Stability and Visual Outcomes of the Capsulotomy-Fixated FEMTIS-IOL After Automated Femtosecond Laser-Assisted Anterior Capsulotomy.

PURPOSE: To evaluate stability and performance of a new monofocal anterior capsulotomy-fixated intraocular lens (IOL) (FEMTIS; Teleon Surgical B.V., Spankeren, Netherlands) after femtosecond laser-assisted cataract surgery (FLACS). DESIGN: Prospective, multicenter, interventional, noncomparative case series. METHODS: FLACS with FEMTIS IOL was performed in 336 eyes of 183 cataract patients with fixation of the IOL to the anterior capsulotomy followed up for 12 months. Examination included uncorrected distance visual acuity (UDVA), best-corrected visual acuity (CDVA), subjective refraction, IOL centration, posterior capsule opacification (PCO), and investigators' satisfaction questionnaire. RESULTS: At 12 months, mean IOL rotation was 1.50 ± 1.76 degrees and decentration 0.14 ± 0.14 mm from baseline (day of surgery). Mean horizontal IOL tilt was 0.70 ± 0.60 degrees and vertical 1.15 ± 1.06 degrees relative to the baseline (crystalline lens). Mean distance between IOL and iris was 0.32 mm to 0.36 mm for all measured meridians. Mean UDVA was 0.12 ± 0.14 logMAR (range -0.20 to 0.54 logMAR), mean CDVA -0.01 ± 0.09 logMAR (range -0.30 to 0.20 logMAR). Mean spherical equivalent was 0.35 ± 0.53 diopter (D) and 98% of eyes (n = 235) were within ±1.0 D. Median PCO score was 1 with an Nd:YAG laser rate of 3.1% after 12 months. Most surgeons were very satisfied (median score: 1) with surgery and implanted IOL. CONCLUSIONS: Implantation of FEMTIS IOL provided excellent visual and stable refractive outcomes. IOL decentration was very low compared to other published studies and showed an exceptional high in-the-bag stability over a 12-month period. This lens benefits from femtosecond laser capsulotomies. It can be positioned very predictably and offers an optimal platform for toric and multifocal IOL optics.

[Retrospective Study of Long-term Patient Satisfaction after Bilateral Implantation of Multifocal Intraocular Lenses of Different Generations - a 10 Year Follow-up]. / Patientenzufriedenheit nach Implantation von Multifokallinsen verschiedener Generationen ­ ein 10-Jahres-Follow-up.

BACKGROUND: This retrospective study investigates the postoperative satisfaction of patients with a mixed generation background after bilateral implantation of non-toric multifocal intraocular lenses between the year 2006 and year 2017. PATIENTS/METHODS: 245 patients between 45 and 95 years old were included in the study. Patient satisfaction was examined with the Heidelberg DATE questionnaire (DATE: Daily Tasks Evaluation), with respect to everyday tasks and the perception of optical phenomena. All criteria of the questionnaire were assessed for significant differences with respect to the time of the operation, the age of the patient, gender as well as the model of the implanted intraocular lens. The data was analysed with the statistics software SPSS 23.0. RESULTS: At the time of the survey, 97.1% of patients reported they were completely or partially satisfied with the outcome of the operation. 95.9% of patients could accomplish all common tasks without any significant problems. 34.6% said they only needed glasses under very challenging visual circumstances. The older patients more often reported that they needed glasses (p < 0.01). Women wore glasses more frequently for driving during night than men. They also described dazzling as more disturbing (p < 0.03). Younger patients perceived halos more drastically than older patients (p < 0.01). Patients with bifocal lens implants used glasses for intermediary distances far more often than patients with trifocal implants (p < 0.01). CONCLUSION: Most patients were independent of additional optical correction. Optical phenomena are commonly reported, so extensive preoperative briefing is inevitable. The need for further information seems to be especially high among younger, female patients. The Heidelberg DATE questionnaire is well suited for surveying patient satisfaction after the implantation of multifocal intraocular lenses.