Comparison of bilateral implantation of an extended depth of focus lenses and a blend approach of extended depth of focus lenses and bifocal lenses in cataract patients.

BACKGROUND: To compare the visual outcomes, spectacle independent rate and stereopsis in patients who underwent bilateral implantation of extended depth of focus (EDOF) intraocular lens (IOL), or a blend approach of EDOF and bifocal IOL. METHODS: A total of 60 cataract patients, who were scheduled for phacoemulsification and intraocular lens implantation in both eyes in West China Hospital of Sichuan University, were enrolled and divided into Micro monovision group(-0.5D~-1.0D), Non-micro monovision group (< 0.5D) with Symfony IOL, and Mixed group with Symfony and ZMB00 IOLs. Three months postoperatively, we compared the visual acuity, modulation transfer function (MTF), defocus curve, stereopsis, spectacle independence, and photic phenomena among the three groups. RESULTS: Compared to the Non-micro monovision group (UNVA: 0.07 ± 0.04), Micro monovision group (UNVA: 0.00 ± 0.07, P < 0.001) and Mixed group (UNVA: -0.02 ± 0.06, P < 0.001) showed improvement in binocular uncorrected near visual acuity (UNVA). Additionally, Mixed group exhibited lower MTF10 (MTF10: 0.38 ± 0.24) and point spread function (PSF: 0.192 ± 0.269) results in their non-dominant eye compared to both Micro monovision group (MTF10: 0.56 ± 0.21, P = 0.027; PSF: 0.417 ± 0.282, P = 0.034) and Non-micro monovision group (MTF10: 0.55 ± 0.19, P = 0.038; PSF: 0.408 ± 0.285, P = 0.003). Spectacle independence for near vision were higher in both the Micro monovision (45%) and Mixed (55%) group compared to the Non-micro monovision group (40%). The Mixed group also reported higher incidence of photic phenomena (25%). However, there were no significant differences in stereoscopic function among the three groups. CONCLUSION: Both micro monovision and mix-and-match methods can help patients to obtain better visual outcomes at different distances. Mix-and-match method has better near visual acuity, while micro monovision method has better intermediate visual acuity. Non-micro monovision methods will affect patients' near vision outcomes. Binocularly implanted EDOF IOL has better contrast sensitivity. CLINICAL TRIAL REGISTRATION: Registration date:11/07/2023. TRIAL REGISTRATION NUMBER: ChiCTR2300073433. TRIAL REGISTRY: West China Hospital of Sichuan University retrospectively registered.

Exploring the Effect of Preoperative Stereopsis on Visual Outcomes in Hyperopic Presbyopes Treated with PresbyOND® Laser Blended Vision Micro-Monovision.

We investigated the effects of Laser Blended Vision (LBV) on binocular summation and stereopsis in the treatment of presbyopia and hyperopia. Using a unidirectional, retrospective longitudinal design, data from 318 patients who underwent the Zeiss PresbyOND® LBV surgical procedure at Tecnolaser Clinic Vision Ophthalmology Center in Seville, Spain, were analyzed. The findings indicate that stereopsis quality significantly influenced short-term post-operative visual outcomes in measures like Uncorrected Distance and Near Visual Acuity (UDVA and UNVA). However, the impact of stereopsis on visual outcomes appeared to diminish over time, becoming statistically insignificant at the 12-month post-operative mark. The study suggests that while stereopsis is a crucial factor in the short term, its influence on visual outcomes tends to wane in the long-term postoperative period. Future studies are essential to elucidate the enduring clinical ramifications of these observations.

Effectiveness of SMILE Combined with Micro-Monovision in Presbyopic Patients: A Pilot Study.

Binocular summation along all defocus range after a micro-monovision procedure has scarcely been studied. The aim of this pilot study was to evaluate the efficacy of SMILE combined with different levels of micro-monovision in presbyopic patients and to assess the binocular summation effect on contrast sensitivity defocus curves (CSDC) at the 6-month follow-up. Efficacy was assessed on the basis of visual acuity (VA) and stereopsis at far, intermediate, and near distances. Patient-reported outcomes (PROs) and binocular CSDC were also evaluated. Six patients completed the study with a programmed median anisometropia of 0.81 Diopter. The median binocular uncorrected VA was better than 0 logMAR at the three evaluated distances, and stereopsis was not impaired in any patient, achieving a median of ≤119 arcsec at any distance. CSDC increased binocularly after surgery, significantly in the range of -2 to -3 D (p < 0.05). No clinically relevant changes were observed in PROs compared with the preoperative period, and all patients achieved spectacle independence at intermediate/near distance and were likely or very likely to undergo the same surgery. In conclusion, micro-monovision with SMILE could be an effective procedure, with results that might be comparable to other laser correction techniques specifically designed for presbyopia correction.

Visual outcomes in hyperopic myopic and emmetropic patients with customized aspheric ablation (Q factor) and micro-monovision.

PURPOSE: To evaluate the visual outcomes, visual performance, and stereoacuity in presbyopic patients following treatment by a change in the corneal asphericity and micro-monovision. METHODS: Presbyopic patients with diverse refractive errors and emmetropes (n = 30 eyes) were treated with a custom Q-ablation profile and micro-monovision in the non-dominant eye. There with a difference of Q - 0.30 in the Q profiles between dominant and non-dominant eyes. Patients were assigned in two groups based on the preoperative spherical equivalent (Group 1 + 4.00 to + 0.50, and group 2 neutral to - 3.00). Binocular uncorrected distance visual acuity (binocular UCVA), best-corrected visual acuity (BCVA), binocular uncorrected near visual acuity (binocular UNVA) preoperative and postoperative, spherical equivalent refraction, contrast sensitivity, and stereopsis were analyzed at 1, 3, and 6 months. RESULTS: The mean age was 52.6 ± 5.1 (SD) years. At six months post-operation, the mean binocular uncorrected distance visual acuity (binocular UDVA) was 0.15 ± 0.04 logMAR (20/25-) in group 1, and 0.11 ± 0.05 logMAR (20/25) in group 2, and binocular uncorrected near vision UNVA was 0.5 ± 0.1 M (20/25 J2) in group 1 and 0.45 ± 0.2 M (20/25 J2) group 2. An increase in stereoacuity was found in both groups. CONCLUSIONS: The correction of refractive defects using customized corneal asphericity was an effective treatment in presbyopic patients. Furthermore, the treatment was well tolerated in this group of patients. Following surgery, the quality of vision was adequate, and the stereovision improved in this cohort of patients.

Influences of different reserved diopters during cataract extraction combined with TECNIS Symfony intraocular lens implantation on visual quality of presbyopia correction / 中华实验眼科杂志

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.

Influences of different reserved diopters during cataract extraction combined with TECNIS Symfony intraocular lens implantation on visual quality of presbyopia correction / 中华实验眼科杂志

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.

[The KAMRA™ inlay : A realistic approach?] / Das KAMRA™-Inlay : Ein realistischer Ansatz?

BACKGROUND AND PURPOSE: The KAMRA™ inlay (AcuFocus, Irvine, California, USA) is an additional option for correcting presbyopia that has been used for many years in refractive surgery. Our objective is to report our three-month postoperative results of KAMRA™ inlay implantation in terms of near, intermediate and distance vision. PATIENTS AND METHODS: All 24 patients (average age 54.1 ± 6.0 years) were treated with the KAMRA™ inlay in the non-dominant eye (75 % in the left eye) by the same surgeon (MEH). The KAMRA™ inlay was implanted under a 200 µm-thick femtosecond laser-assisted LASIK flap in 2 emmetropic presbyopic patients, 13 hyperopic presbyopic patients and 9 myopic presbyopic patients, without ocular pathologies. The uncorrected distance, intermediate, and near vision were assessed. The central corneal thickness (CCT), endothelial cell density (ECD) and visual field were assessed both pre- and post-operatively. In addition, patients were asked to complete a patient satisfaction questionnaire. Follow-ups were carried out one day, one week, and 1, 3, 6, 9 and 12 months postoperatively. RESULTS: After three months, all 24 eyes revealed an increase in the mean uncorrected distant visual acuity in the non-dominant eye from 0.4 ± 0.2 to 0.9 ± 0.1, an increase in the mean uncorrected intermediate visual acuity (logMAR, Jaeger 75 cm) from 0.6 ± 0.3 (J 11) to 0.0 ± 0.0 (J 1) and an increase in the mean uncorrected near visual acuity (logMAR, Jaeger 45 cm) from 0.6 ± 0.2 (J 9) to 0.0 ± 0.0 (J 1) monocularly. The visual acuity did not change over the time. The CCT and ECD remained unchanged compared with the findings before surgery. Subjectively, the questionnaire showed high patient satisfaction. CONCLUSION: Femtosecond laser-assisted KAMRA™ inlay implantation can be used in post-LASIK emmetropic patients and patients with a monofocal intraocular lens. It can also be combined with LASIK (for ametropic patients). The potential reversibility, low impairment of psychophysical investigations and the high degree of patient satisfaction makes this novel technique designed to increase depth of focus a reliable method for the surgical correction of presbyopia. Patient selection and centration of the KAMRA™ inlay is crucial.

Long-Term Results of LASIK for Presbyopia Correction in Myopic Patients Using Aspheric Micro-Monovision

PURPOSE: To evaluate the efficacy, safety, and satisfaction of patients who underwent LASIK for presbyopia correction in myopic patients using aspheric micro-monovision. METHODS: LASIK for presbyopic correction using aspheric micro-monovision was performed in 18 patients between December 2010 and December 2011. Distance, intermediate, and near visual acuity, refractive change, and patient's satisfaction were evaluated for at least 12 months after the surgery. RESULTS: Among dominant eyes, 100% achieved uncorrected distance and intermediate visual acuity of 0.8 or better and 100% of the eyes achieved 0.8 or better binocularly. In the non-dominant eyes, 83% achieved uncorrected near visual acuity of J3 or better, and 94% of the eyes achieved J3 or better binocularly. Postoperatively, the mean manifest refraction spherical equivalent (MRSE) of the dominant eyes were -0.09 +/- 0.35D, -0.17 +/- 0.42D, and -0.17 +/- 0.47D at 1, 6 and 12 months, respectively. The MRSE of the non-dominant eyes were -0.94 +/- 0.53D, -1.03 +/- 0.56D, and -1.02 +/- 0.50D at postoperative 1, 6, and 12 months, respectively, without significant regression. After surgery, the patient's overall satisfaction score was good (4.2 out of 5). CONCLUSIONS: The aspheric micro-monovision protocol showed good distance, intermediate, and near visual outcomes, and was a well-tolerated, stable, and effective procedure for treating patients with myopic presbyopia.