[Outcomes of extended depth of focus intraocular lenses implantation]. / Rezul'tat implantatsii intraokulyarnykh linz s rasshirennoi glubinoi fokusa.

Extended depth of focus (EDOF) intraocular lenses (IOLs) are the latest IOL designs. In recent years, several models of EDOF IOLs have become available in Russia, two of which (Tecnis Symfony and Acrysof IQ Vivity) are implanted in our clinic. Comparative studies devoted to the results of implantation of the new EDOF IOLs are rare in the available literature. PURPOSE: This article compares the outcomes of implantation of two EDOF IOLs in patients with presbyopia and/or cataract. MATERIAL AND METHODS: The prospective study included 60 patients (81 eyes) after implantation of EDOF IOL Tecnis Symfony (32 patients, 45 eyes; group 1) or EDOF IOL AcrySof IQ Vivity (28 patients, 36 eyes; group 2). The mean follow-up period was 3.9±1.3 months. RESULTS: All groups showed a significant (p<0.05) increase in uncorrected near visual acuity (UCNVA), intermediate visual acuity (UCIVA), and distance visual acuity (UCDVA) at the maximum follow-up time compared to preoperative values. In group 1, the best corrected near visual acuity (BCNVA) increased from 0.61±0.10 to 0.82±0.16 at the maximum follow-up time, and in group 2 - from 0.58±0.08 to 0.67±0.12 (p>0.05). Both groups showed a significant increase in best corrected intermediate and distance visual acuity (BCIVA and BCDVA) at the maximum follow-up time. The increase in the indicator compared to the preoperative period was not significant in both groups (p>0.05). The frequency of side optical phenomena was low in both groups. No significant differences were found between the groups (p>0.05). CONCLUSION: This study presents a comparative analysis of the results of implantation of two different EDOF IOLs. Both lenses were comparable in most of the studied parameters, including providing good distance and intermediate vision, functional near vision, as well as a low frequency of side optical phenomena. In all cases the patients were satisfied with the results of the surgical intervention.

[Outcomes of bilateral implantation of trifocal and extended depth of focus IOLs]. / Rezul'taty bilateral'noi implantatsii trifokal'noi intraokulyarnoi linzy i intraokulyarnoi linzy s rasshirennoi glubinoi fokusa.

In recent years, a new class of extended depth of focus (EDOF) intraocular lenses (IOLs) has become available on the market. There is only a limited number of scientific papers comparing trifocal and EDOF IOL data, and the results are often contradictory. PURPOSE: Comparative analysis of the results of trifocal and EDOF IOL implantation in patients with presbyopia and/or cataract. MATERIAL AND METHODS: This prospective study included 72 patients (144 eyes) after bilateral implantation of either Tecnis Symfony EDOF IOL (18 patients, 36 eyes; group I) or AcrySof PanOptix trifocal IOL (54 patients, 108 eyes; group II). In 18 patients out of 72 (25%) the implantation involved mini-monovision, i.e. the calculation of the IOL power on the nondominant eye was performed at -0.5 D. The average follow-up period for the patients was 7.1±1.2 months. RESULTS: There was a significant (p<0.05) increase in uncorrected near visual acuity (UCNVA), uncorrected intermediate visual acuity (UCIVA) and uncorrected distance visual acuity (UCDVA) at the maximum follow-up time compared to the preoperative indices in all groups. Group II was characterized by slightly better UCNVA dynamics (0.85±0.13 versus 0.2±0.04 before surgery, as comparted to 0.78±0.11 versus 0.19±0.06 before surgery in group I), but differences were not statistically significant (p>0.05). Statistically significant differences (p=0.046) were observed when comparing best corrected near vision acuity (BCNVA) in groups I and II (0.79±0.05 and 0.98±0.08, respectively) at 6 months compared to the preoperative period (0.62±0.09 and 0.6±0.11, respectively). CONCLUSION: Trifocal IOL implantation was associated with acceptable near and far vision correction and a higher frequency of adverse optical phenomena, while implantation of the EDOF IOL was associated with slightly better correction of intermediate vision and a significantly lower incidence of halo and glare. Patients were satisfied with the outcomes of surgery in all cases.

[Clinical and functional results of bifocal IOLs implanted during combined cataract and glaucoma surgery]. / Kliniko-funktsional'nye rezul'taty implantatsii bifokal'nykh intraokuliarnykh linz v khode kombinirovannoi khirurgii katarakty i glaukomy.

At present, implantation of multifocal IOLs in patients with primary open-angle glaucoma (POAG) remains questionable. PURPOSE: To comparatively analyze the clinical and functional effectiveness of bifocal IOLs implanted during combined cataract and glaucoma surgery. MATERIAL AND METHODS: The prospective study included 41 patients (75 eyes) with presbyopia and POAG who underwent one-stage cataract phacoemulsification with implantation of a multifocal IOL and non-penetrating deep sclerectomy (NPDS) with lens capsule. Group 1 included 24 patients (44 eyes) with implantation of diffractive-refractive IOL. Group 2 consisted of 17 patients (31 eyes) who were implanted aspheric diffractive IOL with asymmetric optics. RESULTS: Mean IOP in both groups was 18.1±2.9 mmHg, and the difference with the preoperative parameters (26.1±2.8) was statistically significant (p<0.05). On average, the patients received 1.3±0.5 antihypertensive drugs compared to 2.4±0.61 before surgery (0.050.1). Implantation of multifocal IOLs in combination cataract and glaucoma surgery is a safe and effective surgical intervention for the described group of patients.

[General ophthalmic ergonomic evaluation of surgery for the subnormal refraction]. / Obshchaia oftal'moérgonomicheskaia otsenka khirurgicheskoi korrektsii anomalii refraktsii.

The authors discuss changes of various anatomic and functional eye parameters after keratorefraction operations. Necessity of ophthalmic ergonomic studies in refraction surgery is stressed, occupational indications are justified.

[Topography and angioarchitectonics of the orbital portion of the optic nerve according to ultrasonic findings and data of three-dimensional optic analysis]. / Topografiia i angioarkhitektonika orbital'noi chasti zritel'nogo nerva po dannym ul'trazvukovykh metodov issledovaniia i trekhmernogo opticheskogo analiza.

Super-sharp gray scale image, highly sensitive digital wide-band Doppler analysis, three-dimensional visualization of vessels in pulsed energy Doppler mode, and three-dimensional optic tomography of the optic disk were used in examination of the posterior segment of the eye in 20 healthy volunteers (40 eyes) aged 20-50 years. Vascular network of the optic nerve was examined under clinical conditions; blood filling of elements of the Zinn-Haller arterial circle, reticular plate, and posterior short ciliary arteries were studied. Vascular architectonics of the retrobulbar space was studied by three-dimensional reconstruction in the energy Doppler mode and biometrical parameters of intraocular and retrobulbar part of the optic disk were determined.

Fine tuning excimer laser correction after intraocular lens implantation and corneal transplantation.

PURPOSE: To conduct an analysis of laser in situ keratomileusis (LASDS) results in patients with artiphakia, after phakic posterior chamber intraocular lens implantation, and after corneal transplantation. METHODS: We analyzed the results of 57 eyes with an IOL that had LASDi: 22 eyes- artiphakia after ECCE with IOL implantation; 8 eyes had phacoemulsification with IOL implantation; 9 eyesartiphakia after removal of transparent lens with IOL implantation in patients with the high myopia (ß eyes) and high hyperopia (3 eyes); 3 eyes- phakic posterior chamber IOL (2 with hyperopia, 1 with myopia); and 15 eyes after corneal transplantation. LASDS correction was performed not earlier than 6 months after IOL implantation and not earlier than 18 months after corneal transplantation. Follow-up ranged from 6 to 12 months after LASDS using the Nidek EC-5000 excimer laser. A thorough ophthalmic examination preceded and followed laser correction. RESULTS: Mean deviation from emmetropia before LASDS was 3.50 D (range, -6.00 to +4.00 D), and astigmatism averaged 2.75 D (range, 0 to 5.00 D). Before LASDS, mean uncorrected visual acuity was 0.2 and mean spectacle-corrected visual acuity was 6 (range, 0.4 to 1.0). After LASDS, mean deviation from emmetropia was 0.50 D (range, -1.50 to +0.75 D) and average astigmatism was -0.75 D (range, 0 to 1.50 D). Mean uncorrected visual acuity was 0.7 (range, 0.4 to 1.0). CONCLUSION: LASIK in patients with artiphakia, phakic posterior chamber intraocular lens implantation, and after corneal transplantation was atraumatic, predictable, and efficient. The best results were seen in patients with a myopic refractive error and myopic astigmatism. For hyperopia, LASDS was our method of choice in eyes with "piggy-back" IOLs. J Refract Surg 2000;16(suppl):S257-S260].

Refractive surgery for hyperopia.

PURPOSE: To determine the efficacy, stability, and predictability of refractive surgery for hyperopia using four different procedures: photorefractive keratectomy (PRK), laser in situ keratomileusis (LASIK), implantation of a phakic intraocular lens (PIOL), and removing the transparent lens with IOL implantation. METHODS: We operated on 184 eyes with hyperopia; 56 eyes had less than +2.00 D (low hyperopia), 62 eyes had +2.00 to +5.00 D (moderate hyperopia), and 66 eyes had greater than +5.00 D (high hyperopia). In the low hyperopia group, PRK was used in 22 eyes and LASIK in 34 eyes. In the moderate hyperopia group, PRK was used in 12 eyes and LASIK in 33 eyes, PIOL implantation in 12 eyes, and transparent lens extraction with IOL implantation in 5 eyes. In the high hyperopia group, PRK was used in 7 eyes, LASIK in 12 eyes, PIOL implantation in 21 eyes, and extraction of transparent lens with IOL implantation in 26 eyes. We used the Nidek EC5000 excimer laser and with the Moria LASIK Evolution microkeratome. The transparent lens was removed by phacoemulsification, and the Phacoprofile Storz IOL with optical power from 28.00 to 36.00 D was implanted. The PIOLs were made of a collagen copolymer with a focal power from +6.00 to +12.00 D. RESULTS AND CONCLUSION: Refraction and visual results depended on amount of baseline hyperopia and age of the patient. For young patients (35 years old or less) with normal accommodation and low or moderate hyperopia, PRK and LASIK were our methods of choice. However, after LASHL stabilization of refraction occurred faster (3 to 12 weeks) compared to PRK, where changes in refraction were noted from 8 to 12 months after surgery. In patients with hyperopia more than +5.00 D, we prefer intraocular methods of correction: phakic IOL implantation for young patients and removing the transparent lens with IOL implantation in patients with presbyopia or anatomical tendency for development of closedangle glaucoma. [J Refract Surg 2000;16(suppl): S242-S246].