Visual Function after Implantation of Diffractive Extended Depth-of-Focus Intraocular Lenses in Eyes with Primary Open-Angle Glaucoma.

INTRODUCTION: The aim of this prospective study was to compare the visual functions of extended depth-of-focus intraocular lenses (EDOF IOLs) and monofocal IOLs in eyes with mild to moderate primary open-angle glaucoma (POAG). METHODS: Cataractous eyes with POAG controlled using medical treatments, no central visual field defects, and mean deviation (MD) values of -10 dB or better on the 30-2 test grid of the Swedish Interactive Threshold Algorithm standard program were included. Twenty-two eyes of 22 patients received EDOF IOLs (ZXR00V and ZXV150-375; J&J), whereas 24 eyes of 24 patients received monofocal IOLs (ZCB00V and ZCV150-375; J&J). MD values, corrected distance visual acuity (CDVA), and photopic contrast sensitivity were measured at 3 months after surgery. Noninferiority of CDVA and contrast sensitivity in eyes with EDOF IOLs to eyes with monofocal IOLs were examined. RESULTS: The postoperative mean MDs of eyes with EDOF and monofocal IOLs were -2.76 dB and -4.21 dB with no significant difference. The CDVA of eyes with EDOF IOLs was noninferior to that of eyes with monofocal IOLs (P = 0.02). There were no inferiority in contrast sensitivity at any spatial frequency (P < 0.001). CONCLUSIONS: The visual function of EDOF IOLs in eyes with mild-to-moderate POAG was not inferior to that of monofocal IOLs. TRIAL REGISTRATION: Registered in the Japan Registry for Clinical Research (identifier: jRCTs032200218).

Five-year postoperative outcomes of apodized diffractive multifocal intraocular lens implantation.

PURPOSE: To assess the long-term postoperative visual performance of an apodized diffractive multifocal intraocular lens (IOL). METHODS: Twenty-one patients (42 eyes) underwent cataract surgery with bilateral implantation of an apodized diffractive multifocal IOL. The monocular uncorrected and corrected distance visual acuities, uncorrected, distance-corrected and corrected near visual acuities, and manifest refractive spherical equivalent were measured 1 and 5 years postoperatively. The contrast sensitivity, incidence of glare or halos, and rate of neodynium:YAG (Nd:YAG) posterior capsulotomy were evaluated 5 years postoperatively. RESULTS: No significant differences were found between the distance and near visual acuities at 1 and 5 years postoperatively. The contrast sensitivity was within the normal range for all spatial frequencies. No patients reported severe glare or halos. Six (14.3 %) eyes required Nd:YAG posterior capsulotomy. CONCLUSIONS: The apodized diffractive multifocal IOL provides good, stable distance and near visual acuity levels over a 5-year follow-up period.

Surface light scattering and visual function of diffractive multifocal hydrophobic acrylic intraocular lenses 6 years after implantation.

PURPOSE: To evaluate the surface light scattering associated with diffractive multifocal intraocular lenses (IOLs) and visual function 6 years after implantation. SETTING: Private practice. DESIGN: Retrospective comparative case series. METHODS: Patients received a hydrophobic acrylic IOL and were followed for more than 6 years. Six years postoperatively, the intensity of the surface light scattering was measured using a Scheimpflug camera-based anterior segment analyzer. The corrected distance (CDVA) and near (CNVA) visual acuities and contrast sensitivity were assessed. RESULTS: Twenty eyes of 10 patients received a diffractive multifocal IOL (Acrysof Restor SA60D3, study group), and 16 eyes of 8 patients received a monofocal IOL (Acrysof SA60AT, control group). Six years postoperatively, the anterior surface light scattering was more than 100 computer compatible tape units in both groups, with no significant difference between groups (P=.417). The mean CDVA and CNVA in the study group were -0.06 logMAR ± 0.04 (SD) and -0.04 ± 0.05 logMAR, respectively; however, the CNVA in both groups decreased compared with that at 1 year, as did the CDVA in the control group. Contrast sensitivity was within normal range at all spatial frequencies in both groups. There were no significant correlations between surface light scattering and the changes in corrected visual acuities (distance or near) between 1 year and 6 years postoperatively in either group. CONCLUSION: Although there was significantly increased surface light scattering 6 years postoperatively, the visual function with a diffractive multifocal IOL was comparable to that with a monofocal IOL.

Observation of the corneal flap interface with metal particles in a rabbit model.

PURPOSE: To observe changes, such as diffuse lamellar keratitis, at the corneal interface when metal particles from microkeratome blades were left in rabbit eyes. SETTING: Department of Ophthalmology, Tokyo Dental College, Suidobashi Hospital, Tokyo, Japan. METHODS: Following the creation of a corneal flap with microkeratome, metal particles from a microkeratome blade were placed at the corneal interface in 14 rabbit eyes. Microscopic and histopathologic changes were compared with those in the control eyes (n = 4), which did not receive any metal particles. Each examination was conducted at 3 days, 2 weeks, and 1 and 3 months postoperatively. The change in the depth of the metal particles was also measured. RESULTS: Slitlamp examination did not show an inflammatory reaction or corneal opacification in any eye (100%) with metal particles at the flap interfaces. Histopathologic examinations showed no obvious changes at the flap interfaces or around the metal particles in any eye. CONCLUSION: Inflammatory reactions, such as diffuse lamellar keratitis, do not appear to be induced by metal particles from the microkeratome blade itself.