Clinical Outcomes of a New Hybrid Monofocal IOL With Extended Depth of Focus.

PURPOSE: To evaluate a new extended depth of focus intraocular lens (IOL), the xact Mono-EDOF ME4 (Santen Pharmaceuticals), Conformitè Europëenne-marked as a monofocal IOL, which has four diffractive rings intended to enhance intermediate vision. METHODS: Results are reported for 47 IOLs implanted in 28 patients who underwent cataract surgery and implantation of the xact Mono-EDOF ME4 IOL in one (9 patients) or both (19 patients) eyes. Postoperative follow-up examinations included visual acuity testing (monocular and binocular; uncorrected distance visual acuity [UDVA], corrected distance visual acuity [CDVA], uncorrected intermediate visual acuity [UIVA], distance-corrected intermediate visual acuity [DCIVA]), defocus curve and contrast sensitivity testing, and dysphotopsia evaluation. RESULTS: Follow-up at 6 months postoperatively revealed a monocular UDVA of 0.08 ± 0.15 logMAR, binocular UDVA of -0.02 ± 0.09 logMAR, monocular CDVA of -0.07 ± 0.08 logMAR, binocular CDVA of -0.09 ± 0.09 logMAR, monocular UIVA (70 cm) of 0.18 ± 0.16 logMAR, binocular UIVA (70 cm) of 0.09 ± 0.12 logMAR, monocular DCIVA (70 cm) of 0.25 ± 0.14 logMAR, and binocular DCIVA (70 cm) of 0.13 ± 0.11 logMAR. Defocus curve testing demonstrated a functional defocus of 1.25 diopters at 0.20 logMAR for monocular and 1.50 diopters at 0.20 logMAR for binocular testing. The contrast sensitivity corresponded to the age-appropriate normal values. Patients reported low levels of halo and glare. CONCLUSIONS: The xact Mono-EDOF ME4 IOL showed good functional results for far and intermediate distance visual acuity while inducing a low level of photic phenomena. [J Refract Surg. 2021;37(9):601-608.].

Corneal Incision Enlargement in Two Preloaded Intraocular Lens Injectors: An Intraindividual In Vivo Study.

PURPOSE: To assess enlargement of the clear corneal incision site and functional outcome in patients with cataract, following the use of two preloaded intraocular lens (IOL) injectors. METHODS: In this prospective, randomized, intraindividual comparative clinical study, 58 paired-eyes were randomly assigned for implantation with two preloaded injectors: AutonoMe with a Clareon IOL (Alcon Laboratories, Inc) and iSert with a Vivinex IOL (Hoya). The size of the corneal incision, 2 mm for the iSert and 2.2 mm for the AutonoMe, was measured before and after phacoemulsification and after IOL implantation. Patients were examined 3 months after surgery to assess keratometry, subjective refraction, and visual acuity. RESULTS: The incision enlargement was 0.20 ± 0.10 mm for the AutonoMe and 0.29 ± 0.10 mm for the iSert, with a statistically significant difference (P < .05). The final wound size after IOL implantation was 2.41 mm for the AutonoMe and 2.35 mm for the iSert. The mean absolute surgically induced astigmatism (SIA) was 0.50 ± 0.25 diopters (D) in the iSert eyes and 0.45 ± 0.20 D in the AutonoMe eyes (P > .05). The 3-month postoperative uncorrected and corrected distance visual acuity (UDVA and CDVA) were similar in both groups, with a UDVA of 0.10 and 0.12 logMAR and CDVA of -0.04 and -0.03 logMAR, respectively for the AutonoMe and iSert. CONCLUSIONS: The iSert injector caused more enlargement of the corneal wound during IOL implantation compared to the AutonoMe. Despite the initially different incision sizes, the final incision size and functional outcomes were similar in both groups. [J Refract Surg. 2021;37(5):331-336.].

Semi-fluorinated Alkane Eye Drops Reduce Signs and Symptoms of Evaporative Dry Eye Disease After Cataract Surgery.

PURPOSE: To clinically evaluate the efficacy and tolerability of semi-fluorinated alkane eye drops (EvoTears; URSAPHARM GmbH) as ocular surface treatment after cataract surgery in patients with evaporative dry eye disease. METHODS: This prospective, monocentric, open-label clinical trial included 40 patients undergoing cataract surgery and showing symptoms of evaporative dry eye disease as measured by the Symptom Assessment in Dry Eye (Visual Analogue Scale [VAS]) questionnaire, Ocular Surface Disease Index (OSDI), and tear break-up time (TBUT) of less than 10 seconds. EvoTears was prescribed four times a day for 5 weeks and administered 15 minutes after the standard postoperative topical anti-inflammatory regimen. The primary endpoint was the change in TBUT. Secondary endpoints included assessment of the subjective symptoms (VAS), corrected distance visual acuity (CDVA), slit-lamp examination, intraocular pressure, and Schirmer's test, which were evaluated at 1 day, 1 week, and 5 weeks postoperatively. At 5 weeks postoperatively, the tolerability and efficacy of EvoTears were evaluated by physicians and patients. RESULTS: At 5 weeks postoperatively, the median TBUT increased from 6.8 (preoperative) to 14 seconds (P < .001) and the average total corneal staining score decreased from 3.53 (preoperative) to 2.36 (P < .001). The mean CDVA improved from 0.41 (preoperative) to 0.14 logMAR (P < .001) and there was a statistically significant decrease in all scores from the VAS questionnaire at 5 weeks postoperatively. There was no statistically significant change in Schirmer's test (P = .150). CONCLUSIONS: EvoTears improved tear film, ocular surface, and subjective impressions of patients with dry eye disease 5 weeks after cataract surgery. Patients' and physicians' assessment indicated good efficacy and high tolerability of EvoTears, suggesting its suitability in postoperative management of the ocular surface in patients with dry eye disease. [J Refract Surg. 2020;36(7):474-480.].