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AIM: To investigate the effect of different lens combinations on visual acuity, visual quality and patient satisfaction by comparing mixed implantation of Tecnis Symfony ZXR00(ZXR00)and Tecnis ZMB00(ZMB00)lenses, bilateral implantation of ZMB00 lenses, and bilateral implantation of ZXR00 lenses.METHODS:This retrospective case-control study included 117 patients with cataracts(234 eyes)who underwent phacoemulsification combined with intraocular lens(IOLs)implantation from August 2020 to December 2021. The 3 groups included 36 patients(72 eyes)who underwent bilateral implantation of ZXR00(RR group), 37 patients(74 eyes)who underwent bilateral implantation of ZMB00(MM group), and 44 patients(88 eyes)who underwent implantation with a combination of ZXR00 and ZMB00(MR group). The uncorrected distance visual acuity(UDVA, 5 m), uncorrected intermediate visual acuity(UIVA, 80 cm), uncorrected near visual acuity(UNVA, 40 cm), corrected distance visual acuity(CDVA), defocus curve, stereopsis and VF-14 and QoV visual quality scale of the patients in the three groups were assessed at 3-month follow-up.RESULTS:Bilateral UNVA in the MM and MR group were significantly better than that in the RR group(P<0.05). Bilateral UIVA was the best in the RR group. There were no significant differences in bilateral UDVA, CDVA and stereopsis among the groups(P>0.05). Values for near-stereoscopic acuity at 40 cm were 107.27±80.53, 105.67±83.79, and 108.69±97.66(20-400)arcsec in the MR, MM, and RR groups, respectively(P>0.05). Satisfaction rates exceeded 90% in all groups.CONCLUSION:All groups achieved good distance, intermediate, and near visual acuity and near-stereoscopic vision postoperatively. Mixed implantation with ZXR00 and ZMB00 lenses achieved excellent full-range vision and resulted in high satisfaction. These results may aid in developing individualized clinical treatment plans.
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Purpose: To compare the postoperative uncorrected distance visual acuity (UDVA) and refractive outcomes of cataract patients with astigmatism following implantation of Eyecryl™ and Tecnis® toric intraocular lenses (IOLs). Methods: We conducted a single?center, retrospective study including patients who had undergone phacoemulsification and implantation with either Eyecryl™ toric (Group 1) or Tecnis® toric (Group 2) IOL. The primary outcome measures included postoperative UDVA and residual astigmatism at 3 months. The secondary outcome measure was IOL misalignment >10° throughout the follow?up period. Results: One hundred and eight eyes of 76 patients (44 males and 32 females) were analyzed. Twenty?nine patients (38 eyes) received Eyecryl™ toric IOL (Group 1), and 47 patients (70 eyes) received Tecnis® toric IOL (Group 2). Groups 1 and 2 showed a mean postoperative logMAR UDVA of 0.09 ± 0.11 and 0.06 ± 0.09, respectively, at 3 months (P = 0.114). In both groups, all the eyes achieved a postoperative UDVA of ?0.3 logMAR. The postoperative residual astigmatism of group 1 and group 2 was ?0.29 ± 0.34 D and ?0.16 ± 0.27 D, respectively (P = 0.038). Postoperative astigmatism was within ± 1.00 D in all the eyes. No eyes had an IOL misalignment >10° throughout the follow?up period. Conclusion: Both Eyecryl™ and Tecnis® toric IOLs provided significant improvement in uncorrected visual acuity and astigmatism correction postoperatively. The Tecnis® toric IOL provided statistically significant lower residual astigmatism than Eyecryl™toric IOL. However, the difference in postoperative astigmatism between the two IOLs was clinically insignificant
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@#AIM: To evaluate the clinical outcomes in terms of vision across distances(near, intermediate and far), contrast sensitivity and subjective patient satisfaction after femtosecond laser-assisted cataract surgery(FLACS)with implantation of an extended range of vision(ERV)intraocular lens(IOL).<p>METHODS: Forty patients(55 eyes)underwent bilateral or monocular FLACS with implantation of the ERV IOL Tecnis Symfony(Johnson & Johnson Vision)were enrolled. Uncorrected distance(UDVA), intermediate(UIVA)and near visual acuities(UNVA)were evaluated at 3mo after surgery, as well the defocus curve, contrast sensitivity, patient satisfaction and spectacle independence.<p>RESULTS:No severe complications occurred. All eyes showed a central position of the IOL in the capsular bag without tilting at 3mo after surgery. 3mo postoperative mean logMAR visual acuity at 5 m, 67 cm and 40 cm were -0.04 ±0.08, -0.17±0.22, 0.37±0.17, respectively. All patients obtained satisfactory UDVA and UIVA, as well as functional UNVA, meeting the needs of daily life. Spectacle independence rate was 94.55%. Contrast sensitivity results did not differ from those obtained with monofocal aspheric lenses. Likewise, no moderate and severe photic phenomena were reported. Mean patient satisfaction scores with distance, intermediate and near vision were 9.0, 9.0, and 7.0, respectively.<p>CONCLUSION: FLACS with implantation of the ERV IOL TECNIS Symfony provides a successful visual restoration at far, intermediate distance and a functional-range near vision acuity, with minimal level of disturbing photic phenomena, and high rates of spectacle independence and patient satisfaction.
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Objective To compare the efficacy and visual quality of biocular cataract surgery combined with TECNIS Symfony intraocular lens( IOL) implantation in the correction of presbyopia with three different methods of reserved diopters. Methods A prospective cohort design was adopted. From October in 2016 to December in 2018,120 patients 240 eyes with binocular cataract surgery implanted TECNIS Symfony IOL were divided into regular group,micro-near-vision group and micro-monovision group according to different reserved diopters,40 patients 80 eyes in each group. The binocular IOL reserved diopter is +0. 10--0. 20 D in regular group. The binocular IOL reserved diopter is -0. 20--0. 50 D in micro-near-vision group, meanwhile, the dominant eye reserved diopter is +0. 10--0. 20 D, and the non-dominant eye reserved the myopia of -0. 50--0. 75 D in micro-monovision group. Defocus curves of single eye and binocular were measured and full distance visual acuity were analyzed 3 months after surgery. MTF values were detected by iTrace and compared between different groups. Visual function questionnaire of multifocal intraocular lenes ( MIOLs ) were analyzed and spectacle independence rate of presbyopia correction and disturbing photic phenomena were compared 3 months after surgery. This study protocol was approved by the ethics committee of Chongqing Aier Mega Eye Hospital, and this study followed the Declaration of Helsinki. Results Compared with regular group, the whole defocus curve of micro-near-vision group actually shifted to the right by 0. 35 D,with almost no change in shape. The shape of the binocular defocus curve of micro-monovision group changed significantly compared with that of regular group,that is the wave peak became significantly wider,and the downward trend was more gentle. Spectacle independence rate of the three groups were all 100. 00％, spectacle independence rate of intermediate distance in Micro-monovision group was 100. 00％, which was higher than that of regular group (80. 00％) and micro-near-vision group(90. 00％),and the differences were statistically significant (χ2=37. 04;P<0. 01). The MTF value of the dominant eye was higher than that of the non-dominant eye in the Micro-monovision group,and the difference was statistically significant(t=3. 74,P=0. 001). There was no statistically significant difference in the occurrence rate of disturbing photic phenomena among the three groups(P>0. 05). Conclusions Different reserved diopter design during cataract extraction combined with TECNIS Symfony IOL implantation suits different patients. Among the three different reserved diopters methods, the effect of micro-monovision method can obtain the highest spectacle independence rate, and provide satisfactory binocular far to near full-distance visual acuity.
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Objective@#To compare the efficacy and visual quality of biocular cataract surgery combined with TECNIS Symfony intraocular lens(IOL) implantation in the correction of presbyopia with three different methods of reserved diopters.@*Methods@#A prospective cohort design was adopted.From October in 2016 to December in 2018, 120 patients 240 eyes with binocular cataract surgery implanted TECNIS Symfony IOL were divided into regular group, micro-near-vision group and micro-monovision group according to different reserved diopters, 40 patients 80 eyes in each group.The binocular IOL reserved diopter is + 0.10--0.20 D in regular group.The binocular IOL reserved diopter is -0.20--0.50 D in micro-near-vision group, meanwhile, the dominant eye reserved diopter is + 0.10--0.20 D, and the non-dominant eye reserved the myopia of -0.50--0.75 D in micro-monovision group.Defocus curves of single eye and binocular were measured and full distance visual acuity were analyzed 3 months after surgery.MTF values were detected by iTrace and compared between different groups.Visual function questionnaire of multifocal intraocular lenes (MIOLs)were analyzed and spectacle independence rate of presbyopia correction and disturbing photic phenomena were compared 3 months after surgery.This study protocol was approved by the ethics committee of Chongqing Aier Mega Eye Hospital, and this study followed the Declaration of Helsinki.@*Results@#Compared with regular group, the whole defocus curve of micro-near-vision group actually shifted to the right by 0.35 D, with almost no change in shape.The shape of the binocular defocus curve of micro-monovision group changed significantly compared with that of regular group, that is the wave peak became significantly wider, and the downward trend was more gentle.Spectacle independence rate of the three groups were all 100.00%, spectacle independence rate of intermediate distance in Micro-monovision group was 100.00%, which was higher than that of regular group(80.00%) and micro-near-vision group(90.00%), and the differences were statistically significant (χ2=37.04; P<0.01). The MTF value of the dominant eye was higher than that of the non-dominant eye in the Micro-monovision group, and the difference was statistically significant(t=3.74, P=0.001). There was no statistically significant difference in the occurrence rate of disturbing photic phenomena among the three groups(P>0.05).@*Conclusions@#Different reserved diopter design during cataract extraction combined with TECNIS Symfony IOL implantation suits different patients.Among the three different reserved diopters methods, the effect of micro-monovision method can obtain the highest spectacle independence rate, and provide satisfactory binocular far to near full-distance visual acuity.
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PURPOSE: To compare the effectiveness of toric intraocular lens (IOL) implantation and monofocal IOL implantation with a limbal relaxing incision (LRI) for correcting astigmatism in the Korean population. METHODS: The medical records of 79 patients (100 eyes) with corneal astigmatism over 1.25 diopters (D) who underwent toric IOL implantation (toric group; 54 eyes), monofocal IOL implantation with a concurrent LRI (LRI group; 24 eyes), or monofocal IOL implantation without correcting astigmatism (control group; 22 eyes), were retrospectively reviewed. For subgroup analyses, the three groups were subdivided according to preoperative astigmatic severity under 2.5 D. Visual, refractive, and keratometric outcomes were compared 2 and 6 months postoperatively. RESULTS: The uncorrected distance visual acuity was at least 20/25 (0.1 logMAR) in 64.8%, 41.7%, and 27.3% of the toric, LRI, and control group eyes, respectively at 2 months after surgery. The toric group had the greatest refractive cylindrical error change (toric group, −2.48 ± 1.84 D to −0.98 ± 0.92 D; LRI group, −2.02 ± 1.03 D to −1.65 ± 0.86 D; control group, −1.69 ± 0.88 D to −1.49 ± 0.60 D; p < 0.001) and the LRI group showed the greatest mean corneal cylindrical error change (toric group, 2.40 ± 1.33 D to 2.23 ± 1.42 D; LRI group, 1.86 ± 0.44 D to 1.29 ± 0.55 D; control group, 1.60 ± 0.39 D to 1.35 ± 0.60 D; p = 0.025). The 85 eyes with moderate corneal astigmatism (between 1.25 D and 2.5 D) were under evaluation. The toric group showed the highest mean refractive cylindrical change (0.97 ± 0.66 D; p < 0.001), followed by the LRI group (0.53 ± 0.87 D; p = 0.046). CONCLUSIONS: Both surgical techniques significantly reduced astigmatism and had comparable visual outcomes. Toric IOL implantation was more reliable for correcting astigmatism than monofocal IOL implantation with a concurrent LRI regardless of the preoperative astigmatic severity. Both procedures were effective in reducing astigmatism in eyes with moderate corneal astigmatism.
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Humanos , Astigmatismo , Implantación de Lentes Intraoculares , Lentes Intraoculares , Registros Médicos , Estudios Retrospectivos , Agudeza VisualRESUMEN
PURPOSE: In this study evaluated clinical outcomes and higher-order aberrations in patients with implanted Tecnis ZCT toric intraocular lens (IOL) (Abbott Medical Optics Inc., Santa Ana, CA, USA) and the Zeiss AT TORBI toric IOL (Carl Zeiss Meditec AG, Jena, Germany) in eyes with low to moderate corneal astigmatism. METHODS: We conducted a retrospective study of 32 consecutive eyes of 26 patients with a visually significant cataract and moderate corneal astigmatism (higher than 1.25 diopter [D] and lower than 4.5 D) undergoing cataract surgery with implantation of the aspheric Tecnis ZCT toric IOL (Abbott Medical Optics Inc.) and the Zeiss AT TORBI toric IOL (Carl Zeiss Meditec AG). Phacoemulsification was performed by the same experienced surgeon using 2.2 mm temporal incision. Visual, refractive and aberrometric changes were evaluated during a 3-month follow-up. Power vector analysis of Cartesian astigmatism (J0) and oblique astigmatism (J45) was performed. RESULTS: At the 3-month follow-up, corrected distance visual acuity (CDVA) and residual astigmatism showed no statistically significant differences between groups (p = 0.203 and p = 0.364, respectively). Pre- and postoperative J0 were 0.71 +/- 0.84 and 0.05 +/- 0.39 in the Tecnis Toric group and, 0.88 +/- 1.27 and -0.02 +/- 0.16 in the AT TORBI group, respectively, which showed statistically significant differences (p = 0.029 and p = 0.032, respectively). Pre- and post-operative differences of J0 and J45 were not statistically significant (p = 0.234 and p = 0.603, respectively). No eye had IOL rotation > or =10degrees. Ocular aberrometry values were statistically significantly differenct between the groups, except for spherical aberration, which was higher in the AT TORBI group (p = 0.0047). CONCLUSIONS: Both IOLs showed good postoperative uncorrected distance visual acuity, CDVA and refractive results in this study. Rotational stability was excellent for both IOLs until the 3-month follow-up.
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Humanos , Aberrometría , Astigmatismo , Catarata , Estudios de Seguimiento , Lentes Intraoculares , Facoemulsificación , Estudios Retrospectivos , Agudeza VisualRESUMEN
PURPOSE: To evaluate the efficacy of Tecnis(R) toric intraocular lens (IOL) implantation for the correction of astigmatism and rotational stability during cataract surgery in patients with cataract and astigmatism. METHODS: We prospectively analyzed 17 eyes of 14 patients with 1 to 4 diopters (D) of corneal astigmatism who underwent phacoemulsification and Tecnis(R) toric IOL implantation at Seoul National University Hospital from June 2013 to May 2014. Informed consent was obtained from all participants before the clinical trial. We evaluated the changes in visual acuity, refraction, astigmatism, IOL axis and higher order aberration for 3 months postoperatively. Power vector analysis was used to analyze astigmatism. RESULTS: The mean uncorrected visual acuity (log MAR) significantly improved from 0.58 +/- 0.34 to 0.26 +/- 0.43 at 3 months postoperatively. The mean refractive astigmatism was significantly decreased by 77.9% from a mean value of -2.67 +/- 0.89 D to -0.59 +/- 0.48 D at 3 months postoperatively. According to power vector analysis, M, B, J0, and J45 were significantly reduced after the surgery. The mean difference between achieved and intended IOL axis was 3.26 degrees clockwise at postoperative 3 months, which was statistically insignificant. Most of the rotational changes were observed within a month after the surgery. CONCLUSIONS: Phacoemulsification and Tecnis(R) toric IOL implantation in patients with cataracts and astigmatism showed efficacy for the correction of astigmatism and rotational stability.
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Humanos , Astigmatismo , Vértebra Cervical Axis , Catarata , Consentimiento Informado , Implantación de Lentes Intraoculares , Lentes Intraoculares , Facoemulsificación , Estudios Prospectivos , Seúl , Agudeza VisualRESUMEN
Purpose: To study the relationship between the axial length and personal A‑constant for the 1‑piece Tecnis (Abbott ZCB00), AcrySof MA60AC (Alcon) and the Quatrix aspheric preloaded (CROMA) intraocular lenses (IOL). Materials and Methods: Patients matching the inclusion criteria were further subdivided according to the implanted IOL in this prospective comparative study. The obtained refractive outcomes were introduced into the formula installed in the biometry machine (Humphrey model 820 ultrasonic biometer) to obtain the personal A‑constant for each eye. Polynomial regression analysis was done to study the individualized A‑constant for each type of IOL in relation to preoperative axial length measurement. Results: Two hundred and forty five eyes of 186 patients were enrolled into this study, of whom 73 eyes with Tecnis 1‑piece, 116 eyes with MA60AC, and 56 eyes with Quatrix. The median of personalized A‑constant for Tecnis 1‑piece, MA60AC, and Quatrix were 119.21 (SD 1.3, Std. Mean error 0.15), 119 (SD 1.2, Std. Mean error 0.11) and 120.4 (SD 1.2, Std. Mean error 0.16) respectively. Regression plots for the same range of axial length among all the groups showed that the Tecnis1 group followed the same pattern of the Quatrix group in which there was a linear relationship of a trend towards myopia when the axial length had increased and a hyperopic shift when decreased. This relationship changed into a plateau when the axial length became in the range of 23.5 mm to 27 mm in the MA60AC group. Conclusions: Personal A‑constant follows different trends with different IOLs even for the same range of axial length.
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PURPOSE: To compare the anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA) and refractive change after cataract surgery between 3-piece and 1-piece aspheric intraocular lens (IOL) implantation. METHODS: The present study consisted of 16 patients (25 eyes) having 3-piece aspheric Tecnis(R) ZA9003 IOL and 21 patients (30 eyes) having 1-piece aspheric Tecnis(R) ZCB00 IOL. The ACD, ACV, and ACA were measured using an anterior eye segment analysis system (Pentacam, Oculus, Wetzlar, Germany) preoperatively and postoperatively 1 week and 1 month. Refractive outcomes were evaluated using an autokeratometer. RESULTS: When comparing the 3-piece (Tecnis(R) ZA9003) and 1-piece (Tecnis(R) ZCB00) IOL with the same optic, ACD, ACV, and AVA increased significantly after cataract surgery. The 1-piece IOL showed deeper ACD than the 3-piece IOL at postoperative 1 week and 1 month. Postoperative refraction showed slight myopic shift compared with target diopter, but was stable in both groups. CONCLUSIONS: There was significant increase in ACD, ACV, and ACA after cataract surgery in both IOL-inserted groups. Results showed stable refraction after cataract surgery in both groups. Consideration of the A-constant will be needed because of myopic change with the 1-piece IOL.