Comparison of short-term visual acuity and visual disturbance phenomena and spectacle independence after implantation of three different intraocular lenses / 国际眼科杂志(Guoji Yanke Zazhi)

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.

Clinical efficacy of femtosecond laser-assisted cataract surgery combined with PanOptix trifocal intraocular lens implantation / 国际眼科杂志(Guoji Yanke Zazhi)

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.

Comparison of visual quality between extended depth and trifocal intraocular lens implantation / 国际眼科杂志(Guoji Yanke Zazhi)

@#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.

Comparison of vision-related quality of life between monocular and binocular trifocal IOL implantation / 国际眼科杂志(Guoji Yanke Zazhi)

@#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.

Comparison of visual quality between bifocal and trifocal intraocular lens implantation / 国际眼科杂志(Guoji Yanke Zazhi)

@#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.

Resultados clínicos con la lente intraocular trifocal Acriva Trinova / Clinical results obtained with the Acriva Trinova trifocal intraocular lens

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)

Femtosecond laser-assisted cataract surgery combined with trifocal intraocular lens implantation / 国际眼科杂志(Guoji Yanke Zazhi)

@#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.

Resultados visuales de implante de lente trifocal en pacientes con glaucoma / Visual outcomes with trifocal lens implant in glaucoma patients

Objetivo: Evaluar los resultados visuales en pacientes con sospecha de glaucoma y glaucoma leve candidatos a cirugía de catarata e implante de lente intraocular trifocal. Diseño del estudio: Estudio longitudinal, prospectivo, experimental y analítico. Métodos: Se incluyeron pacientes con catarata y diagnóstico de glaucoma leve o sospechoso de glaucoma que contaran con campo visual, tomografía de nervio óptico y estudio de sensibilidad al contraste y se les realizo cirugía de catarata por facoemulsificación del cristalino con implante de lente intraocular trifocal AT LISA tri 839 MP. Resultados: Se incluyeron 9 ojos de 5 pacientes (4 mujeres y 1 hombre) entre los 66 y 87 años con un promedio de 73.2 ± 7.6 años. La agudeza visual prequirúrgica con corrección lejana fue de 0.29±0.16 LogMar (20/40), intermedia 0.67±0.49 LogMar (20/60), cercana 0.66± 0.57 LogMar (20/80); al mes postquirúrgico la agudeza visual con corrección lejana fue 0.08± 0.06 LogMar (20/25), intermedia 0.05± 0.06 LogMar (20/20), cercana 0.02±0.03 LogMar (20/20). Encontramos una mejoría estadísticamente significativa de la agudeza visual al mes de postoperatorio. En el análisis de la sensibilidad al contraste prequirúrgica y postquirúrgica, no observamos diferencias estadísticamente significativas en ninguna de las frecuencias espaciales (3cpg 1.32 ± 0.25 vs 1.34 ± 0.26, 6cpg 1.41 ± 0.30 vs 1.46 ± 0.28, 12 cpg 1.094 ± 0.42 vs 0.98 ± 0.37, 18cpg 0.69 ± 0.41 vs 0.60 ± 0.30). Conclusiones: Los resultados visuales obtenidos a diferentes distancias con el diseño trifocal indican que esta técnica emergente constituye una alternativa para la cirugía de catarata para pacientes candidatos con glaucoma leve o sospecha de glaucoma sin que el procedimiento altere su seguimiento ni modifique la sensibilidad al contraste.

Objective: To evaluate visual results in patients with glaucoma suspect and mild glaucoma, candidates for cataract surgery and trifocal intraocular lens implantation. Study design: Longitudinal, prospective, experimental and analytical study. Methods: We include patients with cataract and diagnosis of mild or glaucoma suspect who had a visual field, optic nerve tomography and contrast sensitivity study. They underwent to cataract surgery with trifocal intraocular lens implant (ATLISAtri839MP). Results: 9 eyes of 5 patients (4 women and 1 man) were included between 66 and 87 years, with an average of 73.2 ± 7.6 years. Preoperative visual acuity with distance correction was 0.29 ± 0.16 LogMar (20/40), intermediate 0.67 ± 0.49 LogMar (20/60), near to 0.66 ± 0.57 LogMar (20/80); the results per month were: the visual acuity with distance correction was 0.08 ± 0.06 LogMar (20/25), intermediate 0.05 ± 0.06 LogMar (20/20), near to 0.02 ± 0.03 LogMar (20/20). We found improvement in visual acuity at the month of postoperative, statistically significant. In the analysis of preoperative and postsurgical contrast sensitivity, we did not observe statistically signifi cant differences in any of the spatial frequencies (3cpg 1.32 ± 0.25 vs 1.34 ± 0.26, 6cpg 1.41 ± 0.30 vs 1.46 ± 0.28, 12 cpg 1.094 ± 0.42 vs 0.98 ± 0.37, 18 cpg 0.69 ± 0.41 vs. 0.60 ± 0.30). Conclusions: The visual results obtained at different distances with the trifocal design indicate that this emerging technique is an alternative for cataract surgery for candidates with mild glaucoma or glaucoma suspect; whereas the procedure does not alter follow-up or contrast sensitivity.