to group B. Group A had significantly better uncorrected near visual acuity than groups B and C (p=0.032). Mesopic contrast sensitivity testing showed group C had higher contrast sensitivities without glare in at the spatial frequency of 6 CPD (p=0.038) and with glare at 3 CPD (p=0.039) and at 12 CPD (p=0.009). MTF average height analysis showed that the group A had significantly superior resolution in far targets compared to groups B and C (p=0.001). At near targets, groups A and C had better resolutions compared to group B (p=0.017). There was no significant difference in patient satisfaction for far, intermediate and near VA among the groups. CONCLUSION: Eyes implanted with any of the 3 trifocal IOL designs achieved excellent uncorrected and bestcorrected distance, intermediate and near vision. FineVision and PanOptix provided significantly better intermediate vision than LISA tri at both 80 cm and 60 cm testing distance. FineVision had better near visual outcomes than PanOptix and LISA tri. Patient satisfaction was high in all 3 trifocal IOLS
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Lenses, Intraocular , Vision, OcularABSTRACT
We report a case of trifocal choroidal melanoma (three separate tumors) in a 48-year-old Caucasian female who had been followed for oculodermal melanocytosis since childhood. At presentation, no tumor was present and annual examination was advised. Seventeen years later, three choroidal melanocytic lesions were detected in the right eye. Growth of each was documented, enucleation was performed, and histopathology revealed three independent choroidal melanomas. The patient developed extensive liver and bone metastases and subsequently died. Oculodermal melanocytosis is a risk factor for the development of uveal melanoma and a potential marker for worse prognosis. Careful long-term follow-up is required.
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RESUMEN Objetivo: Describir los resultados clínicos obtenidos con la lente trifocal Acriva Trinova. Métodos: Se realizó un estudio observacional, descriptivo, longitudinal y prospectivo donde se describieron los resultados visuales en 6 pacientes (12 ojos) operados del cristalino con la técnica de facochop e implante de lente intraocular trifocal modelo Acriva Trinova, en el Instituto Cubano de Oftalmología Ramón Pando Ferrer en noviembre del año 2017. Se analizaron variables como: edad, sexo, agudeza visual sin y con corrección a diferentes distancias, equivalente esférico, sensibilidad al contraste, síntomas disfotópticos y estado de satisfacción subjetiva de pacientes operados. Resultados: La edad media fue 54,5 años y la mayoría de los ojos (91,7 por ciento) eran portadores de un componente esférico hipermetrópico. Se constató una recuperación posoperatoria de la agudeza visual de lejos monocular sin corrección con una media de 0,90. En visión binocular sin corrección se alcanzó una mejoría tanto de la visión intermedia (la mitad de los pacientes lograron leer un J1), así como de la visión de cerca (83,3 por ciento logró leer un J2 o mejor). El equivalente esférico medio posoperatorio fue de 0,38 D ± 0,29. En este trabajo la totalidad de los pacientes se manifestaron satisfechos con sus resultados visuales, y en cuanto a la sensibilidad al contraste con esta lente se obtuvieron resultados compatibles con criterios de normalidad. Conclusiones: El implante de esta lente trifocal disminuye la dependencia de las gafas después de la cirugía del cristalino y mejora la calidad de vida en estos pacientes(AU)
ABSTRACT Objective: Describe the clinical results obtained with the Acriva Trinova trifocal lens. Methods: An observational descriptive longitudinal prospective study was conducted of the visual results of 6 patients (12 eyes) undergoing crystalline lens surgery by phaco-chop technique and implantation of a trifocal intraocular lens model Acriva Trinova at Ramón Pando Ferrer Cuban Institute of Ophthalmology in November 2017. The variables analyzed were age, sex, visual acuity with and without correction at various distances, spherical equivalent, contrast sensitivity, dysphotopsia symptoms and patient satisfaction. Results: Mean age was 54.5 years and most eyes (91.7 percent) had a hyperopic spherical component. Postoperative recovery was observed of far monocular visual acuity without correction with a mean of 0.90. In binocular vision without correction improvement was achieved of both intermediate vision (half the patients were able to read a J1) and near vision (83.3 percent were able to read a J2 or better). Mean postoperative spherical equivalent was 0.38 D ± 0.29. All the patients in the study expressed satisfaction with their visual results. The contrast sensitivity results obtained with the lens met normality criteria. Conclusions: Implantation of this trifocal lens reduces dependence on eyeglasses after crystalline lens surgery and improves the quality of life of patients(AU)
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Humans , Male , Female , Middle Aged , Quality of Life , Multifocal Intraocular Lenses/adverse effects , Epidemiology, Descriptive , Prospective Studies , Longitudinal Studies , Observational StudyABSTRACT
@#AIM: To evaluate the clinical efficacy of femtosecond laser-assisted cataract surgery combined with trifocal intraocular lens(IOL)implantation.<p>METHODS:From September 2016 to November 2017, 42 cases(59 eyes)of cataract patients receiving trifocal IOL implantation in Shanxi Eye Hospital were retrospectively enrolled in this study. Moreover, the visual and refractive outcomes, defocus curve, refractive stability, high order aberrations, patient satisfaction, and spectacle independence were evaluated at 1wk, 1mo, 3mo and 6mo after surgery, respectively.<p>RESULTS: All patients had attained good visual acuity of >0.1 LogMAR at different distances during the follow-up period; besides, the visual acuity at each distance was remarkably higher compared with that before surgery(<i>P</i><0.05). The defocus curve had displayed no significant decrease between 0D to -2.5D at 6mo postoperatively, with the visual acuity better than 0.8. At 6mo postoperatively, 63%(37 eyes)eyes had a spherical equivalent(SE)of ±0.25D, and 88%(52 eyes)eyes had a SE of ±0.50D. The incidences of high order aberrations, coma, spherical aberration and trefoil of all eyes were evidently lower than those before surgery, and the difference was statistically significant(<i>P</i><0.05). <p>CONCLUSION: Femtosecond laser-assisted cataract surgery combined with trifocal IOL implantation can provide patient with a comfortable and natural full-range vision, which can greatly improve the postoperative satisfaction of patients.
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BACKGROUND: We compared the efficacy between trifocal and bifocal diffractive intraocular lens (IOL) implantation. METHODS: Through PubMed, MEDLINE, EMBASE, and CENTRAL, we searched potentially relevant articles published from 1990 to 2018. Defocus curves, visual acuities (VAs) were measured as primary outcomes. Spectacle dependence, postoperative refraction, contrast sensitivity (CS), glare, and higher-order aberrations (HOAs) were measured as secondary outcomes. Effects were pooled using random-effects method. RESULTS: We included 11 clinical trials, with a total of 787 eyes (395 subjects). The trifocal IOL group showed better binocular distance VA corrected with defocus levels of −0.5, −1.0, −1.5, and −2.5 diopter than the bifocal IOL group (All P ≤ 0.004). The trifocal IOL group showed better monocular uncorrected distance and intermediate VAs (mean difference [MD], −0.04 logarithm of the minimum angle of resolution [logMAR]; 95% confidence interval [CI], −0.07, −0.01; P = 0.006 and MD, −0.07 logMAR; 95% CI, −0.13, −0.01; P = 0.03, respectively). Postoperative refraction, glare, CS, and HOAs were not significantly different from each other. CONCLUSION: The overall findings indicate that trifocal diffractive IOL implantation is better than the bifocal diffractive IOL in intermediate VA, and provides similar or better in distance and near VAs without any major deterioration in the visual quality.
Subject(s)
Cataract , Contrast Sensitivity , Glare , Lens Implantation, Intraocular , Lenses, Intraocular , Methods , Telescopes , Visual AcuityABSTRACT
PURPOSE: To evaluate the clinical outcomes of patients with diffractive aspheric trifocal intraocular lens FineVision Pod F IOL (PhysIOL, Liège, Belgium) implantation. METHODS: Thirty eight eyes received phacoemulsification and implantation of FineVision Pod F IOL. Uncorrected distant visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), refractive values, and defocus curve were evaluated at postoperative 1 month and 3 months. Optical quality was evaluated with the contrast sensitivity test, OQAS® (Optical Quality Analysis System, Visiometrics, Cerdanyola del Vallès, Spain) and questionnaire. RESULTS: At the 3-month postoperative follow-up, the mean spherical equivalent was 0.01 ± 0.31 D and the mean UDVA, UIVA and UNVA were 0.04 ± 0.07, 0.19 ± 0.12, and 0.04 ± 0.07, respectively. Mean contrast sensitivities at 0.75, 1.5, 3, 6, 12, and 18 cycles per degrees were 2.00 ± 1.54, 2.16 ± 1.60, 2.25 ± 1.76, 2.16 ± 1.83, 1.52 ± 1.47 and 1.03 ± 0.95 respectively and mean objective scatter index by OQAS® (Optical Quality Analysis System, Visiometrics) was 1.54 ± 0.74. In satisfaction analysis, general satisfaction with surgery was 89% and spectacle independence were 89% at far, 78% at intermediate and 83% at near distance. Postoperative dissatisfaction factors were dryness (36%), glare at night (32%), halo (18%). CONCLUSIONS: The FineVision Pod F IOL showed excellent distant and near visual acuities with an effective intermediate visual acuity. The eyes with FineVision Pod F IOL expected to achieve the favorable visual outcome and patient satisfaction.
Subject(s)
Humans , Cataract , Contrast Sensitivity , Follow-Up Studies , Glare , Lens Implantation, Intraocular , Lenses, Intraocular , Patient Satisfaction , Phacoemulsification , Visual AcuityABSTRACT
PURPOSE: To evaluate the clinical outcomes of cataract surgery using novel diffractive trifocal intraocular lenses (IOLs) in Koreans. METHODS: This was a retrospective, consecutive, interventional study of cataract surgery using POD FineVision IOL implantation. Complete ophthalmologic examinations were performed preoperatively and postoperatively. Defocus curves were assessed over a range of +1.5 to −4.0 diopters in 0.5-diopter steps at one month postoperatively. Uncorrected distant visual acuity, uncorrected intermediate visual acuity, uncorrected near visual acuity, corrected distant visual acuity, distant-corrected intermediate visual acuity, and distant-corrected near visual acuity were assessed one month postoperatively, and manifest refraction was performed during every visit. RESULTS: The study analyzed 31 eyes in 20 patients. There were statistically significant improvements in uncorrected distance visual acuity, uncorrected intermediate visual acuity, uncorrected near visual acuity, corrected distance visual acuity, distance-corrected intermediate visual acuity, and distance-corrected near visual acuity (p < 0.001). The final postoperative refractive outcomes showed statistically significant myopic shifts compared to the target refraction based on SRK/T, SRK-II, Haigis, and Hoffer Q formulas (p < 0.001). CONCLUSIONS: POD FineVision IOLs provide stable visual restoration with improvements of near and intermediate vision in presbyopic eyes. POD FineVision IOLs show myopic shift in a Korean population; therefore, surgeons should be cautious when selecting IOL power in such patients.
Subject(s)
Humans , Cataract , Lenses, Intraocular , Refractive Errors , Retrospective Studies , Surgeons , Visual AcuityABSTRACT
PURPOSE: To evaluate and compare visual acuity and reading speed for Korean language between a diffractive bifocal and trifocal intraocular lens (IOL) of the same material and haptic design. METHODS: We reviewed the medical records of the patients who had undergone bilateral cataract surgery with bifocal IOLs (AT LISA 801) on the both eyes (bifocal group) and trifocal IOLs (AT LISA tri 839 MP, trifocal group). The main outcome measures were the uncorrected distance, intermediate, and near visual acuity (uncorrected distance visual acuity [UCDVA], uncorrected intermediate visual acuity [UCIVA], and uncorrected near visual acuity [UCNVA]) and corrected distance, near, and distance-corrected intermediate visual acuity (corrected distance visual acuity [CDVA], corrected near visual acuity [CNVA], and distance-corrected intermediate visual acuity [DCIVA]) at last postoperative follow-up month. Reading speeds for Korean language were measured to check near visual function. RESULTS: Fourteen eyes (7 patients) were included in the bifocal group and 32 eyes of 16 patients in the trifocal group. There were no statistical differences between the two groups with respect to UCDVA, UCNVA, CDVA, and CNVA. However, UCIVA (0.35 vs. 0.22 logarithm of the minimum angle of resolution [logMAR], p < 0.01) and DCIVA (0.34 vs. 0.20 logMAR, p < 0.01) were significantly better in the trifocal group than in the bifocal group. The mean reading speed for logMAR 0.5 optotype (point 10) was 86.50 words per minute (wpm) in the bifocal group and 81.48 wpm in the trifocal group without a significant difference (p = 0.70). CONCLUSIONS: Trifocal IOLs provided the same level of distance and near visual acuity and reading speed as that of bifocal IOLs with better intermediate visual acuity.
Subject(s)
Humans , Cataract , Follow-Up Studies , Lens Implantation, Intraocular , Lenses, Intraocular , Medical Records , Outcome Assessment, Health Care , Visual AcuityABSTRACT
@#As cataract surgery has developed from the simple vision rehabilitation surgery into a more challenging refractive surgery, more and more people wish to improve vision and take off glasses through surgeries. Monofocal intraocular lens can solve the distant vision problem of patients, but near vision patients still need to wear glasses due to the loss of crystal regulation. Hence, presbyopia correction intraocular lens emerged accordingly. In the past decades, we have found and endeavored to solve the problems accompanied in the application of bifocal intraocular lens. On the bifocal basis, some newly-produced and extensively-applied presbyopia correction intraocular lens in the market have become hot products. Presbyopia correction is still a huge challenge for cataract surgery, and this paper will summarize the design principles and clinical application effects of some popular types of presbyopia correction intraocular lens.