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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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Purpose: To evaluate the safety, visual performance, and patient satisfaction of a new presbyopic pseudophakic intraocular lens (IOL). Methods: A prospective non?randomized case?series study was performed in Buenos Aires, Argentina. Patients included in the study underwent a programmed Femtosecond laser assisted cataract surgery (FLACS), performed between October and December 2020, with a 6?month follow?up period. The Intensity (Hanita Lenses) IOL was bilaterally implanted. Spherical equivalent (SE) refraction, uncorrected distance and near visual acuity (UDVA/UNVA), defocus curve, endothelial cell density (ECD), central corneal thickness (CCT), and a satisfaction questionnaire were evaluated. Results: A total of 56 patients (112 eyes), aged 65 ± 6.12 years were included. The mean ± SD of preoperative SE was 1.85 ± 2.24 D (range; ?4.50 to 4.75), which had decreased 6 months after surgery to ?0.08 ±0.32 D (range; ?0.75 to 0.63). No eyes experienced a loss of lines of vision, and 94% obtained SE values between ± 0.50 D. Defocus curve for different additions was 0.03 LogMAR (logarithm of the minimum angle of resolution) for ?3.0 D, ?0.005 LogMAR for ?1.5 D, and ?0.07 LogMAR for 0 D. The ECD, CCT remained stable (P: 0.09 and 0.58, respectively) and all patients achieved their preoperative expectations, with a 6?month follow?up period. Conclusion: Patients who underwent a safe bilateral implantation with Intensity IOL achieved a high degree of spectacle independence and satisfaction, 6 months after surgery.
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@#AIM: To analyze the errors of objective visual quality after the implantation of segmented refractive multifocal intraocular lenses in patients with age-related cataract. <p>METHODS: In this retrospective study including 180 eyes of 116 patients with senile cataract, implantation of either Aspira-aA IOL or LS-313 MF30 IOL was performed in Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University. According to the implanted IOL, the patients were divided into the SIOL(Aspira-aA)group(61 patients, 96 eyes)and the MIOL(LS-313 MF30)group(55 patients, 84 eyes). Three months postoperatively, uncorrected distance visual acuity(UCDVA), best corrected distance visual acuity(BCDVA), uncorrected intermediate visual acuity(UCIVA)and uncorrected near visual acuity(UCNVA)were assessed. Total higher-order aberrations(HOAt), internal higher-order aberrations(HOAi), corneal higher-order aberrations(HOAc), spherical aberration(SA), coma aberration(CA), trefoil aberration(TA), Strehl ratio(SR), average height of modulation transfer function(MTF AvgHeight)and dysfunctional lens index(DLI)were measured by iTrace visual quality analyzer(scanning diameter 3mm)three months postoperatively. <p>RESULTS: Three months postoperatively, there was no statistically significant difference between the two groups in UCDVA and BCDVA(t=-0.789, -0.815; all P>0.05). UCIVA and UCNVA in the MIOL group were better than those in the SIOL group, with statistically significant difference(t=1.971, 3.215; all P<0.05). No statistically significant differences were observed in HOAc and spherical aberration between the two groups(t=1.126, -0.995; all P>0.05). HOAt, HOAi, coma aberration and trefoil aberration were larger in the MIOL group than those in the SIOL group(t=-2.518, -2.926, -2.859, -3.128; all P<0.05). Strehl ratio, MTF AvgHeight and DLI in the MIOL group were lower than those in the SIOL group, with statistically significant difference(t=2.8537, 2.014, 3.292; all P<0.05). The results of retinal letter, MTF AvgHeight and SR showed that HOAt and HOAi increased significantly in the MIOL group. The retinal spot diagram showed that coma aberration and trefoil aberration increased significantly with the addition of +3D spherical diopter. <p>CONCLUSION: Segmented refractive multifocal intraocular lens can provide excellent uncorrected distance, intermediate and near visual acuity. There may be errors in aberration measurement by iTrace visual quality analyzer after segmented refractive multifocal intraocular lenses implantation. The design of intraocular lens may lead to the postoperative increase in aberration and a decrease in objective visual quality.
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Objective:To evaluate and compare the postoperative visual quality after phacoemulsification combined with toric (ART) and non-toric (ReSTOR) multifocal intraocular lens (IOL) implantation.Methods:A cohort study was conducted.Thirty-nine cataract patients (50 eyes) who underwent phacoemulsification combined with ART IOL implantation were enrolled as ART group, and 32 patients (41 eyes) who received ReSTOR IOL implantation were enrolled as ReSTOR group in Tianjin Medical University Eye Hospital from January 2017 to January 2018.Three months after surgery, the uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA) and uncorrected near visual acuity (UNVA), manifest refraction, defocus curve, contrast sensitivity (CS), modulation transfer function cutoff, Strehl2D ratio (SR), objective scattering index, OQAS values under 100%, 20%, 9% contrasts (OV 100%, OV 20%, OV 9%), total aberrations, total lower-order aberrations, total higher-order aberrations, spherical aberrations, coma and trefoil aberrations of the two groups were tested and compared.The study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Tianjin Medical University Eye Hospital (No.2019KY[L]-04). Written informed consent was obtained from each subject prior to entering the cohort.Results:UDVA at 3 months after surgery was (0.07±0.09)LogMAR and (0.09±0.12)LogMAR in ART group and ReSTOR group, and CDVA was (-0.01±0.07)LogMAR and (-0.01±0.07)LogMAR, and UIVA was (0.23±0.11)LogMAR and (0.22±0.13)LogMAR, and UNVA was (0.11±0.15)LogMAR and (0.06±0.11)LogMAR.UNVA was slightly better in ReSTOR group than ART group, and the difference was statistically significant ( t=2.085, P=0.040). The mean depth of focus was (4.12±0.79)D in ART group and (4.24±0.95)D in ReSTOR group.The postoperative residual astigmatism (0.32±0.31)D was significantly lower than preoperative corneal astigmatism (1.27±0.40)D in ART group ( t=13.209, P<0.001). CS values at 6, 12, and 18 c/d under photopic without glare, 12 and 18 c/d under photopic with glare, 3, 6, and 12 c/d under scotopic without glare in ART group were slightly lower than those in ReSTOR group, showing statistically significant differences (all at P<0.05) without clinical significance.SR and OV 20% values in ART group were 0.14±0.05 and 0.55±0.24, which were slightly lower than 0.17±0.06 and 0.66±0.29 in ReSTOR group, with statistically significant differences ( t=-2.012, P=0.048; t=-2.557, P=0.043). Total aberrations and coma aberration under 5 mm pupil diameter in ART group were 0.88(0.59, 1.13)μm and 0.21(0.13, 0.30)μm, which were higher than 0.58(0.47, 0.74)μm and 0.10(0.08, 0.21)μm in ReSTOR group, showing statistically significant differences ( Z=-2.073, P=0.038; Z=-2.101, P=0.036). Conclusions:Cataract phacoemulsification combined with ART IOL implantation can provide good vision and visual quality while correcting preoperative corneal astigmatism, and the resolution in dim light or low to medium spatial frequencies is slightly weaker than eyes implanted with ReSTOR IOL.
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Cataract is one of the most common causes of vision loss and even blindness in patients, and surgery is a proven and effective treatment option. Traditional cataract surgery for vision loss has increasingly given way to refractive cataract surgery as science and technology have progressed. There are also a variety of refractive intraocular lenses on the market place. Patients are increasingly accepting and recognizing multifocal intraocular lens(MIOL)as an alternative to traditional single focus intraocular lens(SIOL). Through classification and listing, the existing MIOL are discussed in this article, as well as the features of different types of MIOL and techniques for evaluating the clinical impacts of patients after surgery, so as to provide references for ophthalmologists.
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AIM: The clinical outcomes of unilateral single-focal intraocular len(SIOL), contralateral implanted multifocal IOL(MIOL)and the SIOL was implanted in binoculus were compared.METHODS: There were 60 cases with 120 eyes age-related cataract patients in January 2019 to January 2021 underwent phacoemulsification and IOL implantation in Chengdu Aier Eye Hospital. The SIOL has been implanted in the dominant eyes, all patients were divided into three groups according to the types of IOL implanted in the contralateral non-dominant eyes, among them, there were 36 eyes of 18 cases in group A with non-dominant eyes implanted MIOL(SBL-3); 38 eyes of 19 cases in group B were implanted MIOL(SN6AD1)in non-dominant eyes. SIOL was implanted in all 46 eyes of 23 cases of control group. After operation at 3mo,the results of binocular vision and visual quality of the three groups were evaluated and compared.RESULTS: After operationat 3mo, there was no difference in the uncorrected distance vision and corrected distance vision, uncorrected medium vision and corrected near vision among the three groups(P<0.05).The uncorrected near visual acuity and corrected intermediate visual acuity of both eyes in groups A and B were significantly improved in both groups compared with the control group(P<0.05). The scores of Catquest 9SF-CN scale showed that the quality of life of patients in group A and group B(11.11±1.323, 11.89±1.883 scores)was better than that in the control group(14.65±1.722 scores, both P<0.05). The rate of lens removal in group A, B and control group were 88.9%, 84.2% and 39.1%, respectively, and the rate of lens removal in group A was significantly higher than that in the control group(P<0.0167).CONCLUSION: Dominant eye implantation of SIOL in patients with cataract and contralateral non-dominant eye implantation of MIOL(SBL-3/SN6AD1)can obtain better full-range visual acuity than binoculus, less postoperative adverse visual symptoms, and higher patient disengagement rate and satisfaction.
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@#AIM: To observe the visual quality after implantation of regional refractive multifocal intraocular lens(MIOL)SBL-3. <p>METHODS: A retrospective and controlled study. Fifty-seven cataract patients(68 eyes)in our hospital from September 2019 to July 2020 were enrolled. Totally 33 cases(36 eyes)received regional refractive MIOL SBL-3(SBL-3 group), while 24 cases(32 eyes)received aspheric single focal intraocular lens(SIOL)ZCB00(ZCB00 group). Uncorrected and corrected distance, middle and near visual acuity, defocus curve, OPDⅢ objective visual quality, the quality of vision(QoV)questionnaire, patient satisfaction and spectacle independence were evaluated 3mo postoperatively.<p>RESULTS: No significant differences were found between the SBL-3 group and the ZCB00 group in terms of LogMAR value of corrected and uncorrected distance visual acuity(UDVA)at 3mo after the operation(0.13±0.09 <i> vs</i> 0.10±0.08, 0.06±0.06 <i>vs</i> 0.08±0.08, all <i>P</i>>0.05)and the UDVA was significantly improved compared with that before the operation(<i>P</i><0.05). Corrected and uncorrected intermediate and near visual acuity were significantly better for the SBL-3 group than the ZCB00 group(0.10±0.14 <i>vs </i>0.27±0.10, 0.05±0.16 <i>vs </i>0.35±0.17, 0.11±0.14 <i>vs </i>0.26±0.11, 0.03±0.17 <i>vs </i>0.35±0.17, all <i>P</i><0.05). Concerning the comparison of contrast sensitivity, the ZCB00 group was better than SBL-3 group at any spatial frequency evaluated and the differences were significant(all <i>P</i><0.05). Statistically significant differences between groups were observed in intraocular total aberrations, high-order aberrations, coma and Trefoil presenting significantly higher values in the eyes of the SBL-3 group than in the ZCB00 group(<i>P</i><0.05). The average Strehl ratio value was smaller in the ZCB00 group and the difference was statistically significant(<i>P</i><0.05). There were 1 patient who had glare, 1 patient reported halo, 4 patients complained distance blur in the SBL-3 group at 3mo after the surgery. 82% and 88% were completely satisfied in the SBL-3 group and ZCB00 group, respectively. There was no statistically significant difference in satisfaction between the groups. SBL-3 group had a higher percentage of spectacle independence and the difference was significant(94% <i>vs </i>67%, <i>P</i><0.05).<p>CONCLUSION:The regional refractive MIOL SBL-3 provided good range of vision for near, intermediate, and distance. Although few vision phenomena were reported, it resulted in an excellent level of overall patient satisfaction and freedom from spectacles.
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@#AIM:To systematically assess the efficacy and safety of femtosecond laser-assisted cataract surgery(FLACS)implanted with multifocal intraocular lens(MFIOL)with conventional cataract surgery. <p>METHODS: Electronic databases of PubMed, EMbase, Cochrane and OVID were searched for studies comparing FLACS-MFIOL and CP-MFIOL. Two independent reviewers performed the data extraction and analyzed. Visual acuity, spherical equivalent(SE), pseudophakic accommodation, cumulative dissipated energy(CDE)and endothelial cell density(ECD)were measured by Review Manager 5.4. Sensitivity and reporting bias were determined through the STATA 14 software. <p>RESULTS: From 106 screened articles, 1 045 eyes from 6 randomized controlled trials(RCTs)and 5 retrospective cohort studies were included(one of which contained two groups of comparative data). There was no evidence for any important differences in uncorrected distance visual acuity(UDVA)between FLACS-MFIOL and CP-MFIOL group after 1d, 1wk, 1, 3mo and 1a \〖<i>s</i>: -0.02, 95% Confidence Interval(<i>CI</i>)(-0.05, 0.01), <i>P</i>=0.13; <i>s</i>: -0.01, 95% <i>CI</i>(-0.03, 0.01), <i>P</i>=0.24; <i>s</i>: -0.03, 95% <i>CI</i>(-0.06, 0.00), <i>P</i>=0.05; <i>s</i>: -0.03, 95% <i>CI</i>(-0.14, 0.08), <i>P</i>=0.59; <i> s</i>: -0.03, 95% <i>CI</i>(-0.06, 0.00), <i>P</i>=0.10\〗. We found little evidence of any important difference in uncorrected near visual acuity(UNVA)between the two groups after 1d, 1wk, 3mo and 1a \〖<i>s</i>: 0.04, 95% <i>CI</i>(-0.04, 0.12), <i>P</i>=0.30; <i>s</i>: 0.04, 95% <i>CI</i>(-0.06, 0.13), <i>P</i>=0.47; <i> s</i>: 0.00, 95% <i>CI</i>(-0.04, 0.04), <i>P</i>=0.97; <i>s</i>: 0.03, 95% <i>CI</i>(-0.06, 0.12), <i>P</i>=0.54\〗. There was a small advantage in favor of FLACS-MFIOL over CP-MFIOL for UNVA after 1mo \〖<i>s</i>: 0.03, 95% <i>CI</i>(0.00, 0.06), <i>P</i>=0.04; <i>s</i>: 0.06, 95% <i>CI</i>(-0.02, 0.15), <i>P</i>=0.14\〗. In eyes treated with FLACS-MFIOL, SE showed no difference compared to CP-MFIOL \〖<i>s</i>: 0.06, 95%<i> CI</i>(-0.02, 0.15), <i>P</i>=0.14\〗, however, better than CP-MFIOL in distance and near pseudophakic accommodation \〖<i>s</i>: 0.57, 95% <i>CI</i>(0.42, 0.72), <i>P</i><0.001; <i>s</i>: 1.32, 95% <i>CI</i>(0.99, 1.64), <i>P</i><0.001\〗. Smaller CDE \〖<i>s</i>: -1.94, 95% <i>CI</i>(-2.59, -1.30), <i>P</i><0.01; <i>s</i>: -3.81, 95% <i>CI</i>(-5.66, -1.96), <i>P</i><0.01\〗 of Ⅱ and Ⅲ nucleus patients and increased ECD \〖<i>s</i>: 111.75, 95% <i>CI</i>(86.27, 137.23), <i>P</i><0.01\〗 in FLACS-MFIOL group were analyzed. The sensitivity analysis indicated that the results were robust and no obvious reporting bias. <p>CONCLUSION: Compared to CP-MFIOL, FLACS-MFIOL makes a better visual quality and pseudophakic accommodation, as well as reducing endothelial cell loss and phacoemulsification energy.
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@#AIM: To evaluate the centration of the SBL-3 multifocal intraocular lens, the size of the distant and near power zone in the pupil area and the area of the visual axis using Itrace visual function analyzer. <p>METHODS: Retrospective case study. From January 2018 to January 2019, 51 eyes of 36 patients underwent phacoemulsification cataract combined with regional refraction multifocal intraocular lens implantation at Beijing Aier-Intech Eye Hospital were enrolled. The centration, visual axis, angle α, angle Kappa and the orientation of the intraocular lens measured by Itrace were used to calculate the position of the visual axis in the intraocular lens and the changes in the proportions of the distant and near power zones in the pupil area. <p>RESULTS: The centration(R)of intraocular lens is 0.217±0.09mm. The distribution of the visual axis in the intraocular lens is 0.217±0.09mm. The visual axis is evenly distributed in the distant and near power zones. There was no statistical significance between the two groups with postoperative visual acuity ≥0.8 and <0.8(<i>P</i>>0.05). The size of the angle Kappa is 0.187±0.079mm. The displacement of angle Kappa on the y-axis is 0.10±0.06mm. There was no statistical significance between the changes in the pupil size of distant and near power zones in the pupil area caused by the deviation of the pupil and the postoperative visual acuity ≥0.8 and <0.8(<i>P</i>>0.05). <p>CONCLUSION: The intraocular lens centration and axial data measured by the Itrace visual function analyzer can be used to estimate the area where the visual axis is located and the size of the distant and near power zones in the pupil area, thereby assisting in evaluating the postoperative visual quality of the regional refraction multifocal intraocular lens implanted after cataract surgery.
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@#AIM: To investigate the effect of fine capsule treatment on the visual quality of diffractive multifocal intraocular lens.<p>METHODS: Ninety-eight patients(120 eyes)with DMIOL implanted in cataract Department of Hebei Eye Hospital from March 2017 to April 2018. They were randomly divided into A group and B group. 60 eyes in each group. Group A patients were treated with anterior and posterior capsular polishing and posterior continuous circular capsulorhexis, while in B group the fine capsule treatment was not performed. The UCDVA, UCIVA, UCNVA, visual quality, intraocular lens neutrality and PCO incidence were compared 6mo after operation.<p>RESULTS: At 6mo after operation, UCDVA, UCIVA and UCNVA in group A were superior to those in group B. The difference was statistically significant(<i>P</i><0.05). At 6mo after operation, the amount of eccentric intraocular lens in group A was less than that in group B. The difference was statistically significant(<i>P</i><0.05). PCO incidence: group A: 0 eyes; group B: 5 eyes(8.3%)in gradeⅠ, 3 eyes(5.0%)in grade Ⅱ, 2 eyes(3.3%)in grade Ⅲ.<p>CONCLUSION: In order to enhance the stability of IOL and maintain the long-term transparency of the optic axis, we performed fine polishing of the anterior and posterior capsule and continuous circular capsulorhexis of the posterior capsule. These could improve the visual quality and satisfaction of patients after surgery.
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@#AIM: To compare the therapeutic effects of phacoemulsification respectively combined with diffractive multifocal intraocular lens(IOL)and monofocal IOL implantation in the treatment of cataract. <p>METHODS: A total of 99 cataract patients(145 eyes)who underwent phacoemulsification combined with IOL implantation in the hospital from January 2015 to February 2019 were divided into observation group(<i>n</i>=51, 75 eyes)and control group(<i>n</i>=48, 70 eyes)according to the non-randomized clinical trial and patient voluntary principles. The observation group was treated with diffractive multifocal IOL implantation, while the control group was treated with monofocal IOL implantation. The visual acuity, corneal endothelial cell count, loss rate of corneal endothelial cells, results of corneal topography, and contrast sensitivity(CS)in daytime, day glare time, nighttime and night glare time were compared between two groups. The complications and spectacles-independent rate were counted. <p>RESULTS: At 1wk, 1mo and 3mo, there were no significant differences in the best corrected distance visual acuity(BCDVA)and best corrected near visual acuity(BCNVA)between two groups(<i>P</i>>0.05). However, the uncorrected distance visual acuity(UCDVA)at 1wk and 1mo, the uncorrected near visual acuity(UCNVA)and the distance corrected near visual acuity(DCNVA)at 1wk, 1mo and 3mo of the observation group were significantly lower than those of the control group(<i>P</i><0.05). After surgery, corneal endothelial cell counts and astigmatism of two groups decreased significantly. No significant differences were found in corneal endothelial cell count, loss rate of corneal cells and astigmatism between two groups(<i>P</i>>0.05). CS in daytime of 1.5c/d frequency band, in day glare time of 1.5c/d, 3c/d and 6c/d frequency bands, in nighttime of 3c/d and 18c/d frequency bands, in night glare time of 3c/d, 6c/d and 18 c/d frequency bands were significantly lower, while CS in daytime of 12c/d frequency band was significantly higher in the observation group than in the control group. There was no significant difference in the incidence of complications between two groups(<i>P<</i>0.05), but the spectacles-independent rate was significantly higher in the observation group than in the control group(<i>P</i><0.05). <p>CONCLUSION: Phacoemulsification combined with diffractive multifocal IOL implantation can obtain good total range visual acuity, with a higher spectacles-independent rate and relatively low CS after surgery.
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@#AIM:To review the objective visual quality after multifocal intraocular lens implantation.<p>METHODS:The PubMed, The Cochrane Library, CNKI, Sinomed, Metstr, Wanfang Database were searched for Meta-analysis of the literature on the objective visual quality after multifocal intraocular lens implantation. The retrieval time limit is from the establishment of the database to December 31, 2019. The objective visual quality was evaluated based on the objective visual quality analysis system Ⅱ(OQAS Ⅱ), which included object scatter index(OSI), modulation transfer function cut off(MTF cut off), Strehl ratio(SR), predicted 100% contrast visual acuity(OV100%), predicted 20% contrast visual acuity(OV20%), and predicted 9% contrast visual acuity(OV9%).<p>RESULTS: A total of 8 articles met the inclusion criteria of this study, a total of 432 cases(567 eyes). Meta-analysis showed that there was significant difference between multifocal intraocular lens and monofocal control group in OSI \〖<i>MD</i>=0.66, 95% <i>CI</i>(0.42-0.90), <i>P</i><0.05\〗, but there was no significant difference in MTF cut off \〖<i>MD</i>=-1.94, 95% <i>CI </i>(-5.58-1.70), <i>P</i>=0.30\〗, SR\〖<i>MD</i>=0.00, 95%<i>CI </i>(-0.02-0.02), <i>P</i>=0.87\〗, OV100% \〖<i>MD</i>=-0.02, 95%<i>CI</i>(-0.14-0.11), <i>P</i>=0.76\〗, OV20% \〖<i>MD</i>=-0.03, 95% <i>CI</i>(-0.14-0.08), <i>P</i>=0.60\〗, OV9% \〖<i>MD</i>= -0.01, 95% <i>CI </i>(-0.09-0.07), <i>P</i>=0.82\〗.<p>CONCLUSION: The increase of objective scattering after multifocal intraocular lens implantation may lead to the decrease of visual quality, and the other parameters have no significant difference with the control group. However, no patient follow-up was reported in the included studies. Due to the changes and adaptability after operation, the long-term evaluation of objective visual quality of patients after multifocal intraocular lens implantation needs further research.
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PURPOSE: To compare the postoperative clinical outcomes after cataract surgery with implantation of bifocal intraocular lenses (IOLs) and extended depth of focus (EDOF) IOLs. METHODS: A total of 60 patients were divided into three groups, and each group included 20 patients of 40 eyes: group A with a +3.25 D bifocal IOL in both eyes, group B with an EDOF IOL in both eyes, and group C with a +3.25 D bifocal in one eye and an EDOF IOL in the other eye. We retrospectively reviewed the patients' medical charts to analyze their binocular uncorrected visual acuities (UCVAs; distant, intermediate, and near) and refraction at postoperative 3 months. RESULTS: The binocular distant UCVAs were 0.04 ± 0.01, 0.05 ± 0.02, and 0.04 ± 0.01 in groups A, B, and C, respectively, and there were no differences between the groups (p > 0.05). The intermediate UCVAs were 0.16 ± 0.01, 0.10 ± 0.01, and 0.10 ± 0.01, respectively, and group A was the lowest (A–B, p = 0.031; A–C, p = 0.018; B–C, p = 1.000). The near UCVAs were 0.05 ± 0.01, 0.24 ± 0.01, and 0.13 ± 0.01, respectively, and there were significant differences between the groups (A–B, p < 0.001, A–C: p = 0.009; B–C, p = 0.003). CONCLUSIONS: There were no significant differences among the three groups in binocular distant UCVA, and groups B and C showed better intermediate UCVAs than group A. Near UCVA was ranked in the order of groups A, C, B.
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Humans , Cataract , Lenses, Intraocular , Retrospective Studies , Telescopes , Visual AcuityABSTRACT
@#AIM:To analyze the effect of phacoemulsification and astigmatism corrected multifocal intraocular lens(IOL)implantation on corneal astigmatism and visual quality in cataract patients. <p>METHODS:Ninety-five patients who underwent ophthalmic surgery in our hospital for cataract disease between December 2016 and February 2018 were studied. All subjects were randomized and compared. Both groups were treated with phacoemulsification. The control group was treated with astigmatism-corrected monofocal intraocular lens implantation. The observation group was combined with astigmatism-corrected multifocal intraocular lens implantation. The differences in corneal astigmatism, visual quality, and vision improvement were compared between the two groups.<p>RESULTS: Uncorrected distance vision, best corrected distance vision, uncorrected near vision and best corrected near vision were significantly improved in the two groups after treatment at 3mo after operation. The degree of improvement in the observation group was significantly higher than that in the control group(<i>P</i><0.05). The corneal astigmatism of the two groups was significantly improved after treatment(<i>P</i><0.05). There was no significant difference between the two groups(<i>P</i>>0.05). After the treatment,the visual contrast sensitivity was significantly increased(<i>P</i><0.05). The visual contrast at the 18 cpd spatial frequency in the observation group was significantly lower than that in the control group(<i>P</i><0.01).One day after surgery, only two eyes in the observation group showed corneal endothelial edema, and only one eye in the control group showed corneal endothelial edema. There was no significant difference in the incidence of complications between the observation group and the control group(<i>P</i>>0.05).<p>CONCLUSION: The treatment of cataract patients with phacoemulsification and astigmatism-corrected multifocal IOL implantation can effectively correct vision, reduce corneal astigmatism, and improve visual contrast. The entire surgical procedure is safe and has fewer postoperative complications.
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@#AIM: To observe the visual quality after segmental Refractive multifocal intraocular lens(IOL)implantation.<p>METHODS: Totally 50 cases(83 eyes)of cataract patients who receiving phacoemulsification and IOL implantation in our hospital from June 2016 to February 2017 were selected as the study object. Based on the IOL types, the patients were divided into two groups: 22 cases(37 eyes)in observation group implanted segmental refractive multifocal IOL, 28 cases(46 eyes)in control group implanted monofocal IOL. Three months after surgery, the uncorrected visual acuity was recorded. A double-pass optical quality analysis system(OQAS II)was used to evaluate the visual quality. The near spectacle independence, satisfaction, and symptoms of visual disturbance were assessed by a questionnaire.<p>RESULTS: Three months after surgery, there were no statistical differences in uncorrected distance visual acuity(UCDVA)between the observation group and control group(<i>P</i>=0.273). The uncorrected intermediate visual acuity(UCIVA)and uncorrected near acuity(UCNVA)of observation group was better than control group(<i>P</i><0.05). There were no statistical differences in MTF cutoff; contrast visual acuity between the groups. The OSI in the observation and control groups was 2.64±0.68 and 1.52±0.47, respectively; objective amplitude of accommodation was(2.91±0.71)D and(1.32±0.41)D, respectively; near spectacle independence was 91% and 7%, respectively. There were statistical differences between the groups(<i>P</i><0.05). There were no statistical differences between the groups for visual disturbances(glare, ghosting)and satisfaction(<i>P</i>>0.05).<p>CONCLUSION: Segmental refractive multifocal intraocular lens provides wider objective amplitude of accommodation and good overall visual acuity, reduces spectacle dependency and provides high patient satisfaction.
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@#AIM: To measure the optical quality after implantation of SBL-3 and SN6AD1 multifocal intraocular lens(MIOL)in patients by a double-pass optical quality analysis system(OQAS).<p>METHODS: Totally 47 cases of age-related cataract who received phacoemulsification and the implantation of MIOL were enrolled from March 2017 to April 2018 in Chengdu Aier Eye Hospital. According to the difference of implanted MIOLs, patients were divided into SBL-3 group(22 patients, 22 eyes)and SN6AD1 group(25 patients, 25 eyes). Three months postoperatively, uncorrected distant visual acuity(UDVA), uncorrected intermediate visual acuity(UIVA), uncorrected near visual acuity(UNVA), corrected distant visual acuity(CDVA), corrected intermediate visual acuity(CIVA), corrected near visual acuity(CNVA), and objective optical quality measured by OQAS were all compared between two groups.<p>RESULTS: Three months postoperatively, significant difference was found in UIVA \〖0.14(0.04, 0.26)<i>vs</i> 0.26(0.12, 0.40), <i>P</i><0.05\〗 which was better in SBL-3 group. Moreover, significantly higher values of OSI \〖2.52(2.35, 3.86)<i>vs</i> 1.89(1.39, 2.28)\〗 and pseudophakic accommodation(2.47±0.88D <i>vs</i> 1.25±0.70D)were found in SBL-3 group. Significantly lower values of MTF-cut/off, SR, OV 100%, OV 20% and OV 9% were found in SBL-3 group(<i>P</i><0.01).<p>CONCLUSION: Both SBL-3 and SN6AD1 MIOL could provide patients with good subjective visual quality, but OQAS could find the differences in visual quality after implantation of different MIOLs objectively.
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Purpose: The aim of this study was to analyze the objective and subjective visual outcomes of patients bilaterally implanted with the extended range of vision intraocular lens (EROV IOL), the Tecnis Symfony. Methods: This was a prospective interventional case series conducted at a tertiary eye care hospital in South India. The study included patients with bilateral implantation of EROV IOLs. The uncorrected and corrected visual acuity for distance, intermediate, and near vision was recorded at 6 weeks and 6 months' postoperative visit. A subjective questionnaire was administered to assess spectacle independence, photic phenomenon, and overall satisfaction. All data were recorded using Microsoft Excel worksheet. The analyses were performed using SPSS for windows software. Results: Our study included fifty patients with bilateral implantation of EROV IOLs. The mean age was 59.84 ± 11.68 years. The mean uncorrected binocular distance, intermediate, and near visual acuity (in standard decimal equivalent) was 0.89,0.99 and 0.99 respectively, at 6 months' postoperative visit. Ninety-six percent of the patients did not require spectacles for distance and 98% of the patients were free from spectacles for intermediate and near vision. 94% of our patients perceived no or minimal photic phenomena such as glare and halos. The mean subjective patient satisfaction score (out of 10) for distance, intermediate, and near was 9, 10, and 9, respectively. Conclusion: The EROV IOLs demonstrated high levels of spectacle independence for distance, intermediate, and near vision. The incidence of photic phenomena observed was minimal with a high level of patient satisfaction.
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@#AIM: To observe the clinical efficacy and safety of regional refractive multifocal intraocular lens SBL-3. <p>METHODS: Eighty-five senile cataract patients(130 eyes)who underwent phacoemulsification and intraocular lens implantation in our hospital were divided into two groups according to the difference of implanted intraocular lens: patients with regional refractive multifocal intraocular lens(MIOL)42 example(65 eyes)as an observation group, 43 patients(65 eyes)of a single-focus aspheric intraocular lens were used as a control group. Three months after operation, the indicators were: uncorrected distance visual acuity(UCDVA), uncorrected intermediate visual acuity(UCIVA), uncorrected near visual acuity(UCNVA), and spherical equivalent power(SE). The naked eye defocus curve was measured and the patient's subjective visual quality was investigated by questionnaire, including the rate glasses removal, visual interference symptoms and satisfaction. <p>RESULTS: At 3mo after operation, UCDVA was significantly improved in both groups compared with preoperative, and the difference was statistically significant(<i>P</i><0.01). However, there was no significant difference between the two groups(<i>P</i>>0.05), while UCIVA and UCNVA in the observation group were significantly better than the control group, the difference was statistically significant(<i>P</i><0.01). At 3mo after operation, the difference of computerized optometry spherical equivalent power(SE)of the two groups was statistically significant(<i>P</i><0.01). At 3mo after operation, the naked eye defocus curve of the observation group was stable in the range of +0.50 to -3.00D, the LogMAR visual acuity was below 0.301, and the curve began to rise slowly after -3.50D; the control group showed trough between ±0.5D, both ends are rising rapidly. At 3mo postoperatively, the proportion of patients with visual interference symptoms in the observation group(4/42)was not significantly different from that in the control group(2/43)(<i>P</i>=0.433). The glasses removal rate of the observation group was 97.6%(41/42), control group was 18.6%(8/43), the difference was statistically significant(<i>χ</i><sup>2</sup>=4.318, <i>P</i>=0.038). In the observation group, the single eye distance satisfaction was 92.3%, and the control group was 93.8%. The difference was not statistically significant(<i>P</i>=1.000). The observation group had a single eye near fullness of 98.5%(64/65)and the control group was 16.9%(11/65), the difference was statistically significant(<i>χ</i><sup>2</sup>=88.526, <i>P</i><0.01). <p>CONCLUSION: The regional refraction MIOL can provide good near-intermediate-distance and full-distance uncorrected visual acuity. It can meet the needs of the patients at daily, distance-middle distance-near use. Postoperative visual interference symptoms were fewer and patient satisfaction was higher.
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Objective To compare the vision and visual quality after implantation of refractive rotationally asymmetric mutifocal IOL (SBL-3) and diffractive mutifocal IOL (Zeiss809) in cataract surgery.Methods Totally 80 patients (100 eyes) who underwent cataract surgery in our hospital from May 2016 to June 2017 were chosen in the research,followed by the implantation of SBL-3 in 39 patients (50 eyes,SBL group) and Zeiss809 in other 41 patients (50 eyes,Zeiss group).The gender,age,length of optic axis and corneal curvature between the both groups were not significantly different (all P ＞ 0.05) before surgery.Variables including far,middle and near uncorrected vision acuity,defocus curves,vision quality were observed 3 months after surgery.Objective scattering index (OSI),modulation transfer function cutoff frequency(MTFcutoff) and Strehl ratio (SR) were detected,and objective optical quality analysis system was conducted.Results Both groups has no ocular hypertension and complications after surgery.The far uncorrected vision acuity of both groups in 3 months after surgery showed significant statistic difference from preoperation (both P ＜ 0.01).There has no statistic difference between both groups in far and near uncorrected vision acuity 3 months after surgery (both P ＞0.05).SBL group showed better outcomes than that in Zeiss group in the middle uncorrected vision acuity 3 months after surgery (P =0.04).Defocus curves showed the better middle uncorrected vision acuity in SBL group than that in Zeiss group when the degree was-1.50 D (70 cm).The OSI,MTFcutoff and SR in both groups significantly improved after surgery when compared with before surgery (all P ＜0.05).And the OSI,MTFcutoff and SR 3 months after surgery had no statistic difference between the two groups (all P ＞ 0.05).Questionnaire results showed there were 3 patients in SBL group and 4 in Zeiss group complaining glare at night,and there was no statistic difference between the two groups (P ＞ 0.05).Conclusion Both refractive rotationally asymmetric mutifocal IOL and diffractive multifocal IOL shows satisfactory vision acuity after cataract surgery.Significant improvement of vision quality in both groups can be presented after IOL implantation.
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It is great significant for angle Kappa in refractive surgery,and it has been a consensus to adjust angle Kappa,especially in the correction of hyperopia corneal refractive surgery.The population distribution of angle Kappa is influenced by race,age,gender,eye,refractive status,ocular biometry and different precision measuring instruments,and it may also vary with the change of position or pupil size and other factors.At present,fewer researches on visual quality and treatment have been conducted in femtoseeond laser and cataract phacoemulsification combined with multifocal intraocular lens implantation in eyes with large angle Kappa,so more large sample researches are needed to perform in order to provide evidences for clinicians.